Chapter 5: Theories and Therapies Nursing School Test Banks

Chapter 5: Theories and Therapies
Test Bank

MULTIPLE CHOICE

1. A male client who has a diagnosis of generalized anxiety disorder (GAD) is seen in the emergency room with complaints of chest pain, shortness of breath, and inability to concentrate, along with feelings of overwhelming anxiety. The nurse uses Maslows theory to triage the clients complaints, knowing that which complaint must be addressed first?
a. Inability to concentrate
b. Shortness of breath
c. Overwhelming anxiety
d. Chest pain
ANS: B
According to Maslows hierarchy of needs, the nurse first must address shortness of breath, followed by chest pain, then feelings of overwhelming anxiety and inability to concentrate. Even though, based on his diagnostic history, this client may be having a panic attack; the nurse cannot ignore basic needs that are not being met first.

DIF: Cognitive Level: Application REF: p. 46 OBJ: 4
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Implementation
MSC: Client Needs: Psychosocial Integrity

2. According to Freuds theory, a baby who is crying in response to wanting to be held by his mother is an example of which part of the personalitys control over behavior?
a. Id
b. Ego
c. Superego
d. Self-control
ANS: A
According to Freud, the id is the pleasure center of the brain that seeks immediate pleasure or avoids pain, without regard for possible outcomes. The ego is reality based and has more control than the id; the superego is not developed in early childhood because it includes a conscience. Self-control is not a component of Freuds theory of personality.

DIF: Cognitive Level: Application REF: p. 40 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

3. According to the theorist Erik Erikson, an individual strives to actualize his identity, is most productive, and demonstrates guidance of and concern for others with a core task of caring during which stage of psychosocial development?
a. Young adulthood (18 to 25 years)
b. Maturity (65 years to death)
c. Middle adulthood (25 to 65 years)
d. Puberty (12 to 18 years)
ANS: C
The characteristics of striving to actualize identity, being most productive, and demonstrating guidance of and concern for others, according to Erikson, are seen during middle adulthood. Individuals who do not achieve the core task of caring become stagnant, self-indulgent, and absorbed in themselves. The core task of young adulthood is love; the core task of maturity is wisdom; and the core task of puberty is fidelity.

DIF: Cognitive Level: Comprehension REF: p. 43 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

4. During a therapy session, a client is asked to respond to a word with the first word or phrase that comes to mind. What term is commonly used to refer to this technique?
a. Transference relationship
b. Dream analysis
c. Free association
d. Psychoanalysis
ANS: C
Free association is a technique that is used to interpret the real meaning behind word association. Dream analysis is a technique that is used to interpret the meaning of an individuals dreams as they relate to their unconscious conflicts. Psychoanalysis is the form of therapy developed by Freud, and transference relationship is the technique used during therapy when the client transfers to the therapist emotions associated with significant people in his life.

DIF: Cognitive Level: Knowledge REF: p. 42 OBJ: 2
TOP: Psychoanalytical Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

5. Carl Jung was the founder of analytical psychotherapy; he differed from Freud in that he believed that the mind was divided into three levels: the conscious ego, the personal unconscious, and the:
a. Extroverted personality
b. Introverted personality
c. Psyche
d. Collective unconscious
ANS: D
The collective unconscious stores experiences from the persons ancestral past and is part of what Jung believed was the third level of the mind. Extroversion and introversion were parts of the personality that Jung identified. Psyche is the mental or spiritual part of a person.

DIF: Cognitive Level: Knowledge REF: p. 42 OBJ: 2
TOP: Analytical Psychotherapy KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

6. Jean Piagets theory of cognitive development identifies an interrelationship between the __________ and the __________ functions in the development of ones personality.
a. Id; ego
b. Intellectual; emotional
c. Anxiety; affective
d. Personified; cognitive
ANS: B
Piaget believed that growth and development occurred as a result of the interrelationship between intellectual (cognitive) and emotional (affective) development. The id and the ego are part of Freuds beliefs regarding personality development. Anxiety is a vague feeling of uneasiness. Personification is a term developed by the theorist Sullivan to describe distorted images of certain relationships that occur in development of the personality.

DIF: Cognitive Level: Comprehension REF: p. 43 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

7. How many stages of the human life cycle did Erik Erikson identify?
a. Two
b. Four
c. Six
d. Eight
ANS: D
Erik Erikson identified eight stages of the human life cycle that form ones personality; each stage is marked by a developmental task that must be confronted and resolved. Eriksons theory is commonly used in health care today.

DIF: Cognitive Level: Knowledge REF: p. 43 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

8. A 4-year-old client in a pediatric unit is imitating the actions of the nurse. The nurse knows, according to Erik Eriksons theory, that this child is displaying a characteristic seen during which developmental stage?
a. Genital-locomotor
b. Latency
c. Oral-sensory
d. Anal-muscular
ANS: A
The genital-locomotor stage (preschool years) is characterized by exploration of the environment, cooperative play, fantasy, and imitation of adults. Initiative and guilt are core tasks of this stage. The latency stage occurs during the school-age years (6 to 12 years old), the oral-sensory stage occurs from birth to 1 year of age, and the anal-muscular stage occurs during early childhood.

