Mid Lec Psyche
Removes nail polish
Psychiatrists may use electroconvulsive therapy (ECT) to treat depression in select groups such as clients who do not respond to antidepressants or those who experience intolerable side effects at therapeutic doses. Aling Galieta, a 65-year-old female client with severe psychotic depression has not responded to a two-week trial with antidepressant. The attending psychiatrist ordered electroconvulsive treatment. In preparing the client for ECT, the nurse should do which of the following?
Transference
Psychoanalytic theory supports the notion that all human behavior is caused and can be explained (deterministic theory). Freud believed that repressed (driven from conscious awareness) sexual impulses and desires motivated much human behavior. Nurse Miriam enters Renato's room for the first time and says, "Renato, I'm Miriam, the nurse. I'll help you get settled." Renato responds, "I want another nurse. I don't like you. You are always mean to me." Nurse Miriam recognizes that Renato's response is an example of:
Operate on the pleasure principle to reduce tension or discomfort
Psychoanalytic theory supports the notion that all human behavior is caused and can be explained (deterministic theory). Freud believed that repressed (driven from conscious awareness) sexual impulses and desires motivated much human behavior. Under the psychoanalytic mode of Freud, the ego functions include all of the following except:
to evaluate, assess, or find the unconscious.
Physiological symptoms of a stress response include all the following manifestations aside from:
Visual comprehension and praxis
During the administration of a Mini-Mental Status Exam (MMSE), the healthcare provider asks the client to copy a simple geometric shape. This part of the exam tests which of the following mental functions?
"You're having difficulty sleeping?"
When the psychiatric nurse checks her client, the client states, "I haven't slept the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this client?
Mental illness was linked with sin and demonic possession
During the early history era, healers were often sought to treat the mentally ill. Major treatment consisted of herbs, ointment and precious stones. Which of the following best describes the basis of this treatment during the early history era?
Alarm stage
During which phase of the general adaptation syndrome does our brain prepare our body for the "fight or flight" response?
The ability to understand the client's world and to communicate this to the client
Empathy is:
matching between facial expression and words
In the Carl Roger's client-centered approach, "congruence" is related to which of the following?
Advocacy
It is the process of acting on the client's behalf when he or she cannot do so.
Trust
It is when the client confident in the nurse and the nurse's presence conveys integrity and reliability.
Mental Status Examination
It's represented a cross sections of the client's psychological life and the sum total of the nurse's observations and impressions at the moment.
"Jam, I see you have put on a clean dress and combed your hair."
Jam, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate?
projection
Jenny has a strong dislike for someone; she might instead believe that she does not like by that person. Jenny is unconsciously using what defense mechanism?
love and belongingness needs
Juliana always feels like she is never included in group activities or social events. She has become depressed and lonely. According to Maslow, which category of needs has not been fulfilled?
Preconscious
Katy says, "Give me 10 minutes to recall the name of our college professor who failed many students in our nutrition class." She is operating on her:
Conversion
Leandro, a teenager who is forbidden by his parents to see a sex video scandal was tempted to do by his friends. The next day he suddenly develops blindness, and seems unconcerned about the loss of sight. He unconsciously used which of the following defense mechanism?
Making the client safe and accepted.
Lucia, brought to the hospital by her mother Merly, is wearing sandals, revealing dry and swollen feet, and wrinkled dress with a stain on the front. She moves slowly and looks confused. The initial goal of the nurse, who admits the client should be focused on:
Appraises the event as irrelevant to her own situation
Magda, who lives in Tarlac, hears on the evening news that 25 people were killed in a flashflood in Cotabato. Magda experiences no anxiety upon hearing of this stressful situation. According to the Transactional view of stress, this is most likely because Magda
Herbs should be purchased only from manufacturers with a history of quality control
Which information by the nurse must be included when discussing the use of herbal remedies as alternative or complementary treatment for his/her disorder?
Conservation
Marcel's mother has two crackers, both of equal size. She breaks one of the crackers up into four pieces. Marcel says she wants the one with the most and immediately chooses the four pieces , even though the two amounts are equal. Marcel's choice illustrates Piaget's concept of:
esteem needs
Marco's neighbors welcomed him warmly to the neighborhood. His gourmet dinner featuring sushi, made a good impression. According to Maslow, which category of needs is being prioritized?
Carl Rogers
A group of nursing students in a psychiatric-mental health rotation are reviewing information about various theorists associated with self, therapeutic use of self, and the therapeutic relationship. The students demonstrate understanding of the material when they identify which theorist as having identified three core conditions for a therapeutic relationship?
Recognizes the mind-body-spirit connection
A holistic nurse would be a nurse who:
Initiate a nurse client relationship.
A major intervention designed to assist the client in meeting his/her need for love and belongingness is:
"Sympathy indicates that you are sharing your personal feelings and that changes the focus of the communication from the patient to you."
