NACE Psychosocial Needs and Development 5 — Questions and Answers
Question 1: A nurse is assessing a 3-year-old who insists on doing tasks 'by myself.' According to Erikson, this behavior reflects which developmental stage?
- Trust vs. mistrust
- Autonomy vs. shame and doubt (Correct answer)
- Initiative vs. guilt
- Industry vs. inferiority
Correct answer: Autonomy vs. shame and doubt
Autonomy vs. shame and doubt occurs from ages 1–3 and is characterized by the toddler's drive for independence.
Question 2: A client with schizophrenia tells the nurse, 'The FBI is putting thoughts in my head.' The nurse's best response is:
- 'That sounds frightening. Tell me more about what you're experiencing.' (Correct answer)
- 'Those thoughts aren't real; the FBI is not involved in your care.'
- 'You need to focus on what's happening in reality.'
- 'I'll call your family so they can reassure you.'
Correct answer: 'That sounds frightening. Tell me more about what you're experiencing.'
Acknowledging the client's feelings and exploring the experience is therapeutic; arguing about the delusion reinforces it or damages trust.
Question 3: Which assessment finding best indicates that a client is at risk for complicated grief?
- Crying intermittently two weeks after a loss
- Expressing anger toward the deceased
- Inability to function after six months with persistent denial of loss (Correct answer)
- Describing feelings of sadness and emptiness
Correct answer: Inability to function after six months with persistent denial of loss
Complicated grief is indicated by prolonged, impairing symptoms (>6 months) including persistent denial and inability to function.
Question 4: A nurse uses a therapeutic communication technique when responding to an anxious client. Which response demonstrates the technique of 'focusing'?
- 'Tell me everything that happened today.'
- 'Let's talk specifically about what triggered your anxiety this morning.' (Correct answer)
- 'How does that make you feel?'
- 'I understand exactly how you feel.'
Correct answer: 'Let's talk specifically about what triggered your anxiety this morning.'
Focusing directs the conversation to a specific topic, helping the client explore a particular concern in depth.
Question 5: A nurse is caring for a terminally ill client who states, 'If I can just live until my daughter's wedding, then I'll be ready to go.' This is an example of which stage of grief?
- Anger
- Depression
- Bargaining (Correct answer)
- Acceptance
Correct answer: Bargaining
Bargaining involves making deals or conditions in hopes of postponing death or loss.
Question 6: According to Maslow's hierarchy, which client need must be addressed before focusing on self-esteem needs?
- Belonging and love needs
- Safety and security needs (Correct answer)
- Self-actualization needs
- Cognitive needs
Correct answer: Safety and security needs
Maslow's hierarchy requires physiological and safety needs to be met before higher-level needs such as belonging and self-esteem.
Question 7: A client who was just informed of a terminal diagnosis begins yelling at the nurse, 'This is your fault! You didn't push for more tests!' The nurse recognizes this response as:
- Displacement of anger as part of the grief process (Correct answer)
- A sign of acute psychosis requiring immediate intervention
- Manipulative behavior that should be confronted directly
- Rational frustration that requires an apology from the nurse
Correct answer: Displacement of anger as part of the grief process
Displacement of anger onto the nurse is a normal and expected part of the anger stage of grief following a devastating diagnosis.
NACE Psychosocial Needs and Development 5
A nurse is assessing a 3-year-old who insists on doing tasks 'by myself.' According to Erikson, this behavior reflects which developmental stage?