DIF: Cognitive Level: Application REF: p. 44 OBJ: 3
TOP: Developmental Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

9. Humanistic theories are important to health care because these theories serve as the foundation for the concept of:
a. Assertiveness training
b. Behaviorism
c. Holistic care
d. Behavior modification
ANS: C
Humanistic theories emphasize the total person, which serves as the basis of holistic care. Assertiveness training refers to teaching a person to express his needs in nonaggressive ways. Behaviorism is the belief that all behavior is learned, and behavior modification is a therapy that teaches clients new behaviors that can be used to replace dysfunctional behavior.

DIF: Cognitive Level: Comprehension REF: p. 46 OBJ: 3
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

10. During a conversation with a male client, he voices that he really appreciates his family, likes his job, and enjoys groups in which he volunteers. According to Maslows theory, what is this client experiencing?
a. Symbolization
b. Self-actualization
c. Equilibrium
d. Identification
ANS: B
In Maslows hierarchy of needs theory, a person is said to have reached the highest human need of self-actualization when all basic needs are met, the individual is self-directed, and the individual has reached the highest potential. Symbolization and identification are common defense mechanisms, and equilibrium is a state wherein all body systems are in balance.

DIF: Cognitive Level: Application REF: p. 46 OBJ: 4
TOP: Humanistic Theories and Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

11. The nurse knows that the major concept of the systems theory is that individuals are viewed as functioning:
a. Within a set of interacting and related units
b. According to activities of attention, language, and imagery
c. According to unmet needs
d. Within accepted social aspects of behavior
ANS: A
The interacting and related units are called systems, and both open and closed systems have been identified. Activities of attention, language, and imagery are components of cognitive theories. Met and unmet needs correspond to Maslows hierarchy of needs theory, and social aspects of behavior are seen in sociocultural theories.

DIF: Cognitive Level: Knowledge REF: p. 47 OBJ: 5
TOP: Systems Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

12. Group therapy, which assists in relieving emotional distress and encourages psychological and behavioral changes, was developed following World War II as a result of a:
a. Study of the benefits of group therapy
b. Decreasing number of mental health facilities
c. Shortage of psychiatrists
d. Grant from the federal government
ANS: C
A shortage of psychiatrists prompted the need for group therapy in the 1940s. Mental health facilities did not begin to decrease in number until psychotherapeutic drugs were introduced in the 1950s. No federal grant was provided for group therapy.

DIF: Cognitive Level: Knowledge REF: p. 52 OBJ: 10
TOP: Group Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

13. Betty Neuman developed the nursing theory that promotes nursing interventions to assist individuals in reaching and maintaining the highest level of wellness possible. What is this theory known as?
a. Adaptation model
b. Interpersonal model
c. Systems model
d. Self-care deficit model
ANS: C
Betty Neuman developed this model with a focus on reducing stress as a means of assisting in reaching high-level wellness. The adaptation model was developed by Myra Levine. Peplau developed the interpersonal model, and Orem developed the self-care deficit model.

DIF: Cognitive Level: Knowledge REF: p. 52 OBJ: 9
TOP: Nursing Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

14. Following an argument with his daughter, a father takes away her phone privileges. He later feels guilty about the argument and asks her if she would like to go shopping for new clothes. What is this defense mechanism known as?
a. Compensation
b. Displacement
c. Rationalization
d. Restitution
ANS: D
Restitution involves engaging in an activity that helps to resolve feelings of guilt. Compensation is an attempt to overcome feelings of inferiority. Displacement involves redirecting energy to another person or object, and rationalization is a way of explaining something in a good, although not true, way.

DIF: Cognitive Level: Application REF: p. 41 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

15. A female client with low self-esteem tries to dress and act like the nurse who cares for her in an outpatient clinic setting. This behavior is an example of which defense mechanism?
a. Identification
b. Symbolization
c. Displacement
d. Projection
ANS: A
Identification occurs when an individual takes on personal characteristics of someone she admires, especially when she has low-self esteem or poor self-concept. Symbolization involves the use of unrelated objects to represent a hidden idea. Displacement involves the redirecting of energies to another person or object; projection occurs when an individual projects onto another person his or her unacceptable thoughts or emotions.

DIF: Cognitive Level: Application REF: p. 41 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

16. During group therapy, certain group change mechanisms may be observed. When an individual engages in helping others, resulting in improvement in his or her own self-esteem, which group change mechanism has the individual experienced?
a. Altruism
b. Feedback
c. Expressiveness
d. Communion
ANS: A
Altruism occurs when not only recipients benefit from assistance, but the individual who is giving assistance also benefits through improvement in his own self-esteem. Feedback refers to receipt of information about how one is perceived by others. Expressiveness is a group change mechanism in which group members share positive and negative emotions, and communion occurs in a group when members feel a sense of belonging.

