Exam 3 Flashcards
During which of the cycles of violence does the abuser release their
buildup tensions by brutal beating?
Acute battering stage
The honeymoon stage is characterized by
loving and kind behavior and promises
never to repeat the behavior.
The tension-building stage is
characterized by minor incidents by the abuser
of pushing or shoving.
The acute battering stage would be when
the abuser releases their buildup tensions
by brutal beatings.
What is the risk of prescribing SSRIs for a patient with epilepsy?
Lower seizure threshold. SSRIs may interact with antiepileptics. They can lower the seizure threshold. This risk should be considered in patients who also suffer from epilepsy.
There are several criteria for involuntary outpatient commitment
Some of the criteria includes:
a) history of repeated decompensation that needs involuntary treatment.
b) without treatment the patient’s health will deteriorate resulting in hospitalization
c) persistence of the mental disease without awareness that it is affecting them.
If the patient on lithium is experiencing such symptoms as sweating or diarrhea,
they may experience a rise in their lithium levels. This could potentially call for a temporary reduction in their dosage.
If a patient is at risk of repeated victimization from being in an abusive relationship, what is the first step that the nurse practitioner needs to assist the patient in doing?
The nurse practitioner has an obligation to report abuse. Patients at risk of being victimized again should be encouraged to report the abuse themselves. The nurse practitioner may also assist with taking steps to ensure the patient’s safety.
Clients who are committed are still
capable of participating in healthcare decision
if an adult is ruled incompetent by a court
a guardian is appointed to make decisions on the person’s behalf.
What will increase the clearance of benzodiazepine?
Smoking increases the metabolic rate.
This will increase clearance of benzodiazepines.
Patients who smoke need to be monitored carefully
When a person exhibits a clinically significant response to a pill containing a therapeutically inert substance this is known as which of the following?
When a person exhibits a clinically significant response to a pill containing a therapeutically inert substance this is known as the placebo effect.
Placebo effects are not limited to subjective reports; physiologic functions may be objectively influenced.
The Community Mental Health Centers Act supported which of the following mental healthcare delivery systems?
The CMHC Act passed by Congress in 1963 supported mental health centers and deinstitutionalization in all 50 states.
It represented a shift from the focus of the mentally ill in public mental hospitals to flexible, community care in an ambulatory setting.
There are six standards of practice.
They include:
- assessment,
- diagnosis,
- outcome identification
- planning
- implementation
- evaluation.
Antidepressant medication (SSRI) is more helpful in treating
bulimia than anorexia.
According to the dyadic interpersonal communication model
communication is a dynamic interaction that consists of a source, who has a purpose that is understandable to another person, and an encoder, who is able to understand the meaning of the message.
The message is processed and decoded and understood by the recipient, or decoder
Which of the drugs may cause a false positive cocaine result in lab tests?
Amoxicillin–Amoxicillin may cause a false positive result for cocaine in lab tests.
Most antibiotics and NSAIDs have the same effect.
Persons with mental illness are guaranteed the same rights under federal and state laws as any other citizen. Things such as the right to vote, the right to receive a driver’s license, and the right to religious freedom and practice are known as:
Civil Rights
Circumstantiality is a thought and speech process in which an individual
digresses into unnecessary details and inappropriate unrelated thought while trying to express a central idea.
Which tic disorder can possibly start at the age of 13, wax and wane, include multiple motor and vocal tics, and not be tied to physical disorders?
Tourette’s Disorder
When you communicate in a way that limits the focus on or understanding of the opinions, values, or beliefs of others, you are using which of the following?
Aggressive communicators make decisions for themselves and others with the intent of always coming out the winner. Aggressive individuals want their needs met exclusively and immediately using manipulative tools to do this.
Culture-bound syndromes are
specific mental behaviors related to a person’s culture and not linked to a psychiatric disorder.
What would be an appropriate question to ask during a risk assessment to determine if a patient has suicidal ideation?
Do you have a plan?
What are diagnostic criteria for dissociative fugue?
The predominant disturbance is sudden, unexpected travel away from home with the inability to recall one’s past.
There is confusion about personal identity or assumption of a new identity.
The symptoms cause clinically significant distress or impairment in functioning
Natural law is based upon the theory .
