mental health 7115
loosening of association
ideas that fail to follow one another with logical flow and sequence
One effective nursing management strategy for auditory hallucinations is to:
identify with the person activities that appear to stimulate hallucinations and devise ways of coping.
Apraxia
impaired motor activities
Aphasia
impairment in the understanding or transmission of idea by language in any form due to brain impairment
serotonin
improves moos
One of the main differences between dementia and delirium is that:
in dementia the course of the illness is slow and progressive, whereas in delirium the course of the illness is short and rapid.
stimulants
increase body's activities. eg meth Cocainem nicotine caffeine
The primary purpose of reflection for a nurse is to:
increase their own understanding and self-awareness. All of these are important outcomes, but the primary purpose of reflection is to develop the nurse's individual understanding and awareness.
Advantages of providing mental health services through primary healthcare include all of the following except:
increased client burden.
S.30 MHA92
inpatient order not to leave lock ward without permission must have treatment
According to Erikson, one of the major developmental tasks for older adulthood is
integrity versus despair
panic disorder
intense surg of anxiety. provide CBT or benzodiazdpines
glutamate
is a powerful excitatory neurotransmitter that is released by nerve cells in the brain. it is responsible for sending signals between nerve cells helps " memory and learning "
One of the main concerns regarding the use of electroconvulsive therapy (ECT) as an intervention is that:
it remains controversial.
S.16 MHA92
judges reveiw
Cognitive changes that may be associated with starvation in eating disorders include
lack of concentration, and increased obsession with food and body image.
externalising problems
lashing out agressive violence theft
culturally safe nurses?
learn about themselves and their own culture, examining their own attitudes and values
neuroleptic malignant syndrome
life threatening usually develops quickly. typically haloperidol. symptoms include hyperthermia severe motor rigidity BP pyrexia sweating hypotension
mood stabilizers
lithium stabilizers.
social or sexual behavior
loss of ego boundaries can cause confusing in relationships with others
anhedonia
loss of feeling of pleasure
noradrenaline
main neurotransmitter of sympathetic nerves in the cardiovascular system.
A life crisis can disrupt people's daily activities and routines. People involved in a crisis might:
make behavioural, social and emotional adjustments in their lives.
psycho motor retardation
marked slowly in mental and physical activity often associated with depression
One of the principles of nursing care of a client with a personality disorder is that the nurse must:
monitor the client for signs of self-harm and suicidality.
The French physician Philippe Pinel (1745-1826) believed that the cure for mental illness was:
moral treatment.
acute dystopia reaction
muscle spasm in body trunk and necklaces eyes can roll up uncontrolled life treating when larynx spasm and occluded the airway
euthymic
normal and non depressed mood
A major principle that has been a driving force behind the design and creation of services for people with an intellectual disability is:
normalisation.
The mental health nurse who is interviewing a client for the first time should begin the client's assessment with:
observation of the client's behaviour.
acute stress disorder
occurs within a month of exposure to trauma.
An acute dystonic reaction that is a side effect of some typical antipsychotic medications is:
oculogyric crisis. In an acute dystonic reaction, muscle spasms are seen in the body trunk and the neck (opisthotonos and torticollis) and on occasion these spasms result in the eyes rolling up uncontrollably (oculogyric crisis).
hyperventilating first aid
offer a paper bag checking ABCD
depression
often abrupt. usually after traumatic life events. can last 6 weeks to a year. mood sad and helplessness
The Australian survey of people living with psychosis identified that
one in three people with a serious mental illness were sedentary
ideas of reference
perception that the TV is addressing that person
disorganised thinking
person switches topic erratically. word salad
Being older places individuals at risk of delirium. There are also a number of other risk factors that predispose older people to delirium, such as:
preexisting brain damage. preexisting dementia. sensory impairment.
The main focus of clinical supervision for nursing staff is
professional support for the nurse's clinical work, interactions and interventions. Clinical supervision focuses on the nurse's clinical work, and although increased confidence and support can improve peripheral areas such as personal and collegial relationships, that is not its primary purpose.
power houses
proprioception is the body moving with regular effect eg weighted blankets deep pressure massage Vestibular body position & space visual and balance oral motor chewing or drinking sweets lollypop sipper bottle
The nurse is counselling a client with schizophrenia and their family about the effects of the illness, and exploring the ways in which they can prevent relapse. The nurse is using a counselling approach known as?
psychoeducation.
