NURS 230 Ch. 3 - Psychosocial Theories and Therapy

The nurse is creating a plan of care for a client experiencing a situational crisis. Which is the most measurable and obtainable goal for the client to achieve?

A. The client will identify possible causes for the crisis.

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

C. The client will resume the precrisis level of functioning.

D. The client will express anger regarding the crisis event.

C. The client will resume the precrisis level of functioning.

A client has just been told they have cervical cancer. When asked about how this is impacting them, they state, "It's just an infection; it will clear up." Which does this statement by the client indicate to the nurse?

A. There is a need for education on cervical cancer.

B. The client is unable to express their true emotions.

C. The client should be immediately referred to a cancer support group.

D. The client is using denial to protect themself from an emotionally painful thought.

D. The client is using denial to protect themself from an emotionally painful thought.

An adolescent client defies the nurse's repeated requests to turn off the video game and go to sleep. The client says angrily, "You sound just like my parents!" and continues to play the video game. Which does the nurse identify this statement indicates?

A. The need for stricter discipline at home

B. Early signs of oppositional defiant disorder

C. The presence of transference

D. Expression of developing autonomy

C. The presence of transference

The nurse is counseling a client with alcoholism who has been abusive to their children. The nurse experienced a similar situation in childhood and states to the client, "How can you mistreat a child?" Which is the best way for the nurse to deal with the countertransference displayed? Select all that apply.

A. Request that another nurse take over the counseling session with the client.

B. Discuss with the client the issues surrounding the response made.

C. The nurse should examine feelings and responses prior to counseling.

D. Talking about feelings and emotions with a trusted colleague.

E. Consider a transfer to a unit that does not require counseling of clients.

A. Request that another nurse take over the counseling session with the client.

C. The nurse should examine feelings and responses prior to counseling.

D. Talking about feelings and emotions with a trusted colleague.

The nurse has established a therapeutic relationship with a client. Which behaviors identified will indicate that the client has entered into the identification phase of the nurse-client relationship?

A. The client is answering questions related to the plan of care.

B. The client is sharing feelings and emotions with the nurse.

C. The client is attending all therapy sessions and utilizing the services provided.

D. The client states that they feel the issues have been resolved and no longer need

to come

B. The client is sharing feelings and emotions with the nurse.

A nurse is meeting with a crisis support group. Which statement by the nurse will be effective to explain about the crisis experience?

A. "Even happy events can cause a crisis if the stress is overwhelming."

B. "Only people who have unfortunate life events will experience a crisis."

C. "A person has no control over how a crisis will affect them."

D. "People can prevent all crises if they develop good coping skills early."

A. "Even happy events can cause a crisis if the stress is overwhelming."

A client presents to the emergency department with a flat affect and disheveled appearance. Which statement(s) made by the nurse indicates that the client is experiencing an adventitious crisis? Select all that apply.

A. "My spouse passed away 2 months ago."

B. "We experienced a tornado that destroyed our home."

C. "I was walking home from work and was attacked, beaten, and robbed."

D. "I just got home from being deployed from overseas from the front line of war."

E. "I am preparing to move away from my parents' home to my own apartment."

B. "We experienced a tornado that destroyed our home."

C. "I was walking home from work and was attacked, beaten, and robbed."

D. "I just got home from being deployed from overseas from the front line of war."

A nursing supervisor reprimands an employee for being chronically late for work. If the employee handles the reprimand using the defense mechanism of displacement, which behavior by the employee will be observed?

A. Arguing with the supervisor that the employee is usually on time

B. Making a special effort to be on time tomorrow

C. Telling fellow employees that the supervisor is picking on the employee

D. Telling the unit housekeeper that the unit housekeeper's work is sloppy

D. Telling the unit housekeeper that the unit housekeeper's work is sloppy

The nurse is assessing a client who is talking about the client's child's recent death but shows no emotion of any kind. The client describes the physiologic events that occurred as the son died. The nurse identifies that the client is using which defense mechanism?

