Psychiatric nursing unit 1 – Flashcards
Unlock all answers in this set
Unlock answersquestion
Which statement about mental illness is true? a. Mental illness is a matter of individual nonconformity with societal norms b. Mental illness is present when individual irrational and illogical behavior occurs. c. mental illness is defined in relation to the culture, time in history, political system, and group in which it occurs. d. mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.
answer
c. mental illness is defined in relation to the culture, time in history, political system, and group in which it occurs.
question
Axis V of the DSM multiaxial system: a. refers to medical illnesses b. reports psychosocial and enviromental problems c. indicates a need for substance abuse treatment d. describes a person's level of functiong
answer
d. describes a person's level of functioning
question
Why is it important for a nurse to be aware of the multiple factors that can influence an individual's mental health? a. Rates of illness differ among various groups b. The DSM cannot be used without information on multiple factors. c. The nurse diagnoses and treats human responses, which are influenced by many factors. d. The nurse must contribute these data for epidemiological research.
answer
c. The nurse diagnoses and treats human responses, which are influenced by many factors.
question
Factors that affect a person's mental health are: (select all that apply) a. support systems b. developmental events c. socioeconomic status d. cultural beliefs
answer
a. support systems b. developmental events d. cultural beliefs
question
Which statement best describes a major difference between a DSM-IV-TR and a nursing diagnosis? a. There is no functional difference between the two. Both serve to identify a human deviance. b. The DSM diagnosis disregards culture, whereas the nursing diagnosis takes culture into account. c. The DSM is associated with present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems. d. The DSM diagnosis distinguishes a person's specific psychiatric disorder, whereas a nursing diagnosis offers a framework for identifying interventions for phenomena a patient is experiencing.
answer
d. The DSM diagnosis distinguishes a person's specific psychiatric disorder, whereas a nursing diagnosis offers a framework for identifying interventions for phenomena a patient is experiencing.
question
Which of the following contributions to modern psychiatric nursing practice was made by Freud ? a. The theory of personality structure and levels of awareness b. The concept of a "self actualized personality" c. The thesis that culture and society exert significant influence on personality d. provision of a developmental model that includes the entire life span
answer
a. The theory of personality structure and levels of awareness
question
The theory of interpersonal relationships developed by Hildegard Peplau is based on the foundation provided by which of the following early theorists? a. Freud b. Piaget c. Sullivan d. Maslow
answer
c. Sullivan
question
According to Maslow's Hierarchy of needs, the most basic needs for psychiatric mental health nursing are: a. Physiological b. safety c. love and belonging d. self-actualization
answer
a. Physiological
question
The premise that an individual's behavior and affect are largely determined by the attitudes and assumptions the person has developed about the world underlies: a. modeling b. milieu therapy c. cognitive behavioral therapy d. psychoanalytic psychotherapy
answer
a. modeling
question
Providing a safe environment for patients with impaired cognition, referring an abused spouse to a "safe house," and conducting a community meeting are nursing interventions that address aspects of: a. milieu therapy b. cognitive therapy c. behavioral therapy d. interpersonal psychotherapy
answer
c. behavioral therapy
question
A 24 year old female is diagnosed with alcohol dependence and requires acute detoxification. The most appropriate setting is: a. partial hospitalization b. residential setting c. rehab unit d. acute inpatient care
answer
d. acute inpatient care
question
A significant influence allowing psychiatric treatment to move from the hospital to the community was: a. television b. the development of psychotropic medications c. identification of external causes of mental illness d. the use of a collaborative approach by patients and staff focusing on rehabilitation.
answer
b. the development of psychotropic medications
question
Which of the following is a benefit for patients being treated for mental health problems by a primary care physician rather than a psychiatrist? a. A high level of expertise in the diagnosis of psychiatric disorders b. Extended time in the physician's office for a through psychiatric assessment c. Feeling that there is less stigma attached to treatment d. A high level of expertise in the management of psychopharmacological medications for psychiatric illnesses
answer
c. Feeling that there is less stigma attached to treatment
question
A 45 year old patient experiencing increased symptoms of anxiety lives in a rural community over 100 miles from the nearest psychiatrist. Other health team members are located closer to his residence. Which of the following health care professionals could provide an initial screening and treatment plan for this patient? ( select all that apply) a. social worker b. psychologist c. primary care provider d. advanced practice psychiatric nurse
answer
b. psychologist
question
A community mental health student nurse is asked by her supervisor to develop a stress reduction class for the residents in the surrounding community. The student nurse resists, saying that her responsibilities are to her patient caseload. The supervisor explains to the student why this assignment is appropriate for her role. Which is the most suitable rationale that the supervisor can provide to the student nurse? a. stress reduction is important to patient's mental health. b. funding sources will support the class only if it is developed by a nurse. c. an important concept for community health nursing is to view the entire community as a patient. d. research has demonstrated that stress reduction reduces hypertension in mental health patients.
answer
c. an important concept for community health nursing is to view the entire community as a patient.
