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Mental Health > Week 6-Exam 2 > Flashcards

Week 6-Exam 2 Flashcards

1
Q

Stress occurs when we are forced to __________ to changes

A

adapt

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2
Q

Holmes-Rahe’s life illustrates the cumulative ________ of stress

A

nature

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3
Q

Selye’s GAS stages include:
1.
2.
3.

A

Alarm stage
Resistance stage
Exhaustion stage

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4
Q

The fight or flight response is activated in what stage?

A

alarm

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5
Q

The individual uses the fight or flight response to adapt to the stressor to prevent which next stage?

A

resistance stage

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6
Q

Physical problems and mental disorders occur in what stage?

A

exhaustion

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7
Q

When responding to a tragedy, its important to remember the following:
1.
2.
3.
4.

A
  1. be aware of physical needs and limitations
  2. Provide emotional support to each other
  3. debrief after the incident
  4. utilize available counseling resources.
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8
Q

Trauma patients often have difficulty ____________ and feel ___________ from others

A

concentrating, detached

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9
Q

If symptoms are present for less than one month, the diagnosis is _________ stress disorder.

A

acute

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10
Q

When trauma symptoms last longer than a month, the diagnosis is _________

A

PTSD

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11
Q

Children experiencing PTSD commonly present with ____________

A

regression

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12
Q

________ percent of people will experience trauma, but not many develop PTSD

A

50-60

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13
Q

The lifetime prevalence of PTSD is __________?

A

6-9%

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14
Q

Which trauma is more likely to lead to PTSD?

Intentional or non-intentional

A

intentional trauma

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15
Q

_________ are more likely to develop PTSD

A

men

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16
Q

Trauma treatments include:
1.
2.
3.
4.
5.

A
  1. CBT techniques (socratic questioning and exposure)
  2. cognitive processing therapy
  3. eye movement desensitization and reprocessing (EMDR)
  4. mindful based stress reduction
  5. guided imagery (visualize peaceful scene)
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17
Q

The first line of medications for trauma is __________

Paroxetine, sertraline, venlafaxine, mirtazapine

A

antidepressants (SSRIs, SNRIs)

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18
Q

_____________ receptor blockers can help with PTSD -related sleep disturbances

A

alpha- adrenergic

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19
Q

given the high prevalence of substance abuse and PTSD, ____________ are usually avoided

A

benzodiazepines

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20
Q

Assigning the ________ nurse will help build a trusting relationship with PTSD clients

A

same

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21
Q

Be sensitive to the issue of _______ for a client who has experienced rape

A

gender

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22
Q

PTSD: Ask ___________ before touching the client

A

permission

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23
Q

PTSD: Reassure the client that he or she is ________

A

safe

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24
Q

PTSD: Reassure the client that feelings of _______ are normal

A

grief

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25
Q

PTSD: Assess clients for ________ ideation

A

suicidal

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26
Q

PTSD: Use ________ listening skills if a client expresses feelings of guilt

A

active

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27
Q

PTSD: teach clients to avoid ____________ and __________

A

alcohol, caffeine

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28
Q

Anxiety disorders are characterized by excessive amounts of anxiety that ____________________

A

disrupt functioning

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29
Q

what level of anxiety sharpness the senses, increases motivation and productivity, and allows instruction?

A

mild anxiety

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30
Q

what level of anxiety decreases the perceptual field, alertness, and concentration, but increases muscle tension?

A

moderate anxiety

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31
Q

What level of anxiety causes the perceptual field, and concentration to be severely diminished. Clients lose situational awareness and have impaired functioning. Physical symptoms are very prominent.

A

severe anxiety

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32
Q

What level of anxiety causes a person to be unable to focus on a single detail in the environment. Clients may lose contact with reality and experience hallucinations or delusions

A

panic anxiety

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33
Q

________ disorders are the most common category of mental illness

A

anxiety

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34
Q

Most anxiety disorders are more common in ____________

A

women

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35
Q

Behavioral theory illustrates the __________ cycle that causes anxiety disorders.