Delirium
rapid onset, short lasting hours to days, can have hallucinations. mood emotional liability and distress.
The biological action of a drug depends on how its structure interacts with a specific:
receptor.
obsessive compulsive disorder
recurring experience of anxiety. treatment combination of medication and talking therapy
In some people with schizophrenia who smoke, nicotine may be used as self-medication to:
reduce the negative symptoms of their illness.
What are personality traits
reflect people's chracteristics patterns of thoughts feelings and behaviours
To develop self-awareness, a nurse must be willing to be
reflective. Reflection is the first step in developing self-awareness. It is related to the nurse's ability to consider their feelings/experiences in relation to their application of knowledge to clinical situations.
The foundation for recovery-informed practice is:
relationships.
Social skills training helps people to?
relearn skills.
Complex crises are associated with:
religious persecution.
akathsia
restless leg syndrome disturbs both sleep and rest.
protective factors influencing attachment
safe environment being emotionally response to children empathy setting clear expectations separating emotions from actions you can be angry but do not hit
Nurses need to develop their understanding of trauma-informed care to include knowledge of:
safety, trustworthiness, choice, collaboration and empowerment
visual hallucinations auditory hallucinations
seeing things "evil angels" the hearing of voices
Principles of sleep hygiene include all of the following except
sharing the bed with pets.
The nurse is caring for a client who is receiving lithium carbonate therapy. It is important for the nurse to educate the client on:
side effects and signs of toxicity.
basic sensory system
sight smell touch taste hearing
depressants
slow activity of the brain. can produce euphoria relaxation. example diazepam temazepam bezodiapines.
social phobia
socially induced distress feat of embarrassment humiliation or negative judgement treatment CBT with SSRI and hypnotherapy
mania nursing interventions
speak calm supportive tone then firm simple directions or comments do not argue or engaged in debate never reinforce hallucinations. always response to legitimate complaints.
pressure of speech
speech increased and difficult to interrupt
adjustment disorder
steps response. treatment figure out the trigger of their anxiety
mood
subjective emotion cry happy sad
What is the best description of peer support in mental health? Peer support is decribed as:
support to peers by people who have also experienced mental health challenges.
physical drug dependence
sweating raised blood pressure
symptoms of panic attack
sweating vomitting tachycardia increased breathing faint
A Mini Mental State Examination (MMSE) is useful when there is little time to conduct a full mental status exam and when
the client is experiencing psychological distress.
One of the most important principles of the therapeutic relationship when the nurse works with a client with a mental disorder is that:
the client is the primary focus of the interaction
Cultural safety is the practice of:
the nurse being aware of his or her own cultural bias
diathesis stress model
the theory is that some people are more vulnerable to mental illness could be related to gentics environmental factors aberration in brain anatomy of biochemistry or combination of all
biochemical theories
this theory is often referred to as the dopamine hypothesis and the theory is a mixture of known factors and hypothesis
anti anxiolytics
treats anxiety eg benzodiazdpines which inhibit GABA
6 domains that the WHO 2001
understanding and communicating getting around self care getting along with others household and work activities participation in society
Focusing on a person's strengths has superseded the deficits-based approach to practice. The main aim of working with strengths is to
value a person's talents, uniqueness and resilience.
incoherence
verbal rambling
What lifestyle interventions can nurses implement to assist with the management of cardiometabolic health
waist measurement BP height weight calculator BMI lipid profile and liver test. life style changes eg smoking cessation alter dietary habits
The underlying principle of family therapy is based on the fundamental premise that?
when a person has a problem, it usually involves the whole family.
psychological dependence
withdraw craving the drug when they have stopped
drug dependence
withdraw symptoms
catatonia
withdrawn that they appear unconscious staring grimacing ridged
is alcohol a form of self harm
yes as it causes bodily harm fatty liver hypertension violence suicides depression. obesity
should older people be assessed for suicide?
