Psych Class 8 Addiction

rationalization

"a couple of drinks calms me down"

- mood and behavioral changes - reduced coordination - impaired judgment

s/s of alcohol intoxication? (MCJ)

family violence

the intentional intimidation, abuse, or neglect of children, adults, or elders by a family member, intimate partner, or caregiver in order to gain power and control over the victim

1. denial 2. rationalization 3. projection

top three defense mechanisms of alcohol and substance abuse?

projection

turns their problems onto someone else

substance misuse

use of any psychoactive substance for a purpose other than it was intended

club drugs (MDMA, flunitrazepam, GHB)

visual hallucinations, disorientation, confusion, paranoia, euphoria, anxiety, panic, and tachycardia are symptoms of use for?

2

when planning the hospital discharge of a client with chronic anxiety, the nurse evaluates achievement of the discharge maintenance goals. which of the following goals would appropriately have been included in the plan of care? 1. the client continues contact with a crisis counselor 2. the client identifies anxiety-producing situations 3. the client ignores feelings of anxiety 4. the client eliminates all anxiety from daily situations

2

when working with clients diagnosed with anxiety disorders, the nurse interprets that a client with which of the following problems is least likely to be treated with behavior therapy? 1. OCD 2. PTSD 3. agoraphobia 4. panic disorder

3

which emotional response related to chronic respiratory disease requires immediate nursing intervention? 1. anxiety 2. depression 3. suicidal ideation 4. ineffective coping

4

which of the following assessment data indicates to the nurse that a client is experiencing a major depressive episode? 1. the client is a man 2. the client states,"since my wife died last week, I've been waking up hours before i should and i'm tired all day." 3. the client uses marijuana 4. the client states,"the last 3 weeks, i'm doing all the things i used to do but I'm not enjoying them.

20's, males, females

Adults in their __'s have a higher rate of substance use and addiction than any other age group, and _____ are twice as likely as _____ to be represented.

4

on the second day of hospitalization, a depressed client comes to the dayroom dressed neatly in slacks and a blouse, with hair combed back in a ponytail. the nurse should make which of the following statements to the client? 1 wow you look terrific! 2 you must be feeling better today. 3 this is a first time event! 4 i notice that you are dressed and that your hair is combed

cns depressants (anxiolytics, alcohol, sedatives, hypnotics)

relaxation, loss of inhibitions, lack of concentration, drowsiness, slurred speech are symptoms of use for?

use, intoxication, withdrawal

substance abuse is a maladaptive pattern of any psychoactive substance that leads to a disorder of ___, ____________, and __________, despite negative consequences

- denial - dependent - demanding - destructive - domineering

Alcohol Dependent Behavior (the five D's)

3

a nurse is caring for a client who verbalizes a need to increase her self-esteem. to aid the client in achieving her goal, the nursing care plan should include which of the following actions? 1. institute measures to prevent tooth decay 2. maintain a daily diary of negative feelings 3. maintain a well-groomed appearance 4. verbalize feelings of being unloved

denial

barrier to deal with reality

1

when collecting data during the psychosocial assessment of a human immunodeficiency virus-infected client, the nurse should first determine which of the following? 1. the presence of any concerns or fears 2. what type of career the client would like to pursue 3. why the client waited so long to seek treatment 4. which family member will assume the client's care after discharge

1

an extremely angry client on a mental health inpatient unit has been placed in restraints because of aggressive behavior. the nurse plans to remove the restraints when the client exhibits which of the following behaviors? 1. initiates no aggressive acts for an hour after the release of two leg restraints 2. is under the effects of a sedative that has been administered 3. divulges all the reasons for the aggressive behavior 4. apologizes and tells the nurse that it will not happen again

2

a nurse is caring for a client with schizophrenia and notes that the client is experiencing poverty of speech. the nurse documents this finding based on which of the following assessment findings? 1. speech is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotypes or obscure phrases 2. speech is restricted in amount and ranges from brief to monosyllabic one-word answers 3. the client stops talking in the middle of a sentence 4. the client remains quiet

3

an initial goal in the nursing plan of care for a client with schizophrenia newly admitted to the mental health unit would be which of the following? 1. to improve self care 2. to decrease bizarre behavior 3. to develop a trusting relationship 4. to encourage verbalization of feelings

1

as a nurse approaches a client who was recently admitted to the inpatient unit of a psychiatric hospital, the client says,"quit following me. youre with the FBI, i can tell by the way you are walking." this is an example of which of the following alterations in thinking? 1. delusion 2. hallucination 3. circumstantiality 4. loose association

acute battering stage

brutal beatings of victim police called and back in emergency room (victim blames self)

addiction

chemical or substance abuse disorders (SUDs), eating disorders, or impulse control disorders are considered forms of?