“do good and avoid evil.”
What causes depression and pain to be reduced by using breathing to focus on the present moment?
Mindfulness meditation is thousands of years old. It teaches the practitioner to live in the moment. Breathing guides the meditation.
Natural law is based on the writings of St. Thomas Aquinas.
It states that a person’s ethics must be grounded in the concern for human good
Trust-mistrust
the oral-sensory stage 1.
Industry-inferiority
the latency stage 4.
Identity-role confusion
adolescence stage 5.
Generalized anxiety disorder is an anxiety that has
the nature and focus of worry shift frequently. The symptoms seem to come and go. No clear link exists between the anxiety and life events or stressors. The person finds it very hard to control the anxiety.
A specific anxiety disorder indicated by excessive worry, apprehension or anxiety about a range of life stresses that occur more days than not for a period of at least 6 months is:
Dysthymic disorder is similar to MDD but with
less acute symptoms; one of which is less discrete episodes of illness than MDD. Symptoms often go undetected and therefore untreated for years.
Stereognosis is the ability
to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spatial properties, and temperature, etc.
Stereognosis tests determine whether or not which part of the brain is intact?
the parietal lobe of the brain is intact.
The type of service that provides structure and offers therapeutic activities to patients who come to the program one or more days per week is called a(n):
Day programs provide structure and offer therapeutic activities to patients who come to the program one or more days per week. Services include social skills training, social contact and peer support.
Maslow Heirarchy of needs include
Maslow’s hierarchy of needs theory is a health model rather than an illness model. According to Maslow, needs from the most basic to the highest level are: physiological, safety, love and belonging, self-esteem and self-actualization.
The somatic symptoms of severe anxiety include
headache, nausea, dizziness and insomnia which increase as the anxiety becomes severe. The person may experience hyperventilation and a sense of impending doom or dread.
Some of the things seen during withdrawal from morphine use are
watery eyes, runny nose and dilated pupils, anxiety, fever, nausea and vomiting with diarrhea, achiness, abdominal cramps, insomnia and tachycardia.
Psychosis is more likely seen
with an overdose of a hallucinogenic drug.
A dysthymic disorder differs from major depressive disorder in all but which of the following ways?
Dysthymic disorder has a more protracted chronic disease course than MDD. Symptoms often go undetected and therefore untreated for years.
Premature menopause
. Women going through menopause prior to the age of 40 are considered to be going through premature menopause.
The category of abused substances with the most pronounced, obvious withdrawal symptoms is:
The most obvious category of pronounced withdrawal symptoms is that of sedatives. In most cases, the withdrawal symptoms are almost always the opposite of the acute action of the substance being abused. Other examples of this category are alcohol, opioids, hypnotics, and anxiolytics.
PCP and hallucinogens
have little to no withdrawal symptoms.
Cannabis, nicotine and stimulants have
less pronounced withdrawal.
Mental health promotion includes
teaching about interventions and ways to cope with specific stressors, validating feelings, helping clients identify community resources ensuring clients that they are not “crazy,” and helping clients recognize and identify their feelings or behaviors.
Culture-bound syndromes are
specific mental behaviors related to a person’s culture and not linked to a psychiatric disorder.
What would be a psychoeducational topic for the caregiver of a patient with OCD?
Ritualistic behavior
Skin care measures
Relaxation techniques
Which of the following would be a typical side effect of Dalmane?
The common side effects are: CNS sedation Physiological dependence Rebound insomnia Psychological dependence
Cost-benefit analysis is the process of
examining scenarios to determine the relative value of an intervention when measured against predetermined criteria. While traditional cost-benefit analysis techniques have been used in health care for many years, more sophisticated systems are now being introduced.
type of dementia seen in children?
Dementia does not only affect adults. It can affect children. Most children with dementia inherit it. Some types of inherited dementias include: Batten disease, Niemann-Pick disease, and Lafora disease.
Seroquel is used to combat bipolar disorder.
The medication may increase effectiveness of antihypertensive medications. If chosen, blood pressure needs to be monitored carefully.
The three major components of cognitive therapy are
didactic or educational aspects, cognitive techniques, and behavioral interventions.
