1912 Exam 2
How should a nurse screen for SI?
Establish trusting relationship and willingness to discuss SI. Screen for past history, immediate risk and strength of the pt's intent to kill themselves.
Substance use disorders predisposing factors: _____Hereditary. Children of alcoholics are 4x more to become alcoholics (even if they didn't live with their biological parents. _____ alcohol has effects on all neurotransmitters but affect opioid, catecholamine (dopamine), glutamate and GABA.
Genetics: Biochemistry:
Which statement made by an artist after her painting has been rejected by an art gallery can be attributed to dichotomous thinking?
I thought I was good but I guess im a bad painter after all all or nothing/black and white thinking
Which statement made by the nurse while interacting with a client helps develop a trusting relationship?
I will listen to you if you want to discuss your feelings
Which credentials are the minimum required for a member of the psychiatric care unit to conduct an in-depth psychosocial history during psychotherapy?
Masters in social work
Suicide risk _____ pt's with PTSD present with physical complaints, reports of nightmares, SUD and unless healthcare professionals screen for SI, it may go undetected.
Military personnel:
non-lethal, repetitive act used to reduce distress rather than end one's life. They need screening for SI because the probability of an SI attempt is high. Borderline personality disorder.
Nonsuicidal self-injuring behavior NSSIB:
suicide risk _____ are another population that isn't assessed enough for SI risk in primary health settings. Just because a pt responds "No" on an SI assessment tool that does not mean they are not at risk (they lie).
Older adults with depression
Psychological factors for alcohol SUD _____low self-esteem, frequent depression, passivity, antisocial personality traits (criminals), inability to relax (me), defer gratification and inability to communicate. Self-medicating with substances.
Personality factors:
Alcohol Use Disorder patterns of use Most diagnosed substance use disorder in US. 88k deaths annually. _____ use of alcohol to relieve everyday stress.
Phase I prealcoholic phase:
_____ blackouts. The drug is now needed to function. Binge drinking and the user feels enormous guilt.
Phase II the early alcoholic phase:
Alcohol Use Disorder patterns of use _____ the user loses control of their use and physiological addiction is clearly evident. They can no longer choose to not drink. Binge drinking can last from a few hours to several weeks. The user is extremely ill.
Phase III the crucial phase:
_____ emotional and physical disintegration. The user is drunk more than sober. This can lead to psychosis and physical manifestations in every body system. Alcohol withdrawal is lethal at this stage.
Phase IV the chronic phase:
Which credentials are the minimal educational credentials required for the interdisciplinary treatment team member who administers medication to psychiatric clients?
RN
Which health-care professional on an interdisciplinary team is responsible for ascertaining that the client's physiological needs are met?
RN
Which health-care professionals are a part of the interdisciplinary team that conducts the initial assessment of a client with a psychiatric disorder?
RN psychiatrist
Which educational credentials are required to become a psychiatric clinical nurse specialist?
RN with a masters in psych nursing
Screening for substance use disorders SUD evidenced based approach used in ER's, trauma centers, primary care and other community settings.
Screening, Brief intervention, and referral to treatment SBIRT:
identify clinically significant symptoms that require further assessment and intervention.
Screening:
Sociocultural factors for alcohol SUD _____modeling, imitation and identification on behavior is learned from childhood. Kids learn to abuse drugs from their parents.
Social learning:
_____care that incorporates sensitivity to the impact of trauma on current behavior and relationships. Pt's are at risk for retraumatization if trauma screening is conducted without awareness or sensitivity to the impact of that trauma on the individual's current functioning.
Trauma informed care:
AD symptoms Impairment is evident in _____ _____ individual loses the ability to speak. Personality change: _____
abstract thinking, judgment and impulse control Aphasia: a very neat polite person becomes an angry belligerent toddler who can no longer perform ADL's.
