Psych Exam 1 Q4
A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept?
Schema Schemas are unique assumptions about ourselves, according to Beck's theory. This statement is an example of a negative schema. Emotional consequence is the end result of negative thinking process, as described by Ellis. Actualization is a level of Maslow's Hierarchy of Needs. Aversion is a therapy characterized by punishment.
What information should be obtained during that assessment interview?
The Suicide Assessment Five-step Evaluation and Triage (SAFE-T) is an assessment tool that allows the clinician to benchmark relative risk (high, moderate, low) and to develop a treatment plan, in consultation with the patient, to reduce current risk. The tool does not provide for specific interventions Focus of SEFE-T tool: Identify level of suicidal risk. Development of client focused treatment. Stress collaboration with the client
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports what conclusion about this client?
The client is not conforming with social norms. Behavior that deviates from socially accepted norms does not indicate a mental illness unless there is significant disturbance in mental functioning.
Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful?
"I can be successful if I do all the things required to learn the job." Cognitive reframing changes the individual's perceptions of stress by reassessing a situation and replacing irrational beliefs with more positive self-statements. The other options are all negative cognitive distortions that would prevent the individual from success.
Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met?
"I'm experiencing much less anxiety about school now." Both Sullivan and Freud coined terms to mean actions that individuals do that are an attempt to reduce anxiety. The terms to do not refer to activities that increase self-esteem. Security operations and defense mechanisms are not conscious and therefore do not increase self-awareness. These terms do not refer to reducing cognitive distortions.
What is resilience?
- the ability and capacity for people to secure the resources they need to support their well-being. - What makes some people adapt to tragedy, loss, trauma, and severe stress better than others. - Being resilient does not mean being unaffected by stressors. - People who are resilient are effective at regulating their emotions and not focusing on negative, self-defeating thoughts.
The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience?
Encouraging them to talk about their school plans to help achieve identity According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood. While appropriate activities none of the options are specifically identified with the developmental task for a 14-year-old.
A nursing diagnosis for a client with a psychiatric disorder serves what purpose with considering the plan of care?
Establishing a framework for selecting appropriate interventions. Nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the phenomena a client with a mental health disorder is experiencing. While the nursing diagnosis may contribute to the other options, none describe the purpose of the nursing diagnosis.
The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority?
Making the client feel physically and emotionally safe Maslow describes safety as a basic need, meaning that it is so basic to existence that it must be resolved to reduce the tension associated with it. These needs have the greatest strength and must be satisfied before a person turns his attention to higher level needs.
What supplements can help with sleep?
Melatonin, chamomile tea, valerian root
Role-playing is associated with which type of psychotherapy?
Modeling In modeling, the therapist provides a role model for specific identified behaviors, and the client learns through imitation. The therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose. Some behavior therapists use role-playing in the consulting room for modeling therapy. Demonstration of specific behaviors are not supported by any of the remaining options.
What are examples of things that can be done by individuals to enhance their overall wellbeing?
Nurse: help remind people what are their strengths Diet Exercise Probiotics (gut microbiome) Pet therapy
What are some risk concerns regarding suicide?
Nurses should assess the lethality of the client's plan for suicide. Whether the plan has specific details Whether the method is one that could cause death Whether the client has the means to implement the plan rationale: Lethality refers to how deadly a plan is. The length of time a client has been suicidal or a history suicidal thoughts have nothing to do with the lethality of the plan. "I think things will be better soon." needs further assessment rationale: This response may be a covert, or indirect, clue that the patient is thinking of suicide
The mental status examination aids in the collection of what type of data?
Objective The mental status exam mostly aids in the collection of objective data.
How can advertising about over the counter supplements be misleading and how should nurses handle these types of discussions professionally?
Patients should discuss with MD before starting any supplements while taking psych meds because they can interfere with the effect of the medication ***
Jacob, a college student whose friend recently committed suicide, rates his stress as low. Melissa was also friend with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by which coping mechanism?