Antisocial personality disorder, bipolar disorder and schizophrenia

comorbidities for substance abuse?

- tension building stage - acute battering stage - honeymoon stage

cycle of violence stages

2

a nurse is conducting a session regarding relaxation techniques to relieve stress with a client diagnosed with anxiety. which of the following would be an indicator that the client is applying relaxation techniques? 1. the client watches television with her eyes closed 2. the client enters a room where soft music is playing and breathes slowly 3. the client states, "dont interrupt me, im meditating." 4. the client talks in a soft tone at all times

4

a nurse is monitoring a depressed female adolescent who may be suicidal. which behavior observed by the nurse indicates that the client is at high risk for suicide? 1. the client refuses to communicate 2. the client attempts to manipulate another nurse 3. the client argues with her parents when they visit 4. the client gives her special book of poems to another client

2

a nurse is planning care for a client with an obsessive-compulsive disorder. the nurse assigns initial priority to which of the following nursing interventions? 1. educating the client about self-control techniques 2. establishing a trusting nurse-client relationship. 3. monitoring the client for abnormal behavior 4. encouraging participation in daily self-care and unit activities

codependence

doing for others what others could not do for themselves

3

a nurse is reviewing the assessment data of a client who has been admitted to the mental health unit. the nurse notes that the admission nurse has documented that the client is experiencing anxiety as a result of a situational crisis. which of the following circumstances can precipitate a situational crisis? 1. a hurricane that destroyed the clients home 2. an earthquake that destroyed a community 3. the loss of a job 4. witnessing a fatal automobile accident

2

a nurse is working with a client during crisis intervention. which statement by the client indicates a successful outcome of crisis intervention? 1. i still cannot return to work, but my concentration is better 2. i have learned that my old ways of coping did not work. i have learned new ways of dealing with things. 3. i am sleeping better now 4. i am going to have to work on repairing my relationship with my family

4

during the first day after admission to a mental health unit, a client experiences more than one "flashback of a distressing event." the nurse notes that these flashbacks are most likely consistent with which of the following diagnoses? 1. paranoia 2. schizophrenia 3. OCD 4. PTSD

3

a nurse suspects that a female client is a victim of physical abuse. which statement encourages the client to confide in the nurse? 1. youve got a huge bruise on your face. did your husband hit you? 2. if your husband has hit you, you can take him to court or get a restraining order for that 3. i sometimes see women who have been hurt by their boyfriends or husbands. did anyone hit you? 4. that look svery sore. i dont know how people can do that to one another.

3

a nurse uses the proverb,"while the cat's away, the mice will play!" to evaluate for abstract thinking ability in a schizophrenic client. which of the following client responses demonstrates appropriate abstract thinking? 1. cats and mice dont play. they fight. 2. i dont have a cat 3. when the boss is gone, everyone relaxes in the office 4. when the cat is gone, then the mice can get the cheese

3

a woman is admitted to the inpatient mental health unit. when asked her name, she responds, "i am the first lady, the president of the united states wife." the nurse concludes that this client is experiencing which of the following? 1. a visual illusion 2. an auditory hallucination 3. a grandiose delusion 4. a loose association

violence

abusive or unjust exercise of power over another; may be overt

Hallucinations Seizures Insomnia Sweats Tremens Stomach pain Shakes

alcohol withdrawal signs (HSISTSS)

methamphetamines

epidemic in the US, mostly in a rural farm area - main components: decongestants, anhydrous fertilizer (kills brain cells)

opioids (opium, morphine, codeine, heroin, meperidine, methadone)

euphoria, lehargy, drowsiness, and lack of motivation are symptoms of use for?

cns stimulants (amphetamines, cocaine, meth, nicotine)

hyperactivity, agitation, euphoria, insomnia, anorexia, and tachycardia are symptoms of use for?

valium, seizure, tremors, shakes

in alcohol withdrawal, ______ is given to prevent ________, _______, and ______

honeymoon stage

kindness and loving behavior perpetrator " I won't do it again" "im sorry" gives gifts

