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

Answer and Explanation

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.

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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.

A. A health care provider gives a telephone order B. A peer fails to provide patient care due to being under the influence of alcohol C. A team member violates relationship boundaries with a patient D. A medication is prescribed by a licensed health care provider

Correct Answer is B

Explanation

Choice A reason: A provider giving a telephone order is a standard practice in healthcare, not inherently requiring reporting unless the order is unsafe. It does not indicate negligence or ethical violations, unlike impaired practice or boundary issues, making it incorrect for mandatory intervention and reporting.

Choice B reason: A peer under the influence of alcohol compromises patient safety due to impaired judgment and coordination, a serious ethical and professional violation. Nurses are obligated to report such behavior to protect patients, aligning with nursing ethics and safety protocols, making this a correct choice.

Choice C reason: Violating relationship boundaries with a patient, such as inappropriate personal interactions, breaches ethical standards and risks patient harm. Nurses must report this to ensure patient safety and maintain professional integrity, aligning with mental health care ethics, making this a correct choice.

Choice D reason: A licensed provider prescribing medication is a routine clinical action, not requiring reporting unless the prescription is unsafe or inappropriate. This choice does not inherently indicate a need for intervention, unlike impaired practice or boundary violations, making it incorrect.

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An adult says, "I have no answers," and "My opinion does not count." Which psychosocial crisis was unsuccessfully resolved for this adult?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?

Correct Answer is B

Explanation

In which situations would a nurse have the duty to intervene and report? (Select all that apply)

Correct Answer is B

Explanation

Which individual is demonstrating the highest level of resilience?

A nurse is preparing morning medications for all patients, and one patient says, "I am not taking any of those pills!" The nurse gets frustrated and forcefully holds the patient to administer the medication over the patient’s objection. Which term best describes this action?

The plan of care for a patient is not completed within 24 hours of the patient’s admission due to the unit being short-staffed. Which action should the nurse prioritize?

What must the nurse obtain from the patient in order for medical information to be released to another health care facility or third party regarding a patient diagnosed with a mental illness?

Which tasks are safe and appropriate to be performed by a basic-level nurse for a patient suffering from mental illness?

Which comments by a nurse demonstrate the use of therapeutic communication techniques? (Select all that apply)

Which individual diagnosed with a mental illness may require an emergency or involuntary admission?

What is an important nursing consideration for patients taking a nonbenzodiazepine such as zolpidem?