Unit 1 Quiz - Behavioral Health Nursing 212

A patient who recently lost 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"

mental health continuum

A conceptual line used to represent levels of mental health and mental illness that vary from person to person and vary for a particular person over time. kind of a scale to determine the severity of how the mental illness is affecting the specific person

Never in your charting should you put

A incident report because they should stay at the facility in which they happened and when a patient requests those records you do not want another patient's name in there

ICD-10-CM

A mental illness must be coded correctly in order for insurance to cover it when charting and giving diagnosis

Psychoanalytic theories and therapies

To treat mental health you use pills and skills

Reinforcement

Which causes a behavior to occur more frequentlyEx.treats

Ego

Within the first few years of life as the child begins the interact with others, the ego develops. The ego resides in the conscious, preconscious, and unconscious levels of awareness

operant conditioning

Learning based on the consequences of responding.Ex.spanking

Conventional Stage 4

Maintaining the social order. A rules are rules mindset returns and the person begins to adopt a broader view of society and listens to authority

Assertion

Most psychiatric disorders result from a combination of genetic vulnerablility

A client tells the nurse "I really feel close to you. You are like the friend i never had" The nurse can assess this statement as indicating the client may be experiencing which unconscious emotion?

Positive transference

Conventional

Self-sacrifice is goodness -- responsibility to others

Epidemiology of mental disorders

Study distribution of mental disorders Identify high-risk groups Identify high-risk factors Incidence Prevalence

Postconventional Stage 5

The social-contract orientation. Understand that laws are meant to hold up principles...it's the principles that matter, not the law "Although there is a law against stealing, the law wasn't meant to violate a person's right to life.../if Heinz is prosecuted for stealing, the law needs to be reinterpreted to take into account situations in which it goes against people's natural right to keep on living"

Superego

The superego, which develops between the ages 3 and 5, represents the moral component of personality. If resides in all levels of awareness

A nurse on the floor has a history of alcoholism. Which statement made by the nurse would indicate countertransference?

" My patient has been abusing alcohol, I told her the only way to quit was 'cold turkey' and to get away from her dysfunctional family and do it now!"

Which of the following statements represent a non-therapeutic communication technique?

"What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" "Why didn't you attend group this morning" "If I were you, I would quit the stressful job" "I am really proud of you how you stood up to your brother when he visited this morning"

The nurse best assesses the client's spiritual life by asking which question?

"What role does religion play in your life?"

A 26 year old client is brought to the ED 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 would love to gather any information regarding the history that you can provide"

A client has been admitted to an inpatient psychiatric unit with suicidal ideation. In a one-to-one session with the nurse, he shares the terrible guilt he feels over sexually abusing his stepdaughter and wanting to die because of it. Which response reflects a helpful trait in a therapeutic relationship?

"You are suffering with guilt over what you did. Let's talk about some goals we could work on that may make you want to keep living."

Postconventional stage 6

- stage of moral development that has the goal to make decisions on basis of highest relevant moral principles - rules of society integrated with conscience

The transactional model

-Communication is "built" (mutual influence) -Each person is both a sender and a receiver

Intimate distance

0-18 inches

Defense mechanisms

1. They all (except suppression) operate on an unconscious level 2. They deny, falsify, or distort reality to make it less threatening

Public distance

12 or more feet

personal distance

18 inches - 4 feet

Social distance

4-12 feet

Which statements are true regarding the differences between a social relationship and a therapeutic relationship?

A. A social relationship, both parties' needs are met; in a therapeutic relationship only the client's needs are to be considered. B. Giving advice is done in social relationships; it is not appropriate to give advice in therapeutic relationships C. In a social relationship both parties come up with solutions to problems and solutions may be implemented by both; in a therapeutic relationship solutions are discussed but only implemented by the client

Preconscious

Contains material that can be retrieved rather easily through conscious effort Ex. Having to think to remember something

The client's priority nursing diagnosis has been established as risk for self-directed violence: suicide related to multiple losses. The priority outcome would be that the client will A. refrain from attempting suicide. B. be placed on suicide precautions. C. attend self-help group daily. D. state absence of feelings of powerlessness.

A. refrain from attempting suicide

Voice quality

AKA paralanguage refers to the qualities of speech that do not involve words. These qualities include voice volume pitch, rate, and frequency

During a clinical interview the client falls silent after disclosing that she was sexually abused as a child. The nurse should engage in which intervention in response to the client's silence?

Allow the client to break the silence

When a client states, "That nurse never seems comfortable with me." How is the client characterizing the nurse?

As not seeming genuine to the patient

A nurse is about to interview an older client whose glasses and hearing aids were placed in the bedside drawer for safe keeping. Before beginning the interview, which nursing intervention will best facilitate data collection?

Assist the client in putting on their glasses and hearing aids

Behavioral therapy

Assumes that change in maladaptive behavior can occur without insight into the underlying cause

Id

At birth, we are all id. The id is totally unconscious and impulsive. The id lacks the ability to problem solve and is illogical

During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this?

Content of messages may be contradicted by process

Always the number one goal in treating

Safety

The nurse is finding it difficult to provide structure and set limits for a client. The nurse should self-evaluate for which characteristic of a dysfunctional nurse--patient relationship?

Boundary blurring

Over-involvement increases the risk of

Boundary crossings Boundary violations Professional sexual misconduct Blurring of roles

Consider the nurse-patient relationship on an inpatient psychiatric unit. Which of the following statements made by the nurse reflects an accurate understanding of when the issue of termination should first be discussed? a. "You are being discharged today, so I'd like to bring up the subject of termination—discussing your time here and summarizing what coping skills you have attained." b. "I haven't met my new patient yet, but I am working through my feelings of anxiety in dealing with a patient who wanted to kill herself." c. "Now that we are working on your problem-solving skills and behaviors you'd like to change, I'd like to bring up the issue of termination." d. "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."