2

a client who is experiencing suicidal thoughts greets the nurse with the following statements,"it just doesnt seem worth it anymore. why not just end it all?" the nurse should further assess the client by making which of the following responses? 1 did you sleep at all last night? 2 tell what you mean by that 3 i know you have had a stressful night 4 im sure that youre family is worried about you

4

a client who is hospitalized on an inpatient psychiatric unit with a diagnosis of schizophrenia tells the nurse that voices in his head are telling him that he is worthless and doesn't deserve to be alive. the nurse identifies which problem as the priority for this client? 1. demonstrating the inability to cope 2. exhibiting behavior that indicates a problem with sensory perception 3. verbally expressing feelings of low self esteem 4. exhibiting behavior that indicates violence toward self

4

a client with a diagnosis of depression says to the nurse,"i always make mistakes, i never do anything right!" the best nursing action is to provide whic of the following responses? 1. tell the client that everyone makes mistakes 2. tell the client that this is not true and that things will get better 3. reassure the client that you know how the client is feeling 4. identify recent client accomplishments that demonstrates skills and ability

substance abuse

maladaptive pattern of any psychoactive substance use that leads to a disorder of use, intoxication & withdrawal if taken away -despite negative consequences

tension building stage

minor accidents someone may have threw something (may need stitches and just goes back home - forgiving)

3

a client with a psychotic disorder has been receiving haldol. after 6 weeks of therapy with this medication, the client is evaluated for a therapeutic response from that medication. the nurse documents a therapeutic response when the nurse notes which of the following in the client? 1. a tense facial expression 2. an inability to concentrate 3. an interest in what is happening in the environment 4. an increase in muscle strength

1. Lost productivity at work 2. Crime 3. Health problems 4. Loss of employment 5. Failure in school 6. Family dysfunction 7. Domestic violence 8. Child abuse 9. Legal problems/fees

negative consequences of substance abuse? (9) (PCHESFDCL)

2

a female client with a history of personality disorder has an appointment for counseling at the mental health clinic. on entering through the clinic door, the client begins to fuss loudly about what the wind has done to her hair, and asks the receptionist if she likes her new lipstick. the nurse interprets that the client likely has which of the following types of personality disorders? 1. borderline 2. histrionic 3. narcissistic 4. avoidant

substance dependence

a maladaptive pattern of tolerance, leading to clinically significant impairment or distress leading to development of tolerance and/or withdrawal syndrome

tolerance, withdrawal syndrome

substance dependence is a maladaptive pattern of tolerance, leading to clinically significant impairment or distress leading to development of _________ and/or __________ ________

4

a manic client is placed in a seclusion room after an outburst of violent behavior that included a physical assault on another client. as the client is secluded, the nurse takes which of the following actions? 1. remains silent because verbal interaction woulkd be too stimulating 2. tells the client that he will be allowed to rejoin the others when he can behave 3. asks the client if he understands why the use of therapeutic seclusion is necessary 4. informs the client that he is being secluded for the purpose of helping him regain control of himself.

1

a nurse employed in a long-term care facility is observing for signs of depression in an older client. the nurse monitors for which of the following? 1. change in appetite and social withdrawal 2. change in appetite and gait disturbances 3. change in behavior and impaired judgment 4. delusions and disorganized thought processes

1

a nurse is assessing a client who is diagnosed with agoraphobia. which of the following information would the nurse expect to obtain during the assessment? 1. palpitations, fear of losing control or dying when driving in a car and traveling over bridges 2. complaints of palpitations, sweating, trembling or shaking, nausea, dizziness, and chills or hot flashes 3. a rapid pulse, fear of apprehension, derealization, and psychomotor hyperactivity 4. persistent, osessive worries about real-life problems accompanied by the client's attempts to neutralize them

4

a nurse is caring for a client in whom anorexia nervosa has been diagnosed. the nurse assesses the client, knowing that which of the following is a characteristic of this disorder? 1. the client is not concerned about control and autonomy 2. the client has a realistic view of the body 3. the disorder is characterized by eating binges followed by maladaptive or inappropriate reparative behavior. 4. the client is determined to lose weight mainly by restricting food intake, even when emaciated

1. to ease and cope with pain (mental/physical) 2. pleasure/alleviate boredom 3. to expand their consciousness (such as expression of personal freedom)

the 3 reasons people abuse substances...(CBC)

bullying

the abuse of power by one person over another through repeated aggressive behaviors