Perception Perception, which is influenced by gender, culture, age, and life experience, plays a part in how someone will respond to a stress. The perception of a stressor determines the person's emotional and psychological reactions to it. The other options are all defense mechanisms that do not explain the difference in reactions to a stressor.
The mental health status of a particular client can best be assessed by considering which factor?
Position placement on a continuum from health to illness Many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Therefore, these disorders can be regarded as "diseases." Visualizing these disorders along the mental health continuum is helpful.
What three structural components comprise a nursing diagnosis?
Problem, probable cause, supporting data Nursing diagnostic statements are made up of the following structural components: problem/potential problem, probable cause, and supporting data.
A client tells the mental health nurse "I am terribly frightened! I hear whispering in my head that someone is going to kill me." Which criteria of mental health can the nurse assess as lacking?
Rational thinking The ability to think rationally is lacking for this client. The client does not have an accurate picture of what is happening that is based on reliable cognitive thinking. The statement fails to meet the criteria for any of the other options.
The client's priority nursing diagnosis has been established as risk for self-directed violence: suicide related to multiple losses. What is the priority outcome for this client?
Refrain from attempting suicide. Refraining from suicidal attempts is the only outcome that addresses the risk for self-directed violence. The absence of a feeling of powerlessness is not appropriate for the stated nursing diagnosis. The remaining options are interventions.
When clients become angry on the unit, what actions can nurses take to avoid milieu disruptions?
Request that the client accompany the nurse to the client's room rationale: Least restrictive alternative doctrine requires using the least drastic means of achieving a specific goal. By first attempting to remove the client to a safer location, the nurse is respecting the client's right to treatment that is less restrictive than the other options.
Which nursing intervention demonstrates the theory behind operant conditioning?
Rewarding the client with a token for avoiding an argument with another client Operant conditioning is the basis for behavior modification and uses positive reinforcement to increase desired behaviors. For example, when desired goals are achieved or behaviors are performed, clients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges. This reward system is known as a token economy. None of the remaining options demonstrate reward for positive behaviors, climate, and structure, for healing.
A 17-year-old client confides to the nurse that they have been thinking of ways to kill a peer. What response should the nurse give when the client states, "you have to keep it a secret because its confidential information"?
"Issues of this kind have to be shared with the treatment team and your parents." Although adolescent clients request confidentiality, issues of sexual abuse, threats of suicide or homicide, or issues that put the client at risk for harm must be shared with the treatment team and the parents. A threat of this nature must be discussed with the treatment team and the parents. Confidentiality laws do not protect information that would lead to harm to the client or others.
A patient admitted with anxiety asks, "What exactly are stressors?" What is the nurse's best response to the patient's question?
"Stressors are events that happen that threaten your current functioning and require you to adapt." Stressors are psychological or physical stimuli that are incompatible with current functioning and require adaptation. Stressors are not complicated neuro stimuli; telling the patient to address these questions to her provider fails to educate the patient, which is the nurse's responsibility. Exploring coping skills would be a good intervention at a later time but does not address the patient's question and changes the subject.
A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "What does that title mean?" Keeping in mind the diagnosis of the client, how should the nurse respond to this question?
"We have the specialized skills needed to care for those with mental illnesses." A psychiatric mental health nurse has specialized nursing skills and implements the nursing process to manage and deliver nursing care to the mentally ill. The remaining options either do not effectively answer the client's question or assume that the question is the result of the client's paranoia.
Which response should the nurse provide a client who asks, "Why you need to conduct an assessment interview"?
"We will be able to form a relationship together where we can discuss the current problems and come up with goals and a plan for treatment." Some of the purposes of the assessment interview are to establish rapport, learn more about the presenting issues, and form mutual goals and a plan for treatment. The other options do not appropriately explain the assessment purpose.
A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement?
"What I did was stupid." Cognitive therapists help clients identify, reality test, and correct distorted conceptualizations and dysfunctional beliefs, such as realizing that doing a stupid thing does not mean the person is stupid.