DIF: Cognitive Level: Comprehension REF: p. 53 OBJ: 10
TOP: Group Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

17. A client is granted permission to watch a favorite television show in the evening because she participated in an occupational therapy activity. Her therapist bases this on ______ theory.
a. Psychoanalytic
b. Humanistic
c. Behavioral
d. Developmental
ANS: C
Behavioral theory believes behavior is a result of rewards to enforce desired behaviors. Psychoanalytic theory explores the unconscious, humanistic theory deals with the whole person, not just behavior, and developmental theory focuses more on life tasks at particular points.

DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 3
TOP: Behavioral Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

18. A client does not participate in group sessions due to feeling inferior to others in the group. Based on cognitive theory, he would be directed to:
a. Review his previous relationship with his parents.
b. Participate in group to receive extra privileges.
c. Suppress negative thoughts about the group.
d. Recognize and change his negative thoughts.
ANS: D
Cognitive theory and therapy stress self-regulation and control to change behavior. Reviewing relationships with parents is indicative of psychoanalysis. Behavior change for reward is based on behavioral theory and suppression of thoughts is a negative means of coping.

DIF: Cognitive Level: Comprehension REF: p. 48 OBJ: 5
TOP: Cognitive Theories and Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

19. Which of the following assessment parameters is a priority in a biobehavioral model of practice?
a. Blood chemistry
b. Physiologic needs
c. Coping mechanisms
d. Psychosocial level
ANS: A
Biobehavioral theories follow the medical model, which states that illness is the result of abnormalities in the structure, function, or chemistry of the body. A history, physical examination, laboratory tests, imaging techniques, and electroencephalograms (EEGs; brain wave recordings) are used to assist in diagnosis. Blood chemistry is the only option providing for this structure, function, or chemical abnormality.

DIF: Cognitive Level: Comprehension REF: p. 49 OBJ: 8
TOP: Biobehavioral Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

20. The nurse who feels the most beneficial part of the clients inpatient stay is the establishment of an interpersonal relationship with the nurse is an example of which nursing theorist?
a. Orem
b. Watson
c. Peplau
d. Roy
ANS: C
Peplaus goal of nursing is to develop interpersonal interaction between client and nurse. Orems goal is to help client attain self-care, Watsons goal is to promote and restore health, and Roys goal is to identify demands on clients and adaptation.

DIF: Cognitive Level: Comprehension REF: p. 52 OBJ: 9
TOP: Nursing Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

21. Freuds psychoanalytical theory states that an adult is more likely to be mentally healthy if there is a balance between which parts of the mind? (Select all that apply.)
a. Id
b. Ego
c. Superego
d. Conscience
ANS: A, B, C
Freud believed if there was a dynamic balance between the id, the ego, and the superego, an adults personality would develop in a healthy manner. The conscience is part of the superego.

DIF: Cognitive Level: Knowledge REF: p. 40 OBJ: 1
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

22. Psychobiology theory considers the causes of mental illness to be which of the following? (Select all that apply.)
a. Genetics
b. Neurotransmitter activity
c. Immune system dysfunction
d. Social setting
e. Unmet needs
ANS: A, B, C
Psychobiological theories about the causes of mental illness relate to genetics, neurotransmitter activity, viruses, fetal development, and immune system dysfunction.

DIF: Cognitive Level: Knowledge REF: p. 51 OBJ: 8
TOP: Psychobiological Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

COMPLETION

23. Freud believed that an individuals personality developed through stages of sexual instinct from birth to adulthood. This is known as the __________ theory of personality development.

ANS:
psychosexual
Freud believed that all individuals experience certain stages of psychosexual development to some degree. He believed that if these stages were not psychologically completed and released, a person could be emotionally halted in development, resulting in the excessive use of defense mechanisms to avoid anxiety produced during these stages.

DIF: Cognitive Level: Knowledge REF: p. 40 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

24. Dr. Sigmund Freud believed that a persons unconscious thoughts and emotions affect his or her behavior. The now well-known therapy that he developed to explore an individuals unconscious thoughts is referred to as ____________.

ANS:
psychoanalysis
Freud developed an approach to therapy of individuals based on exploration of the unconscious, which is known as psychoanalysis.

DIF: Cognitive Level: Knowledge REF: p. 40 OBJ: 2
TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

OTHER

25. Good problem-solving is necessary for the mentally healthy individual. Place the following steps of the problem-solving process in chronological order. (Separate letters by a comma and space as follows: A, B, C, D, E, F, G.)
A. Examine all possible options.
B. Examine outcomes of the options application.
C. State the problem.
D. Evaluate and revise actions based on outcomes.
E. Collect information about the problem.
F. Choose the best option, and apply it to the problem.
G. Identify the causes or patterns of the problem.

ANS:
C, E, G, A, F, B, D
First, the problem must be identified, then information regarding the problem must be collected if causes or patterns of the problem are to be identified. Options then can be examined for choice of the best option, and possible outcomes of options can be determined. Finally, evaluation of the entire process is necessary to determine whether any revisions are necessary.

DIF: Cognitive Level: Application REF: p. 48 OBJ: 5
TOP: Cognitive Theories and Therapies KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

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