psych exam 1 part 1

identification

A client attempts to increase her self-worth by acquiring certain characteristics of an individual whom she admires. Which type of ego defense mechanism does the nurse suspect in this client?

discuss weight management strategies with the client

A client recently diagnosed as being obese is experiencing stress related to weight gain during Covid. How can the nurse best help the client focus on the eustress (moderate or normal stress) nature of this stressor? Discuss weight management strategies with the client Encourage the client to discuss self-loathing about being obese Provide the client with a list of realistic, time focused weight loss goals Re-enforce for the client that obesity is a serious health problem that is manageable

The client snaps at the nurse and criticizes the nursing care provided.

A client who is being treated for chronic kidney disease complains to the health-care provider that he does not like the food available to him while hospitalized. The health-care provider insists that the client strictly adhere to the diet plan. What action can be expected if the client uses the defense mechanism of displacement?

compensation

A client with mild anxiety tells the nurse, "I am disabled and unable to participate in sports. However, I am a great scholar." Which ego defense mechanism does the nurse suspect in this client?

reaction formation

A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize this behavior as indicative of which defense mechanism?

Defense mechanisms can be appropriate responses to stress and need not be eliminated.

A psychiatric nurse intern states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement?

deficient somatostatin

Alzheimers disease

repression

Anna's dog Lucky got away form her when they were on a walk. He ran into the street and was hit by a car. Anna cannot remember any of the circumstances of his death. This is an example of which defense mechanism?

Teaching relaxation

For a client who is increasingly agitated, which nursing intervention is most likely to increase anxiety? Being assertive Responding early Providing choices Teaching relaxation

excess somatostatin

Huntingtons disease

Use short sentences and an authoritative voice

What nursing intervention should be used with a client experiencing panic level anxiety? Use short sentences and an authoritative voice Describe the possible reasons for the client's anxiety. Keep asking questions because the client is probably not going to volunteer information. Suggest that the client refrain from crying, because most of the time crying makes things worse.

suppression

Which defense mechanism is considered a conscious measure that is used to cope with anxiety?

perceptual field

Which parameter would be assessed to determine the degree of anxiety being experienced by a client?

being too preoccupied to respond when the fire alarm is being tested

Which patient behavior noted by the nurse supports the diagnosis of a severe level panic?

anxiety

____ is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.

regression

a retreat to an earlier level of development and the comfort measures associated with that level of functioning ex: throwing a tantrum as an adult to release built up anger

deficient acetylcholine

alzheimers, Huntington chorea, parkinsons disease

identification

an attempt to increase self worth by aquiring certain attributes and characteristics of an individual one admires

excess norepinephrine

anxiety

excess serotonin

anxiety

deficient GABA

anxiety, schizoprenia, mania, Huntington chorea

effective communication skills

appropraite, sensitive use of silence. active listening, clarifying techniques, paraphrasing as reflection of content (restating, reflection of feelings) presupposition (the miracle question) silence is effective when: patient is reflecting, thinking of answer, explaining

rationalization

attempt to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors

noneffective communication skills

avoid agreeing/disagreeing, asking excessive question, do not ask WHY QUESTION- 'Y is a crooked letter', be careful giving advice

excess histamine

both anxiety and depression

deficient neurotensin

decreased levels of spinal fluid of patients with schizoprenia

insufficient transmission

deficient release of neurotransmitters from the presynaptic cell or by a decrease in receptors

deficient norepinephrine

depression

deficient serotonin

depression

excess acetylcholine

depression

excessive transmission

excessive release of a neurotransmitter or to increased receptor responsiveness

severe anxiety

greatly diminished perceptual field, only extraneous details are percieved, extremely limited attention span, headaches, dizziness, insomnia, palpitations. feelings of dread, loathing, horror

generalized behaviors and characteristics of anxiety

impacts perceptual field and the ability to learn

introjection

internalization of the beliefs and values of another individual, which symbolically become apart of the self, to the extent that the feeling of separateness or distinctness is lost. ex: a son trying not to cry because his dad told him 'boys dont cry'- dad believed boys dont cry so son adapts same belief onto self

defence mechanisms

major means of managing conflict, personal preservation of ego integrity

glutamate

major mediator of excitatory signals in CNS. Involved in most aspects of normal brain function, including cognition, memory and learning

mild anxiety

normal and healthy, hightened perceptions, enhanced learning, some restlessness/irritability, may remain superficial with others, increased motivation

deficient dopamine

parkinsons disease, depression

excess GABA

reduction of anxiety, schizoprenia and mania

denial

refusal to acknowledge the existence of a real situation or the feelings associated with it

substance P

regulation of mood and anxiety, role in pain management s

panic anxiety

risk to self/others. unable to focus on even one detail with the environment, learning CANNOT occur. dilated pupils, labored beathing, severe trembling, sleeplessness, palpitations, muscular incoordination. sense of impending doom

excess dopamine

schizophrenia, mania

isolation

seperating a thought or memory from the feeling, tone, or emotions associated with it. ex: no longer being sad about the death of a loved one

termination phase

stage of the therapeutic relationship: A plan of action for more adaptive coping with future stressful situations has been established. feelings about termination of the relationship have been recognized and explored. Discuss a plan of action for stressful situations FOLLOWING therapy.

working phase

stage of therapeutic relationship: promote client's insight, perception of reality and coping behaviors. Use problem-solving model to work toward achievement of established goals. Overcome resistance behaviors. continuously evaluate progress toward goal attainment. discussion of ways to achieve established goals

orientation

stage of therapeutic relationship: create environment for trust and rapport, establish contract for intervention, including boundaries of the relationship, gather assessment data, identify strengths and weaknesses, formulate nursing diagnosis, set mutually agreeable goals, develop a realistic plan of action

pre-orientation phase

stage of therapeutic relationship: obtain info about the client from chart, self-awareness is key

undoing

symbolic negation or cancellation of a previous axtion or expereince that one finds intolerable ex: apologizing after being assertive with someone

repression

the INVOLUNTARY blockage of unpleasant feelings and experiences from one's awareness ex: child bitten by a dog as a when young- they develop a phobia of dogs years later with NO MEMORY of how the fear originated

suppression

the VOLUNTARY blockage of unpleasant feelings and experiences from one's awareness ex: wanting to tell your boss what you really think about him and his abysmal behavior, but holding it back out of fear of losing your job

compensation

the act of covering up a real or percieved weakness by emphasizing a trait one considers more desirable. ex: going above and beyond at work when having a poor family life

projection

the attribution too another person or feelings or impulses that are unacceptable to one's self

displacement

transference of feelings from one gtarget to another that is considered less threatening or neutral ex: gets frusturated doing the dishes so stopping and watching tv instead

reaction formation

unconscious replacement of unwanted anxiety-provoking impulse with its opposite, often expressed in an exaggerated showy way

moderate anxiety

worsening; REDUCTION in perceptual field, reduced alterness to environment/events, learning occurs but not at optimal abilitty, decreased attention span, increased restlessness, HR and RR, feeling of discontent, can lead to degree of impairement