Predisposing factors for AD Neurotransmitter alterations: _____ Plaques and tangles: cause neurodegeneration Head trauma: increases risk for developing AD Genetic factors: hereditary with 40% of pt's having family history. Pt's with _____ are at high risk.
acetylcholine production is reduced = cognitive disturbance down syndrome
How do the group members behave during the orientation phase of the group development process?
act overly polite with one another
Which action by the group members indicates normative function?
adhering to standards
Which responsibility belongs to the clinical psychologist, as a member of the interdisciplinary treatment team?
administering and interpreting psychological tests that assist in diagnosis
Screenings should be provided to _____ in order prevent mental illness being untreated/undiagnosed.
all pts (young and old)
Which curative factor creates positive self-image and promotes self-growth?
altruism
Which substances may stimulate anger in an individual?
anabolic steroids PCP bath salts alpha PVP flakka
The nursing instructor is teaching a group of students about anger management. Which statements made by the student nurse about the constructive uses of anger indicate effective learning?
anger is a personal symbol of injustice against the self anger promotes conflict resolution if communicated appropriately anger mobilizes the body for self defense
The nurse is caring for a client with behavioral disorders. The nurse finds that the client is aggressive and tries to harm himself or herself. Which nursing intervention would most likely be beneficial to this client as a last resort?
application of restraints
In a psychiatric unit, the nurse observes a health-care professional helping a client analyze his or her own creative work in an effort to recognize the underlying conflict. Which health-care professional would be working in this role?
art therapist
While caring for a client with a history of violence, the nurse observes that the client is very angry and is losing self-control. Which intervention followed by the nurse is an effective way to release the tension associated with high levels of anger in the client?
ask pt to exercise or use a physical outlet to relieve tension
The nurse is caring for a client who expresses anger in inappropriate ways, such as yelling at others and throwing temper tantrums. Which nursing intervention may help obtain an objective measure of the problem?
ask the pt to keep a diary of angy feelings
When working in the therapeutic milieu, which technique would the nurse teach the client to improve confidence and communication?
assertive techniques
Which roles and responsibilities belong to a staff psychiatric nurse?
assist pts in daily activities developing relationships admin of meds
Which statement is true regarding the responsibility of a mental health technician in a psychiatric unit?
assisting the activity therapists run groups
Which is the main focus of cognitive behavior therapy?
automatic thoughts
Which important criteria must be met first in order for a client to achieve a higher level of functioning?
basic physiological needs
encourage differentiation of individual family members
bowens systems approach in family therapy
The nurse observes that a client with a history of violence is exhibiting increased agitation, clenching of fists, and shouting in a loud, demanding voice. Which intervention by the nurse is the priority?
call for assistance
After undergoing group therapy, a client tells the nurse, "I am very happy about the therapy. The fellow members of the group have become like family." Which function of the group therapy is reflected in the client's statement?
camraderie
The nurse is preparing a teaching session on cognitive behavior therapy. The nurse would include which information when teaching clients about cognitive behavior therapy?
changing automatic thoughts that result in dysfunctional thinking
Which member of the psychiatric care unit is responsible for evaluating the psychological tests of the clients and assisting in diagnostic processes?
clinical psychologist
Which statement describes the educational credentials of the team member of the psychiatric care unit who assists clients in their spiritual needs?
college degree in advanced theology
Families would be assessed as functional or dysfunctional based upon which elements?
communication handling differences family interactional patterns
Which step is most important for the nurse to perform following an episode of violence in the psychiatric unit?
conduct a debriefing with staff
A client with a depressed mood is diagnosed with a risk for suicide. Which interventions would the nurse implement to understand the client's personal view of the world and to establish a therapeutic alliance with the client?
convey warmth, geniuneness and empathy
screening for trauma Demographic most affected are women and children. Pt's with a history of trauma are reluctant to disclose history because of _____ Screenings for trauma should be conducted in private and communicate with a _____
denial, frightened of the consequences of sharing information and guilt/shame. compassionate, nonjudgmental attitude.
Identified risk factors for SI:
depression, SUD and chronic pain.
Which statement made by a student nurse needs correction regarding the goals of a therapeutic community?
determine comprehensive tx plan the goals are: teach interpersonal skills adaptive coping techniques develop relationship skills
Which statement describes a goal of ensuring conditions in the therapeutic community are similar to the types of conditions that exist in real-life situations the client will encounter?
develop skills the pt needs in life
Which statement describes the major focus of nursing in a therapeutic milieu?
developing a one to one relationship
The nurse is caring for a short-tempered client who is a member of an anger management group. The client learns to form a satisfactory interpersonal relationship with the other members of the group. Which curative factor did the client adopt to improve the friendly relations with others?
development of socialization techniques
A psychiatric client is diagnosed with bulimia nervosa. Which team member's attention is required for the client?
dietitian
The parent of a 10-year-old client tells the nurse, "My child frequently eats pieces of chalk." Which member of the interdisciplinary treatment team is recommended to this client?