A novice nurse asks, "What is so wrong about being sympathetic with a patient who has also lost a parent like I did?" The psychiatric nurse manager responds:
The nontherapeutic technique of "giving false reassurance"
A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?
: "I can tell the nurse is sincere because the face supports what the mouth is saying."
A patient expresses a sense of genuineness in the nurse providing care when sharing with family members that:
Displacement
A person loses an important advertising account and gets flat tire while driving home. That evening, the person begins to find fault with everyone. Which defense mechanism is the person using?
Generally adapts successfully to stressful situation
A person with a healthy personality is best described as someone who:
"What do you think would be best for you to do?"
Mrs. Manhik-manaog asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse?
Say no and reinforce boundaries
A psychiatric nurse is discharging a patient whom the nurse finds charming and very intelligent. What is the appropriate response when the patient asks for the nurse's phone number?
Ethical dilemma
A situation in which ethical principle conflict or when there is no one clear course of action in a given situation.
milieu
A treatment approach used in an inpatient psychiatric facility in which all facets of the environment are components of the treatment is referred to as __________ therapy.
Mika, 21, recent passer of engineering board exam, mother of a 4 year old girl
No single, universal definition of mental health exists. Generally a person's behavior can provide clues to his or her mental health. After lecturing about the characteristics of a mentally healthy person according to Marie Jahoda, Mr. David asked his students to identify which client can be categorized as mentally healthy:
"Your child has a right to receive treatment in the least restrictive manner."
A 15-year-old who shows poor impulse control and resistance to authority is prescribed outpatient therapy. The parents are insistent that the treatment include commitment to an inpatient facility. Which response by the nurse best supports the outpatient treatment modality?
Concrete operational stage
A child has developed the ability to sort things on the basis of their physical properties and perform complex operations on problems as long as the problems are not abstract. The child is at which one of the following stage of Paiget's theory of Cognitive Development?
Denial
A client admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting. "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the client implementing?
Denial
A client being seen in the emergency department immediately after being sexually assaulted appears calm and controlled. The nurse analyzes this behavior as indicating which defense mechanism?
Assault
A client has refused to eat more than a few spoonfuls of breakfast. The primary health care provider has prescribed that tube feedings be initiated if the client fails to eat at least half of a meal because the client has lost a significant amount of weight during the previous 2 months. The nurse enters the room, looks at the tray, and states, "If you don't eat any more than that, I'm going to have to put a tube down your throat and get a feeding in that way." The client begins crying and tries to eat more. Based on the nurse's actions, the nurse may be accused of which violation?
Responding to the client's information in an accepting manner
A client indicates that he is about to share information about his illness that is shocking and embarrassing. Which nursing intervention has priority in this situation in facilitating the communication process?
The nurse notifies the client's physician of the situation and cancel the procedure.
A client scheduled for ECT at 10 am is caught eating his breakfast at 9 am. Which is the most appropriate action?
Boundaries
A client tells the nurse, "I really like you. You're the only true friend I have." The client's remarks call for the nurse to revisit the issue of:
Caregiver
A client with elevated body temperature needs a tepid sponge bath. The nurse explains to the client the need of touch while performing physical care. Which role did the nurse show during this procedure?
hallucination
A client with schizophrenia hears a voice telling him he is evil and must die. The nurse understands that the client is experiencing:
False imprisonment
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action?
Orientation Phase
Nurse Alex has gathered information about his new client assignment and is about to meet him. Establishing a therapeutic contract is the goal of which phase of the nurse-client relationship?
"Please tell me more about what you are feeling."
Which nursing response would indicate an empathetic approach to a patient who is depressed over recent losses in her life?
Represents learning of specific behavior through rewards or reinforcements
Which of the following accurately characterizes operant conditioning?
A work in progress that classifies mental disorders based on what is currently known
Which of the following best describes the DSM?
The harm was a direct result of the nursing act.
After the nurse discovered a medication error had been made, the patient was carefully observed and effectively treated for symptoms of a headache. What element of malpractice is most critical in determining the nurse's liability?
Challenging
Aika has just received a promotion on her job. She is very happy and excited about moving up in her company, but she has been experiencing anxiety since receiving the news. Her primary appraisal is that she most likely views the situation as which of the following?
Do background check on every client you encounter.
All are points to consider when building a Therapeutic Relationship except?
"I realized that I was angry with my brother, so I sat down to talk about the issue."
All of the following are examples of defense mechanism apart from:
A mentally ill person lacks the resources to provide the necessities of life.
All of the following reasons may an individual be considered gravely disabled apart from?
family therapy
Although Ryan has been in trouble with the law for shoplifting and vandalism, his therapist has asked that Ryan's family participate in his therapy sessions. What therapy modality is Ryan's therapist employing?
