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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.

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c. mental illness is defined in relation to the culture, time in history, political system, and group in which it occurs.

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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

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d. describes a person's level of functioning

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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.

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c. The nurse diagnoses and treats human responses, which are influenced by many factors.

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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

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a. support systems b. developmental events d. cultural beliefs

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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.

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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.

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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

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a. The theory of personality structure and levels of awareness

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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

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c. Sullivan

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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

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a. Physiological

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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

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a. modeling

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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

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c. behavioral therapy

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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

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d. acute inpatient care

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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.

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b. the development of psychotropic medications

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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

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c. Feeling that there is less stigma attached to treatment

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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

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b. psychologist

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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.

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c. an important concept for community health nursing is to view the entire community as a patient.

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Follow up care after administering blood transfusion

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inspect IV site and infusion rate + vitals assess changes in VS + chills, dyspnea, flushing, itching, rash assess lab values

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how long can a bag of blood hang before the risk of bacterial growth occurs

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4 hours

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S/S of an adverse reaction to a blood transfusion

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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

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when is it appropriate to delegate monitoring of a patient who is receiving a blood transfusion?

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Nurse aide may monitor a patient after the blood transfusion is started and the patient's stability has been confirmed

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Therapeutic relationship criteria: 7 examples

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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

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Five Elements required to prove negligence

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1. Duty 2. Breach of duty 3. Cause in fact 4. Proximate cause 5. Damages

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Altruism

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Receiving gratification by meeting others needs

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Sublimation

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Unconscious process of substituting socially acceptable activities for strong impulses that are not acceptable. Ex: A hostile man becoming a butcher

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Humor

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Dealing with emotional conflicts and stressors by emphasizing the amusement or irony

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Repression

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Exclusion of an unwanted feeling idea or experience

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Displacement

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Transferring emotions associated with a person, object or situation to another person, object or situation that's nonthreatening. Man-wife-child-cat

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Passive aggression

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Indirectly or unassertively expresses aggression

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Acting out behavior

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Destructive style of coping Verbal or physical expression of anger temp makes person feel less vulnerable.

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Disassociation

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Separating the threatening event from awareness until the person is able to deal with it.

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Devaluation

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Devaluing others to look better by contrast

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Idealization

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Attributing exaggerated positive qualities to others Development of a sense of self.

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Splitting

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Unable to integrate positive and negative qualities of oneself or others

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Projection

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Unconsciously rejects emotionally unacceptable personal features and attributes them to other people, objects or situations. Blaming, prejudicial and stigmatizing.

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Denial

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Escaping unpleasant realities by ignoring their existence

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Suppresion

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conscious denial of a disturbing situation or feeling.

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Reaction Formation/Uncompensation

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unacceptable feeling or behaviors that are kept out of awareness by developing the opposite feelings. Boy scout leader; really hostile toward children

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Somatization

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transforms anxiety on an unconscious level into a physical symptom that has no organic cause.

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Undoing

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compensates for an act or communication; (compulsive hand washing)

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Rationalization

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justifying unreasonable ideas, actions, or feelings by developing acceptable explanations that satify both listener and speaker; form of self deception

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clinical certificate

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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.

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Petition for hospitalization

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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

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Erikson's stages of development

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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

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Biological theory

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focused on biochemistry and brain structure cause of Mental illness is physical psychotherapy

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Psychoanalytic Theory

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levels of awarness psychosexual stages (Freud, Erikson)

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Transference

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A nurse reminding a patient of someone from their past.

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Countertransference

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A patient reminding a Nurse of someone from their past

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interventions for patient's w/anxiety

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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

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Theraputic techniques

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clarifying and validating encouraging formulation of a plan focus and refocus reflect, restate, summarize share perceptions use Broad openings and open-ended questions

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Nontheraputic techniques

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asking, "why?" being defensive and challenging the patient changing the subject giving advice or approval/disapproval making value judgments providing false reassurance

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Voluntary admission

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pt seeks admission free to sign out of hospital retains full civil rights

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Involuntary admission

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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

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AXIS I on the DSM-4

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Clinical diagnosis (schizophrenia, bipolar, depression)

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AXIS II on the DSM-4

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Personality disorder (borderline, antisocial, OCD, narcissistic)

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AXIX III on the DSM-4

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Medical dx

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Psychiatric nursing unit 1 – Flashcards

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