yes because undiagnosed treatment of depression can put mental health at risk and lead to isolation and suicide
The Tidal Model has been developed based upon a theoretical framework that focuses upon moving from solving problems for the person to finding solutions with the person. The Tidal model is a values based model and the values underpinning this model are called The Ten Commitments
• Value the voice. • Respect the language • Become the apprentice • Use the available toolkit • Craft the step beyond: • Give the gift of time • Develop genuine curiosity • Know change is constant • Reveal personal wisdom • Be transparent
Research involving those with the lived experience of mental illness have identified what are considered to be the most important factors in their recovery
• having self-determination • discovering a more active sense of self (personal agency) • valuing themselves as a person through their interactions with others • realising the need to help themselves and to take responsibility for their distress • seeing the potential for richer identities other than that of a person with mental illness • reflecting on positive experiences leading to consideration of other potentials • exploring experiences with reference to both the present and the future self • finding ways to monitor and manage the symptoms of distress • tapping into their own inner wisdom • having optimism • recognising the importance of spirituality.
A nurse experiencing 'burnout' should keep working, because the feelings will pass. After all, everyone feels exhausted, uninterested and ineffective at work, and so there is no reason to be unduly concerned? True false?
" BURNOUT" FALSE
Behavioural theory is unable to explain how mental illness can occur in a person whose environment is healthy and advantaged? TRUE or False
" Behavioural" TRUE
In all settings the client is supported as a person in interactions with others, rather than as someone suffering from a health problem or disability? true or false
" Disability" TRUE
Reflection is an important part of recovery-informed practice? true or false
"Reflection" TRUE
The Tidal Model is the right theory on which beginning practitioners should base their nursing practice? True or False
"Tidal model" FALSE
blueprint 8 clusters of life
1) family whanau -1 to 3+ years post natal provides good foundation and resilience 2) children with mental and behavioural issues parent support is needed to lower youth mental health and crime 3) youth and adolescents with emerging mental health behavioural and addiction disorders interventions to reduce alcohol and drug addiction 4) youth adolescents at high risk (including forensic) intervene in a pathway that has the potential to lead to life long mental health and addiction issues 5) adults and older people with high prevalence disorders help reduce anxiety depression addiction to create resiliency in this population 6) adults and older people with low prevalence high severity disorders support with talking therapy support employment to improve social inclusion 7) adults and older people involved in foresight and or justice system support inergrated response mental health and justice system 8) adults and older people with mental health and addiction disorders alongside chonic illness and or dementia mental health and addiction
priority and 7 actions
1) providing a good start response earlier to issues B4 school checks 2) positively influencing high risk pathways provide earlier and more effective responsive for youth and adults with mental health and addiction eg youth courts 3) supporting people with episodic needs support return health functioning with independence for people. 4) supporting people with servere needs support return to health functioning. 5)supporting people with complex needs eg disabilities long term conditions and or dementia to achieve quality of life 6) promoting wellbeing reducing stigma promote mental health and well being to families and communities. 7) providing a postive experience of care improving system performance strengthen a culture of partnership and engagement in providing postive care experience
S.8 MHA92
18+ fill from seen pt 36 hours state relationship to pateint and grounds
A diagnosis of PTSD is not made in the first month of symptoms because what percentage of people fully recover within three months of onset?
50%
It has been argued that moral development is more complex than simple developmental stage theories indicate. Taking into account underlying critical factors, which of the following family characteristics helps moral development the most?
A degree of family adaptability, cohesiveness and communication
Agnosia
A failure to recognise objects
Creating relationships of safety
A sense of safety in a relationship is the foundation that creates the ability to connect, to be intimate, to relax into the sense of oneness that a mutual affinity and healthy attachment can foster.
New Zealand legislation specifically allows for people who have been charged with or convicted of an offence, and who meet certain criteria in terms of their mental illness, to be treated for that condition in hospital. Treatment of mental illness can be an important step in helping an individual to?