dietitian (Pica)
Which step would the nurse take first while performing a systematic desensitization technique in a client who has a fear of elevators?
discuss riding in an elevator with a pt the first step in desensitization is discussing. this helps the nurse understand the pt's level of anxiety
Which questions would the nurse ask in order to assess the learning readiness of a client with a mental illness?
do you want to learn new coping strategies what is your lvl of anxiety? do you understand the info being presented
While caring for a client with a history of violence, the nurse observes that the client becomes agitated and begins to threaten the other staff members. The nurse, along with other staff members, restrains the client in the seclusion room. Which interventions would the nurse follow while caring for a client in restraints?
document all observations monitor extremeties q15min check temp, color and pulse
While caring for a therapeutic group of clients with Alzheimer's disease, the nurse finds that one of the members in the group is manipulating others to gain control. Which therapeutic group member role does the client's behavior reflect?
dominator
A client tells the nurse his parent has always said, "I love you so much," but when the client asks for a hug, the parent stiffens up. Which type of communication would this example describe?
double-blind communication
During a group therapy session, a client tells the nurse, "I hope to improve my existing condition by helping change the existing conditions of the group." Which function of the group is reflected in the client's statement?
empowerment
While caring for a client who has low self-esteem, the nurse observes an improvement in the client's present condition due to the functional activities of a group to which the client belongs. Which function of a group can bring change in the client?
empowerment improves the condition of the pt by providing support. It has the power to encourage and support others, which an individual alone cannot perform
Why would the occupational therapist assign responsibilities to the client in a therapeutic community setting?
enhance self esteem
Which aspect is directly manipulated in the treatment when using milieu therapy?
environment of the pt
Which changes would be required for the single young adult to proceed developmentally?
establishment of self (work/finances/community and larger society)
What does the primary health-care provider do to help the client see a broader range of possibilities during cognitive behavior therapy?
examining options and alternatives
Which action is typically performed by the aggressor in a group?
expressing negativism and opposition toward other members they also use sarcasm to degrade
A child is throwing a temper tantrum and insists on watching television. The parent walks away, ignoring the child. Which technique for modifying the child's behavior is the parent using?
extinction withholding positive reinforcement
Screening for trauma Should be conducted when pts _____
first enters the healthcare setting.
The nurse is working with the parents of a child with hydrophobia and teaches the parents to force their child to practice swimming because this will help reduce the child's fear of the phobic stimulus. Which technique does the nurse adapt to modify the child's behavior?
flooding desensitize pts to phobic stimulus
Which member enhances group processes by listening attentively to the group interaction?
follower
Which function of a group is performed by committees within a larger organization?
governance
Which behavior-oriented procedures will help a client to increase his or her number of adaptive behavioral strategies?
graded task assignments (step by step) activity scheduling distraction
After a group therapy session, a client tells the nurse, "I am playing a key role in the success of the group." Which curative factor is reflected in the client's statement?
group cohesiveness members find a sense of belonging
Which statements made by the student nurse indicate effective teaching regarding psychodrama?
group members act as audience based on a real life situation group leader asks for a volunteer to play protagonist
A disagreement between the nurse and a member of the group results in a conflict within the group. Which member of the group minimizes the tension by intervening?
harmonizer
During a group intervention, there was a conflict among the members of the group due to disagreements. Which maintenance role would be beneficial in this situation?
harmonizer
Which client is most likely contraindicated for the usage of a flooding technique for phobia therapy?
heart disease cannot tolerate excess anxiety
The nurse is teaching a group of students about nursing interventions that should be followed while caring for a client with anger. Which statements made by the student nurse indicate effective learning?
help determine the true source of anger refrain from touch find alternative ways to release tension
While caring for a client with complicated grieving, the music therapist plays music. For which reason does the therapist take this action?
help them get in touch with feelings they would not express otherwise
A parent tells the nurse, "My child throws temper tantrums and refuses to listen to warnings." Which suggestion would the nurse give the parent to bring about changes in the child's behavior?
ignore the childs behavior
A client tells the nurse, "There is a man in my Overeaters Anonymous group who eats food that I like. I have started cooking my food in the same way, and I have been following his exercise schedule. Maybe this way I will lose weight." This describes which curative factor?
imitative behavior
The nurse is caring for a client who is a member of an Alcoholics Anonymous group. The client learned about the effects of alcohol on the body from the nurse. Which curative factor most accurately describes the situation?