A

avoidance

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36
Q

physical changes in the brain’s circuitry will further reinforce the avoidance cycle used in anxiety. It becomes ___________

A

hardwired

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37
Q

CBT emphasizes the role of _____________ distortions in producing anxious feelings

A

cognitive

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38
Q

Panic attacks occur suddenly and __________________________ (i.e., they are not associated with any particular situations or triggers). These attacks are usually brief (minutes).

A

unpredictably

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39
Q

“Panic Disorder feels like being in a cage with a _________, except that there is no ________” (Frances, 2013, p. 61). Clients can feel sheer terror, be out of breath, and have a racing heartbeat.

A

tiger, tiger

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40
Q

Panic disorder can sometimes lead to ______________________.

A

agoraphobia

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41
Q

The lifetime prevalence of panic disorder is ________ percent.

A

4.7

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42
Q

Anxiety is twice as common in __________

A

women

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43
Q

Panic treatment CBT technique:
1.
2.
3.
4.
5.

A
  1. self-monitoring,
  2. breathing retraining
  3. muscle relaxation
  4. cognitive restructuring (ABCD method)
  5. exposure therapy.
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44
Q

Common panic disorder medications include __________ (SSRIs, SNRIs, TCAs) and _______________.

A

antidepressants, benzodiazepines

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45
Q

Using ____________ for panic disorder is best at achieving a rapid effect but aren’t the best long term option

A

Benzodiazepine

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46
Q

Panic disorder intervention: Stay with the client and offer _____________. Don’t leave a client who is experiencing severe or panic anxiety alone.

A

reassurance

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47
Q

PD intervention: Anxiety is contagious; remain ________. Use a matter-of-fact approach.

A

calm

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48
Q

PD intervention:
Use ____________ words and phrases. During intense anxiety, clients are unable to focus and are unable to comprehend complicated speech.

A

simple

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49
Q

PD intervention:
Reduce environmental ______________ (e.g., decrease the number of people in the room, turn the TV off, dim the lighting).

A

stimuli

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50
Q

Hyperventilation can be treated by having the client breathe into a small paper bag. This helps the client retain more ____________ ______________, relieving many of the panic attack symptoms. Don’t do this, however, if the client has coronary artery disease, asthma, or COPD.

Administer prescribed fast-acting PRN anxiolytic medication (e.g., a benzodiazepine).
When the client is calm and receptive to learning, _________ teaching on ways to halt anxiety attacks (e.g., relaxation techniques, deep breathing exercises, meditation, exercise).

A

carbon dioxide,

reinforce

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51
Q

Clients with social anxiety disorder have an excessive __________ they might say or do something embarrassing

A

fear

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52
Q

Social anxiety disorder is more severe than normal ________ ; it causes significant distress and _________ functioning

A

shyness, impairs

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53
Q

The lifetime prevalence of social anxiety disorder is ___________%. It is slightly more common in __________. The average age of onset is mid-teens.

A

5-12%, women

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54
Q

Social anxiety treatment: Effective CBT techniques include _________ desensitization and _________ restructuring.

A

systemic, cognitive

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55
Q

common social anxiety disorder meds are __________ and ________

A

antidepressants, benzodiazepines

(benzodiazepines achieve rapid effect, but aren’t best long term)

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56
Q

Clients with social anxiety disorder sometimes use ______________ as a “social lubricant.” Self-medication, however, can easily lead to a ____________ use disorder. Prescribed and monitored treatments (e.g., SSRIs) are safer and more effective.

A

alcohol, substance

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57
Q

Clients with generalized anxiety disorders experience ongoing, excessive worrying about ________________ issues

A

everyday

58
Q

GAD cause significant _________.

A

distress

59
Q

In GAD __________, _______, ________ symptoms are often present.

A

cognitive, mood, physical

60
Q

GAD is more severe than the normal, occasional worrying everyone experiences. GAD is excessive, disruptive, and enduring (i.e., greater than ______ months).

