Concepts of Personality Development

1. A jilted college student is admitted to a hospital following a suicide attempt and states, “No one will ever love a loser like me.” According to Erikson’s theory of personality development, a nurse should recognize that this patient has a deficit in which developmental stage?1. Trust versus mistrust2. Initiative versus guilt3. Intimacy versus isolation4. Ego integrity versus despair
ANS: 3
Rationale: The nurse should recognize that the client who states, “No one will ever love a loser like me” has not adequately completed the intimacy versus isolation stage of development. The intimacy versus isolation stage is presumed to occur in young adulthood between the ages of 20 and 30 years. The major developmental task in this stage is to establish intense, lasting relationships or commitment to another person, cause, institution, or creative effort.

Cognitive Level: Application
Integrated Process: Assessment
2. A nurse observes a 3-year-old client willingly sharing candy with a sibling. According to Peplau, which psychological stage of development should the nurse determine that this child has completed?1. Learning to count on others2. Learning to delay satisfaction3. Identifying oneself4. Developing skills in participation
ANS: 2
Rationale: The nurse should determine that this client has completed the learning to delay satisfaction stage of development, according to Peplau’s interpersonal theory. This stage typically occurs in toddlerhood when one learns the satisfaction of pleasing others.

Cognitive Level: Application
Integrated Process: Assessment

3. A 9-month-old child screams every time his mother leaves and will not tolerate anyone else changing his diaper. The nurse should determine that, according to Mahler’s developmental theory, this child’s development was arrested at which phase?1. The autistic phase2. The symbiotic phase3. The separation-individuation phase
4. The rapprochement phase
ANS: 2
Rationale: The nurse should understand that this client’s development was halted in the symbiotic phase of Mahler’s developmental theory, which usually occurs between 1 and 5 months of age. The child has not entered into the separation-individuation phase of development, in which a child establishes the understanding of being separate from the mother.

Cognitive Level: Application
Integrated Process: Evaluation
4. According to Peplau, a nurse who provides an abandoned child with parental guidance and praise following small accomplishments is serving which therapeutic role?1. Technical expert2. Resource person3. Surrogate4. Leader

ANS: 3
Rationale: The nurse who provides an abandoned child with parental guidance and praise is serving the role of the surrogate, according to Peplau’s interpersonal theory. A surrogate serves as a substitute for another person—in this case, the child’s parent.

Cognitive Level: Application
Integrated Process: Implementation

5. When assessing clients, a psychiatric nurse should understand that psychoanalytic theory is based on which underlying concept?
1. A possible genetic basis for the client’s problems2. The structure and dynamics of the personality3. Behavioral responses to stressors4. Maladaptive cognitions

ANS: 2
Rationale: The nurse should understand that psychoanalytic theory is based on the underlying concepts of the structure and dynamics of personality. Psychoanalytic theory was developed by Sigmund Freud and explains the structure of personality in three different components: the id, the ego, and the superego.

Cognitive Level: Application
Integrated Process: Assessment

6. Which underlying concept should a nurse associate with interpersonal theory when assessing a client?
1. The effects of social processes on personality development
2. The effects of unconscious processes and personality structures
3. The effects on thoughts and perceptual processes
4. The effects of chemical and genetic influences
ANS: 1
Rationale: The nurse should associate interpersonal theory with the underlying concept of effects of social process on personality development. Sullivan developed stages of personality development based on his theory of interpersonal relationships and their effect on personality and individual behavior.

Cognitive Level: Application
Integrated Process: Assessment
7. A physically healthy, 35-year-old, single client lives with parents, who provide total financial support. According to Erikson’s theory, which developmental task should a nurse assist the client to accomplish?1. Establishing the ability to control emotional reactions2. Establishing a strong sense of ethics and character structure3. Establishing and maintaining self-esteem 4. Establishing a career, personal relationships, and societal connections
ANS: 4
Rationale: The nurse should assist the client in establishing a career, personal relationships, and societal connections. According to Erikson, nonachievement of the generativity versus stagnation stage results in self-absorption, including withdrawal from others and having no capacity for giving of the self to others.

Cognitive Level: Application
Integrated Process: Assessment

8. A 1-month-old infant is left alone for extended periods, has little physical stimulation, and is malnourished. Based on this infant’s situation, in which phase of development, according to Mahler’s theory, should a nurse expect to see a potential deficit?1. The symbiotic phase 2. The autistic phase3. The consolidation phase
4. The rapprochement phase
ANS: 2
Rationale: The nurse should expect that a 1-month-old infant who is left alone, has little physical stimulation, and is malnourished would not meet the autistic phase of development. The autistic phase of development usually occurs from birth to 1 month, at which time the infant’s focus is on basic needs and comfort.

Cognitive Level: Application
Integrated Process: Evaluation
9. A 6-year-old boy uses his father’s flashlight to explore his 3-year-old sister’s genitalia. According to Freud, in which stage of psychosocial development should a nurse identify this behavior as normal?
1. Oral2. Anal3. Phallic4. Latency
ANS: 3
Rationale: The nurse should identify this behavior as normal, because the 6-year-old client who focuses on genital organs is in the phallic stage of Freud’s psychosexual stages of development. Children in the phallic stage of development focus on genital organs and develop a sense of sexual identity. Identification with the same-sex parent also occurs at this stage.