imparting of information
Which statement made by the student nurse indicates effective learning regarding therapeutic groups?
improves group relations and interactions between members of the group
Which intervention by the psychiatric social worker is helpful in assessing the needs of the family while conducting family therapy?
in depth psychosocial hx
During cognitive behavior therapy with a client who has bipolar disorder, the primary health-care provider provides a graded task assignment to the client. What are the likely rationales behind this intervention?
increase self esteem decrease hopelessness
Which information is required to prepare an interdisciplinary treatment (IDT) plan for a client with a psychotic disorder in a therapeutic milieu?
info from the initial nursing assessment
Which aspects would the nurse include in the teaching plan for a client with a personality disorder in a therapeutic milieu?
info on medical diagnosis stress mgmt techniques importance of taking meds as prescribed
A client with alcohol withdrawal symptoms is undergoing group therapy. During the therapy, a group member tells the client, "I have also experienced these withdrawal symptoms, and I have found they can be controlled by proper medication." Which function of the group therapy is reflected in this scenario?
information sharing
Which behavior may be observed in an individual of a group who is considered to be a seducer?
inhibiting group progress with excessive premature self disclosure
The nurse is caring for a group of clients in an alcohol rehabilitation center. The new client in the group observes that an established client with alcoholism has adjusted well in the group. The new client thinks, "I can also adjust to the group dynamics." Which curative factor promotes this concept?
installation of hope
Which statements made by the student nurse indicate effective teaching about aggression?
it can arise from anxiety it is reactive vs proactive behavior intended to inflict harm
The nursing instructor is teaching nursing students about operant conditioning. Which statement made by the student nurse about positive reinforcement indicates effective teaching?
it follows a behavoral response and increases the possibility that the behavior will occur through use of a desirable reinforcing stimulus
Which conditions must be met during the preparation of a separate nursing care plan in addition to the interdisciplinary treatment (IDT) plan?
it has a nursing diagnosis includes nursing interventions
The psychiatrist is explaining the conditions that promote therapeutic community to the team members. Which statement made by a team member indicates effective learning?
it is important to set forth norms, rules and behavior limits in the treatment setting
Which statement made by the student nurse indicates effective teaching regarding the autocratic leadership style?
leaders have personal goals for the group
While caring for a client with acute stress disorder, the therapist uses recreational activities as a part of the therapy. Which outcome in the client will indicate effectiveness of the therapy?
learn skills that can be used in leisure time
A client says, "My husband has fallen in love with someone else. He left me and it's all my fault." Which statement made by the nurse reflects the "questioning the evidence" technique?
lets discuss why it may be your fault and why it may not be your fault
While participating in a group activity, the client is unable to complete the task and makes the statement, "I am a complete failure, and I can never do anything right." Which automatic thought process does the client's statement represent?
magnifiation
Which statements describe the functions of the major roles that individuals play in a group?
maintain group processes complete the tasks of the group to fulfill personal or individual needs
Which intervention does the therapist adopt to facilitate interpersonal communication?
maintaining a structured schedule of activities
one partner is dominant in a relationship while the other is passive
marital skew
Which interdisciplinary treatment team member works under the supervision of the psychiatric nurse?
mental health tech
Which member of the interdisciplinary care team requires a high school education plus on-the-job training?
mental health tech
While working with group members, the nurse observes a member controlling the group with his conversation. Which role does the nurse find in this member?
monopolizer
Which statement made by the student nurse indicates effective learning about fluid group work?
multitute of complex interactions involving clients, staff members and visitors
The nurse is caring for a client with severe anger and aggression. On assessing the medical history of the client, the nurse finds that the client had encephalitis. Which predisposing factor is responsible for the client's condition?
neuro disorder inflammation of the brain
The nurse recommends that a client with severe depression be a part of a supportive group. Which statement from the client indicates that the nurse's recommendation is effective?
now I am able to deal with emotional stress
The nursing instructor is teaching a group of nursing students about the program of the therapeutic community. Which statements made by the nursing students require correction? Select all that apply.
only 2-3 members from the IDT should sign the tx plan psychologist perfoms initial assessment to establish the priority of care
what group is common on a short term inpatient setting
open-ended group
Delirium predisposing factors: Pt's with serious medical, surgical, or neurological conditions. Pt's_____are at high risk.