Thought recording is a
cognitive technique used to recognize automatic thoughts and the client’s emotional response to them.
Evidence based practice is available
through dissemination of information.
S-R (stimulus-response) conditioning is a
behaviorist theory. It is based on outcome expectations and incentives.
Cluster B personality disorders are
Borderline, antisocial, Histrionic and narcissistic personality disorders. This classification of personality disorders
shows patterns of responding to their life demands with a dramatic, emotional
or erratic behavior. Cluster B (the “dramatic, emotional, erratic” cluster)
Cluster A personality disorders include
paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.
behavior.are characterized by odd, eccentric thinking
Cluster C personality disorders include
avoidant personality disorder, dependent personality disorder and obsessive-compulsive per
sonality disorder.Cluster C personality disorders are characterized by anxious, fearful thinking or behavior.
A chronic mood disturbance of at least 2-years’ duration involving numerous hypomanic episodes and periods of depressed mood or loss of interest or pleasure is which of the following?
Cyclothymic disorder is defined as a chronic mood disturbance of at least 2-years’ duration involving numerous hypomanic episodes and periods of depressed mood or loss of interest or pleasure. Biologic therapy is fundamentally the same as for bipolar disorders. Psychotherapy is best used to address educational and coping needs.
Ethical egoism
What is both good and right is considered to be the best thing for the person making the decision is called ethical egoism. In ethical egoism the action may not be the best for anyone else involved.
The group psychotherapy which was originally developed for the treatment of patients with borderline personality disorders, but has been extended to other illnesses, and has the goal of improving interpersonal, behavioral, cognitive and emotional skills is which of the following?
Dialectical behavior treatment (DBT) groups are a type of group psychotherapy where patients are seen each week with the goal of improving interpersonal, behavioral, cognitive and emotional skills. Another goal is to reduce self-destructive behaviors. In the DBT group members are discouraged from making observations about others in the group.
When would a patient’s informed consent not be necessary?
Informed consent is not always necessary. Exceptions are made in an effort to preserve life. A patient who is experiencing violent ideation and is a threat to others may be treated without informed consent.
The five characteristics that distinguish collaboration from other types of interaction are
shared goals, mutual participation, maximized resources, clear responsibilities, and set boundaries.
For a patient to be involuntarily committed
, it must be ordered by the courts.
The other 3 options above would be correct criteria. In addition, there is
a likelihood that if the patient is not ordered to be involuntarily committed,
they will deteriorate to the point, they will require inpatient commitment.
The presence of severe mental illness accompanied by not being fully aware
of their illness or the need to seek treatment. A history of requiring involuntary hospitalization.
If the presence of severe and persistent mental illness contributes to the
person becoming incarcerated, homeless, violent or of committing suicide.
Sexual assault is any
sexual act committed through coercion or physical force. Women have a greater incidence of being assaulted than men. Sexual assault is the most common form of abuse. Alcohol is a factor in 34% of all forcible rapes with a record of 1 in 4 being reported. Wealthy men have not been singled out as more likely perpetrators.
Repression is an unconscious mechanism by which
threatening thoughts, feelings and desires are kept from becoming conscious. The repressed material is denied entry into consciousness.
What leaders do or how they conduct themselves is the basis of what theory of leadership?
What leaders do, or how they behave, is the focus of behavioral theorists. For example, impoverished leaders have a low concern for both people and production, while the team leaders show high concern in both of these dimensions.
In the beginning of a cognitive behavioral therapy session,
the client meets with the therapist to discuss specific problems and to set goals they want to work towards. These problems and goals become the basis for planning the content of sessions and discussing how to deal with them.
the following theories of aging in a biological theory?
gene theory
wear-and-tear theory
programmed aging theory
The major theories of aging fall into three categories:
biological, psychological and psychosocial. Maslow’s theory of aging (self-actualization and the evolution of developmental needs occur as the individual ages) is a psychosocial theory
Using growth charts for infants and children, those in the ? percentile for BMI places them at risk for being overweight.
Using growth charts for infants and children, those in the 85th percentile for BMI places them at risk for being overweight. A high BMI is a risk factor for diabetes, heart disease, stroke, hypertension, osteoarthritis, and some forms of cancer. A normal BMI is between 20 and 25.