Acknowledge and address the reasons for their offending, and in doing so reduce the chances of future offending
What are the key principles of the Tidal model
Active collaboration between the mental health clinician and the individuals and family in the planning and delivery of care The development and use of a care plan that is centred on the individuals experience, thus empowering the person. The provision of using care in a multidisciplinary context. The use of narrative based interventions, all of which form the basis of problem resolution and mental health promotion
The recovery paradigm focuses on which of the following factors
Active participation, choices and the person's right to self-determine
Selective serotonin reuptake inhibitors (SSRIs) belong to which group of psychotropic drugs?
Antidepressants SSRIs such as fluoxetine and paroxetine are antidepressants.
A person who exhibits disregard for the law; is reckless, aggressive, deceitful and impulsive; and does not show remorse may be showing signs of which of the following personality disorders?
Antisocial personality disorder
Short Answer EMILY 36 year old with bipolar. She is experiencing hypomanic and her partner Grant is worried about her parenting and wanting more support with 3 children and their relationship. How could principles of recovery informed practice be used to assist Emily?
Apply patient centred approach. assisting Emily and Grant to access the services they need and want ( in their case more support in their family) assisting Emily and the Husband with alleviating distress and identify helpful strategies for now and the future. Potential relationship counselling. working with Emily to ensure her safety and safety around the children.
Which type of medication can affect both the 'positive' and the 'negative' symptoms of schizophrenia?
Atypical antipsychotic
psychological factors that make older people more vulnerable to depression
Bereavement, medication, financial security, independence loss, low activity
The onset of symptoms for some personality disorders may be attributed to which of the following?
Childhood abuse and neglect
Short answer Example of care coordination function
Collaboration symptom mangement monitor wellbeing and recovery identifying and working with risk collaborating with other agencies
Australian and New Zealand communities represent a diverse range of cultures and differing lifestyles. This requires nurses to develop which of the following
Cultural awareness and sensitivity
Wellness recovery action plan: WRAP
Daily maintained plan- visualize yourself in recovery Right list daily to do list Identify risk Early warning signs List signs of what makes you feel not good, when to seek help Crisis plan identify those who you can contact if you are unwell ? Post crisis plan? What do you need to recovery after a crisis?
People typically approach or avoid stressful events. Which of the following is not a characteristic of coping?
Denial
The most dangerous complication of vomiting and purgative abuse by people with an eating disorder is which of the following?
Depletion of potassium, chloride and sodium Frequent vomiting can result in metabolic alkalosis and hypokalaemia, whereas laxative misuse can lead to metabolic acidosis, hyponatraemia and hypokalaemia.
A person classified with a borderline personality disorder might be most effectively helped by which of the following interventions?
Dialectical behaviour therapy
Psychotropic medications can reduce the amount of saliva, leading to the client experiencing which of the following symptoms?
Dry mouth Many psychotropic medications can reduce the amount of saliva the mouth produces leading to a dry mouth, or xerostomia, which is associated with an increase in periodontal disease.
The ability to think in abstract terms defines the concrete operational (7-11 years) stage. Concepts and symbols can be used in advanced problem solving (advanced mathematics). A variety of options can be generated to solve problems and generate creative thought.? True or False
FALSE
Preceptorship is a long-term relationship that extends outside the person's workplace, and helps people to grow and develop and achieve their personal potential. True or False
False Preceptors are usually based in the clinical area where they assist you to develop skills and confidence in a new area.
Which of the following vaccinations is important for people diagnosed with serious mental illness?
Flu
Standardised assessment instruments are used to assess cognitive function and include all of the following except
GDS (Geriatric Depression Scale short form).
Which of the following events is not a potential trigger for posttraumatic stress disorder or acute stress disorder?
Going to the dentist
Leave is an important part of the rehabilitation process for special patients and should generally occur as part of a comprehensive leave plan. What are the first three steps in recommended leave progression?
Ground access with staff escort approved by DAMHS Step 2 Unescorted ground access approved by DAMHS Step 3 Staff-escorted leave outside the hospital grounds approved by Director of Mental Health
common conditions associated with depression in older people
HF Strokes Arthritis Diabetes Amputation
Which of the following are indicators of resilience in family members of people with mental illness?
Hardiness, hope and acceptance
A client is experiencing a hallucination that includes 'being watched by the FBI via cameras attached to the overhead lighting'. The most appropriate response for the nurse to make is
It must be frightening to feel as if you are being watched.'