over the age of 65
The nurse is caring for a client with an alcohol addiction who is receiving disulfiram. Upon consumption of alcohol after taking the medication, the client experiences nausea, vomiting, dyspnea, and palpitations instead of euphoric feelings. Which technique would the nurse include to modify the client's behavior?
overt sensitization produces unpleasant consequences to extinguish unacceptable behavior
An adolescent client tells the nurse that her parents are ignoring her individuality. Based upon the client's statement, which situation would the nurse expect to find?
parents force kid to work at family business instead of going to college
A client tells the nurse her parent forces the entire family to eat dinner together every night. However, during the meal, instead of sharing positive things everyone has done throughout the day, the client's parent criticizes the client about her choice of college, her grades, and her romantic partner. Which option would this example describe?
patterns that are in conflict with each other the parent wants to spend time with the family but destroys healthy interactional patterns
Which statement made by the student nurse indicates the need for correction regarding Skinner's assumptions about how a therapeutic community is based?
peer pressure hinders development (it enhances it)
Which statement made by a student nurse is correct regarding the basic assumptions about a therapeutic community?
peer pressure is a powerful tool in the therapeutic community each pt owns their behavior each pt owns their environment
Which statement describes the role of the psychiatric nurse in a therapeutic community?
performing ongoing assessment of the pts condition
During a family therapy session, a child says to the nurse, "I just want to be like my friends' families." Which response by the nurse would be appropriate?
please explain to the group what you meant by that
A child refuses to clean his or her room and instead spends time watching television. The parent limits the amount of time the child is allowed to watch television. Which technique is the parent using to modify the child's behavior?
premack principle positive reinforcement to provide discipline
what does a psychiatrist do?
prescribe meds treat mental disorders psychotherapy a psychiatrist does not do the ongoing assessment of the pt's condition (nurse)
Which statement made by the student nurse is correct regarding the responsibilities of a psychiatric clinical nurse specialist?
presents ed to nursing staff conducts individual, group and family therapy provides consultation to other nurses
delirium If caused by systemic illness/metabolic imbalance symptoms will manifest slower over several hours or days as: _____ including restlessness, mental cloudiness, insomnia/hypersomnolence and nightmares.
prodromal symptoms
Which characteristics belong to groups with autocratic leadership styles?
productivity is high individual motivation is low focus is on the leader
Which nursing intervention demonstrates a type of contingency contracting?
providing tokens to the pt for good behavior
Which member of the psychiatric team is responsible for managing therapeutic milieu on a 24-hour basis?
psych nurse
Which educational credentials are required to become the leader of a psychiatric care unit?
psychiatrist
Which member of the interdisciplinary treatment team will prescribe somatic therapies for psychologically depressed clients?
psychiatrist
Which members of the interdisciplinary treatment team can conduct individual, group, and family therapy? Select all that apply.
psychologist social worker clinical nurse specialist
The nurse is caring for a client who is receiving occupational therapy. Which outcome in the client is most likely to indicate effective therapy?
pt has fewer self esteem problems
The nurse is caring for a client with disturbed orientation. Which nursing intervention will assist the client in maintaining orientation?
putting up notes and signs
Which information would the nurse include about medications while teaching a client with a behavioral disorder in the therapeutic milieu?
reason for taking meds harmless side effects of meds serious side effects reported to MD
A client with depression says, "I am responsible for the accident. I am the one who insisted my friend take me for a ride." Which cognitive intervention will help to modify this thought process in the client?
reattribution questioning automatic thoughts
The nurse is caring for a client who has phobic behavior. While working with the client, the nurse teaches relaxation techniques to control anxiety during the phobic stimulus. Which technique would the nurse incorporate to modify the client's behavior?
reciprocal inhibition Counter-conditioning means changing the pet's emotional response, feelings or attitude toward a stimulus. For example, the dog that lunges at the window when a delivery person walks by is displaying an emotional response of fear or anxiety.
