A 17-year-old client is diagnosed with leukemia. Which
statements by the teenager reflect Piaget's cognitive processes
associated with adolescence?
a. "My smoking pot probably caused the leukemia."
b. "I'm going to do my best to fight this awful disease."
c. "Now I can't go to the prom because I have this stupid
disease."
d. "I know I got sick because I've been causing a lot of problems
at home."
e. "This illness is serious, but with treatment I think I have a
chance to get better." Correct Answer b. "I'm going to do my
best to fight this awful disease."
c. "Now I can't go to the prom because I have this stupid
disease."
e. "This illness is serious, but with treatment I think I have a
chance to get better."
A 19-year-old woman, arrested for assault and robbery, has a
history of truancy and prostitution but is unconcerned that her
behavior has caused emotional distress to others. The diagnosis
of antisocial personality disorder is made. According to
psychoanalytical theory, the client's lack of remorse and
repetitive behavior probably are related to what underdeveloped
aspect of personality?
,a. Id
b. Ego
c. Superego
d. Limbic system Correct Answer c. Superego
Lack of remorse indicates a weak superego, the aspect of
personality concerned with prohibitions. The id is not
underdeveloped in this person; the id acts to achieve self-
gratification. The ego is not related to acting-out behavior. The
limbic system is not underdeveloped; it is related to the
achievement of pleasure.
A 65-year-old man is admitted to the hospital with a history of
depression. The client, who speaks little English and has had
few outside interests since retiring, says, "I feel useless and
unneeded." The nurse concludes that the client is in which
Erikson's developmental stage?
a. Initiative versus guilt
b. Integrity versus despair
c. Intimacy versus isolation
d. Identity versus role confusion Correct Answer b. Integrity
versus despair
,Integrity versus despair is the task of the older adult; the client
has difficulty accepting what life is and was, resulting in
feelings of despair and disgust. Initiative versus guilt is the task
of the preschool-aged child. Intimacy versus isolation is the task
of the young adult. Identity versus role confusion is the task of
the adolescent.
A 76-year-old widower is terminally ill. He is very quiet and is
unwilling to have visitors. During the initial contact with this
client, what should the nurse do?
a. Assess what the client knows about death and the dying
process.
b. Avoid talking about his condition unless he initiates the
discussion.
c. Encourage him to accept phone calls from those who wish to
visit with him.
d. Explore the extent to which he understands his situation and
what the information means to him. Correct Answer d. Explore
the extent to which he understands his situation and what the
information means to him.
A starting point for working with all clients is ascertaining what
is known, their understanding of their particular situation, and its
meaning to them. It is not merely understanding what death and
the dying process means, but also how the individual feels about
the current situation. Encouraging conversation about the
condition tends to decrease anxiety and is desirable.
, Encouraging him to accept phone calls from those who wish to
visit with him meets the needs of others rather than the client,
who is the priority concern.
A client and the client's spouse are presented with
electroconvulsive therapy (ECT) as a treatment option instead of
pharmacotherapy after the client experiences adverse effects of
medication therapy. The nurse meets with them to discuss the
procedure. What should the nurse's first action be?
a. Allowing the client and family members to voice feelings,
myths, and fantasies about ECT
b. Clarifying misconceptions and emphasizing the therapeutic
value of the procedure for the depressed individual
c. Providing them with a brochure about the treatment and
scheduling another time to review and answer their questions
d. Completing a detailed medical and psychiatric history and
then starting family and client teaching at their level of
comprehension Correct Answer a. Allowing the client and
family members to voice feelings, myths, and fantasies about
ECT
It is most important for the nurse to facilitate a discussion of
feelings before teaching, because misconceptions about the
presumed effects on the brain, public fears, and lack of accurate
information regarding ECT precipitate anxiety. Anxiety
interferes with learning. Misconceptions can be clarified only
after they are expressed; citing the value of the procedure will be
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