The nurse best assesses the client's spiritual life by asking which question?
"What role does religion play in your life?" Asking the client to define the role of religion in their life allows for discussion related to the other topics.
A 26-year-old client is brought to the emergency room by a friend. The client is unable to give any coherent history. Which response should the nurse provide when the client's friend offers to provide information regarding the client?
"Yes, I will be happy to get any information and history that you can provide." The friend is a secondary source of information that will be helpful since the client is not able to give any history or information at this time. Confidentiality laws do not prohibit obtaining information from a secondary source. The friend can provide information and/or history immediately and may be able to relate events that happened just before coming to the hospital. A release would not be necessary to take information about the client from a secondary source, and a psychotic client would not be competent to sign a release.
What is the biological model?
(aka medical model) of a mental illness, assumes that abnormal behavior is the result of a physical problem. Focuses on: neurological, chemical, biological, genetic issues seeks to understand how the body & brain interact to create emotions, memories, and perceptional experiences consider other influences that play a role in the development and treatment of mental disorders like social, environmental, cultural, economic Focuses on: qualities of a therapeutic relationship understanding pt's perspective
Which severe mental illness has a prevalence of over 6% among the populace of the United States? (Select all that apply.)
- Major depressive disorder - Bipolar disorder Data suggests that prevalence among the US populace is: Alzheimer's disease 10% (65 years and older), any personality disorder 9.1%, Social phobia 6.8%, Major depressive disorder 6.7% . The prevalence of Bipolar disorder is 2.6% while Generalized anxiety disorder is 3.1
Define advocacy.
- nurse reports incidents of abuse or neglect to the appropriate authorities for immediate action. - upholds patient confidentiality, which has become more of a challenge with the use of electronic medical records. - supporting the patient's right to make decisions regarding treatment.
The Client - Nurse Relationship
1) Pre Interaction Phase: Gather data. Analyze own feelings of prejudice. Collect information and Plan. 2) Introductory . Information Phase. Establish rapport, gain trust. Initiate conversation. Identify issues and discuss possible solutions. 3) Working Phase: Gather more data. Help with coping mechanisms. Evaluate problems and redefine them. 4) Termination Phase. Explain reality of separation. Explore feelings and emotions, as well as behaviors. Evaluate effectiveness of goals Discuss future plans for meetings if needed.
Can we accept third party information from others rather than the client? If so... what is this called?
A 26-year-old client is brought to the emergency room by a friend. The client is unable to give any coherent history. Which response should the nurse provide when the client's friend offers to provide information regarding the client? "Yes, I will be happy to get any information and history that you can provide." rationale: The friend is a secondary source of information that will be helpful since the client is not able to give any history or information at this time. Confidentiality laws do not prohibit obtaining information from a secondary source. The friend can provide information and/or history immediately and may be able to relate events that happened just before coming to the hospital. A release would not be necessary to take information about the client from a secondary source, and a psychotic client would not be competent to sign a release.
What client assessment data demonstrates parity related to mental health care?
A client's mental health coverage is equal to his/her medical/surgical coverage. Parity refers to equivalence that requires insurers who provide mental health coverage to offer annual and lifetime benefits at the same level provided for medical/surgical coverage. None of the other options are associated with mental health insurance coverage.
How does Harry Stack Sullivan's Interpersonal Theory view anxiety?
A painful emotion arising from social insecurity. According to Sullivan, the purpose of all behavior is to get needs met through interpersonal interactions and decrease or avoid anxiety. He viewed anxiety as a key concept and defined it as any painful feeling or emotion arising from social insecurity or blocks to getting biological needs satisfied.
What are the advantages of group therapy?
A type of support session that involves a counselor (or psychiatrist, psychologist, or other behavioral health professional) working with more than one child at a time.
What is Assertive Community Treatment (ACT)?
