An adult says, "I have no answers," and "My opinion does not count." Which psychosocial crisis was unsuccessfully resolved for this adult?
Trust versus mistrust
Autonomy versus shame and doubt
Initiative versus guilt
Identity versus role confusion
The Correct Answer is D
Choice A reason: Trust versus mistrust, Erikson's first psychosocial stage (0–1 year), focuses on developing trust in caregivers for basic needs. Failure leads to fear and suspicion, not feelings of worthlessness or insignificance. These symptoms do not align with the adult’s statements about opinions not counting, making this choice scientifically inaccurate for the described crisis.
Choice B reason: Autonomy versus shame and doubt, Erikson’s second stage (1–3 years), involves gaining independence in actions like self-care. Failure results in shame and self-doubt about autonomy, not a broader sense of worthlessness or lack of influence. This stage is unrelated to the adult’s expressed feelings, rendering this choice incorrect.
Choice C reason: Initiative versus guilt, the third stage (3–6 years), centers on initiating activities and asserting control. Failure leads to guilt over actions, not a diminished sense of self-worth or influence. The adult’s statements reflect identity struggles, not guilt from initiative, so this choice does not fit the psychosocial crisis described.
Choice D reason: Identity versus role confusion, Erikson’s fifth stage (12–18 years), involves forming a cohesive self-identity. Failure leads to role confusion, low self-esteem, and feelings of insignificance, directly aligning with the adult’s statements about having no answers and opinions not counting. This unresolved crisis persists into adulthood, making this the correct choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Weight gain and metabolic changes are side effects of clozapine, primarily due to its antihistaminic and serotonergic effects, not its dopaminergic action. Dopamine blockade is more associated with movement disorders, making this choice incorrect for teaching related to dopaminergic effects.
Choice B reason: Clozapine’s strong dopaminergic effect, particularly D2 receptor blockade, can cause extrapyramidal symptoms like tardive dyskinesia, a movement disorder. Patient education must emphasize monitoring for abnormal movements, as these are significant risks in antipsychotic therapy, making this the correct choice.
Choice C reason: Infection risk, particularly agranulocytosis, is a serious clozapine side effect but is unrelated to its dopaminergic action. It stems from bone marrow suppression, requiring blood monitoring, not dopamine-related teaching, making this choice incorrect for the question’s focus.
Choice D reason: Improved mood is not a direct result of clozapine’s dopaminergic effect, which primarily addresses psychotic symptoms. Mood changes occur over weeks and involve multiple receptors, not just dopamine, making this choice incorrect for dopaminergic-focused teaching.
Correct Answer is A
Explanation
Choice A reason: Focusing on the nurse’s experiences shifts attention from the patient, undermining therapeutic communication. This violates psychiatric nursing principles, which prioritize patient-centered dialogue to build trust and explore feelings, making this a non-therapeutic technique that disrupts effective mental health care.
Choice B reason: Making value judgments imposes the nurse’s beliefs on the patient, creating a judgmental environment. This hinders open communication, fosters defensiveness, and undermines trust, contrary to therapeutic communication goals in mental health nursing, making this a correct choice for non-therapeutic behavior.
Choice C reason: Giving advice assumes the nurse knows best, disempowering the patient and limiting self-exploration. Therapeutic communication encourages patients to find their own solutions, making advice-giving non-therapeutic, as it disrupts autonomy and trust, correctly identifying this as a non-therapeutic technique.
Choice D reason: Active listening, involving empathy and nonverbal cues, is a cornerstone of therapeutic communication. It fosters trust and validates patient feelings, essential in mental health care. This technique enhances therapeutic relationships, making it incorrect as a non-therapeutic communication example.
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