2

a nurse is caring for a client with schizophrenia and documents in the clients record that the client has a flat affect.. which of the following appropriately describes this behavior observed by the nurse? 1. a minimal emotional response 2. an immobile facial expression or blank look 3. an emotional response that is incongruent with the tone of the situation 4. grimacing, giggling, or mumbling to oneself

1

a nurse is caring for a client with schizophrenia and documents that the client has an inappropriate affect. which of the following best describes this type of behavioral response? 1. the clients emotional response to a situation is not congruent with the tone of the situation 2. the client has an immobile facial expression or blank look 3. the client displays minimal emotional responses 4. the client is mumbling to himself

hereditary, physical effects, and environmental

Most theorists agree that the choice to use alcohol and other drugs, the level of involvement, and the risk of developing other problems are due to a combination __________, ________ _______, and _____________ of factors that play a role in the etiology

anabolic steroids

No intoxication effects, hostility & aggression, abnormal hormonal changes

inhalants (gas, varnish remover, lighter fluid, glue, spray paint, etc)

Relaxation, loss of inhibitions, lack of concentration, slurred speech, and euphoria are symptoms of use for?

cannabinols (marijuana, hashish)

Relaxation, talkativeness, lowered inhibitions, euphoria, and mood swings are symptoms of use for?

younger, likelihood

The _______ the age of first use of drugs or alcohol, the greater the __________ of misuse as an adult.

hallucinogens (LSD, mescaline, psilocybin) and dissociative drugs (ketamine, PCP and analogs)

Visual hallucinations, disorientation, confusion, paranoia, euphoria, anxiety, panic, tachycardia Dissociative symptoms, anxiety, psychosis, and aggression are symptoms of use for?

alcohol withdrawal

When alcohol is no longer in the brain, the brain begins craving it, neurons become overactive, resulting in?

2

a client admitted to a psychiatric unit for a psychotic episode is observed running around, banging on doors and yelling,"let me out. there's nothing wrong with me. i dont belong here." the nurse interprets these behaviors as which of the following? 1. projection 2. denial 3. regression 4. rationalization

4

a client has been admitted to the mental health unit with a diagnosis of social phobia disorder. which behavior does the nurse expect the client to exhibit? 1. fear of leaving the house 2. shortness of breath and palpitations when riding in an elevator 3. persistent hand washing before eating foods 4. fear of embarrassing himself in front of others

3

a client hospitalized in the mental health unit is angry and punches the wall. which defense mechanism is the client using? 1. denial 2. regression 3. displacement 4. reaction formation

2

a client is admitted to the ED with drug-induced anxiety related to overingestion of prescribed antipsychotic medication. the most important piece of info the nurse should obtain is the 1. name of the nearest relative and his or he phone number 2. name of the ingested medication and the amount ingested 3. cause of the attempt and if the client plans another attempt 4. length of time on the medication and any noted side effects

1

a client is brought to the ED by the police after having lacerated both wrists in a suicide attempt. the nurse should take which initial action? 1. examine and treat the wound sites 2. obtain and record a detailed history 3. encourage and assist the client to ventilate feelings 4. administer and antianxiety agent

2

a client is hospitalized with a diagnosis of severe depression. the client is withdrawn and exhibits poor motivation and concentration. the nurse plans to involve the client in which of the following activities at this time? 1. small group discussions 2. simple two-person card games 3. cooking class 4. dance therapy

2

a client is not able to leave home without checking several times to be sure that the iron is turned off. the client then rechecks the coffeepot several times to be sure that it is turned off. the client arrives late to many appointments and other functions because of this repetitive ritual and misses other engagements completely. the nurse interprets that the symptoms exhibited by this client are consistent with which of the following disorders? 1. posttraumatic stress disorder 2. OCD 3. generalized anxiety disorder 4. phobia

2

a client says to the nurse,"i hate these discolored areas on my skin." the nurse determines which of the following problems exists for this client? 1. the presence of chronic low self esteem 2. the presence of body image disturbance 3. the inability to cope 4. the presence of skin breakdown

2

a client was admitted to a medical unit with acute blindness. many tests were performed, resulting in no organic reason why this client cannot see. the nurse learns that the client became blind after witnessing a hit-and-run car accident in which a family of three was killed. the nurse suspects that the client may be experiencing a 1. psychosis 2. conversion disorder 3. dissociative disorder 4. repression