A. Dissociation

B. Displacement

C. Intellectualization

D. Suppression

C. Intellectualization

A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow student, "I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is so unreasonable." Which defense mechanism(s) are being used by the student? Select all that apply.

A. Denial

B. Displacement

C. Rationalization

D. Projection

E. Regression

C. Rationalization

D. Projection

The nurse has informed a client that they should be ambulating in the hall several times a day. The client refuses to get out of bed, asks for a bed bath, and makes demands of the nurses, yelling, "the nurses are lazy and incompetent." Which behavior identified by the nurse is the client displaying?

A. Introjection

B. Projection

C. Rationalization

D. Reaction formation

B. Projection

The nurse is educating a client with anxiety about mind-body interventions. Which statement made by the client indicates that the education is effective?

A. "Meditation will be effective for me to use to relax and refocus my energy."

B. "I will start using dietary supplements and essential oils included in therapy."

C. "It would be beneficial to start having therapeutic massage every 2 weeks."

D. "The use of magnetic fields will help rechannel my spiritual energy."

A. "Meditation will be effective for me to use to relax and refocus my energy."

The nurse is talking with the parent of a 4-year-old that has been toileting independently for 2 years and with the birth of a sibling has started wetting their pants again. Which response to the parent will be most therapeutic?

A. "Your child is angry with you for having another child."

B. "It is likely the child has regressed to a previous developmental stage when needs were met"

C. "The incontinence is a way for the child to act just like the newborn and get attention."

D. "This behavior indicates that there is a lack of discipline in the home and should be addressed."

B. "It is likely the child has regressed to a previous developmental stage when needs were met"

The nurse is leading a group that is discussing anxiety. Members are sharing that they identify with what others are saying. The nurse identifies that the group is in which stage of group development?

A. Planning

B. Initial

C. Working

D. Termination

C. Working

The family members of a client with bipolar disorder express frustration with the proposed treatment plan of their loved one. Which group will the nurse suggest as most helpful to this family?

A. Family therapy group

B. Family education group

C. Psychotherapy group

D. Self-help support group

B. Family education group

The nurse is caring for a client with borderline personality disorder that has been admitted several times with suicide attempts. Which type of cognitive behavioral therapy will be best for the nurse to educate the client about?

A. Gestalt therapy

B. Logotherapy

C. Dialectical behavioral therapy

D. Rational emotive therapy

C. Dialectical behavioral therapy

The nurse observes the client experiencing a panic attack in the day room in the behavioral health unit. Which is the priority action by the nurse?

A. Stay with the client and maintain a safe environment.

B. Take the client for a walk around the unit.

C. Redirect the client to an activity or task.

D. Educate the client in ways to prevent a future panic attack.

A. Stay with the client and maintain a safe environment.

The nurse is leading a group therapy session. When evaluating the group after the session, which statement will indicate the group was therapeutic? Select all that apply.

A. Clients stated that they feel inspired and hopeful in their situation.

B. Clients were interacting with one another during the group session.

C. Clients felt comfortable to leave the group session prior to the end.

D. Clients stated they no longer felt alone in their particular situation.

E. Clients indicated they felt accepted and no longer ostracized.

A. Clients stated that they feel inspired and hopeful in their situation.

B. Clients were interacting with one another during the group session.

D. Clients stated they no longer felt alone in their particular situation.

E. Clients indicated they felt accepted and no longer ostracized.

The nurse is developing a plan of care for a client experiencing a crisis. Which intervention is most essential when creating the plan of care?

A. Explore previous coping strategies

B. Explore underlying personality dynamics

C. Focus on emotional deficits

D. Offer a referral to a self-help group

A. Explore previous coping strategies

The nurse is performing an initial assessment and interview for a client in crisis. Which is the priority action by the nurse during this assessment?

A. Assess the adequacy of the support system

B. Assess for substance use

C. Determine the precrisis level of functioning

D. Evaluate the potential for self-harm

D. Evaluate the potential for self-harm

The nurse on the behavioral health unit reinforces to the clients that they can earn off-unit privileges for daily use of socially appropriate behavior. Which behavioral modification technique is the nurse employing?