A

6

61
Q

The lifetime prevalence of GAD is _________%. It is twice as common in ________ . The average age of onset is later than most anxiety disorders. Preclinical symptoms usually develop before age _____, but the full syndrome does not emerge until later.

A

5-12, women, 20 yrs

62
Q

GAD psychotherapy and medicine is the same as the other anxiety disorders.

Effective CBT techniques include self-monitoring, relaxation training, cognitive restructuring (ABCD method), and exposure therapy.
Common medications include antidepressants (SSRIs, SNRIs), buspirone, and benzodiazepines. Benzodiazepines are best at achieving a rapid effect but aren’t the best long-term option.

A
63
Q

GAD intervention: Anxiety is ____________________; maintain a calm demeanor.

A

contagious

64
Q

Don’t leave clients who are in distress. ________ with them.

Be careful not to stigmatize clients with anxiety disorders. You may find yourself thinking, “Why don’t they knock it off?” “Why won’t they focus on something else?” Be patient and gracious. Remember, thoughts and emotions are byproducts of the brain. The brain is an organ and sometimes organs don’t function properly.

A

Stay

65
Q

Clients with OCD have both __________ and _________

A

obsessions, compulsions

66
Q

_______________ are intrusive thoughts or images that provoke anxiety. For example, a client might be frequently bothered by the thought, “There are germs everywhere. I can easily catch the stomach flu and become unimaginably sick.”

A

obsessions

67
Q

_____________ are acts clients perform (physical or mental) to neutralize the anxiety or distress produced by the obsession. Sometimes clients believe the compulsion will help prevent the obsession from occurring.

A

compulsions

68
Q

Most clients have good ______________ about their OCD (i.e., it is egodystonic). They would love to stop or control their behaviors.

A

insight

69
Q

The lifetime prevalence of OCD is _______%. It is slightly more common in ________. The average age of onset is 19.5 years. Men, however, tend to have an _______ age of onset than women.

A

2.3,
women,
earlier

70
Q

OCD treatment: A key CBT technique is ________________ prevention (ERP) therapy.

A

exposure and response

71
Q

OCD meds commonly used are ____________

A

antidepressants (SSRI, TCAs)

72
Q

OCD intervention:
In the early stages of treatment, allow sufficient ________ for the client to perform rituals. Preventing a client from performing a ritual could lead to panic anxiety, damage thenurse-client relationship, and interfere with treatment. ⭐

A

time

73
Q

OCD intervention:As the client becomes involved in other activities, develops healthy coping mechanisms, etc., gradually ____________ the amount of time available for rituals.

A

reduce

74
Q

OCD intervention:
Avoid ___________ attitudes and criticizing the client’s rituals.
Provide a __________ schedule of activities.

A

judgmental, structured

75
Q

Body dysmorphic clients experience exaggerated concerns about real or imagined physical __________ (e.g., skin, hair, nose, stomach, hips, buttocks, breasts). Clients may spend an inordinate amount of time in front of mirrors, scrutinizing self. Alternatively, some clients may avoid mirrors.

A

flaws

76
Q

The lifetime prevalence of body dysmorphic disorder is around _____%. It is slightly more common in _________. The average age of onset is _______ years. Onset is typically gradual.

A

2,
women,
17

77
Q

Body dysmorphic treatment:
Effective CBT techniques include ________ restructuring (ABCD method) and _________ interviewing.

A

cognitive, motivational

78
Q

Body dysmorphic meds is _____________

A

antidepressants (SSRIs, SNRIs)

79
Q

BD interventions: Encourage the _______________ of fears and anxiety. Invite clients to participate in activities that promote positive feelings about themselves that are not based on physical appearance.

A

verbalization

80
Q

BD intervention:
Be sensitive to the presence of comorbidities. About 90% of people with body dysmorphic disorder also have major ____________________. Around 70% have an ______________ disorder (usually OCD). Approximately 30% have had a psychotic disorder.

