Psychological Health

basic cognitive functioning

perception, pattern recognition, attention

what causes/triggers dementia?

physiological causes

depression memory

poor concentration, and low motivation, unable to make simple decision.

depression reversibility

potential

Dementia—Course/Prognosis

progessive

psychosocial theory

provides a way to understand people as interactions of psychological and social events

What are health and well-being influenced by?

psychological, social, and spiritual development

Dementia/Memory

recent and remote memory impaired; loss of recent memory is first sign

declaritve memory

refers to the ability to consciously learn and recall information

procedural memory

retention of motor skills

Complex attention

focus, planning, working memory

Dementia - Alertness

generally normal

Dementia onset

gradual, chronic, and insidious

learning disability

often identified during childhood, these exist challenge in data signals in and then processing the information received

depression response to questions

often says, I don't know

dementia and language

disoriented, rambling, incoherent; difficulty using nouns

executive function

higher-order, complex cognitive processes, including thinking, planning, and problem solving

Dementia and Sleep

- insomnia - daytime sleepiness - night wandering - obstructive sleep apnea

Depression Thinking

inability to concentrate

Dementia reversible?

irreversible, progressive

what causes/triggers depression?

loss; stress

maturational loss

losses normally expected due to the developmental processes of life

The nurse is caring for a client with severe anxiety. When assessing the client, what should the nurse do when asking questions? A. Ask open=ended questions B. Ask simple and direct questions C. Avoid asking questions until the anxiety subsides D. Postpone questions until the client can offer information

B. Ask simple and direct questions rationale: The nurse continue to speak with the client in a comforting way

necessary loss

losses that every person experiences

situational loss

experienced as a result of an unpredictable event

A nurse is explaining to a client the differences between physiological and psychological responses to anxiety. Which statements indicate the client understands the physiological indicators? Select all that apply. -"My heart feels like it's racing all the time." -"I don't know why my speech is so rapid." -"I wish I could have something for this diarrhea." -"My wife complains how irritable I am all the time." -"When I drive in the car, I start to hyperventilate." -"I have a difficult time falling asleep."

-"My heart feels like it's racing all the time." -"I wish I could have something for this diarrhea." -"When I drive in the car, I start to hyperventilate." -"I have a difficult time falling asleep.

Which factors are beyond the control of the client in relation to self-concept? -Age -Sex -Lifestyle -Body Image -Developmental level

-Age -Sex -Developmental level

The nurse is working with a client who is ready to improve his or her self-concept. What do the four interrelated components of self-concept include? Select all that apply. -Gender -Body image -Role performance -Locus of control -Personality -Self-esteem

-Body image -Role performance -Personality -Self-esteem

What does the nurse know is true about depression? -Depression is more common in women -Once depression is cured, it does not return -Depression is associated with low socioeconomic status -medication is the answer for those with depression -spiritual anguish has been noted in clients with depression

-Depression is more common in women -Depression is associated with low socioeconomic status -spiritual anguish has been noted in clients with depression

The nurse is caring for an elderly client who is suddenly confused and disoriented. The client is usually alert and oriented to time, place, person, and situation. Which factors should the nurse assess for in the client's health record that could cause this change in mental status? - Age -Infections -Dehydration -Medications -Recent loss of a spouse

-Infections -Dehydration -Medications

The nurse is preparing to interview a 25-year-old client who reports having problems at work. Which skills should the nurse incorporate into the interview to promote open communication with the client? -Allowing emotions to show -Maintaining the focus on the client -Incorporating open-ended questions -Being respectful of cultural details -Being cognizant of self-imposed biases -Permitting the client to control the interview direction

-Maintaining the focus on the client -Incorporating open-ended questions -Being respectful of cultural details -Being cognizant of self-imposed biases

Which disorders place the client at a higher risk for abusing substances? -Mood disorders -Conduct disorders -Anxiety disorders -Neurological disorders -Gastrointestinal disorders

