Psych exam 1

A client hates her mother because of childhood neglect. Which of the following client statements does the client's nurse feel represents the use of the defense mechanism of reaction formation? A. "I don't like to talk about my relationship with my mother." B. "My mother hates me." C. "I have a very wonderful mother whom I love very much." D. "My mom always loved my sister more than she loved me."

"I have a very wonderful mother whom I love very much"

A patient says, "My husband doesn't love me! He brought me a dozen red roses for my birthday when he knows I only like pink ones. He never tries to make me happy." Which statement best reflects the nurse's understanding of the most effective means of communicating therapeutically with a patient demonstrating cognitive distortions? a. "How do you want your husband to show you that he loves you?" b. "When was the last time your husband showed you that he loves you?" c. "All wives deserve to be shown by their husband that they are loved. What did your husband have to say in his own defense?" d. "Let me see if I understand you. You think your husband doesn't love you because he brought you roses of the wrong color for your birthday?"

"Let me see if I understand you. You think your husband doesn't love you because he brought you roses of the wrong color for your birthday?"

As the move-out date to leave the shelter gets closer, a battered wife states, "I'm afraid to leave here. I'm afraid for my safety and the safety of my children." Which nursing statement is most supportive? A. "This is a difficult transition. Let's formulate a plan to keep you all safe in the community." B. "It's the policy that patients can only live here for 30 days. Maybe we can ask for more time." C. "You've had a month to come up with a plan for keeping you and your family safe." D. "Hopefully, your husband has been in counseling. I'm sure this will work out fine."

"This is a difficult transition. Let's formulate a plan to keep you all safe in the community."

What are Peplau's four levels of anxiety?

1.) Mild: seldom a problem 2.) Moderate: perceptual field diminishes 3.) Severe: perceptual field is very diminished 4.) Panic: the most intense state

When should blood samples be drawn for a patient taking Lithium?

12 hours after last dose

Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? A. The time of year in which the event occurred B. The presence of support systems C. A lack of adequate coping mechanisms D. The individual's family birth order

A lack of adequate coping mechanisms

What complementary therapy is based on the concept that healing energy flows through pathways (meridians) that connect to a series of points that need pressure applied to them?

Accupressure/puncture

What is the therapeutic range for lithium?

Acute mania: 1.0-1.5 mEq/L Maintenance: 0.6-1.2 mEq/L

Clozapine (Clozaril), an antipsychotic, can cause?

Agranulocytosis

Selye has three stages of general adaption syndrome, what are they?

Alarm reaction stage Stage of resistance Stage of exhaustion

Which of the following medications would be an appropriate prn medication for an individual with anxiety symptoms? A. Buspirone B. Alprazolam C. Fluoxetine D. Sertraline

Alprazolam (quick onset)

What are the three aspects of motivation to change?

Ambivalence, discrepancy and behavior change

Metabolic syndrome can be associated with what medication class?

Antipsychotics

During a group meeting, a client raises the concern that noise at the nurses' station keeps him awake at night. The nurse, present in the meeting, interrupts, stating, "I'll handle this matter. We need to move on." The nurse is demonstrating which type of leadership style? A. Democratic B. Autocratic C. Laissez-faire D. Surrogate

Autocratic

A client expresses a desire to begin attending the self-help group Alcoholics Anonymous. Which nursing response gives the client pertinent information about this type of group? A. "In this type of group, membership is always within a fixed timeframe." B. "Group members receive comfort and advice from others undergoing similar experiences." C. "The purpose of this type of group is to convey information to a number of individuals." D. "The function of this type of group is to accomplish a specific outcome."

B. "Group members receive comfort and advice from others undergoing similar experiences."

The unit manager needs to meet with a patient who is exhibiting escalating hostility. Which would be the most appropriate location for the nurse to meet with this patient? A. The patient's room with the door shut B. A quiet corner of the day room C. The nurse's station D. The unit's treatment room

B. A quiet corner of the day room

Which antianxiety medication does not depress the CNS

Buspirone

The nurse is performing an initial assessment on a newly admitted patient who is oriented times four. Which of the following communication techniques would best facilitate obtaining accurate and complete patient data? A. Closed-ended questions B. Requesting an explanation C. Open-ended questions D. Interpreting

C. Open-ended questions

A client, diagnosed with borderline personality disorder, approaches the nursing station often with various requests. The nurse intervenes by stating, "You may approach the nurse's station only once an hour." Which nursing intervention has been employed? A. Providing reality orientation B. Ensuring physical need fulfillment C. Setting limits on behavior D. Providing client education

C. Setting limits on behavior

Which charting entry is an example of the documentation of a subjective symptom? A. Temperature 101.4 degrees Fahrenheit B. No muscle rigidity or drooling noted C. Client is hypervigilant and scanning the environment. D. Client states, "I'm seeing green men in my room."

Client states, "I'm seeing green men in my room."

How does cognitive therapy work?