ACT teams work intensively with patients in their homes or in agencies, hospitals, and clinics—whatever settings patients find themselves in. Creative problem solving and interventions are hallmarks of care provided by mobile teams. The ACT concept takes into account that people need support and resources after 5 p.m. Therefore, teams are on call 24 hours a day. The primary goal and benefit of assertive community treatment (ACT) is demonstrated by which situation? A client diagnosed with schizophrenia has avoided being rehospitalization for 16 months. rationale: A primary goal of ACT is working intensely with the client in the community to prevent rehospitalization.
The nurse is conducting an admission interview with a client who was raped 2 weeks ago. When asked about the rape, the client becomes very anxious and upset and begins to sob. What should be the nurse's response to the client's reaction?
Acknowledge that the topic of the rape is upsetting and reassure the client that it can be discussed at another time when she feels more comfortable. The best atmosphere for conducting an assessment is one with minimal anxiety on the client's part. If a topic causes distress, it is best to abandon the topic at that time. It is important not to pry or push for information that is difficult for the client to discuss. The use of silence continues to expect the client to discuss the topic now. Reassurance of confidentiality continues to expect the client to discuss the topic now.
What is AMA, and how can you think it is appropriately used on a psych unit?
Against Medical Advice Which hospitalized patient should the nurse identify as being a candidate for the appropriate use of a release from hospitalization known as against medical advice (AMA)? A 37-year-old patient scheduled for discharge in 24 hours wishes to be discharged immediately rationale: AMA discharges are sometimes used when the patient does not agree with the provider, as long as the patient is not a danger to himself or herself or to others.The patient with dementia and the patient who is actively suicidal would pose a safety risk and would be not allowed to be discharged AMA. A p
According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory?
All memories Freud described the conscious part of the mind as containing all of the material that the person is aware of at any one time and so as dysfunction of the conscious mind involves all memories.
How can nurses get involved in advocating for changes to mental illness policies?
As a patient advocate, the nurse reports incidents of abuse or neglect to the appropriate authorities for immediate action. The nurse also upholds patient confidentiality, which has become more of a challenge with the use of electronic medical records. Another form of nursing advocacy is supporting the patient's right to make decisions regarding treatment.
Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority?
Assessing the client for strengths upon which a nurse-client relationship can be based The value of Maslow's model in nursing practice is twofold. First, the emphasis on human potential and the client's strengths is key to successful nurse-client relationships. The second value lies in establishing what is most important in sequencing of nursing actions in the nurse-client relationship.
A nurse is about to interview an older client whose glasses and hearing aid were placed in the bedside drawer for safe keeping. Before beginning the interview, which nursing intervention that will best facilitate data collection?
Assist the client in putting on glasses and hearing aid. A client whose hearing or sight is impaired may have difficulty providing information if these items have been removed from his or her possession. Assisting the client in wearing these assistive devices is the best initial intervention. None of the other options will be as effective in facilitating the interview.
Which client problem would be most suited to the use of interpersonal therapy?
Dysfunctional grieving Interpersonal therapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit.
What is eustress? Provide examples?
Bad Stress Versus Good Stress? individuals become energized by both negative and positive events. These reactions are distress and eustress: • Distress is a negative, draining energy that results in anxiety, depression, confusion, helplessness, hopelessness, and fatigue. Stressors such as a death in the family, financial overload, or school/work demands may cause distress. • Eustress ("eu" is Greek for well or good) refers to the normal physiological workings of an organism. It is a positive energy that motivates individuals and results in feelings of happiness, hopefulness, and purposeful movement. Examples of eustress are a much-needed vacation, playing a favorite sport, the birth of a baby, or the challenge of a new job.
According to Maslow, how can nurses meet the "Hierarchy of Needs" for bipolar clients and in what order?
Based on Maslow's theory, physiological needs such as food, water, air, sleep, etc., are the priority and must be taken care of first. The other options are symptoms of mania but not as critical as lack of sleep. Human beings are active participants in life, striving for self-actualization. When lower needs are met, higher needs are able to emerge
What is the premise underlying behavioral therapy?
Behavior is learned and can be modified. The premise underlying behavior therapy is that behavior is learned and can be modified. Behaviorists agree that behavior can be changed without insight into the underlying cause. None of the remaining options are true statements when considering behavioral therapy.