-Mood disorders -Conduct disorders -Anxiety disorders

When researching the correlation between depression and health-related issues in older adults, what will the nurse find? -Older adults with depression have increased longevity -Older adults with depression report higher rates of physical ailments -Older adults with depression present with greater functional impairments -Older adults with depression have lower suicide rates than younger adults -Older adults with depression tend to use healthcare services more frequently

-Older adults with depression report higher rates of physical ailments -Older adults with depression present with greater functional impairments -Older adults with depression tend to use healthcare services more frequently

Which factors work together to form a client's self-concept? -Phobias -Beliefs and values -Sexual performance -Physical appearance -Intellectual abilities -Problem-solving abilities

-Sexual performance -Physical appearance -Intellectual abilities -Problem-solving abilities

Which behaviors would the nurse expect to find in a client with dementia? -Inability to concentrate -Sleeping a lot during the day -Difficulty finding correct words -Slow to respond to verbal stimuli -Answers questions inappropriately

-Sleeping a lot during the day -Difficulty finding correct words -Answers questions inappropriately

The school nurse is preparing a presentation to a group of teenagers about how cognitive understanding affects body image. Which norms influence cognitive understanding? -Social -Family -Cultural -Genetic -Gender

-Social -Family -Cultural

four components of self-concept

-body image -role performance -personal identity -self-esteem

Kubler-Ross stages of grief

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

Which one of the following statements made by a client would indicate a beginning level of acceptance of a change in body image? A. A client who is 2 days postoperative with a left BKA and states a desire to look at the stump and learn how to change the dressing B. A teenager with severe facial burns who doesn't want any visitors C. A pregnant woman at 33 weeks who asks if she looks fat D. A client receiving chemotherapy and has alopecia refuses to look in a mirror because he or she feels "ugly"

A. A client who is 2 days postoperative with a left BKA and states a desire to look at the stump and learn how to change the dressing

Which theorist focused research on identifying developmental stages according to tasks that one is able to complete? A. Erikson B. Kolb C. Maslow D. Bloom

A. Erikson rationale: Erikson's work focused on developmental stages by tasks

Clients who experience anxiety may use defense mechanisms to cope. The nurse knows that a common defense mechanism is denial. What is denial? A. Refusing to acknowledge reality or associated feelings B. Transferring feelings from one object or person to another C. Attempting to pattern or resemble the personality of an admired person D. Attributing one's own unacceptable feelings and thoughts to others

A. Refusing to acknowledge reality or associated feelings

The nurse is caring for a client whose child died a month ago. The client was admitted to the psychiatric unit and does not recall the circumstances of the child's death. The client is demonstrating which of the following defense mechanisms? A. Repression B. Suppression C. Denial D. Reaction formation

A. Repression Rationale: Repression is an involuntary response to submerge painful thoughts and feelings into the unconscious

A newly divorced parent of two children reports working full-time and returning to school to obtain a higher degree. He or she says it is difficult to meet the demands of life. Which role performance difficulty is this client experiencing? A. Role strain B. Interrole conflict C. Role expectations D. Interpersonal role conflict

A. Role strain

Which client is most likely to have the lowest self-concept and body image? A. A client of lower socioeconomic status B. A client who has just graduated college C. A client born with cerebral palsy who uses a walker D. A teenage client who excels in athletics in high school

A. client born with cerebral palsy who uses a walker

The nurse is working at a community clinic and meets a woman who is homeless and has not eaten in 3 days. What is the priority nursing diagnosis for this client? A. Anxiety B. At-risk for not meeting body requirements, imbalanced C. Coping D. Social isolation

B. At-risk for not meeting body requirements, imbalanced Rationale: Physiological need is the priority diagnosis in this case.

Which client behavior demonstrates an external locus of control? A. taking responsibility for mistakes B. Blaming a corporation for getting the client fired C. understanding drinking while driving can result in jail time D. Listening to his or her own intuition before making decisions

B. Blaming a corporation for getting the client fired

A nurse is teaching a community class about concepts of depression. Which fact is correct about depression? A. People enjoy talking about how they feel. B. Depression is more common in women than men. C. Medication is always the answer for depression. D. Depression can be cured.