question
Follow up care after administering blood transfusion
answer
inspect IV site and infusion rate + vitals assess changes in VS + chills, dyspnea, flushing, itching, rash assess lab values
question
how long can a bag of blood hang before the risk of bacterial growth occurs
answer
4 hours
question
S/S of an adverse reaction to a blood transfusion
answer
Fever with or without chills Tachycardia and/or tachypnea and dyspnea Drop in blood pressure Hives or skin rash, including assessment of the trunk and back Flushing Gastrointestinal symptoms Wheezing, chest pain, and possible cardiac arrest Patient complaints of headache or muscle pain in the presence of fever
question
when is it appropriate to delegate monitoring of a patient who is receiving a blood transfusion?
answer
Nurse aide may monitor a patient after the blood transfusion is started and the patient's stability has been confirmed
question
Therapeutic relationship criteria: 7 examples
answer
1. Always goal directed and purposeful 2. Nurse must evaluate own behavior to help patient identify his needs and goals 3. Nurse needs to expect to hear and listen to patient problems 4. Nurse is responsible for staying with patient trough problems that may provoke anxiety. 5. Nurse is responsible for structuring relationship and prepare patient and self for termination 6. Communication is purposeful 7. Nurse has skills that are shared with patient consciously and purposefully
question
Five Elements required to prove negligence
answer
1. Duty 2. Breach of duty 3. Cause in fact 4. Proximate cause 5. Damages
question
Altruism
answer
Receiving gratification by meeting others needs
question
Sublimation
answer
Unconscious process of substituting socially acceptable activities for strong impulses that are not acceptable. Ex: A hostile man becoming a butcher
question
Humor
answer
Dealing with emotional conflicts and stressors by emphasizing the amusement or irony
question
Repression
answer
Exclusion of an unwanted feeling idea or experience
question
Displacement
answer
Transferring emotions associated with a person, object or situation to another person, object or situation that's nonthreatening. Man-wife-child-cat
question
Passive aggression
answer
Indirectly or unassertively expresses aggression
question
Acting out behavior
answer
Destructive style of coping Verbal or physical expression of anger temp makes person feel less vulnerable.
question
Disassociation
answer
Separating the threatening event from awareness until the person is able to deal with it.
question
Devaluation
answer
Devaluing others to look better by contrast
question
Idealization
answer
Attributing exaggerated positive qualities to others Development of a sense of self.
question
Splitting
answer
Unable to integrate positive and negative qualities of oneself or others
question
Projection
answer
Unconsciously rejects emotionally unacceptable personal features and attributes them to other people, objects or situations. Blaming, prejudicial and stigmatizing.
question
Denial
answer
Escaping unpleasant realities by ignoring their existence
question
Suppresion
answer
conscious denial of a disturbing situation or feeling.
question
Reaction Formation/Uncompensation
answer
unacceptable feeling or behaviors that are kept out of awareness by developing the opposite feelings. Boy scout leader; really hostile toward children
question
Somatization
answer
transforms anxiety on an unconscious level into a physical symptom that has no organic cause.
question
Undoing
answer
compensates for an act or communication; (compulsive hand washing)
question
Rationalization
answer
justifying unreasonable ideas, actions, or feelings by developing acceptable explanations that satify both listener and speaker; form of self deception
question
clinical certificate
answer
written document by, physician or psychiatrist regarding a person who needs treatment once 1st cert is filled out, 2nd cert MUST be filled out w/in 24 hrs.
question
Petition for hospitalization
answer
Person picked up by police or taken to hospital by someone (family, friend) Valid for 10 days, then a new one MUST be filled out completed by family, police, ER MSW
question
Erikson's stages of development
answer
trust vs mistrust, autonomy vs shame, initiative vs guilt, industry vs inferiority, identity vs role confusion, intimacy vs isolation, generativitiy vs stagnation, ego integrity vs despair
question
Biological theory
answer
focused on biochemistry and brain structure cause of Mental illness is physical psychotherapy
question
Psychoanalytic Theory
answer
levels of awarness psychosexual stages (Freud, Erikson)
question
Transference
answer
A nurse reminding a patient of someone from their past.
question
Countertransference
answer
A patient reminding a Nurse of someone from their past
question
interventions for patient's w/anxiety
answer
assist client to identify source of anxiety; explore methods to reduce anxiety assess client's us of defense mechanisms avoid criticizing patient's behavior and the use of defense mechanisms
question
Theraputic techniques
answer
clarifying and validating encouraging formulation of a plan focus and refocus reflect, restate, summarize share perceptions use Broad openings and open-ended questions
question
Nontheraputic techniques
answer
asking, "why?" being defensive and challenging the patient changing the subject giving advice or approval/disapproval making value judgments providing false reassurance
question
Voluntary admission
answer
pt seeks admission free to sign out of hospital retains full civil rights
question
Involuntary admission
answer
necessary when person is mentally ill, when patient is a danger to self/others right to refuse meds loses right to refuse treatment when the pt poses as a threat or danger court hearing is held w/in 72 hours
question
AXIS I on the DSM-4
answer
Clinical diagnosis (schizophrenia, bipolar, depression)
question
AXIS II on the DSM-4
answer
Personality disorder (borderline, antisocial, OCD, narcissistic)
question
AXIX III on the DSM-4
answer
Medical dx