Cognitive therapy works to change "automatic thoughts" that lead to bad behaviors ex.) "what is the worst thing that could happen" NOT EVERYTHING IS ALL OR NOTHING

Practices uses IN CONJUNCTION WITH traditional practices

Complementary medicine

Which of the following best describes the role of the psychiatric social worker as a member of the interdisciplinary treatment team? A. Provides ongoing assessment of client's mental and physical condition B. Functions under the supervision of the psychiatric nurse C. Serves as the leader of the treatment team D. Conducts individual, group, and family therapy

Conducts individual, group, and family therapy

What type of crisis is related to a normal like-cycle transition that may be anticipated but the individual feels like they have a lack of control over it?

Crisis of anticipated life transitions

What type of crisis is related to pre-existing psychopathology?

Crisis reflecting psychopathology

What type of crisis is precipitated from an unexpected, external stressor over which the person has little control and they feel emotionally overwhelmed or defeated?

Crisis resulting from traumatic stress

What type of crisis is an acute response to an external situational stressor

Dispositional crisis

A child is taking guanfacine for ADHD. Which of the following would be part of the client education associated with administration of this medication? A. Do not take with foods that contain tyramine. B. Always use sunblock when spending time outdoors. C. Report for blood tests once a month. D. Do not discontinue the medication abruptly

Do not discontinue the medication abruptly

A patient threatens to kill himself, his wife, and their children if the wife follows through with divorce proceedings. During the pre-interaction phase of the nurse-patient relationship, which interaction should the nurse employ? A. Acknowledging the patient's actions and encouraging alternative behaviors B. Establishing rapport and developing treatment goals C. Providing community resources on aggression management D. Exploring personal thoughts and feelings that may adversely impact the provision of care

Exploring personal thoughts and feelings that may adversely impact the provision of care

Describe an autocratic leadership style

Focus on the leader to do all of the work. Production is high but morale is low

Define Utilitarianism

Greatest good for the greatest number

What are the four major dimensions of recovery?

Health Home Purpose Community

Horwitz describes two elements that affect how individuals view mental illness, what are the elements and describe them

Incomprehensibility: the general population being unable to understand motivation behind behavior. Cultural relativity: normal behavior is determined by culture

An operating room nurse asks a psychiatric nurse, "How can you work with the mentally ill day in and day out?" The psychiatric nurse replies, "It's just the right thing to do." The psychiatric nurse is operating from which ethical framework? A. Kantianism B. Christian ethics C. Ethical egoism D. Utilitarianism

Kantianism

What type of crisis occurs in response to a situation that triggers emotions related to unresolved conflict in someone's life?

Maturational/developmental crisis

According to the American Nurses Association standards of practice for psychiatric/mental health nurses, which specific intervention can be implemented by any psychiatric/mental health nurse generalist? A. Milieu therapy B. Psychotherapy C. Consultation D. Prescriptive authority

Milieu therapy

Norepinephrine, dopamine, serotonin, histamines are all an example of what kind of a neurotransmitter

Monoamines

A nurse gave a client 5 mg of haloperidol (Haldol) for agitation. The client's chart was clearly stamped "Allergic HALDOL." The client suffered anaphylactic shock and died. How would the nurse's actions be labeled? A. Intentional tort B. Negligence C. Battery D. Assault

Negligence

Opioid peptides, substance P and somatostatin are all an example of what kind of a neurotransmitter

Neuropeptides

Describe a laissez-faire leadership style

No focus in this group, goals are undefined and everyone does whatever they want. Productivity and morale are both low

Which phase of the therapeutic nurse-patient relationship includes creating rapport and trust, gathering assessment data, developing a plan of care, and identifying patient strengths and limitations?

Orientation (introductory)

Which phase of group development is when everyone establishes rules, the leaders promote trust and the members are usually superficial and overly polite?

Phase I. Initial or orientation phase

Which phase of group development is when the group starts to work towards completion of a task, the leader turns to a facilitator, and trust is established among the members?

Phase II. Middle or working phase

Which phase of group development is when characterized by a sense of loss, the leader may encourage conversation about the feeling of loss and ask the group to reminisce about the accomplishments of the group?

Phase III. Final or termination phase

WHat are the five basic needs included in reality therapy?

Power Belonging Freedom Fun Survival

Which is the primary nursing goal when establishing a therapeutic relationship with a patient? a. Promote patient growth b. To develop the nurse's personal identity c. To establish a purposeful social interaction d. To develop communication skills

Promote patient growth

What type of crisis is when general functioning is severely impaired and the person is rendered incompetent?

Psychiatric emergency

What is milieu therapy?

Psycho therapy in which a patient's social environment is controlled and manipulated to prevent self destructive behaviors

All clients who recieve care from a nurse have the right to what three things?

Right to treatment Right to refuse treatment Right to least restrictive treatment

Define values clarification

Self-exploration through indentifying and ranking you own personal values

Which drug is lethal in a one month supply?