Cognitive Level: Application
Integrated Process: Assessment
10. A married, 26-year-old client works as a schoolteacher. She and her husband have just had their first child. A nurse should recognize that this client is successfully accomplishing which stage of Erikson’s developmental theory?
1. Industry versus inferiority2. Identity versus role confusion3. Intimacy versus isolation4. Generativity versus stagnation
ANS: 3
Rationale: The nurse should recognize that a 26-year-old client who is married and has a child has successfully accomplished the intimacy versus isolation stage of Erikson’s developmental theory. The intimacy versus isolation stage of young adulthood involves forming lasting relationships. Achievement of this task results in the capacity for mutual love and respect.

Cognitive Level: Application
Integrated Process: Assessment

11. A 10-year-old child wins the science fair competition and is chosen as a cheerleader for the basketball team. A nurse should recognize that this child is in the process of successfully accomplishing which stage of Erikson’s developmental theory?1. Industry versus inferiority2. Identity versus role confusion3. Intimacy versus isolation4. Generativity versus stagnation
ANS: 1
Rationale: The nurse should recognize that a 10-year-old child who is successful in school both academically and socially has effectively accomplished the industry versus inferiority developmental stage of Erikson’s psychosocial theory. The industry versus inferiority stage of development usually occurs between 6 and 12 years of age, at which time individuals achieve a sense of self-confidence by learning, competing, performing successfully, and receiving recognition from others.

Cognitive Level: Application
Integrated Process: Assessment
12. A client has flashbacks of sexual abuse by her uncle. She had not had these memories until recently, when she became sexually active with her boyfriend. A nurse should identify this experience as which part of Sullivan’s concept of the self-system?1. The good me2. The bad me3. The not me4. The bad you
ANS: 3
Rationale: The nurse should identify a client remembering sexual abuse when becoming sexually active with her boyfriend as experiencing the not me part of the personality. According to Sullivan, the not me part of the personality develops in response to situations that produced intense anxiety in childhood.

Cognitive Level: Application
Integrated Process: Evaluation
13. According to Freud, which statement should a nurse associate with predominance of the superego?
1. “No one is looking, so I will take three cigarettes from Mom’s pack.”2. “I don’t ever cheat on tests; it is wrong.”3. “If I skip school, I will get into trouble and fail my test.”4. “Dad won’t miss this little bit of vodka.”

ANS: 2
Rationale: The nurse should associate the statement “I don’t ever cheat on tests; it is wrong” as indicative of the predominance of the superego. Freud described the superego as the part of the personality that internalizes the values and morals set forth by primary caregivers. The superego can be referred to as the “perfection principle.”

Cognitive Level: Application
Integrated Process: Evaluation

14. A female complains that her husband only satisfies his sexual needs and never her needs. According to Freud, which personality structure should a nurse identify as predominantly driving the husband’s actions?
1. The id
2. The superid3. The ego4. The superego

ANS: 1
Rationale: The nurse should identify that the husband’s actions are driven by the predominance of the id. According to Freud, the id is the part of the personality that is identified as the pleasure principle. The id is the locus of instinctual drives.

Cognitive Level: Application
Integrated Process: Evaluation

15. A father of a 5-year-old demeans and curses his child for disobedience. In turn, when upset, the child uses swear words at kindergarten. A school nurse recognizes this behavior as unsuccessful completion of which stage of development, according to Peplau?
1. Learning to count on others2. Learning to delay satisfaction3. Identifying oneself4. Developing skills in participation
ANS: 3
Rationale: The nurse should identify that the child using swear words in kindergarten has not successfully completed the identifying oneself stage, according to Peplau’s interpersonal theory. During this stage of early childhood, a child learns to structure self-concept by observing how others interact with him or her.

Cognitive Level: Application
Integrated Process: Evaluation
16. A nurse is caring for a hospitalized client who is quarrelsome, opinionated, and has little regard for others. According to Sullivan’s interpersonal theory, the nurse should associate the client’s behaviors with a previous deficit in which stage of development?1. Infancy2. Childhood3. Early adolescence4. Late adolescence
ANS: 2
Rationale: The nurse should associate the client’s behavior with a deficit in the childhood stage of Sullivan’s interpersonal theory. The childhood stage in Sullivan’s interpersonal theory typically occurs from 18 months to 6 years of age, during which the child learns to experience a delay in personal gratification without undue anxiety.

Cognitive Level: Application
Integrated Process: Evaluation
Multiple Response

17. Which of the following concepts should a nurse identify as being included in Black and Andreasen’s definition of personality? (Select all that apply.)
1. Personality is the characteristic way in which a person thinks, feels, and behaves.2. Personality is the ingrained pattern of behavior that each person evolves, both consciously and unconsciously. 3. Personality is developed in sporadic stages that vary from person to person and experience to experience.4. Personality has to do with a person’s style of life or way of being.
5. Personality is inborn and cannot be influenced by developmental progression.

ANS: 1, 2, 4
Rationale: Black and Andreasen (2011) define personality as “the characteristic way in which a person thinks, feels, and behaves; the ingrained pattern of behavior that each person evolves, both consciously and unconsciously, as his or her style of life or way of being.”

Cognitive Level: Application
Integrated Process: Assessment

Fill-in-the-Blank

18. “It is never right to take something that doesn’t belong to you.” According to Sigmund Freud, this statement reflects the predominance of the _______________ structure of the personality.

ANS: superego
Rationale: According to Sigmund Freud, the statement “It is never right to take something that doesn’t belong to you” reflects the predominance of the superego structure of the personality. Freud organized the structure of personality into three major components: the id, the ego, and the superego, which are distinguished by their unique functions and different characteristics. The superego is the perfection principle, in which the values and morals set forth by primary caregivers are internalized.

Cognitive Level: Analysis
Integrated Process: Evaluation