Jason is a 31 year old male and is the second oldest of five in his family. He has been involved on and off with mental health and addiction services for the past 12 years following his first experience of mental distress as a 19 year old.In his twenties, and when his cannabis and methamphetamine use was regular and heavy, he prospected for a gang but was never patched as they found him "a bit too crazy". He says that he now wants to get away from that lifestyle and not fall back into old patterns, keep his cannabis use under control, get a job and reconnect with his family. He says he would like to have a lot more to do with raising his sons and would like to be better able to financially support them. Being a good role model and father is a significant goal for Jason and the main reason for wanting to get his "life back together again".
Jason identifies family as one of his top five values. He tells you that participating in criminal activity carries the risk of punishment (such as imprisonment) which takes him away from his family (for example, his sons and brother). A key question might be "How does going to prison show your sons that you care?" and "How could you show your sons you care for them in other ways that really align with your chosen values?"
Which of the following factors is not characteristic of professional relationships?
Judgemental
Angela has experienced mental health problems since she was a teenager. Now in her early twenties she is tired of treatments which cause her problems and don't solve the things that bother her. After months experiencing black moods and severe anxiety, Angela is exhausted, overwhelmed and very distressed. While not feeling that she should end her own life, she has lost hope that anything will ever work and cannot imagine having a life worth living.
Keep key messages in mind to share by validating Angela's feelings and then letting her know that the work you are doing together will make a positive difference and that your service and you are committed to her wellbeing, whatever that means for her. Demonstrate confidence by letting Angela know about you and your service's experience and good outcomes in working with people with similar stories to hers.
Social inclusion
Key features of the recovery paradigm include the need for self-determination, personal agency, the importance of social inclusion and having choice in a range of services. Valuing the person's imperatives rather than clinical imperatives drives the recovery paradigm: it represents a change in values
Which of the following diseases may be misdiagnosed as a mental illness?
Lyme disease One example of a disease that may be misdiagnosed as a mental illness is Lyme disease. Lyme disease is a tick-borne disease that manifests symptoms in a variety of ways. Commonly, the person presents with psychiatric symptoms like paranoia, anxiety and depressive symptoms and because the person often doesn't realise they have been in contact with a tick, correct diagnosis can be difficult.
When screening for metabolic health, which of the following actions are correct when measuring waist circumference?
Make sure the tape is parallel to the ground and not twisted. Make sure the tape is snug, without compressing the skin. Ask the client to breathe in and out twice and measure on the second out breath.
MICAMHS
Maternal Infant Child and Adolescent Mental Health Service they offer support to young people and their significant others who are experiencing a moderate to severe mental health issue
Regional Forensic services are responsible for the care of special and restricted patients. What is a special patient?
Mentally ill offenders detained under specific legislative provisions.
Mental health nurses can provide exercise advice and physical activity counselling to mental health consumers. Which of the following strategies could you recommend?
Monitoring devices such as pedometers Ways to increase light physical activity Adding brief 5-minute walks throughout the day
'Pre-contemplative', 'contemplative' and moving into the 'action stage' are part of which therapy?
Motivational interviewing (MI)
nursing intervention
Motivational interviews - pre contemplation (Denial or resistance to change) contemplation (client is aware of problem) preparation (client intends to change needs support though) action (client implements a realistic plan)
If the nurse feels unsure about the best course of action following an interview, they should do which of the following?
Openly discuss this with a co-interviewer and include the consumer in that discussion
Facilitating self-help and personal responsibility
Past practices in mental health focused on the illness to the exclusion of the person experiencing the illness. Describes the process as follows: A person would go to a health professional for help. The professional would ask about 'the problem' (usually symptoms of illness), building a bigger and bigger picture of 'the problem'. This would lead to the person focusing more and more on 'the problem'. The problem would grow bigger and bigger and be added to by the person's family or others asking about it. Soon the person's identity would be taken over and consumed by 'the problem', 'the illness'.
Which of the following constitutes a misconception about mental health?
People with a mental illness will never recover.
Motivational interviewing (MI) was initially an intervention developed for working with which type of clients?