B. Depression is more common in women than men.

The nurse is interviewing a client who has lost his or her job and has increased his or her alcohol consumption to at least four to six drinks a day. Which nursing diagnosis is most appropriate for this client? A. Social isolation B. Ineffective coping C. Parental role conflict D. Posttraumatic stress disorder (PTSD)

B. Ineffective coping

A nurse is reviewing the various theories of depression. What are the causes of psychodynamic depression? A. Biochemical, hormonal, and genetics B. Loss, abandonment, and emotional detachment C. Negative thinking D. Poor family relationships and socioeconomic factors Rationale: These factors are related to social/environmental theories

B. Loss, abandonment, and emotional detachment

A client with dementia demonstrates progressive mental status changes. Which behavior should the nurse expect to be affected? A. Hallucinations and delusions B. Memory impairment C. Speech pattern D. Wandering

B. Memory impairment

A client arrives at the clinic and is very agitated and feeling out of control. The nurse decides to assess the client's anxiety level with the Anxiety Assessment Guide and the rating is 103. What action should the nurse take next? A. Practice deep breathing exercises. . B. Refer the client to a mental health professional. C. Give the client an Ativan. D. Send the client home and tell him or her to return tomorrow for a follow-up visit.

B. Refer the client to a mental health professional.

A nurse admitted a client diagnosed with depression and suicidal ideation 2 days ago. Which new finding is the greatest concern? A. The client does not participate in social activities. B. The client becomes happy and wants to be discharged as soon as possible. C. The client does not eat breakfast. D. The client sleeps 10 to 15 hours per day.

B. The client becomes happy and wants to be discharged as soon as possible. Rationale: This finding should cause the greatest concern as the client has changed mood and is at the highest risk for suicide.

Which assessment findings for a client in a panic level of anxiety require a referral to a mental health professional? A. Increased alertness and motivation . B. Thoughts of bodily harm to self or others C. Narrowed perception and poor concentration D. Connections between details not noticed and senses reduced

B. Thoughts of bodily harm to self or others

A nurse is caring for a client with depression. What does the nurse understand that a collaborative intervention is? A. Taking vital signs every shift B. Working with a psychotherapist to develop a plan of care. C. Assessing a client for suicide risk D. Providing information on support groups

B. Work with a psychotherapist to develop a plan of care

A client's partner died very suddenly at the age of 38 three weeks ago. A nurse caring for the client is conducting the assessment interview and asks about the client's home life. The client tells the nurse that his/her daily routine consists of having coffee with his/her partner in the morning, then going to work, and coming home to have dinner and watch a movie or play a board game with his/her partner. Which defense mechanism is the client displaying by providing this response to the interview questions? A. Repression B. Suppression C. Denial D. Reaction formation

C. Denial rationale: Denial is blocking out painful thoughts or feelings.

The nurse is caring for a client diagnosed with severe depression. Which statement made by the client should alert the nurse of an increased risk for suicide? A. I don't understand why my spouse wants a divorce. B. I am going to cancel my plans this weekend C. I have outlived my friends and spouse. There is nothing left for me in life. D. I am so unhappy in my life. I have lost my job and my family due to gambling

C. I have outlived my friends and spouse. There is nothing left for me in life.

There are several theories that can assist nurses to care for their clients holistically. Who developed a psychosocial theory that nurses can utilize with clients that consists of a hierarchy of physiological and psychological needs? A. Erikson B. Kolb C. Maslow D. Bloom

C. Maslow Rationale: Maslow's theory is a hierarchy of basic needs to self-actualization.

Bowlby: Four Stages of Grief

numbness or protest, disequilibrium, disorganization and despair, reorganization

A client is in the ICU and has been diagnosed with delirium. Which is the priority intervention for this client? A. Identify the causative factor(s). B. Administer donepezil as ordered. C. Provide adequate nutrition and hydration. D. Provide a safe environment.

