Foundations Of Mental Health Care 4e by Morrison-Valfre – Test Bank

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Morrison-Valfre: Foundations of Mental Health Care, 4^th Edition

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Chapter 5: Theories and Therapies

MULTIPLE CHOICE

1.Which is the best description of a modern theory?

ANS: B

Modern theories, which are developed through observation and research, explain the relationships among events, concepts, and ideas. Models comprise a pattern of behaviors that help to explain a theory, and early theories were developed through observation and deductions. The beliefs and values held by a person come from the person’s culture. A code of ethics helps professionals to make decisions.

DIF: Cognitive Level: Comprehension REF: Page 37 OBJ: 1

TOP: Theories and Therapies KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

2.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 Maslow’s theory to triage the client’s complaints, knowing that which complaint must be addressed first?

ANS: B

According to Maslow’s 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: Page 43 OBJ: 4

TOP:Humanistic Theories and Therapies

KEY:Nursing Process Step: Implementation

MSC:Client Needs: Psychosocial Integrity

3.According to Freud’s theory, a baby who is crying in response to wanting to be held by his mother is an example of which part of the personality’s control over behavior?

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 Freud’s theory of personality.

DIF: Cognitive Level: Application REF: Page 38 OBJ: 2

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

4.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?

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: Page 42 OBJ: 3

TOP:Developmental Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

5.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?

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 individual’s 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: Page 39 OBJ: 2

TOP: Psychoanalytical Therapies KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

6.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:

ANS: D

The collective unconscious stores experiences from the person’s 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: Page 39 OBJ: N/A

TOP: Analytical Psychotherapy KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

7.Alfred Adler, developer of the theory of individual psychology (Adlerian psychology), identified the life tasks of self and spirit. The task of self states that individuals must:

ANS: A

Adler believed that a person must learn to master certain life tasks. The task of self states that people must find meaning in life and must be able to define themselves. Recognizing one’s own life philosophy and meaning of spirit is part of the life task of spirit. To be viewed as total organisms functioning within the environment describes Adler’s belief of individual therapy (Adlerian therapy).

DIF: Cognitive Level: Comprehension REF: Page 40 OBJ: 1

TOP: Individual Psychotherapy KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

8.Jean Piaget’s theory of cognitive development identifies an interrelationship between the __________ and the __________ functions in the development of one’s personality.

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 Freud’s 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: Page 41 OBJ: 3

TOP:Developmental Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

9.How many stages of the human life cycle did Erik Erikson identify?

ANS: D

Erik Erikson identified eight stages of the human life cycle that form one’s personality; each stage is marked by a developmental task that must be confronted and resolved. Erikson’s theory is commonly used in health care today.

DIF: Cognitive Level: Knowledge REF: Page 41 OBJ: 3

TOP:Developmental Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

10.A 4-year-old client in a pediatric unit is imitating the actions of the nurse. The nurse knows, according to Erik Erikson’s theory, that this child is displaying a characteristic seen during which developmental stage?

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 (1 to 3 years old).

DIF: Cognitive Level: Application REF: Page 42 OBJ: 3

TOP:Developmental Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

11.Humanistic theories are important to health care because these theories serve as the foundation for the concept of:

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: Page 43 OBJ: 3

TOP:Humanistic Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

12.The nurse is providing care to a female client who has been given the diagnoses of schizophrenia and chronic obstructive pulmonary disease (COPD). The client is experiencing visual and auditory hallucinations, is short of breath with cyanosis of nail beds, and has cool moist skin. According to Maslow’s theory, toward what should the nurse’s first intervention be directed?

ANS: B

Nursing care today is based on Maslow’s hierarchy of needs. Physiological needs are the first needs in the hierarchy that must be met before other needs in the hierarchy can be met. Because this client has the diagnosis of COPD, shortness of breath and cyanosis must be addressed before other needs can be addressed.