During a group meeting, a member of the group talks about his or her personal achievements to gain the attention of other group members. Which type of individual role does the member assume in the group?
recognition seeker
Which therapy would best help in redirecting a client's destructive energy?
recreational therapy
Which statement describes the corrective recapitulation of the primary family group during family therapy?
reexperience early family conflicts that have remained unresolved
According to Bowen, which characteristics would be associated with a firstborn sibling?
reliable perfectionistic
A client with a history of violence is placed in restraints. While assessing the client alone, the nurse observes that the client is under control and no longer requires restraints. How would the nurse proceed with the client?
remove one restraint at a time with assistance
Which action is the responsibility of the leader in the working phase of group development?
resolving conflicts with group members
After assessing a client with a psychiatric illness, the nurse suspects that the client has prodromal syndrome. Which behaviors of the client support the nurse's suspicion?
rigid posture clenched fists/jaw pounding or slamming objects
The nurse is caring for an adult client with abusive behavior. On further assessment, the nurse finds that the client was a victim of physical abuse during childhood. Which predisposing factor is responsible for aggressive behavior in this client?
role modeling
Which is an example of a mild aggressive behavior?
sarcasm
Which statement made by the student nurse requires correction regarding types of relaxation techniques?
shallow breathing is a relaxation technique These are correct: progressive relaxation tensing up and relaxing mental imagry
A teacher asks a child with autism spectrum disorder to follow his or her lip movement while talking and then imitate the word to elicit speech. Which technique is the teacher using to modify the child's condition?
shaping
Which information would the nurse provide specifically to the client's parents as a part of the therapeutic milieu?
signs/symptoms of substance abuse
Which information would be kept as a written record in the three-column thought-recording cognitive behavior therapy technique?
situations, automatic thoughts and emotional response
A family is participating in a type of therapy in which the therapist focuses on expanding clients' rigid and inflexible views of the world. Which type of therapy would this describe?
social constructionist therapy
Which community factors affect treatment in the therapeutic community setting?
social interactions schedule of activities physical structures of treatment setting
Which does milieu therapy emphasize?
social skills
Which member of the interdisciplinary treatment team is concerned with financial support for the members of the therapeutic community?
social worker
Which statement describes the responsibility of a chaplain in a therapeutic community?
spiritual needs
strive to create change in destructive behavior through improvement in communication and interaction patterns
strategic approach in family therapy
try to change family principles that may be promoting dysfunctional behavior patterns
structural approach in family therapy
Which function of a group will help impart a feeling of security in an individual who is undergoing group therapy?
support
A client tells the nurse he is in love with someone, but his parents do not approve because they are not of the same race or social class. His family will disown him if they marry, so instead of telling his parents how he feels, he breaks off all ties with his romantic interest. Which type of communication does this example describe?
surrendering
Nurses most often participate in which kinds of groups?
task teaching supportive-therapeutic
The nurse is caring for a client who has a history of violence. The nurse, along with other staff members, is trying to restrain the client in the seclusion room. Which group function do the staff members exhibit along with the nurse?
task completion
Which statement describes the responsibility of an occupational therapist in the therapeutic community?
teach the pt independence in daily activities
Which statement made by the client indicates a need for knowledge and demonstrates a readiness to learn?
the doc diagnosed me with schizophrenia. What does it mean?
A family is undergoing family therapy. Which behavior of the family members indicates catharsis?
the family expresses both positive/negative emotions that were never expressed
Which statement made by the student nurse would indicate that a client is experiencing taking over?
the parent asks the child to wash the car and before the child can wash the car the parent is already doing it
When a parent asks her child to pick up toys, the child becomes angry and throws temper tantrums. Which action by the parent toward the child's behavior indicates negative reinforcement by operant conditioning?
the parent picks up the toys the anger of the child is negatively reinforced
While caring for a client with post-trauma disorder, the art therapist uses the creative abilities of the client to encourage the expression of feelings and emotions through artwork. Which action of the client indicates the effectiveness of the treatment?
the pt will analyze their work and understand and resolve underlying conflict
While caring for a client who has low self-esteem, the primary health-care provider assists the client in examining the validity of negative automatic thoughts. Which outcome in the client indicates effectiveness of the therapy?
the pt will get through a crisis
While caring for a new client with obsessive-compulsive disorder, the therapist initially emphasizes the client's current distressing situations. Which outcome in the client would indicate effectiveness of this part of the therapy?
the pt will show a reduction of symptoms
Which action taken by the client with severe depression demonstrates the effectiveness of therapy provided by the occupational therapist?
the pt will show enhanced self esteem
The primary health-care provider recommends that a cognitively impaired client join a task group. Which outcome will be expected in the client after successful therapy?
the pt will solve problems by making their own decisions
The spouse of a client says, "My wife has been depressed for the last 2 months due to emotional stress at work." Which type of group does the nurse expect will be beneficial for this client?