How many stages of pubic hair growth are there?
There are five stages of pubic hair growth. The stages occur in both males and females during puberty. The stages go as follows: first appearance of hairs, few hairs are found, hairs become numerous, pubic hairs become dense, and the spread of pubic hair onto thighs.
Mild Benzo withdrawal s/s
Whereas withdrawal reactions from cessation of benzodiazepine use were once thought to be rare, clinicians now believe that clients taking benzodiazepines for long periods are vulnerable to withdrawal reactions if the drug is discontinued abruptly. Mild symptoms include insomnia, dizziness and headache. Severe signs of withdrawal may include hypotension, hyperthermia, psychosis, and seizures.
To win a malpractice case, all of the basic elements of a nursing malpractice lawsuit should be proven. The four basic elements of a nursing malpractice lawsuit.
The elements include: existence of a duty to correspond with a set standard of care, failure to conform to required nursing standards of patient care, actual proven injury, and a reasonably close causal connection between both the nurse’s conduct as well as the patient’s injury.
Which of the following would be considered a core competency in the emotional intelligence framework upon which other competencies depend?
Accurate self-assessment is a core competency in the emotional intelligence framework upon which other competencies depend. Other core competencies include: emotional self-awareness; self-confidence; emotional self-control; and empathy.
the incidence of physical abuse in pregnant women is approximately
20%,
In the deliberative model
the professional acts as friend or counselor to the patient, not just by presenting information but also in actively advocating a particular course of action. The deliberative approach is commonly used to modify injurious behavior like trying to stop smoking. With the informative model, the doctor delivers the facts and the patient makes the decision which the doctor carries out. The interpretive model has the doctor giving the facts and leading the patient to a preference for treatment and with the paternalistic method, the doctor promotes the patient’s well-being independent of the patient’s current preference.
The MMSE may involve asking clients to draw clocks with designated times. This activity tests for which of the following?
Visuospatial ability refers to time and space. Assessing higher brain function involves several areas, including visuospatial ability along with orientation, level of consciousness, memory, concentration and attention, reading and writing, cognition and intellectual performance, ability to abstract, impulsivity, judgment and insight, and reliability.
An increase in the level of potassium can indicate:
Elevated levels of potassium can indicate insulin deficiency. In addition, increased levels can be indicative of acidosis, acute renal failure, infection or dehydration.
Risk sharing
focuses on target payment for health care costs per member per month between a plan and a provider or a network of providers. The provider and the HMO each accept partial responsibility for the financial risks and rewards.
many children with conduct disorder are
irritable, have low self-esteem, and tend to throw frequent temper tantrums. Some may abuse drugs and alcohol.
Peer review is a
collegial, systematic, and periodic process that helps
hold the registered nurse accountable for their practice.
General systems theory provides
a framework that explains the dynamic structure and function of the family within the context of a unified whole. Each family system has its own characteristics, and the whole is greater than the sum of the parts, rather than just the sum of the characteristics of individual parts of a system.
Suicidal tidbit
Gunshot wounds are the leading cause of death among suicide victims.
Most people who are threatening suicide are actually crying for help.
Suicide is definitely not inherited. But, if a family member has committed suicide
it can increase an individual’s risk for suicide.
People who commit suicide are unhappy, they are not necessarily psychotic
or mentally ill.
parts to the standards of care for implementation are:
pharmacological, biological, and integrative therapies; prescriptive authority and treatment; psychotherapy; and consultation, coordination of care
health teaching and promotion, milieu therapy
The onset of bipolar disorder typically occurs
in the late teens and early twenties. About 20% develop symptoms by 19. Late onset may be an indication of another condition present.
A persons tendency to respond to a challenge in a predictable way, would
be which of the following terms?
Temperament can be calm or laid back or temperament can also be uptight or
anxious. Typically, these characteristics stay the same throughout an
individuals life.
Motor and vocal tics are divided into simple and complex types. Is a complex motor tic?
Echopraxia (imitation of observed behavior) is a common complex motor tics. Other complex motor tics include: grooming behaviors, the smelling of objects, jumping, touching behaviors, and copropraxia (display of obscene gestures).
