Chapter 07: Models for Working with Psychiatric Patients
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. When interacting with patients, it is important for the nurse to recognize that it‘s appropriate to
expect defense mechanisms to be used for what outcome?
a. Keep id impulses from gaining control.
b. Protect oneself from excessive anxiety.
c. Access unconscious feelings and memories.
d. Prevent conflict among the id, ego, and superego.
ANS: B
Theorists widely accept the Freudian concept that ego defense mechanisms operate
unconsciously to lower anxiety. The function of defense mechanisms is limited to anxiety
control, so the other options are incorrect.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
2. A nurse plans an intervention associated with cognitive therapy. What makes this action a
therapeutic intervention?
a. It provides rational, logical reality testing.
b. It is primarily concerned with right and wrong.
c. It uses primary process imagery to meet basic needs.
d. It is derived from the individual‘s pattern of thinking.
ANS: A
, Cognitive therapy examines the distorted perceptions, erroneous beliefs, self-deceptions, and
blind spots that lead to ―excessive, inappropriate emotional reactions‖ to events or stimuli.
Reality testing and problem solving are aimed at correcting faulty cognitions andprocesses; the
individual develops ―more realistic appraisals of himself and his world‖. None of the other
options are related to interpreting emotions.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
3. A patient asks, ―Why is it important to uncover memories and conflicts hidden in the
unconscious?‖ According to Freud, what effect does this intervention support?
a. Resolves developmental issues, fears, and crises.
b. Allows an individual control over the id and superego.
c. Suppress painful feelings and increase rational thinking.
d. Provides insight into behavior and allow meaningful change to occur.
ANS: D
Freud believed that uncovering unconscious material generates an understanding of behavior that
enables individuals to make choices about behavior and thus improve mental health. It will not,
however, automatically resolve issues, give the patient control over id and superego strivings, or
result in rational thinking.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A patient is suspected of using defense mechanisms inappropriately. This suspicion is supported
when the nurse finds evidence that the patient is demonstrating what behavior? a. Has difficulty
with problem-solving.
b. Becomes psychosis.
c. Levels of emotions are great intensified.
d. The patient regularly denies reality.
, ANS: A
Excessive use of defense mechanisms results in the distortion of reality. When reality is not
perceived accurately, problem-solving is impaired. The other options are not generally associated
with defense mechanism use.
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. When interacting with patients, it is important for the nurse to recognize that it‘s appropriate to
expect defense mechanisms to be used for what outcome?
a. Keep id impulses from gaining control.
b. Protect oneself from excessive anxiety.
c. Access unconscious feelings and memories.
d. Prevent conflict among the id, ego, and superego.
ANS: B
Theorists widely accept the Freudian concept that ego defense mechanisms operate
unconsciously to lower anxiety. The function of defense mechanisms is limited to anxiety
control, so the other options are incorrect.
DIF: Cognitive level: Applying TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
2. A nurse plans an intervention associated with cognitive therapy. What makes this action a
therapeutic intervention?
a. It provides rational, logical reality testing.
b. It is primarily concerned with right and wrong.
c. It uses primary process imagery to meet basic needs.
d. It is derived from the individual‘s pattern of thinking.
ANS: A
, Cognitive therapy examines the distorted perceptions, erroneous beliefs, self-deceptions, and
blind spots that lead to ―excessive, inappropriate emotional reactions‖ to events or stimuli.
Reality testing and problem solving are aimed at correcting faulty cognitions andprocesses; the
individual develops ―more realistic appraisals of himself and his world‖. None of the other
options are related to interpreting emotions.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
3. A patient asks, ―Why is it important to uncover memories and conflicts hidden in the
unconscious?‖ According to Freud, what effect does this intervention support?
a. Resolves developmental issues, fears, and crises.
b. Allows an individual control over the id and superego.
c. Suppress painful feelings and increase rational thinking.
d. Provides insight into behavior and allow meaningful change to occur.
ANS: D
Freud believed that uncovering unconscious material generates an understanding of behavior that
enables individuals to make choices about behavior and thus improve mental health. It will not,
however, automatically resolve issues, give the patient control over id and superego strivings, or
result in rational thinking.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A patient is suspected of using defense mechanisms inappropriately. This suspicion is supported
when the nurse finds evidence that the patient is demonstrating what behavior? a. Has difficulty
with problem-solving.
b. Becomes psychosis.
c. Levels of emotions are great intensified.
d. The patient regularly denies reality.
, ANS: A
Excessive use of defense mechanisms results in the distortion of reality. When reality is not
perceived accurately, problem-solving is impaired. The other options are not generally associated
with defense mechanism use.