A

depression, anxiety

81
Q

The most likely event to trigger PTSD is ____________

A

rape

82
Q

Grief is the painful emotional response to the ________ of something or someone significant.

A

loss

83
Q

Kubler Ross Model of Grief

Initially, clients may have difficulty accepting that the loss has really occurred. _________ is a common first reaction.

A

denial

84
Q

Clients who are grieving often experience strong feelings of _________. They may express anger toward themselves, others, or even the lost person.

A

anger

85
Q

During grief, clients may attempt to strike a deal with God or some higher power for an alternative plan. For example, a person may plead, “If you will let me live to see my daughter’s wedding, I’ll accept my cancer diagnosis.” is called _____________

A

bargaining

86
Q

Of course, clients that are grieving will experience intense feelings of sadness, sorrow, and loss called _____________

A

depression

87
Q

Eventually, most clients come to _________ the loss. They utilize coping strategies and become less preoccupied with it. That’s not to say they no longer feel the loss or still grieve; they still have ups and downs. But they’ve found new ways to stay connected to the loss as they continue life.

A

accept (acceptance)

88
Q

Which grief is it?

Clients experience the stages of grief (denial, anger, bargaining, etc.).

Somatic complaints are common (e.g., headaches, nausea, fatigue, sleep difficulties).

Some authors say that clients usually achieve some degree of acceptance within six months. Keep in mind, each situation is unique and there is no set time limit for grieving. Remember, anger is a normal emotion during grief.

A

normal grief

89
Q

________________ occurs when a client experiences the stages of grief before the loss occurs

A

anticipatory grief

90
Q

___________________ occurs when the grief response may be inhibited, exaggerated, or prolonged.

A

Complicated or maladaptive grief

A helpful way to distinguish normal grief from maladaptive grief is that the latter is often accompanied by feelings of worthlessness or low-self esteem

91
Q

_____________________ occurs when an individual experiences too many losses at too rapid of a pace. Older adults are especially prone to experiencing this.

A

bereavement overload

92
Q

Hicks (2001) gives four recommendations on how to help people that are suffering.

1.
2.
3.
4.

A

1.Don’t speak; be present
2. listen
3. take action
4. express compassion and care

93
Q

Mood disorders occur when these states are prolonged and cause ____________________.

A

impairment (dysfunction)

94
Q

Clients with major depressive disorder have a depressed mood or loss of interest in pleasurable activities called ____________

A

anhedonia

95
Q

Melancholic features - This is a severe version of depression in which a client’s mood is extremely ________ and unremitting. Even extremely positive news will not temporarily lift the client’s spirits. Clients often experience early morning awakenings and loss of appetite. Suicidal ideation is common.

A

dark

96
Q

Some clients with depression experience delusions that involve strong feelings of guilt. They may believe they are responsible for someone’s death or a natural catastrophe is called _________________.

A

mood congruent psychotic features

97
Q

_______________ is a form of depression that reoccurs seasonally (usually ____________). Light therapy is an effective treatment.

A

seasonal pattern, wintertime

98
Q

______________ is a subtype of depression is associated with pregnancy. Some of these clients will develop psychotic features.

A

peripartum

99
Q

depression is often called the _____________ of mental disorders

A

common cold

100
Q

The lifetime prevalence of depression is about ______%. It’s nearly twice as common in __________.

A

17, women

101
Q

A common problem is relapsing. The chance of relapsing after one episode is ______%. After two episodes, the relapse rate is ______%.

A

50, 80

102
Q

Cognitive-behavioral theorists note that depressed clients have a similar pattern of thinking: negative beliefs about the __________, ____________________, and the ____________. In addition, depressed clients exhibit several cognitive distortions

A

world, themselves, future

103
Q

Depression may be related to deficiencies of ___________, ____________, and _____________ in the brain. We also know that depression is sometimes caused by a general __________ condition (e.g., hypothyroidism) or medication use

A

serotonin norepinephrine, dopamine.

medical

104
Q

Effective psychotherapy for depression includes ________ and ______________.