How is western medicine different from Eastern medicine?
Best to have a mix of west and eastern medicine for better outcomes *** work together In the Chinese tradition, disease is believed to be caused by what factor? Fluctuations in opposing forces Many Eastern cultures explain illness as a function of imbalance such as Yin-Yang. According to the Western scientific view of health, what causes illness? Pathogens
According to current information what factor is associated with the most disabling mental disorders?
Biological influences Biological and genetic factors influence mental health. The biologically influenced illnesses include schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism. Therefore many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences. Psychological trauma, learned behaviors, and faulty patterns of nurturance may contribute to some forms of mental illness, but they are not major factors in most disabling mental disorders
Which assessment monitors the effect of stress attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex?
Blood glucose levels An increase in gluconeogenesis, stimulated by the release of cortisol, ensures that increased amounts of glucose are available to the individual. Increased glucose levels heighten and maintain energy levels to meet the demands of a crisis or stressor. None of the other options are as directly associated with the hypothalamus-pituitary-adrenal cortex.
What is the difference between a social and therapeutic relationship?
Boundary blurring is often signaled by the nurse being either too helpful or not helpful enough. Which statements are true regarding the differences between a social relationship and a therapeutic relationship? In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. Giving advice is done in social relationships; in therapeutic relationships giving advice is not usually therapeutic. In a social relationship, both parties come up with solutions to problems and solutions may be implemented by both (a friend may lend the other money, etc.); in a therapeutic relationship, solutions are discussed but are only implemented by the patient. rationale: In a social relationship, communication is usually deep and evaluated; in a therapeutic relationship, communication remains on a more superficial level, allowing patients to feel comfortable.
What things structurally need to be in place to minimize self-harm on the inpatient unit?
Break-away closet bars to prevent hanging rationale: Hangings are the most common method of inpatient suicide.
What is St. John's Wart?
Cannot give with SSRI (Serotonin syndrome!) Combining St. John's wort and certain antidepressants can lead to a potentially life-threatening increase in your body's levels of serotonin
Which branch of epidemiology is the nurse involved in when seeking outcomes for clients whose depression was treated with electroconvulsive therapy (ECT)?
Clinical Clinical epidemiology represents a broad field that addresses what happens to people with illnesses who are seen by providers of clinical care. Studies use traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms or by diagnostic procedures or treatments given for the illness or symptoms. None of the other options accurately identify the field that is associated with clinical practice.
What is CAM?
Complementary and Alternative Medicine (CAM) is the conventional term for medical practices and products that are outside of standard medical care. Standard medical care refers to generally accepted treatments provided by healthcare professionals. CAM includes complementary medicine, alternative medicine, and integrative medicine. The distinctions between the three approaches can be seen in the following statements: Complementary medicine uses non-mainstream medicine in conjunction with standard medical care. Alternative medicine uses non-mainstream medicine instead of standard medical care. Integrative medicine uses non-mainstream medicine in conjunction with standard medical care in a coordinated way.
What is the termination of the nurse-patient relationship and how do we handle this with the clients on a psych unit?
Consider the nurse-patient relationship on an inpatient psychiatric unit. Which statement made by the nurse reflects an accurate understanding of when the issue of termination should first be discussed? "Now that we've discussed your reasons for being here and how often we will meet; I'd like to talk about what we will do at the time of your discharge." rationale: The issue of termination is brought up first in the orientation phase. All the other options describe other phases of the nurse-patient relationship—the termination phase, the preorientation phase, and the working phase.
What is a justifiable reason to administer emergency medications inpatient?
Danger To Self or Danger To Others
Freud believed that individuals cope with anxiety by implementing which mechanism?
Defense mechanisms The ego develops defenses or defense mechanisms to ward off anxiety by preventing conscious awareness of threatening feelings. None of the other options were proposed by Freud as a mechanism for dealing with anxiety.