TCAs

Which phase of the therapeutic nurse-patient relationship includes the relationship concluding?

Termination phase

As a last resort, an agitated, physically aggressive client is placed in four-point restraints. The client yells, "I'll sue you for assault and battery." The unit manager determines that the nurses are protected under which condition? A. The client is voluntarily committed and poses a danger to others on the unit. B. The client is voluntarily committed and has a history of being a danger to others. C. The client is involuntarily committed because of a history of violent behavior. D. The client is involuntarily committed and is refusing treatment.

The client is voluntarily committed and poses a danger to others on the unit.

Describe a democratic leadership style

The focus is on the members who participate fully in problem-solving. Production is lower than autocratic but morale is much higher.

For the past 3 days, a student has skipped classes, cried constantly, experienced panic attacks, and is now exhibiting difficulty with short-term memory. In her assessment of this student, what crucial information should the nurse initially obtain prior to planning interventions? A. The student's description of the precipitating stressor B. The student's usual ability to cope with stress C. The student's available support system D. The student's access to community resources

The student's description of the precipitating stressor

What three factors will determine if an individual will experience a crisis in response to a stressful situation?

Their perception of the event The availability of situational supports The availability of adequate coping mechanisms

After a supportive-therapeutic group, a nurse hears one client say to another, "I never thought that other people had the same problems I have." The nurse ascertains that this statement represents which curative factors are described by Yalom? A. Catharsis B. Group cohesiveness C. Universality D. Imitative behavior

Universality

A client diagnosed with chronic alcoholism is suffering from tingling and numbness in the hands and feet. The nurse instructs the client that this may be a result of a nutritional deficiency. Which vitamin supplement may resolve these symptoms? A. Vitamin B1 B. Vitamin K C. Vitamin A D. Vitamin D

VItamin B1

Define moral behaviors

When you act in a way that was critically thought out when thinking of how to treat others

Which phase of the therapeutic nurse-patient relationship includes maintaining trust and support, promoting patient insight, working towards achieving goals, and overcoming resistance behaviors?

Working

Define a right

a legally recognized entitlement without government interference

Define legal right

a right on which the society has agreed and formalized into law

Define criminal law

a system of law concerned with the punishment of those who commit crimes.

A 25-year-old man barely avoids a motor vehicle accident. His heart is pounding, his palms are sweaty, and his respirations are increased. This is an example of which stage of the general adaptation syndrome? a. Alarm reaction stage b. Stage of resistance c. Stage of exhaustion d. Stage of biological stress

alarm reaction stage

Practices that are used INSTEAD OF traditional practices

alternative medicine

Antipsychotic drugs lower your blood pressure, so if someone is also on _________, be aware of additive effects

antihypertensives

Define nonmaleficence

avoidance of harm or hurt

How does Hans Selye define stress?

basically when fight-or-flight is activated *physical response

Acetylcholine is an example of what kind of a neurotransmitter

cholinergic

Antianxiety drugs such as Benzos act by

depressing the CNS

What is the basic concept of a recovery model?

empowerment of the consumer

What is catharsis?

expressing positive and negative feelings

What is the problem solving model?

identifying the patient's problem, discussing desired changes realistically and alternatives

Define values

personal belief about what is important

Which phase of the therapeutic nurse-patient relationship includes obtaining patient info from the chart, family members, another nurse, etc. And examines your own feelings about working with this patient.

preinteraction

Antipsychotics have what effect on an EKG

prolonged QT

When giving someone a SSRI and they are also on Buspar, St Johns Wort or other antidepressants, be aware of what syndrome

serotonin syndrome

Lithium depletes what?

sodium

When a patient is on Lamictal (A ood stabilizer), be aware of what possible syndrome

steven johnsons syndrome

Define Kantianism

suggests that decisions and actions are bound by a sense of duty

A client is brought to the emergency department and diagnosed with a panic level of anxiety. What biological system domination would be responsible for this diagnosis? A. Parasympathetic system B. Sympathetic system C. The cerebral cortex D. The cerebellum

sympathetic system

Define veracity

telling the truth

What are ethics?

the branch of philosophy that deals with issues of right and wrong

Define civil law

the system of law concerned with private relations between members of a community

define beneficence

to do good

What are bioethics?

used when ethics refers to concepts in medicine, nursing, etc.

What is the definition of mental health?

when someone can successfully adapt to stressful enviornments

In the working phase of the therapeutic nurse-patient relationship, you may run into countertransference, what is that?

when the NURSE feels a certain way about the patient because of their experience with someone from their past. ex.) the patient looks like the nurse's grandma so she gives them extra attention

In the working phase of the therapeutic nurse-patient relationship, you may run into transference, what is that?

when the PATIENT feels a certain way about the nurse because of their experience with someone from their past. ex.) the nurse has blonde hair, their ex that hurt them has blond hair, they don't like the nurse

Define absolute right

when there is no restriction whatsoever on the individual's entitlement