People with substance abuse and dependence problems
(PIMHS)
Perinatal, Infant and Maternal Mental Health Service PIMHS is available for women who are experiencing moderate to severe mental health issues during pregnancy and up to 12 months after birth.
Manu is a 58 year old man who identifies as Māori and Pacifica. He has been referred to your service by his General Practitioner following many months of concern by his whanau about his memory problems. Manu has a past history of head injury and has a case history with ACC. He has been initially assessed by the service intake worker and referred into the community mental health team. This is his first experience with mental health services and you have been advised that although he doesn't like hospitals he is willing to come to the community clinic. You are planning to meet him for his first assessment with the community psychiatrist.
Plan ahead to arrange for provision of a nice large space for everyone during the appointment. (Manaakitanga) Greet and welcome Manu and his whanau at the reception area. (Manaakitanga) Check on car parking matters, indicate where the toilets are and offer a refreshment - especially if they have travelled (it is very common for whanau to travel large distances to support their whanaunga at hospital appointments with a specialist). (Awhi) Introduce yourself, your role, your card and who they will be seeing at the appointment. Give the community psychiatrist's name. (Whanaungatanga, manaakitanga) Let them know approximately how long you will all be together. (Awhi) Try to pronounce names correctly. (Manaakitanga, awhi) Offer to stay with them during the appointment if Manu and they wish. (Awhi) Be available to answer any questions after the appointment and let them know what happens next. (Awhi) Farewell them and take them to the nearest exit to their vehicle. (Awhi)
Which of the following are features of executive function?
Planning, decision making, working memory, responding to feedback, inhibition and mental flexibility
What is the overarching strategy that staff can use to empower clients
Providing support to find solutions to problems
When a family is deemed to have high levels of expressed emotion (EE), which of the following is the appropriate intervention?
Psychoeducation
"recovery informed practice" and "traditional practice" is?
Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness. traditional focus on a broad theoretical and philosophical basis for mental health nursing while envisioning the mental health nurse as a practitioner with a recovery orientation who is highly skilled in a wide range of effective interventions.
A person is exhibiting evidence of some paranoid ideation, lacking social networks or friends, expressing odd beliefs and thinking in their speech, and is odd in their appearance. They may be showing signs of which of the following personality disorders?
Schizotypal personality disorder
Attending to language and meaning
Since language conveys meaning we prefer the expression 'people who have experience of mental health challenges' because it is part of the spectrum of human experience we may all have.
The patient experiencing a panic attack may exhibit which of the following symptoms?
Tachycardia or chest pain
Engaging with curiosity
Takes a stance of 'unknowing' and curiosity to help uncover the meaning people make of their experience
Hope (and keeping it alive)
The National Framework for Recovery-oriented Mental Health Services promotes a culture of hope and optimism evidenced by the language used, and emphasises ensuring people feel valued, important, welcome and safe. To stress the importance of hope, research has found hope to correlate with wellbeing, quality of life, subjective satisfaction with life, spirituality, resilience, self-esteem and self-confidence. In practice, this means communicating positive expectations and supporting the person in doing what they can to maintain hope.
Gloria is in her sixties and lives in a sunny unit on the city fringe. She has three grown up children who all live in other towns, so she doesn't see them as often as she would like. Since her husband died two years ago Gloria has felt a bit isolated. When he was alive she and her husband would regularly have a glass of wine with their meal in the evening. Lately she has been having a few glasses, starting drinking in the afternoon and continuing through the evening. When her children call or Skype her she often does not remember what they have talked about the next day. Her mood is very low and she is going out less and having less to do with other people most of the time.
The most important thing to do is to engage in conversations with Gloria about what she thinks of her responses, what is the most important or pressing for her to address and how she might start to do so.
Whose responsibility is it to maintain professional boundaries?
The nurse Professional boundaries are always the responsibility of the nurse; boundaries define the nurse's professional role and the purpose of their relationship with the client.
The nurses primary role is to:
The nurses primary role is to:
What are Forensic Mental Health Services required to balance?
The rights, treatment and rehabilitative needs of the individual patient against the safety of the public and the concerns of victims.