When it comes to HIPAA, what are some examples of possible ways patient information could be inappropriately disclosed.
Discussing a patient's information in public places where it may be overheard is a violation of a patient's confidentiality, i.e. while transporting a client in the staff elevator.
The nurse planning care for a mentally ill client bases interventions on which concept?
Every client has a certain degree of resilience. Nurses are expected to evaluate clients with mental health issues for their strengths and their areas of high functioning. You will find many attributes of mental health in some of your clients with mental health issues. These strengths should be built upon and encouraged. Resilience is the ability and capacity for people to secure the resources they need to support their well-being. None of the remaining options describe concepts that are the foundation for the actual creation of individualized care plans.
What can nurses teach about herbal supplements?
Find out about side effects and if there is any adverse effect with current medication (i.e st. johns wort)
What is "group work" in the inpatient setting mean?
Group work is a method whereby individuals with a common purpose come together and benefit by mutually giving and receiving feedback within the dynamic and unique group context. None of the other options accurately and adequately describe group work. The objective of a therapy group is to assist the members to change behavior so they are able to participate in life in a more satisfying manner
How can a nurse best differentiate whether an Asian client is demonstrating a mental illness after having attempted suicide?
Identify the client's culture's view regarding suicide. One approach to differentiating mental health from mental illness is to consider what a particular culture regards as acceptable or unacceptable. In this view, the mentally ill are those who violate social norms and thus threaten (or make anxious) those observing them. For example, traditional Japanese may consider suicide to be an act of honor, and Middle Eastern "suicide bombers" are considered holy warriors or martyrs. Contrast these viewpoints with Western culture, where people who attempt or complete suicides are nearly always considered mentally ill. While the remaining options are appropriate interventions, they fail to address the possible cultural component of the client's behavior.
The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention?
Ignoring the tantrum and giving attention when the child acts appropriately Ignoring the tantrum provides no reinforcement of the undesirable behavior. Instead, approval and reinforcement are given when the child is behaving in the desired way. This is an example of absence of reinforcement, or extinction.
Which nursing diagnosis for a psychiatric client is correctly structured and worded?
Imbalanced nutrition: less than body requirements related to poor self-concept as evidenced by reporting "I'm not worthy of eating" This diagnosis contains all the required components: problem statement, related factors, and defining characteristics.
A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement?
In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account. In believing only in the biological model to the exclusion of other theories and perspectives, influences such as educational, social, spiritual, cultural, environmental, and economic are not considered, and these have also been proven to play a part in mental health and mental illness. The other options are untrue.
What principle forms the basis of nursing outcome planning?
Individuals have the right to outcomes that is reflective of their abilities. Outcome criteria are the hoped-for outcomes that reflect the maximal level of patient health that the patient can realistically achieve through nursing interventions. None of the other options accurately describes the guiding principle of outcome planning.
Define Integrative Therapies and their uses.
Integrated Treatment :A model of treatment developed to support individuals with co-occurring substance use and mental/emotional disorders . An integrated treatment model addresses alcohol/substance and emotional/behavioral disorders simultaneously, thereby increasing the chances of recovery for both. Integrative therapies: Light Acupuncture Guided imagery Meditation, mindfulness, 10min/d
Which tool can the novice nurse might refer to when writing nursing outcomes?
International Classification for Nursing Practice (ICNP) International Classification for Nursing Practice ([ICNP], 2017) provides a classification of nursing diagnoses. In addition to these diagnoses, the INCP also provides nursing interventions, and nursing outcomes. That is not the function of any of the other options.
How can we express empathy properly and appropriately to clients when they are grieving?
Interpersonal therapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit. A patient who recently loss a parent begins crying during a one-to-one session with the nurse. Which response by the nurse illustrates empathy? "That must have been such a hard situation for you to deal with." rationale: This response reflects understanding of the patient's feelings, which is empathy. Feeling sorry for the client represents sympathy, whereas not addressing the patient's concern belittles the patient's feelings of grief she is expressing by changing the subject. Telling the patient, she will get over it does not reflect empathy and is closed-ended.