C. Now that we are working on your problem-solving skills and behaviors you'd like to change, I'd like to bring up the issue of termination

Importance of talk therapy

Changes brain chemistry in much the same way as medication

When discussing her husband, a client shares that "I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nurse using when responding "Are you saying that things would be better if you left your husband?"

Clarification Clarification verified the nurse's interpretation of the client's message.

After a client discusses a personal relationship with a parent, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by this person?" What is the purpose of the nurse's question?

Clarifying the message

The outcome of the nurse's expressions of sympathy instead of empathy toward the client often leads to which outcome?

Decreased client communication

Therapeutic communication benefits the patient

Feeling safer and protected More satisfied with the care Increased recovery rates Improved adherence to treatment

Stigma

Following mental illnesses there us often a stigma that the person is flawed, messed up, or begging for attention

Multidisciplinary teams

Function as a group (multiple) of professionals who work loosely in the same area or with the same client. Work in these

Conventional Stage 3

Good interpersonal relationships. Children begin the view right vs wrong

Outcome criteria

Identify expected outcomes that reflect the maximal level of patient health that can realistically be achieved through planned nursing interventions

Which nursing diagnosis for a psychiatric client is correctly structured and worded?

Imbalanced nutrition: less than body requirements related to poor self-concept as evidence by reporting "I'm not worthy of eating"

unconscious level

Includes all repressed memories, passions, and unacceptable urges lying below the surface

What principle forms the basis of nursing outcome planning?

Individuals have the right to outcomes that are reflective of their abilities

Conditioning

Involves pairing a behavior with a condition that reinforces or diminishes the behavior's occurrence.

A client is sitting with arms crossed over their chest, with their left leg rapidly moving up and down, and there is an angry expression on their face. When approached by the nurse, the client states harshly. "I'm fine! Everything's great!" Which statement related to communication should the nurse focus on when working with this client?

Nonverbal and verbal communication may be different, nurses must pay attention to the nonverbal communication being presented to get an accurate message.

Quality and safety education for nursing

Patient centered care Use of Evidence Based Practice

Postconventional

Principle of nonviolence - do not hurt others or self

Problem focused diagnosis

Problem + probable cause + supporting data

Countertransference

Refers to unconscious feelings that the healthcare worker feels for the patient Ex. Treating a patient differently because they remind you of your son

Principles

Reflect a measurable desired change Provide direction for continuity of care Written in positive terms

During a therapeutic encounter the nurse remarks to a client, "I noticed anger in your voice when you spoke of your father. Tell me about that" What communication techniques is the nurse using.

Reflecting and exploring

Therapeutic use of self

Safe, confidential, reliable, and consistent Use personality consciously and in full awareness Attempt to establish relatedness Structure nursing interventions

Classification of mental disorders

The diagnostic and statistical manual of mental diseases. Classifies the mental disorders by using doctors, psychiatrists, and nursing statistics to classify

Boundaries

The expected and accepted legal, ethical, and professional standards that desperate nurses from patients Provide a safe space for the patient

What is the primary difference between a social and therapeutic relationship>

The kind of responsibility involved.

Diathesis is

The most accepted explanation for mental illnesses

When providing respectful, appropriate, nursing care, how should the nurse identify the patient and his or her observable characteristics?

The patient in room 234 is displaying manic behavior

A 55 year-old client recently came to the US from England on a work visa. The client was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the client shows little emotion. Which of the following explanations is most plausible for the lack of emotion?

The response may reflect cultural norms

Lifetime risk

risk that one will develop a disease in the course of their lifetime Ex. mother has bipolar disorder, father has bipolar disorder. Will the child develop it

Proxemics

study of personal space

Quality Improvement

a process of continuous self-review with the purpose of identifying and correcting aspects of the system that require improvement

Biofeedback

another form of behavioral therapy and is successfully used nowadays, especially for controlling the body's physiological response to stress and anxiety

Preconvential Stage 1

avoidance of punishment punishment (ex, "I would cheat if I knew I wouldn't get caught"

Encoding

the processing of information into the memory system—for example, by extracting meaning.

Diathesis

biological predisposition - if you have been going through it for a long time you will find a way to deal with it on your own

Kinesic communication

communicating through the movement of head, eyes, arms, hands, legs, or torso

Freud's levels of awareness

conscious, preconscious, unconscious

Conscious level

contains all the material a person is aware of at any one time

Psychodynamic therapy

therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight

Interpersonal therapy

treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions

Interdisciplinary teamwork

well-coordinated collaboration across health care professionals toward a common goal (improved, efficient patient care)

Cognitive behavioral therapy

which is based on both cognitive psychology and behavioral theory

Preconvential Stage 2

exchange of favors (ex, "I'll let you copy mine if you my homework"

Preconvential

goal is individual survival - selfishness

Decoding

interpreting and trying to make sense of the message

Prevalence

number of cases regardless when they began

Incidence

number of new cases in a given time

Maslow's Hierarchy of Needs

physiological, safety, love/belonging, esteem, self-actualization

Debriefing

refers to a critical conversation and reflection regarding an experience that results in growth and learning

Transference

refers to unconscious feelings that the patient has toward a healthcare worker that were originally felt with someone else Ex. You remind me exactly of my sister

Mental health parity act

requires insurance companies to offer the same level of coverage for mental health care that they provide for medical and surgical care