Self-determination
The ultimate goal of mental health practice is to value and facilitate the personal recovery of all individuals. This includes promoting their personal agency, connectedness and social inclusion self determination and their active participation in society. It also relates to how they can negotiate the range of resources they need to remain active citizens in the community of their choice, even during periods of mental distress.
There are a number of defining features that make up a crisis. Which of the following could be one of the most common
There is a sense of uncontrollability.
A client has been admitted to the hospital with a diagnosis of Wernicke-Korsakoff syndrome. What is administered to treat this condition?
Thiamine
risk factors for delirium in older people
UTI, resp kidney cardiac failure. chest infection constipation medication or drug withdrawal.
Which of the following principles for verbal interactions is important when engaging a person with challenging behaviour?
Use an appropriate tone, rate and volume of speech
It might be anticipated that a client hospitalised with a diagnosis of anorexia nervosa might have a poor outcome if the disorder is associated with:
a comorbid mental disorder.
elation
a feeling of exhilaration pride joy
Most older clients who develop delirium have a prodromal stage during which changes can be observed in the person's habitual behaviour and cognitive functioning (sleep disturbance, restlessness and irritability, general malaise and anxiety). How long is this prodromal stage?
a few hours to a day
The therapeutic milieu refers to environments where the emphasis is:
a holistic approach to client needs. The therapeutic milieu is intended to meet not only clients' needs for psychiatric, medical and nursing care, but also their needs for recreation, occupation and social interaction
incongruent affect
a mismatch between persons thoughts and their emotional espression
mania
abnormal elevated expansive or irritable mood lasting 1 week
impulsivity
act rash
Benzodiazepines are a commonly prescribed anti-anxiety drug. They reduce anxiety by facilitating the:
action of the neurotransmitter GABA.
What does audit stand for
alcohol use disorders identifications test
One of the reasonably new concepts in mental healthcare is understanding how stress in childhood or adulthood may impact on a person. This is known as:
allostasis.
A client tells you, the student nurse, that she doesn't want to talk about her problems to anyone, as she feels that she will be seen as 'crazy' and is worried that people will reject her. As the student nurse, you would:
allow the client to continue talking, and use your active listening techniques.
S.2 MHA92
an abnormal state of mind characterised by delusions or mood to such a degree that it poses danger
The major difference, for a child, between an authoritative parent and an authoritarian parent according to Baumrind was that
an authoritative parent had clear, rational expectations.
Erikson's work on stage development envisaged successful personality development as
an outcome of conflict resolution through eight psychosocial stages.
internalizing problems
anxiety depression
somatisation
anxiety or phyiological conflict is translated into physical complaints
mse framework
appearance-clothes hygiene scars shaved etc behaviour/mood - eratic eye contact happy sad worries thoughts/orientation- rational content ? sucidal ideation time place person speech/insight- speed and volume pressured speech? are they aware of need for treatment? risk- are you having sucidal thoughts harm to self or others
One of the main influences on one's self-concept, life relationships and life experiences is
attachment.
There is no set format for recording a mental state assessment, but the BATOMI mnemonic is a useful for guiding assessment and includes all of the following except:
attitude and temperament.
The four phases in the process of family recovery include all of the following except:
bargaining and acceptance.
emotional blunting
being flat or monotone
In the past, the traditional antipsychotics, particularly haloperidol, have been prescribed as prn medication for acute agitation and disturbed behaviour. New evidence suggests that
benzodiazepines are just as effective as traditional antipsychotics as prn medication.
Anorexia nervosa is primarily characterised by determined efforts to lose weight or avoid weight gain, whereas bulimia nervosa is primarily characterised by:
binge eating.
challenges with assessing an older people with depression?
can be difficult to diagnosis depression because dementia has similarity.
abnormal motor behaviour
can range from agitation to child like silliness
panic attack first aid
check for breathing and pulse
explain what secure attachment means
child is raised in a nutured environment. has good development factors that promote healthy child outcomes
dysthymic
chonic mild depression
dementia
chronic slow progressive can last month's to years. mood will be flattens or labile.
While interviewing a child and their parents for the first time, the skilled mental health nurse will concentrate on the presenting problems and any associated difficulties so that it becomes possible to:
clarify the parents' goals with their child's.
weight gain medications
clozapine and olanzapine and chlorpromazine
metabolic syndrome
cluster of abnormal clinical and metabolic findings that result in an increased of T2DM
The principles of caring in the community are:
collaboration, recovery and goal setting, and working with clients' strengths.