Which statement best describes the Diagnostic and Statistical Manual, fifth edition (DSM-5) DSM-5?
It is a medical psychiatric assessment system. The DSM-5 is a classification of mental disorders that includes descriptions and criteria of diagnoses. None of the other options are accurate descriptions.
The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of the "id" and the ability to function as an adult?
It is the source of one's survival instincts. Freud delineated three major and distinct but interactive systems of the human personality. At birth we are all id. The id is the source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond as well as all the wishes that motivate us. The id provides an individual with the instincts to survive the emotional trauma associated with physical abuse. None of the other statements accurately describes the id's role in adult functioning.
A nurse is providing care to a 28-year-old client diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which client symptom as having priority?
Lack of sleep Based on Maslow's theory, physiological needs such as food, water, air, sleep, etc., are the priority and must be taken care of first. The other options are symptoms of mania but not as critical as lack of sleep
When it comes to rape, how should you approach the client that is crying uncontrollably to do their intake interview?
Show empathy. Ask them if they need a moment and continue later?*** Allow the client to break the silence.
Which theorist is associated with behavioral therapy?
Skinner B.F. Skinner (1904-1990) represented the second wave of behavioral theorists and is recognized as one of the prime movers behind the behavioral movement.
What are health concerns regarding Kava?
South American plant. Kava is used as a sedative with antianxiety effects. this herb has a dark side. In 2010, the FDA issued a warning regarding the risk of liver damage from kava, which is known to dramatically inhibit the P450 liver enzyme necessary for the metabolism of many medications. This inhibition can lead to liver failure, especially when kava is taken along with alcohol or other medications such as central nervous system depressants (antianxiety agents fall into this category). Can interfere with medications
A 43-year-old client being seen in the mental health clinic states, "I have always been a practicing Jew, but in the past few months I am questioning everything. I just don't know if I believe in it anymore." Which of the following nursing diagnoses best describes the client's comment?
Spiritual distress The client is expressing distress regarding his religion and spiritual well-being. The client could be experiencing ineffective coping, but this does not directly relate to his comment. There is nothing in the client's comment that would lead to the conclusion that the client is having thoughts of harming himself or experiencing hopelessness.
Chinese medical treatments and beliefs.
TCM: traditional Chinese medicine acupuncture: the insertion of thin, sterile, disposable metal needles into your skin to relieve symptoms of disease and restore balance to body functions mainly for treatment of pain arthritis, back pain, neck pain, muscle pain headaches, migraines mind and mood issues, like stress, anxiety, depression and obsessive-compulsive disorder moxibustion: the practice of heating dried, ground mugwort herb atop needles or along certain points on your skin to increase the flow of energy cupping: small glass cups create a suction effect against your skin, which breaks open tiny blood vessels beneath its surface. Your body replenishes blood to the cupped areas to prompt a healing response. "Where there's stagnation, there will be pain. Remove the stagnation, and you remove the pain." arthritis; back, neck, knee, shoulder pain headaches, migraines hypertension tai chi: sometimes described as "meditation in motion," tai chi is a martial arts-based form of exercise that consists of slow movements and deep breathing techniques. Studies show that tai chi can: Relieve fibromyalgia pain. Reduce depression. Sharpen memory and thinking skills.
A client, whose friend recently committed suicide, asks the nurse about some ways to help cope with the stress regarding the event. Which option should the nurse discuss with the client?
Talking with friends and attending a loss support group Social supports and support groups are two effective ways to cope with stress and stressful events. Isolation is never a healthy option; talking about feelings usually decreases stress, not increases. There is no evidence to suggest Melissa is anxious. Trying to "keep her mind off" the stressor does not develop coping mechanisms to deal with stress but rather encourages not dealing with the problem.
Define Transference. Can nursing and therapy staff do this just like the patients do?