GABA
An inhibitory neurotransmitter that is believed to play a role in anxiety refers to which of the following?
A state of well-being where a person can realize his own abilities can cope with normal stresses of life and work productively.
Nurse Ariana has been working as a Psychiatric Nurse at Cavite Center for Mental Health for 8 years now. As an experienced nurse in this field of Nursing, she would BEST define Mental Health as:
"Yes, I see. Go on."
Nurse Dan is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a general lead?
Dog learns to salivate on hearing bell
Which of the following is an example of classical conditioning?
Tangentiality
Nurse Tanya asks her client Mark how he is feeling. Mark answers, "I woke up to a very sunshiny morning, and the sun was so shiny, shiny like the diamonds on my mom's necklace that she wears to parties. She doesn't invite me to those parties. I think she hates me." Nurse Tanya documents this as:
Hypothalamus
Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system? It also regulates appetite and temperature.
Frontal lobe
Which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling?
typically seen as a disorder when they impair function.
Behaviors that deviate from the norms are:
Behavior that is rewarded with reinforcers tends to be extinct
Which of the following principles by Skinner is incorrect?
All of the above
Which of the following things can cause stress in a person's life
When meeting starts.
During her first meeting with a client, a student nurse must be aware of the time when she should mention about terminating the relationship. Ending the relationship is best given
Thought Blocking
During nursing interviewed the client stops talking in the middle of his statement. He seems pre-occupied with his thoughts. The client is manifesting with the following descriptions.
: Constricted pupils
Physiological symptoms of a stress response include all the following manifestations aside from:
Deinstitutionalization
Expanded community and advanced practice roles for nurses in psychiatric mental health care can be traced to which historical trend?
engage all members to be active participants in client's care
Family therapy emphasizes family relationships as an important factor in psychological health. Nurse Stephen is working with a mentally ill client and his family. He should remember that in family therapy, he should: The correct answer is: engage all members to be active
unconscious and unresolved sexual conflicts rooted in childhood experiences
Freud believed that most personality disturbances are due to:
Conflict between id and superego
Freud explains anxiety as:
First statement is TRUE, second statement is FALSE
Freud sensed strong sexual conflicts in the infant and young child, conflicts that seemed to revolve around specific regions of the body. Children at the latency stage are fixated on their genitals and sexual pleasure.
reveal a great deal of repressed material.
Freud's techniques of assessment:
safety needs
Gian noticed that the grocery shopping was taking much longer than expected, but he thought it was important to check for salt, sugar, and fat in the processed foods that he needed to buy because he conscious of his health. According to Maslow, which category of needs is being prioritized?
Threatens violence toward another individual
Guidelines relating to "duty to warn" state that a therapist should consider taking action to warn a third party when his or her client:
Donna is gainfully employed and lives in a residential housing unit
Historically, psychiatric nursing has focused on symptom management. Today, the current trend in mental health care is best exemplified by which of the following clients?
48-72 hrs
How many hours can a client be detained in a psychiatric facility for an emergency basis until a hearing can be conducted to determine whether he or she should be committed to a facility treatment for a specified period of time?
Assessment of one's coping potential
In Lazarus' early transactional model of stress, what follows primary appraisal?
"That seems to be a difficult subject for you. We can discuss when you are ready."
In response to the nurse's statement, "Tell me about your family," the client became silent and displayed nonverbally that he is uncomfortable. Which statement by the nurse reflects sensitivity to the client?
Colorfully decorated walls
Which of the following would not address the safety needs inside the classroom?
"Let the client know that you will not keep a secret that could ultimately cause harm or affect their treatment."
Which response by the nurse manager to a novice mental health nurse is most effective when the nurse asks, "How do I justify not keeping a client's secret?"
Advocate
Which role of the nurse client relationship is being exhibited when the nurse informs the client and then supports him or her and whatever decision he or she makes?
Delusion
While looking out the window, a client with schizophrenia remarks, "That school across the street has creatures in it that are waiting for me." Which of the following terms best describes what the creatures represent?
object permanence
Retrieving hidden objects is an evidence that infants have begun to master which of the following cognitive function?
"Samira, I will maintain confidentiality on matters that are not a risk to you and others
Samira is an adolescent who was recently admitted to the psychiatric ward for use of profanity, violence in school, and serious misconduct. As Nurse Rissa was assessing her, she became irritable and asked if she will relate everything she says to her parents and write a report to her school. Which of the following would be the appropriate response of Nurse Rissa?
Sensory, concrete, abstract
Sequence of development among children from birth to adolescence is:
It allows space for the client to acknowledge the nurse patience.