C. Provide adequate nutrition and hydration. Rationale: Maslow's hierarchy specifies that nutrition and hydration are a priority (highest needs).

A nurse is caring for a client who fears being hospitalized for surgery. What is one caring intervention to maintain this client's self-concept? A. Interrupt the client when he or she is asking questions about the surgery. B. Talk about the client in front of the roommate. C. Use eye contact and touch as appropriate to the client's wishes. D. Call the client a family nickname without his or her permission.

C. Use eye contact and touch as appropriate to the client's wishes. Rationale: This is respectful intervention and puts the client in control.

Which is an example of abnormal anxiety? A. being startle by a snake when gardening B. Being scared of driving across a high bridge C. Feeling nervous before meeting new people D. Choosing to drive long distances due to fear of a plane crash

D. Choosing to drive long distances due to fear of a plane crash

A nurse is admitting a client with anxiety to the behavioral health unit. What level of anxiety is predicted when the client begins to experience hallucinations and delusions? A. Mild anxiety B. Moderate anxiety C. Severe anxiety D. Panic anxiety

D. Panic anxiety

A client states, "I am so angry that my father gave me depression. It's all his fault that I am in the hospital right now." The nurse knows which theory is related to this statement? A. Psychodynamic theory B. Cognitive theory C. Social/environmental theory D. Physiological theory Rationale: This theory relates to the genetic factors of depression.

D. Physiological theory Rationale: This theory relates to the genetic factors of depression.

A client is prescribed citalopram and should be instructed to avoid which of the following? A. tobacco B. Insulin C. Dark leafy vegetables D. St. John's wort

D. St. John's wort

Six domains of cognitive function

Perceptual motor function, language, learning and memory, social cognition, complex attention, and executive function

A nurse is reviewing medication for an 82-year-old man. What medication may be a risk factor for depression? A. Aspirin B. Antibiotics C. Decongestants D. Steroids

Steroids

Worden: Four Tasks of Mourning

Task I-accepting the reality of loss Task II- Using coping mechanisms to experience the emotional pain of the loss Task III- changing the environment to accommodate the absence of the deceased Task IV-finding a meaningful connection with the lost while learning to live again

intellectual disability

a condition of limited mental ability

Depression onset

acute or chronic; can be related to specific events

sef-concept

all our thoughts and feelings about ourselves, in answer to the question, "Who am I?"

working memory

allows a small amount of information to be actively maintained and manipulated for a short period

neurocognitive disorders

an acquired and progressive deterioration of all cognitive functions

impaired cognitive function

an observable or measurable disturbance in one or more of the cognitive processes resulting from abnormality within the brain or factor interfering with normal brain function

dementia response to questions

answers inappropriate or with near misses

percieved loss

any loss defined by a client that is not obvious to others

actual loss

any loss of valued person or item

four major regions of the brain

cerebrum, diencephalon, brainstem, cerebellum

higher-order cognitive function

characterized by learning, comprehension, insight problem solving, reasoning, decision making, creativity, and metacognition

depression and sleep

difficulty falling asleep, early morning awakening, much day sleeping

Dementia Thinking

difficuly with abstraction and word finding, decreased judgement

Engel: Five stages of grief

shock and disbelief, developing awareness, restitution, resolution of the loss, recovery

depression language

speaks slowly; slow to respond to verbal stimuli

delirium

state of disturbed consciousness and altered cognition with a rapid onset occurring over hours or a few days

bereavement

state of sorrow over the death or departure of a loved one

immediate memory

the ability to hold something in mind for just a few seconds

memory

the ability to store and retrieve information over time

grief

the inner emotional response to loss and is exhibited in as many ways as there are individuals

cognition

the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.

Depression Alertness

usually reduced

Depression Course

varies, depending on cause

related memory

visuospatial cognition, the capacity to comprehend, retain, and use visual representations