A. Systematic desensitization

B. Negative reinforcement

C. Classical conditioning

D. Operant conditioning

D. Operant conditioning

A nurse is working with a client with an eating disorder who refuses to eat a muffin. The nurse asks the client, "Is there any way that you could see the muffin as just flour and water, basic nutrients your body needs?" In this statement, the nurse is using which type of therapy?

A. Rational emotive therapy

B. Cognitive therapy

C. Gestalt therapy

D. Reality therapy

B. Cognitive therapy

A client is blaming an impending divorce on the fact that the spouse goes out frequently with friends. Which statement made by the nurse indicates the use of reality therapy?

A. "If you really love your spouse, they should love you as well."

B. "What does being divorced mean for you?"

C. "How do you feel about your marriage ending?"

D. "What role do you think you have played in the end of your marriage?"

D. "What role do you think you have played in the end of your marriage?"

A nurse is assisting a client who is working on the technique of systematic desensitization. Which statement made by the nurse best uses the principle of technique?

A. "Use the deep breathing techniques we practiced yesterday."

B. "What is the worst that will happen if you confront this fear?"

C. "Tell me how you are feeling right now."

D. "I can see you are anxious. Let's stop for a minute."

A. "Use the deep breathing techniques we practiced yesterday."

The nurse is working with a client who has a history of inflicting spousal abuse. Although the nurse does not condone domestic violence, the nurse treats the client with unconditional positive regard through which behavior?

A. Understanding the feelings that might have led to violent behavior.

B. Using honest emotional expression in relating to the client.

C. Viewing the client as someone worthy of respect and assistance.

D. Relating to the client as a spouse.

C. Viewing the client as someone worthy of respect and assistance.

A client is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the following assessment data, which will the nurse place as priority in the plan of care?

A. Weight 24% below normal for height

B. Distorted body image

C. Feelings of inadequacy

D. Frequent vomiting after meals

D. Frequent vomiting after meals

The nurse is admitting a client to the behavioral health unit seeking help voluntarily. Which consideration will have the most influence in the choice of the treatment for the client?

A. The client's feelings and perceptions about the situation

B. The nurse's beliefs about the theories of psychosocial development

C. The nurse's familiarity with the type of treatment

D. Any approach to treatment should work with any client.

A. The client's feelings and perceptions about the situation

The nurse is planning the care for a client experiencing negative thinking. Which approach to therapy is most effective for this client?

A. Behavior modification

B. Client-centered therapy

C. Cognitive therapy

D. Reality therapy

C. Cognitive therapy

A client asks the nurse about the use of complementary and alternative therapies. Which of these therapies will the nurse educate the client regarding? Select all that apply.

A. Massage and osteopathic therapy

B. Support group therapy

C. Aromatherapy

D. Self-help therapy

E. Music and art therapy

A. Massage and osteopathic therapy

C. Aromatherapy

E. Music and art therapy

A nurse is participating in a therapy session along with several clients. Which client(s) does the nurse identify as experiencing moderate anxiety? Select all that apply.

A. A client exhibiting profuse diaphoresis

B. A client that states, "I am feeling a little nausea right now."

C. A client responding to questions in a higher pitched voice

D. A client that states that they are experiencing a rapid heart rate.

E. A client that is unable to communicate verbally

A. A client exhibiting profuse diaphoresis

C. A client responding to questions in a higher pitched voice

D. A client that states that they are experiencing a rapid heart rate.

The nurse is acting in the role of leader during a group therapy session about anxiety. Which intervention by the nurse correlates with this role?

A. The nurse responds to questions that are asked by the members of the group

B. The nurse assists the clients in the group to learn about strategies to control anxiety.

C. The nurse encourages a member of the group that is crying to express their feelings.

D. The nurse guides the clients back to the topic when the group turns the topic to social activities.

D. The nurse guides the clients back to the topic when the group turns the topic to social activities.