NACE Psychosocial Needs and Development 2 — Questions and Answers
Question 1: According to Erikson's theory, which developmental task is the primary focus for adolescents?
- Trust versus mistrust
- Industry versus inferiority
- Identity versus role confusion (Correct answer)
- Intimacy versus isolation
Correct answer: Identity versus role confusion
Erikson identified identity versus role confusion as the central developmental task of adolescence (ages 12-18), where teens develop a sense of personal identity.
Erik Erikson's psychosocial development theory identifies eight stages. Adolescence (12-18 years) centers on Identity vs. Role Confusion, where teens explore roles, values, beliefs, and goals to establish a coherent identity. Successful resolution leads to fidelity.
Question 2: A patient recently diagnosed with cancer states, 'I want to know all about my treatment options.' According to Kubler-Ross, which stage of grief is the patient most likely experiencing?
- Denial
- Bargaining
- Acceptance (Correct answer)
- Depression
Correct answer: Acceptance
Seeking information and actively participating in treatment decisions suggests the patient has moved toward acceptance of the diagnosis.
Kubler-Ross's five stages of grief (DABDA) are: Denial, Anger, Bargaining, Depression, and Acceptance. Acceptance does not mean being happy about the situation but rather acknowledging reality and actively coping.
Question 3: A nurse is caring for an elderly patient who recently lost a spouse and expresses feelings of loneliness. Which intervention is most appropriate?
- Tell the patient they will feel better with time
- Encourage the patient to suppress grief to avoid depression
- Facilitate participation in a bereavement support group (Correct answer)
- Advise the patient to stay busy to avoid thinking about the loss
Correct answer: Facilitate participation in a bereavement support group
A bereavement support group provides peer connection, normalized grief expression, and social support, which directly addresses loneliness and facilitates healthy grieving.
Bereavement in older adults carries significant health risks including increased mortality, depression, and social isolation. Bereavement support groups offer therapeutic factors: universality, mutual support, normalization of grief reactions, and social reconnection.
Question 4: Which therapeutic communication technique involves restating the patient's message in the nurse's own words to verify understanding?
- Reflecting
- Paraphrasing (Correct answer)
- Clarifying
- Summarizing
Correct answer: Paraphrasing
Paraphrasing restates the patient's message using the nurse's own words, demonstrating active listening and allowing the patient to confirm or correct the nurse's understanding.
Paraphrasing is a therapeutic communication technique where the nurse restates the patient's message in different words while maintaining the same meaning. This demonstrates active listening, validates the patient's feelings, and provides opportunity for correction.
Question 5: A nurse observes that a hospitalized 4-year-old child is clinging to a blanket and sucking their thumb. How should the nurse interpret this behavior?
- The child has a developmental delay requiring referral
- This is regression, a normal coping mechanism during stress (Correct answer)
- The child is being defiant and needs behavioral correction
- This indicates inadequate parenting at home
Correct answer: This is regression, a normal coping mechanism during stress
Regression, reverting to behaviors of an earlier developmental stage, is a normal coping mechanism in young children experiencing the stress of hospitalization.
Regression is a defense mechanism involving a return to behaviors characteristic of an earlier developmental stage. It is a common and normal response to the stress of hospitalization in young children. The behavior typically resolves after the stressor is removed.
Question 6: A patient with anxiety tells the nurse, 'I feel like I'm going to die.' What is the most therapeutic response?
- Don't worry, you're going to be fine
- That must feel very frightening. Tell me more about what you're experiencing (Correct answer)
- I'll call the doctor right away
- Many patients feel this way, it's normal
Correct answer: That must feel very frightening. Tell me more about what you're experiencing
Acknowledging the patient's feelings and inviting further expression validates their experience and promotes therapeutic communication.
Therapeutic communication principles require the nurse to acknowledge the patient's emotional experience before moving to interventions. This response demonstrates empathy, validates the patient's feelings, and uses an open-ended exploration technique.
NACE Psychosocial Needs and Development 2
According to Erikson's theory, which developmental task is the primary focus for adolescents?