A

CBT, group therapy

105
Q

Antidepressants (SSRIs, SNRIs, TCAs, MAOIs) are commonly used for depression. __________ are usually the first-line agents since their side effects are milder.

A

SSRIs

106
Q

Electroconvulsive therapy (ECT) is an effective option for clients who are extremely ________________ or have failed numerous other treatments. The evidence supporting ECT for these clients is strong.

A

suicidal

107
Q

_______________________ (TMS) is another option. TMS, as the name suggests, is a procedure in which strong magnetic pulses are sent through the skull into the brain—usually the left prefrontal cortex

A

transcranial magnetic stimulation

108
Q

Depression intervention:

____________ is always the top priority. Depressed clients might be suicidal. Assess for suicidal ideation often and monitor closely.

A

safety

109
Q

Depression intervention:

Clients who are depressed may take longer than expected to respond to questions or to speak. An important therapeutic communication strategy is to allow sufficient _______ for such clients. In other words, learn to slow down and be comfortable with brief periods of silence. ⭐

A

time

110
Q

Depression intervention:

Explain that antidepressants can take up to four __________ to begin working.

A

weeks

111
Q

Clients with mania seem to have endless energy, are always moving about, and may feel little or no need for sleep. They are high on life. Their thoughts race (____________ of ideas) and their speech is “__________________.”

A

flight, pressured

112
Q

Clients in the mania phase of bipolar disorder experience psychotic delusions (usually __________________) and hallucinations (usually ________________) may also occur. Manic episodes usually end with a crash into a deep depression.

A

grandiose, auditory

113
Q

_____________ is a less severe version of mania. Clients experience an elevated mood, enhanced creativity, increased energy, and may act intrusively. Hypomania by itself does not cause significant _______________.

A

hypomania, impairment

114
Q

______________ - These clients experience mania (and usually depression).

A

bipolar 1

115
Q

__________________ - These clients experience hypomania and depression.

A

bipolar 2

116
Q

Clients who experience four or more mood episodes in a 12-month period are classified as “__________ cyclers.”

A

rapid

117
Q

Bipolar disorder has a strong ______________ basis.

A

genetic

118
Q

Having a first-degree relative with bipolar disorder increases a person’s lifetime risk to ___________%.

A

5-10

119
Q

____________ and _____________ can help clients with bipolar disorder learn coping skills and improve medication adherence.

A

CBT, group psychoeducation

120
Q

Common medications for bipolar disorder include ______________, anticonvulsants (valproate, lamotrigine, carbamazepine), and second generation antipsychotics (e.g., aripiprazole, clozapine, ziprasidone). ____________ are often ineffective and sometimes precipitate mania.

A

lithium, antidepressants

121
Q

__________ can help clients with extreme manic behavior or who are having difficulty achieving symptom control

A

ECT

122
Q

Bipolar disorder interventions:

  1. Decrease environmental ______________ (e.g., low lighting, low noise, fewer people) when clients are manic. Do not, however, isolate a client.
  2. Assess for suicidal and __________________ thoughts.
  3. Remove all dangerous objects when clients are agitated, confused, or suicidal.
  4. Assess for illicit drug use. Substances can increase the risk of harm and make medication management more difficult.
  5. Maintain a calm demeanor and tone of speech. Remember that anxiety can be contagious.
  6. Set ____________ on dangerous and manipulative behaviors. Clearly describe what is expected. Explain the consequences if limits are broken. Ensure the entire team is enforcing the same limits. Give immediate feedback when limits are broken. Don’t argue, bargain, try to reason, or become emotional with the client. Provide positive reinforcement for non-manipulative behaviors.
  7. Listen to and act on legitimate complaints.
  8. Avoid __________ struggles; don’t become emotional.
  9. Provide outlets for physical energy (e.g., exercise, punching bag).
  10. Clients experiencing mania have increased caloric needs and may have difficulty sitting down to eat meals. Monitor nutritional status. Provide frequent high-protein, high-calorie, ________________ foods and drinks. ⭐
  11. Promote good sleep hygiene and limit caffeine use during manic episodes. Remember to provide frequent rest periods during the day too. ⭐
A
  1. stimuli
  2. homicidal
  3. limits
  4. power
  5. portable
123
Q

More than 90% of people who kill themselves have a diagnosable mental illness. Mood disorders and __________________ abuse are the most common.