Transference refers to unconscious feelings that the patient has toward a healthcare worker that were originally felt in childhood for a significant other. The patient may say something like, "You remind me exactly of my sister." The transference may be positive (affectionate) or negative (hostile). Psychoanalysis actually encourages transference as a way to understand original relationships. Such exploration helps the patient to better understand certain feelings and behaviors. Countertransference refers to unconscious feelings that the healthcare worker has toward the patient. For instance, if the patient reminds you of someone you do not like, you may unconsciously react as if the patient were that individual. Strong negative or positive feelings toward the patient could be a red flag for countertransference. Such responses underscore the importance of maintaining self-awareness and seeking supervisory guidance as therapeutic relationships progress.
What things can occur to trigger mental illness in an individual's life that may or may not be related to genetics?
Traumatic experiences
What is reportable when it comes to the safety of others?
When a patient is a DTS or DTO
What statements show that a client might be progressing towards recovery?
Working, living, and participating in the community rationale: Recovery is described as the ability of the individual to work, live, and participate in the community. Never having to visit a mental health provider is unrealistic. While important to recovery understanding of the disorder is not a demonstration of recovery. Remission is a period of time when signs and symptoms are being managed.
DBT - dialectical behavior therapy
a long-term therapy (1 to 1.5 years) that uses strategies from CBT and other skills to enhance emotional regulation. They include (Behavioral Tech, n.d.): Mindfulness: Being aware and present in the moment. Distress tolerance: Tolerating pain in challenging situation, rather than frantically trying to transform the pain. Interpersonal effectiveness: Asking for what you want and saying no in the context of self-respect and effective relationships with others. Emotional regulation: Choosing and changing emotions that are problematic.
What is Cognitive Behavioral Therapy (CBT) and its Concepts?
an active, directive, time-limited, structured approach. This evidence-based therapy is used to treat a variety of psychiatric disorders, such as depression, anxiety, phobias, and pain. It is based on the underlying theoretical principle that feelings and behaviors are largely determined by the way people think about the world and their place in it Trauma-focused cognitive behavioral therapy (TF- CBT) Newer treatment developed to address sexual abuse trauma in children; expanded for all ages Short-term, incorporating caregivers and family therapy Helps children and adolescents identify feelings and how to manage them
Define "Operant Condition" and nursing interventions.
basis for behavior modification and uses positive reinforcement to increase desired behaviors "a method of learning that occurs through rewards and punishment for voluntary behavior. Behavioral responses are elicited through reinforcement, which causes a behavior to occur more frequently." ex. "when desired goals are achieved or behaviors are performed, patients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges."
Who is Sullivan and how are the concepts in "Security Operations" similar or different from Freud's "Defense Mechanisms."
believed that human beings are driven by the need for interaction developed the Interpersonal Theory interpersonal theory: the purpose of all behavior is to get needs met through interpersonal interactions and to reduce or avoid anxiety anxiety: painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied security operations: measures the individual employs to reduce anxiety and enhance security
What is the primary source for data collection during a psychiatric nursing assessment?
client's own words and actions. The client should always be considered the primary data source. At times, however, the client will be unable to fulfill this role.
What term is used to identify the quantitative study of the distribution of mental disorders in human populations?
epidemiology Epidemiology is the quantitative study of the distribution of mental disorders in human populations. Mortality refers to deaths. Prevalence refers to the proportion of a population with a mental disorder at a given time. Clinical epidemiology deals with what happens to people with illnesses who are seen by providers of care
What statements show a client has developed resilience?
scale of how good emotions are regulated/coping with difficult situations Brief Resilient Coping Scale 1. I look for creative ways to alter difficult situations. 2. Regardless of what happens to me, I believe I can control my reaction to it. 3. I believe that I can grow in positive ways by dealing with difficult situations. 4. I actively look for ways to replace the losses I encounter in life.
What is the id?
the part of the mind in which innate instinctive impulses and primary processes are manifest.
What is Valerian root?
used for: Insomnia, anxiety, depression - considered safe for short time periods - mild side effects could include morning fatigue, headaches, dizziness, upset stomach