Silence is therapeutic when communicating with a depressed client. Which statement describes the effectiveness of silence as a therapeutic technique in communication?
bloodletting
The Hippocratic perspective dominated medical thought in Western countries until the middle of the nineteenth century (Golub, 1994). People trained in the Hippocratic tradition viewed "disease" as a unitary concept. In an attempt to rid the body of the excessive humors or fluids thought to be causing psychological disorders, physicians throughout history have used treatments such as ________.
Empathy
The ability to enter-into the life of another person's and perceive his current feelings and their meaning is known as one of the ff:
Formal operations stage
The ability to think abstractly and systematically solve problems emerges during the:
An inappropriate affect
The client facial expression shows sadness as he remarks that he is very happy. This is a suggestive of:
Noncompliance to medication
With the birth of Assertive Community Treatment (ACT) programs, Clients with schizophrenia are no longer hospitalized for long periods. Most return to live in the community with assistance provided by family and support services. As a psychiatric nurse, you know that the major cause of relapse and rehospitalization among clients is:
Classical conditioning
Your dog loves to go on walks around the neighborhood. You begin an experiment by clapping your hand 3 times before getting the leash to walk your dog. Soon every time you clap your hands the dog comes running. This is an example of what concept?
Reality orientation
The component of mental health that allows the individual to distinguish fact from fantasy and act accordingly is:
Sympathetic Division
The division of the ANS that is involved in activities associated with the expenditure of energy specially in times of stress, from reserves that are stored inside the body refers to which of the following?
"It's amazing how much you remind me of my favorite teacher."
The healthcare provider is counseling a patient who is diagnosed with depression. Which of the following statements made by a patient should the healthcare provider recognize as a sign of transference?
Interaction among staff and clients
The milieu in a psychiatric unit refers to the:
Temporary memory loss and confusion
The most common side effects of ECT are:
"What would you do if you smelled smoke in your home?"
The nurse assesses a client's judgment by asking:
Magical thinking
The nurse can infer a client's thought process from speech and speech patterns. A 20 year-old Japanese female client admitted in the psychiatric ward was seen crying. She tells the nurse that the earthquake and tsunami that destructed her hometown was her fault because she was wishing for a reason not to go back in Japan. The nurse knows that this is an example of:
Establish trust and rapport
The nurse is discussing the orientation phase. The student nurse asks what the primary goal between the nurse and the client is during this phase. The nurse should respond that the primary goal is to:
The nurse is responsible for developing a therapeutic relationship with the client. There are many factors that enhance the nurse client relationship. What is the first step the nurse must take in order to prepare to accomplish this goal?
The nurse is responsible for developing a therapeutic relationship with the client. There are many factors that enhance the nurse client relationship. What is the first step the nurse must take in order to prepare to accomplish this goal?
Safety and security
The nurse works in a half-way house where children at risk are taken cared of. At night when the children were being prepared to go to sleep, the nurse heard from a frightened child, "Ayaw ko matulog mag-isa. May multo!" (I don't want to sleep alone. There's a ghost!"). The nurse assesses this behavior as need for:
Teacher
The nurses role is varied, and one area of the nursing role may supersede another role in importance at any given time during the nurse - client relationship. Which of the following roles is being exhibited when the nurse instruct the client about his medication regime?
the understanding of the client's world from the client's point of view
The phrase "empathic understanding of the client" relates to which of the following?
Ensure that the consent form has been signed
The priority nursing intervention before starting ECT therapy is to:
The nurse and the client agree about the areas to work on and evaluate the outcomes
The student nurses are practicing communication techniques with their clients in order to establish a therapeutic method of assessing; planning; implementing; and evaluating the client through the art of communication. Which of the following is true regarding the establishment of a therapeutic relationship?
"Do you feel that you are always watched by others
To be able to elicit specific information during a mental status examination, the nurse asks questions which he or she incorporates during the interview. Which among the following is appropriate to ask in assessing a client's thought content?
reaction formation
Treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings is an example of______?
Keep the agreed schedule of meeting with the client
Trust facilitates nurse-client relationship. One of the steps which the nurse should undertake to gain client's trust is to:
Uses consistence in approaching the client.
Trust may develop in the Nurse Client Relationship when the nurse:
Looking at the client the nurse commands, "Remove your hands. You are not supposed to do that."
Unexpectedly a client puts his arm around the nurse waist. How should the nurse respond?
: a theory of meaning
Viktor Frankl defined logotherapy as:
Their thinking becomes more logical and organized, but still very concrete
What are the major characteristics and development changes among 7-11 years old individuals?
A mechanism designed to reduce stress and conflict caused by specific experiences.
What is a defense mechanism?
Responds to the question with a blank look and incomprehensible.
When asked about her during the admission interview, the client stares blankly at the nurse and mutters unintelligibly. The nurse would chart this behavior as:
Continuously evaluating the patient's nonverbal cues
When providing discharge teaching to a patient for whom English is a second language, what technique will the nurse use to assess the patient's understanding of the information being shared verbally?