therapeutic groups
Which options describe the defining characteristics of aggression?
threats of suicide increase in agitation panic level anxiety
The nurse punishes the client with maladaptive behaviors by keeping the client in an isolated room and restricting visitors. Which behavior technique is the nurse using in this situation to instill proper behavior in the client?
time out
Which statement describes the rationale behind generalizing the goals of milieu therapy?
to develop situations similar to real life
While caring for a client with negative self-perceptions, the nurse asks the client to list his or her own successes and strengths. What is the rationale behind this intervention?
to enhance self esteem
While performing cognitive behavior therapy in a client with depression, the primary health-care provider gently questions the client and then reviews the data. Which statement describes the importance of this intervention?
to help the pt evaluate the validity of their thoughts
Why does a primary health-care provider use a daily record of dysfunctional thoughts (DRDT) while performing cognitive behavior therapy with a client diagnosed with bipolar disorder?
to record, identify and modify automatic thoughts and to forumulate a rational alternative
A primary health-care provider uses reattribution as a part of cognitive behavior therapy in a client with depression. Which statement describes the basis for this intervention?
to reverse the negative assignment of blame/responsibility in the depressed pt
While explaining curative factors to the group members, the nurse informs them that group situations are beneficial because group members experience similar medical conditions. Which curative factor better explains this condition?
universality
A member of a therapeutic group asks the nurse, "Why does this always happen only to me?" Which curative factor is beneficial for this client?
universality helps the pt understand they are facing the problem and it also helps them not feel so alone
Which statement made by the nurse indicates an attempt to use covert sensitization to assist a client in reducing alcohol consumption?
visualize vomitting when you crave alcohol imagine unpleasant sensations when thinking about undesirable behavior
While caring for a client with anger, the nurse observes that the client becomes confused, irritated, and boisterous. Which priority interventions would the nurse follow to reduce the client's anger?
walk outdoors offer food/drink provide relaxation techniques
A nurse is caring for a 6-month-old client who is admitted to the hospital with an infection. According to Pavlov's model of classic conditioning and stimulus generalization, when would the infant client show an unconditioned response?
when an unfamiliar nurse wearing a colorful uniform administers an injection
Which symptoms of anger would the nurse observe in a client?
yelling/shouting intense eye contact frowning
A client in the milieu unit tells the nurse, "I think it's stupid to close the front gate at 10 p.m. We should be allowed to be out until midnight." How would the nurse respond to this client?
you are not the only person on the unit. Decisions are made as a group.
Delirium develops rapidly over a short period _____
(following a head injury or seizure).
Two item nursing screen for suicide risk in any medical setting:
1. In the past month, have you had thoughts about suicide? 2. Have you ever made a suicide attempt?
_____ the most common neurocognitive disease NCD. The number of people diagnosed doubles every for every 5 year age group beyond the age of 65. AD is not _____. 2/3 of AD pts are _____. Health care costs for AD are higher than any other illness.
Alzheimer's disease a normal part of aging women
SBIRT for substance use disorders · _____ the severity of substance use and ID's the appropriate level of treatment · _____ focuses on increasing insight/awareness regarding use and motivation toward behavior change. · _____ to treatment provides those identified as needing more extensive treatment with access to specialty care.
Assesses Brief intervention Referral
Psychological factors for alcohol SUD _____ irrational thinking patterns. Denial (I'm not addicted), projection (it's my wife's fault I snort crack) and rationalization (I have to take drugs because I'm in pain).
Cognitive factors:
Sociocultural factors for alcohol SUD _____ substance abuse becomes a learned response. Drug abusers condition themselves to take drugs to cope with life.
Conditioning:
Sociocultural factors for alcohol SUD _____ influences attitude towards drugs and cultural acceptance of abuse.
Cultural and ethnic influences:
doing the minimum number of interventions needed to "meet the letter of the law". This is why brief SI screening is inadequate.
Defensive medicine:
mental state characterized by an acute disturbance of cognition, manifested by short-term confusion, excitement, disorientation, and clouded consciousness. Hallucinations and illusions are common.
Delirium:
a disease process in which there is progressive decline in cognitive ability in the presence of clear consciousness. It involves many cognitive deficits and significantly impairs social and occupational functioning.
Dementia:
Psychological factors for alcohol SUD _____ punitive superegos turn to drugs to cope with anxiety and increase feelings of self-worth.
Developmental influences:
