Mental Health

Of the following responses, which would be your best response to Mr. G regarding the snake that he sees?

"I don't see a snake. It is time for your group meeting. I'll walk with you to the meeting room."

Your best response to Mr. S might be:

"I see some cracks in the plaster, but I do not see snakes. Let's go to the day room."

The next day, Susan tells you that she has another plan to " finish the job when I get out of here. Please don't tell anyone." What would be your best response?

"What are you planning to do?"

Susan is 27 years old and has been admitted from the ED with an overdose of an antidepressant. She tells you, "My boyfriend broke up with me and I can't live without him." What is your best response?

"You must have been feeling very sad when he told you"

suicide pacts

"copycat" suicides among some adolescent groups

Suicide is the ____ leading cause of death in the US

10th

The most current thinking on the cause of schizophrenia is that it is:

A brain disorder

schizoaffective disorder

A disorder manifested by schizophrenic behaviors with a strong element of mood disorders, including depression or mania

extrapyramidal symptoms

A variety of responses associated with drugs that antagonize the dopamine receptors outside the pyramidal tract, causing a variety of effects including tremors and rigidity

For the patient with antisocial personality disorder, which of the following behaviors would be the most difficult for the patient to comply with?

Abiding by the rules in the hospital

A patient who has committed multiple crimes would probably have which of the following personality disorders?

Antisocial

David, 30 years old, comes to your unit for treatment of multiple broken bones following a car accident. He is friendly and flirtatious, but very demanding. As you gather data from him, you learn that the police have been looking for him for petty theft. He laughs and says, "Like they don't have better things to do!" He states he has changed jobs three times in the past year and has just broken off his second engagement. HIs former fiancee is visiting and privately tells you that you need to be careful because "He doesn't always tell the truth." You suspect which of the following personality disorders?

Antisocial

suicide attempt

Any act with the intention of taking one's own life in which the individual survived.

Your charge nurse tells you that Mr. P must be placed on suicide precautions. The first intervention you begin is:

Begin one-on-one observation at least every 15 minutes

You are caring for a 25-year-old male who has been admitted for infections that resulted from self-inflicted burns. This is not the first admission for this young man, but he is new to you as a new nurse on the unit. You have not read his entire chart, but you suspect he has a history of which one of the following personality disorders?

Borderline

Shawna is a 22-year-old woman who has episodes of extreme muscle rigidity and hyperexcitability. She sometimes repeats a word or a phrase over and over. Attempts to move her are met with even more muscle resistance. What is she exhibiting?

Catatonia

An individual stands on the train track with the train coming nearer. The person exclaims, "I am invincible! The train will not hurt me." This is an example of:

Delusions of grandeur

Further discussion with Mr. P reveals he is of a religious sect that believes there is honor in dying for one's religion. He does not understand why everyone is so afraid to die in this country. As his nurse, you:

Document the discussion but tell him that the suicide precautions remain in effect.

A patient who repeats a word or part of a word over and over might be said to have which of the following symptoms?

Echolalia

Mr. G is calling out, "Nurse!" When you arrive in his room, he tells you to be careful of the snake in the corner. You do not see anything in the corner. Mr. G is experiencing a:

Hallucination

Mr. S states, "Look at the snakes on the ceiling," You see some cracks in the plaster. Mr. S is experiencing a (an)

Illusion

Brian, an 18-year-old with schizophrenia, has a negative attitude, is delusional, hears voices, and is withdrawing from others. A nursing intervention that is appropriate for promoting activity for Brian is:

Invite him to join in the party

Statistically, which of the following people is at highest risk for suicide based on the information provided?

Jim is a 68-year-old recent widower with a long history of alcohol abuse.

A nursing intervention for a person with schizophrenia is to:

Keep the person oriented to reality and to the present

Which of the following is not a sign of untreated schizophrenia?

Maintaining satisfactory performance on the job

Which of the following pairs of symptoms are closely associated with EPS?

Muscle rigidity and protruding tongue

Your patient has been admitted with a diagnosis of bilateral pneumonia. You have trouble communicating with this patient, who is pouty and is demanding of your constant attention. She talks for long periods about the smallest details of her life. Besides the pneumonia, you ask the physician if the patient has a history of which of the following personality disorders?

Narcissistic

personality disorder

Nonpsychotic, maladaptive behavior that is used to satisfy the self.

. Mr. P is brought to the hospital by his wife. She states that he has been treated for depression recently, but that tonight he said, "You and the kids don't need me messing up your lives." Mr. P tells you he has been thinking about suicide for some time now. A nursing diagnosis for Mr. P would be:

Potential for violence, self-directed, as evidenced by stating suicidal thoughts

Patients who display very bizarre behavior most likely have which of the following types of personality disorder?

Schizotypal

Which intervention describes an important component in treatment of personality disorders?

Self-awareness by the nurse is necessary to ensure a therapeutic relationship

The fact that Susan is telling you she has another plan indicates what?

She is reaching out for help and is ambivalent about wanting to die.

Your patient tells you, "I am just a burden. Everyone would be better off if I was dead." Nurses are aware that:

Suicidal talk or ideation can lead to suicidal behavior

schizophrenia spectrum disorder

The gradient of psychopathology seen in schizophrenia from least to most severe.

Nursing care for people with personality disorders includes all of the following except:

Vague communication ( to decrease feelings of inferiority)

When setting limits with patients with personality disorders, the consequences of violating those limits should be set:

When the limit is set

borderline personality disorder

a disorder characterized by a pattern of intense and chaotic relationships with emotional instability and tendency toward self-destructive behavior

Narcassistic Personality Disorder

a disorder that displays exaggerated self-love and self-importance

psychosis

a mental state in which there is a severe loss of contact with reality

schizoid personality disorder

a pattern of extreme detachment from social relationships and restricted range of emotional responses

antisocial personality disorder

a pattern of irresponsible, exploitive, and guiltless behavior with tendency to fail to conform to the law and exploit and manipulate others for personal gain.

schizotypal personality disorder

a personality disorder characterized by odd and eccentric behaviors but not to the degree of schizophrenia

suicide contract

a written agreement between the patient and the treating team in which the patient agrees to inform the team before taking any action to harm himself or herself.

avoidant personality disorder

an individual with extreme sensitivity to rejection leading to avoidance of social contacts

histrionic personality disorder

associated with extreme dramatic, excessive behaviors in someone who has a pattern of strong emotions

dependent personality disorder

characterized by a pervasive and excessive need to be taken care of

obsessive-compulsive personality disorder

characterized by preoccupation of rules, orderliness, and control

paranoid personality disorder

consistent pattern of suspiciousness and mistrust that interferes with functioning in society

The primary goal in working with an actively psychotic, suspicious patient is to:

decrease her anxiety and increase trust

Splitting

defense mechanism often used in those with borderline personality disorders when there is difficulty assimilating both positive and negative aspects of a situation

Self-mutilating behavior

deliberate, self-injurious behavior such as cutting with the intent of causing nonfatal injury to attain the relief of tension

what are the most common psychiatric diagnoses for suicidal patients?

depression and substance abuse

caring for a suicidal patient requires what?

excellent observation and communication skills

Hallucinations

false sensory perception; can affect any of the five senses

Survivors of Suicide

family or friend of an individual who commits suicide

Delusions

fixed, false beliefs relating usually to persecution or grandeur

A person is more likely to commit suicide when he or she:

has a sudden lift from previous depressed mood

what will most ambivalent suicidal people do?

leave clues as to their plans

A nursing intervention that is appropriate for a patient who is suicidal is?

listen to the patients concerns and worries

A primary mechanism used by people with personality disorders is:

manipulation

Illusions

misperceptions of real external stimuli

what is essential when caring for a patient who expresses suicidal ideation?

open communication

Echopraxia

repeating the movements of others

Echolalia

repetition of phrases, words, or part of a word; often part of catatonia

catatonia

rigidity and inflexibility of muscles, resulting from immobility or extreme agitation

Suicide

self-inflicted death, with evidence that the person intended to die

Schizophrenia

serious mental health disorder characterized by impaired communication, alteration of reality, a deterioration of personal and vocational functioning

what do family, friends, and health-care providers of a someone who commits suicide need?

special support

suicidal ideation

suicidal thoughts

personality

sum of the behaviors and character traits of a person

lethality

the level of risk of death in the suicide method

obsessive-compulsive disorder

the presence of obsessions and compulsions that the individual feels compelled to think about and perform that interfere with daily functioning