DIF: Cognitive Level: Application REF: Page 43 OBJ: 3 | 4

TOP:Humanistic Theories and Therapies

KEY:Nursing Process Step: Implementation

MSC:Client Needs: Psychosocial Integrity

13.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 Maslow’s theory, what is this client experiencing?

ANS: B

In Maslow’s 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. Not all individuals reach self-actualization, but this client exhibits the characteristics of an individual who has reached this point. Symbolization and identification are common defense mechanisms, and equilibrium is a state wherein all body systems are in balance.

DIF: Cognitive Level: Application REF: Page 43 OBJ: 4

TOP:Humanistic Theories and Therapies

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

14.The nurse knows that the major concept of the systems theory is that individuals are viewed as functioning:

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 Maslow’s hierarchy of needs theory, and social aspects of behavior are seen in sociocultural theories.

DIF: Cognitive Level: Knowledge REF: Page 44 OBJ: 5

TOP: Systems Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

15.Selye’s stress adaptation theory consists of three stages, with the second stage characterized by:

ANS: C

The second stage of Selye’s stress adaptation theory is the stage of resistance, in which the body attempts to cope with stress by applying coping skills and defense mechanisms. The fight-or-flight response, the first response to stress, is the alarm reaction. Depletion of body resources occurs during the stage of exhaustion, which is the last stage. Homeostasis refers to a stage in which all body systems are in balance; it is not a stage of the stress adaptation theory.

DIF: Cognitive Level: Knowledge REF: Page 47 OBJ: 7

TOP: Stress Adaptation Theory KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

16.New studies on how genetics, neurotransmitters, viruses, fetal development, and dysfunction of the immune system may lead to various mental health disorders have been conducted as a result of theories in which field?

ANS: D

Psychobiological theory focuses on the biochemical bases of an individual’s thoughts, mood, emotions, and behavior and how these are affected. Behavior therapy focuses on the belief that an individual’s behavior is learned, as well as on ways to modify behavior when necessary. Psychoanalytical theories resulted from Freud’s work and focused on the unconscious development of the personality. Humanistic theory focuses on the individual as a whole and led to the development of holistic care models.

DIF:Cognitive Level: ComprehensionREF:Page 47 | Page 48

OBJ:8TOP:Psychobiology

KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity

17.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:

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: Page 49 OBJ: 10

TOP: Group Therapies KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

18.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?

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 to apply the client’s resources for adaptation to stress. Peplau developed the interpersonal model that emphasizes the nurse-client relationship, and the self-care deficit model’s goal is to help the client attain the ability to care for himself or herself.

DIF: Cognitive Level: Knowledge REF: Page 49 OBJ: 9

TOP: Nursing Theories KEY: Nursing Process Step: Assessment

MSC: Client Needs: Health Promotion and Maintenance

19.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?

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: Page 39 OBJ: 2

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

20.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?

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: Page 39 OBJ: 2

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

21.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?

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: Page 50 OBJ: 10

TOP: Group Therapies KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

1.Freud’s 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.

ANS: A, B, C

Freud believed if there was a dynamic balance between the id, the ego, and the superego, an adult’s personality would develop in a healthy manner. The conscience is part of the superego.

DIF: Cognitive Level: Knowledge REF: Page 38 OBJ: 1

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

COMPLETION

1.Freud believed that an individual’s 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: Page 38 OBJ: 2

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

2.Dr. Sigmund Freud believed that a person’s unconscious thoughts and emotions affect his or her behavior. The now well-known therapy that he developed to explore an individual’s 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: Page 38 OBJ: 2

TOP: Psychoanalytical Theories KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity

OTHER

1.Good problem-solving is necessary for the mentally healthy individual. Place the steps of the problem-solving process in order.

a. Examine all possible options

b. Examine outcomes of the option’s 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: Page 46 OBJ: 5

TOP: Cognitive Theories and Therapies KEY: Nursing Process Step: Assessment

MSC:Client Needs: Psychosocial Integrity