A

substance

124
Q

Males have the highest rate of suicide, but women have more ________________.

A

attempts

125
Q

The highest suicide risk _________ now is 45- to 64-year-olds.

A

group

126
Q

____________ are the highest risk group. American Indians are the second highest risk group.

A

whites

127
Q

The following items increase a client’s risk of committing suicide.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

A
  1. age
  2. gender
  3. ethnicity/race
  4. marital status
  5. socioeconomic status
  6. occupation
  7. religion
  8. family history
  9. military
  10. previous attempts
128
Q

The IS PATH WARM mnemonic can help you recognize imminent warning signs.

A

ideation
substance
purposelessness
anger
trapped
hopelessness
withdrawing
anxiety
recklessness
mood shifts

129
Q

A helpful way to raise an uncomfortable topic like suicide is to use the ______________________ technique. For example, “Sometimes when clients are going through intense emotional pain, they have thoughts about killing themselves. Have you had any thoughts like that?”

A

normalizing

130
Q

Pay attention to _____________ (also called “covert”) statements (e.g., “I don’t have anything worth living for anymore.” Or “I wish I could fall asleep and never wake up.”). Assess for suicidal ideation when you hear statements like these. ⭐

A

indirect

131
Q

Be alert to the warning signs (i.e., IS PATH WARM). Remember, a lethal plan that a client has the means to carry out is a major warning sign. If a client has __________________ the plan, the risk is even greater.

A

rehearsed

132
Q

Ensure that clients are not “________________” medications. Clients may save these pills to attempt an overdose.

A

cheeking

133
Q

A sudden ____________ in a client’s mood can indicate the client intends to commit suicide in the near future. ⭐

A

improvement

134
Q

______________ - ECT is a very effective treatment for ____________ depression. Other indications include bipolar disorder (depression and mania), schizophrenia (especially with catatonic features), and schizoaffective disorder

A

efficaciousness, severe

135
Q

In the vast majority of ECT cases, clients give informed consent. In cases where a client is too ill or lacks the capacity to consent, the provider must seek a __________ order.

A

court

136
Q

In ECT clients are given a short-acting ____________ (e.g., propofol) to render them unconscious during the procedure. In addition, a paralytic

A

anesthetic

137
Q

A standard treatment course is __2__ or __3______ treatments per week for a total of six to _______ treatments. Unfortunately, relapse is common.

A

12

138
Q

ECT is one of the safest procedures performed under general anesthesia. It can even be performed on clients who are ________________

A

pregnant

139
Q

ECT adverse effects:
1.
2.
3.
4.

A
  1. headache
  2. elevated vitals (seizures temporarily elevate vitals)
  3. memory loss ⭐
  4. Miscellaneous (dental and tongue injuries, muscle soreness, nausea, and aspiration)
140
Q

ECT interventions:
1.Assess the client and family’s understanding of ECT. Help correct any misconceptions.

2.Know your medications. An ______________________________ (atropine or glycopyrrolate) is given before the procedure to dry up secretions and prevent a seizure-induced vagal response.

3.____________ is your top priority when clients have been under anesthesia.

  1. Monitor vital signs and mental status before and after the procedure. If a client has a history of ________________________, make sure it is under control.
  2. Maintain the client’s ____ until recovery is fully completed.
  3. Stay with the client. Reorient the client to time and place. Explain what has occurred. Provide reassurance
A
  1. anticholinergic
  2. airway
  3. hypertension
  4. IV

Mental Health (8 decks)

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