Question 1

A nurse and patient discuss a problem the patient has kept secret for many years.Afterward the patient says,"I feel so relieved that I finally told somebody." Which term best describes the patient's feeling?

Accepted Answer

Freud initially used talk therapy,known as the cathartic method.Today we refer to catharsis as "getting things off our chests." The superego represents the moral component of personality.

Question 2

A patient says to the nurse,"My father has been dead for over 10 years,but talking to you is almost as comforting as the talks he and I had when I was a child." Which term applies to the patient's comment?

Accepted Answer

Transference refers to feelings a patient has toward the health care workers that were originally held toward significant others in his or her life.Counter-transference refers to unconscious feelings that the health care worker has toward the patient.The superego represents the moral component of personality; it seeks perfection.

Question 3

Which comments by an elderly person best indicate successful completion of the developmental task? Select all that apply.

Accepted Answer

The developmental crisis for an elderly person relates to integrity versus despair.Pride in one's offspring indicates a sense of fulfillment.Recognition of the wisdom gained from difficult experiences (such as being in a war)indicates a sense of integrity.Blaming and regret indicate despair and unsuccessful resolution of the crisis.

Question 4

A patient states,"I'm starting cognitive-behavioral therapy.What can I expect from the sessions?" Which responses by the nurse would be appropriate? Select all that apply.

Accepted Answer

Cognitive therapists are active rather than passive during therapy sessions because they help patients reality-test their thinking.Homework assignments are given and completed outside the therapy sessions.Homework is usually discussed at the next therapy session.The goal of cognitive therapy is to assist the patient in identifying inaccurate cognitions and in reality- testing and formulating new,accurate cognitions.One distracter applies to psychoanalysis.Increasing subjectivity is not desirable.

Question 5

Which comments by an adult best indicate self-actualization? Select all that apply.

Accepted Answer

Self-actualized persons enjoy privacy,have a sense of democracy,and show positive outcomes associated with peak experiences.Self-doubt,defensiveness,and blaming are not consistent with self-actualization.

Question 6

A college student received an invitation to attend the wedding of a close friend who lives across the country.The student is afraid of flying.Which type of therapy would be most helpful for this patient?

Accepted Answer

Systematic desensitization is a type of therapy aimed at extinguishing a specific behavior,such as the fear of flying.Psychoanalysis and short-term dynamic therapy seek to uncover conflicts.Milieu therapy involves environmental factors.

Question 7

A psychotherapist works with an anxious,dependent patient.Which strategy is most consistent with psychoanalytic psychotherapy?

Accepted Answer

Positive or negative feelings of the patient toward the therapist indicate transference.Transference is a psychoanalytic concept that can be used to explore previously unresolved conflicts.The distracters relate to biological therapy and supportive psychotherapy.Use of psychoeducational materials is a common "homework" assignment used in cognitive therapy.

Question 8

Which activities represent the art of nursing? Select all that apply.

Accepted Answer

Peplau described the science and art of professional nursing practice.The art component of nursing consists of the care,compassion,and advocacy nurses provide to enhance patient comfort and well-being.The science component of nursing involves the application of knowledge to understand a broad range of human problems and psychosocial phenomena,intervening to relieve patients' suffering and promote growth.See related audience response question.

Question 9

Which comment best indicates a patient is self-actualized?

Accepted Answer

The self-actualized personality is associated with high productivity and enjoyment of life.Self-actualized persons experience pleasure in being alone and an ability to reflect on events.

Question 10

A patient is fearful of riding on elevators.The therapist first rides an escalator with the patient.The therapist and patient then stand in an elevator with the door open for five minutes and later with the elevator door closed for five minutes.Which technique has the therapist used?

Accepted Answer

Systematic desensitization is a form of behavior modification therapy that involves the development of behavior tasks customized to the patient's specific fears.These tasks are presented to the patient while using learned relaxation techniques.The patient is incrementally exposed to the fear.

Question 11

A patient would benefit from therapy in which peers as well as staff have a voice in determining patients' privileges and psychoeducational topics.Which approach would be best?

Accepted Answer

Milieu therapy is based on the idea that all members of the environment contribute to the planning and functioning of the setting.The distracters are individual therapies that do not fit the description.

Question 12

A patient says,"I always feel good when I wear a size 2 petite." Which type of cognitive distortion is evident?

Accepted Answer

Automatic thoughts,or cognitive distortions,are irrational and lead to false assumptions and misinterpretations.The stem offers an example of overgeneralization.See related audience response question.

Question 13

Which patient is the best candidate for brief psychodynamic therapy?

Accepted Answer

The best candidates for psychodynamic therapy are relatively healthy and well-functioning individuals,sometimes referred to as the "worried well," who have a clearly circumscribed area of difficulty and are intelligent,psychologically minded,and well-motivated for change.Patients with psychosis,severe depression,borderline personality disorders,and severe character disorders are not appropriate candidates for this type of treatment.

Question 14

A patient says,"All my life I've been surrounded by stupidity.Everything I buy breaks because the entire American workforce is incompetent." This patient is experiencing a:

Accepted Answer

Automatic thoughts,or cognitive distortions,are irrational and lead to false assumptions and misinterpretations.See related audience response question.

Question 15

A patient repeatedly stated,"I'm stupid." Which statement by that patient would show progress resulting from cognitive behavioral therapy?

Accepted Answer

"I'm stupid" is a cognitive distortion.A more rational thought is "Sometimes I do stupid things." The latter thinking promotes emotional self-control.The distracters reflect irrational or distorted thinking.This item relates to an audience response question.

Question 16

A person says,"I was the only survivor in a small plane crash.Three business associates died.I got depressed and saw a counselor twice a week for 4 weeks.We talked about my feelings related to being a survivor,and I'm better now." Which type of therapy was used?

Accepted Answer

Interpersonal psychotherapy returned the patient to his former level of functioning by helping him come to terms with the loss of friends and guilt over being a survivor.Milieu therapy refers to environmental therapy.Psychoanalysis would call for a long period of exploration of unconscious material.Behavior modification would focus on changing a behavior rather than helping the patient understand what is going on in his life.

Question 17

Which technique is most applicable to aversion therapy?

Accepted Answer

Aversion therapy is akin to punishment.Aversive techniques include pairing of a maladaptive behavior with a noxious stimulus,punishment,and avoidance training.

Quiz 2: Relevant Theories and Therapies for Nursing Practice