Personal recovery processes include:
connectedness, hope, identity, meaning, empowerment.
generalised anxiety disorder
constant worrying. treatment stepped care approach with education
Recovery-informed practice focuses on:
consumer-directed goals and outcomes.
Components of the therapeutic milieu are
containment and structure. support and involvement. validation and symptom management.
In some instances nurses may experience the 'fight or flight' response. Physical symptoms of the 'fight or flight' response may include all of the following except:
deep, rapid respirations.
thought insertion thought broadcasting
delusional beliefs unwilling to accept such diagnosis is the belief that others can hear or are aware of an individual thoughts
A client with a panic disorder has been prescribed a benzodiazepine medication. One of the risks of benzodiazepines is:
dependence.
DSM 5 for depressive disorder
depression mood loss of pleasure weight loss gain insomnia psychomotor agitation fatigue feeling worthless diminished ability to think thoughts of death
One of the most common remediable mental disorders in older people is:
depression.
One interactive therapy that helps to actively incorporate social skills training for the client is:
dialectical behaviour therapy.
PTSD
direct exposure to traumatic event eg sexual harm. treatment cognitive behavioural therapy.
The term 'ageism' refers to:
discrimination against people on the grounds of their age alone.
The primary elements of de-escalation include all of the following except:
don't offer choice.
dopamine and addiction
drugs alcohol gamble eat sex. causes a realise of chemical along the mesolimbic dopamine pathway in the brain "feel good"
One side effect of traditional or typical antipsychotic medication is an adverse anticholinergic effect such as:
dry mouth. Anticholinergic effects that might be experienced in addition to a dry mouth are blurred vision, orthostatic hypotension, tachycardia, urinary retention and nasal congestion.
One of the most effective treatments for depression in the older person is:
early intervention
affect
eg blunted flat restricted labile
anti depressants pharmacology
elevated mood. block reuptake of neurotransmitters eg serotonin dopamine.
negative schizophrenia symptoms
emotional flatness apathy lack of speech not motivation loss of living skills anergia
One underlying premise of Allport's six dimensions of maturity is
emotional security.
Central to a therapeutic relationship in mental health nursing is
empathy. Clients value empathic nurses highly, and empathy is positively linked with the ability to develop therapeutic relationships.
Psychiatric rehabilitation has shifted to the concept of recovery because of:
emphasis on the goals, outcomes and options of the consumer.
The goal of involvement in the therapeutic community is to
encourage clients to be actively engaged in their treatment.
An underlying principle of validation in a therapeutic milieu for the client involves
encouraging open discussion of values, feelings and goals.
One of the main purposes of the multidisciplinary team is to
ensure comprehensive coordinated care by a range of health professionals
Good' outcomes of development proposed by Maslow (1968), Erikson (1963) and Allport (1961) all describe criteria that are normative; that is, they assume that:
everyone is the same and if a certain standard is achieved, this can lead to an ideal end-state.
S.4 MHA92
exclusions; the act cannot invoked soley by reason the persons political religious or personal beliefs
what dose whakatauki mean
expression of hope regardless of illness or disease
delusion
false belief
explain disorganised child attachment
fear anxiety depression poor brain development.
agoraphobia
fear responses to exposure. provide talking therapy
specific phobia
fears of anaimals or natural environment. treatment exposure to the phobia
The elements of 'burnout' syndrome are:
feelings of exhaustion and depersonalisation. Burnout affects people differently. Emotional exhaustion, depersonalisation and feelings of reduced personal accomplishment are elements of burnout syndrome.
egocentric
focus on their self to point that are beyond ones awareness
schizophrenia postive symptoms
hallucinations delusions racing thoughts
Personality disorders:
have their onset in adolescence.
labile
having rapidly or shifted unstable emotions
sensory modulation
helps people identify their unique sensory preferences. attention span alertness emotion regulator self awareness de escalation relaxing and calming grounding
Non-adherence to the prescribed medication regimen may result in:
hospital readmission for a client.