Psychiatric Mental Health Nursing Concepts of Care in Evidence Based Practice 8th Edition by Mary C. Townsend - Test Ban

 The nurse understands that crises are self-limiting. This implies that upon evaluation of

crisis intervention, the nurse should assess for which outcome?

A) The patient will identify possible causes for the crisis.

B) The patient will discover a new sense of self-sufficiency in coping.

C) The patient will resume the precrisis level of functioning.

D) The patient will express anger regarding the crisis event.

Ans: C

Feedback:

Crises usually exist for 4 to 6 weeks. At the end of that time, the crisis is resolved in one

of three ways. In the first two, the person either returns to his or her precrisis level of

functioning or begins to function at a higher level; both are positive outcomes for the

individual. The third resolution is that the person's functioning stabilizes at a level lower

than precrisis functioning, which is a negative outcome for the individual. Assisting the

person to use existing supports or helping the individual find new sources of support can

decrease the feelings of being alone or overwhelmed. The patient may develop guilt if

he or she examines possible causes for the crisis. Expression of anger at 4 to 6 weeks

indicates a less than favorable outcome of crisis intervention.

2. A patient who has been working on controlling impulsive behavior shows a

strengthening ego through which of the following behaviors?

A) Going to therapy only when there is nothing more desirable to do

B) Weighing the advantages and disadvantages before making a decision

C) Telling others in the group the right way to act

D) Reporting having fun at a recent social event

Ans: B

Feedback:

The id is the part of one's nature that reflects basic or innate desires such as pleasure-

seeking behavior, aggression, and sexual impulses. The id seeks instant gratification,

causes impulsive unthinking behavior, and has no regard for rules or social convention.

The superego is the part of a person's nature that reflects moral and ethical concepts,

values, and parental and social expectations; therefore, it is in direct opposition to the id.

The third component, the ego, is the balancing or mediating force between the id and the

superego. The ego represents mature and adaptive behavior that allows a person to

function successfully in the world.

Page 13. A patient has just been told she has cervical cancer. When asked about how this is

impacting her, she states, It's just an infection; it will clear up. The statement indicates

that this patient

A) needs education on cervical cancer.

B) is unable to express her true emotions.

C) should be immediately referred to a cancer support group.

D) is using denial to protect herself from an emotionally painful thought.

Ans: D

Feedback:

Ego defense mechanisms are methods of attempting to protect the self and cope with

basic drives or emotionally painful thoughts, feelings, or events. Most defense

mechanisms operate at the unconscious level of awareness, so people are not aware of

what they are doing and often need help to see the reality. Education and referrals are

premature at this point in the patient's ability to cope.

4. A teenage patient defies the nurse's repeated requests to turn off the video game and go

to sleep. The teen says angrily, You sound just like my mother at home! and continues

to play the video game. The nurse understands that this statement likely indicates

A) the need of stricter discipline at home.

B) early signs of oppositional defiant disorder.

C) viewing the nurse as her mother.

D) expression of developing autonomy.

Ans: C

Feedback:

Transference occurs when the client displaces onto the therapist attitudes and feelings

that the client originally experienced in other relationships. Transference patterns are

automatic and unconscious in the therapeutic relationship. The occurrence of

transference does not indicate ineffective parenting or disciplinary practices, nor is it

indicative of a disorder. Autonomy is developed much earlier in the toddler years.

5. A patient reports a pattern of being suspicious and mistrusting of others, causing

difficulty in sustaining lasting relationships. Which stage according to Erikson's

psychosocial development was not successfully completed?

A) Trust

B) Autonomy

C) Initiative

D) Industry

Ans: A

Feedback:

The formation of trust is essential: mistrust, the negative outcome of this stage, will

impair the person's development throughout his or her life.