psych Flashcards
(195 cards)
1
Q
What is the first step when a client living on the streets comes in?
A
Streamline assessment and establish safety so that you can build trust.
2
Q
What should you do if someone calls the nurses station asking for information?
A
Refuse to give any information.
3
Q
What is promoted during the working phase of a relationship?
A
Promoting a client’s insight and perception of reality.
4
Q
What is transference?
A
Occurs in the working phase and helps sort out past relationship issues.
5
Q
What does the biological theory of depression suggest?
A
It is due to an imbalance of neurotransmitters: serotonin, dopamine, and norepinephrine.
6
Q
According to Erickson, what should a 35-year-old living with their mother be doing?
A
Firmly establishing secure relationships.
7
Q
What should you do for someone whose mother recently passed away and has become quiet?
A
Remain with the client.
8
Q
What is the psychosocial stage for someone aged 47-74 according to Erickson?
A
Ego integrity vs despair.
9
Q
What are individuals susceptible to when experiencing a long-term stress response?
A
Decreased resistance to disease.
10
Q
What is a therapeutic response to someone saying ‘I’m going to die’ and expressing anger about their family’s wishes?
A
You’re feeling angry that your family keeps wishing for a cure?
11
Q
What should a nurse case manager do for someone whose caregiver is ill and unable to care for them?
A
Coordinate needed services.
12
Q
What should you do first when confronting an ethical dilemma?
A
Gather subjective and objective information.
13
Q
When developing care plans for multiple patients, what should you prioritize?
A
Life-threatening potential.
14
Q
What is the outcome of the trust vs. mistrust stage in infants?
A
Viewing the world as safe and reliable; relationships as nurturing, stable, and dependable.
Virtue: Hope
15
Q
What is the outcome of the autonomy vs. shame and doubt stage in toddlers?
A
Achieving a sense of control and free will.
Virtue: Will
16
Q
What is the outcome of the initiative vs. guilt stage in preschoolers?
A
Beginning development of a conscience; learning to manage conflict and anxiety.
Virtue: Purpose
17
Q
What is the outcome of the industry vs. inferiority stage in school-aged children?
A
Emerging confidence in own abilities; taking pleasure in accomplishments.
Virtue: Competence
18
Q
What is the outcome of the identity vs. role confusion stage in adolescence?
A
Formulating a sense of self and belonging.
Virtue: Fidelity
19
Q
What is the outcome of the intimacy vs. isolation stage in young adults?
A
Forming adult, loving relationships, and meaningful attachments to others.
Virtue: Love
20
Q
What is the outcome of the generativity vs. stagnation stage in middle adults?
A
Being creative and productive; establishing the next generation.
Virtue: Care
21
Q
What is the outcome of the ego integrity vs. despair stage in maturity?
A
Accepting responsibility for oneself and life.
Virtue: Wisdom
22
Q
What does the CNS comprise?
A
The CNS comprises the brain, spinal cord, and associated nerves that control voluntary acts.
23
Q
What are the structural components of the brain?
A
The brain consists of the cerebrum, cerebellum, brain stem, and limbic system.
24
Q
How is the cerebrum divided?
A
The cerebrum is divided into 2 hemispheres.
25
How many lobes does each hemisphere of the cerebrum have?
Each hemisphere has 4 lobes.
26
What functions does the frontal lobe control?
The frontal lobe controls the organization of thought, body movement, memories, emotions, and moral behavior.
27
What are the functions of the parietal lobes?
The parietal lobes interpret sensations of taste and touch and assist in spatial orientation.
28
What do the temporal lobes center around?
The temporal lobes are centers for the senses of smell and hearing, and for memory and emotional expression.
29
What is the role of the occipital lobes?
The occipital lobes assist in coordinating language generation and visual interpretation, such as depth perception.
30
What is located below the cerebrum?
The cerebellum is located below the cerebrum.
31
What does the cerebellum control?
The cerebellum controls coordination of movements and postural adjustments.
32
What are the components of the brain stem?
The brain stem consists of the midbrain, pons, and medulla oblongata.
33
What is the function of the medulla?
The medulla is the respiratory and cardiovascular control center.
34
What is the role of the pons?
The pons bridges the gap both structurally and functionally, serving as a primary motor pathway.
35
What does the midbrain connect?
The midbrain connects the pons and cerebellum with the cerebrum.
36
What is the locus coeruleus associated with?
The locus coeruleus is associated with stress, anxiety, and impulsive behavior.
37
What does the limbic system include?
The limbic system includes the thalamus, hypothalamus, hippocampus, and amygdala.
38
What is the function of the thalamus?
The thalamus regulates activity, sensation, and emotion.
39
What does the hypothalamus regulate?
The hypothalamus is involved in temperature regulation, appetite control, and endocrine function.
40
What roles do the hippocampus and amygdala play?
The hippocampus and amygdala are involved in emotional arousal and memory.
41
What are neurotransmitters?
Neurotransmitters are chemical substances manufactured in the neuron that aid in the transmission of information throughout the body.
42
What is the function of dopamine?
Dopamine is excitatory and controls complex movements, motivation, cognition, and emotional response.
43
What does norepinephrine influence?
Norepinephrine causes changes in attention, learning and memory, sleep and wakefulness, and mood.
44
What is the role of epinephrine?
Epinephrine controls the fight-or-flight response.
45
What can high levels of glutamate cause?
High levels of glutamate can result in neurotoxicity.
46
What does serotonin regulate?
Serotonin regulates food intake, sleep and wakefulness, temperature regulation, and emotions.
47
What is the function of GABA?
GABA is inhibitory and modulates other neurotransmitters.
48
What does acetylcholine control?
Acetylcholine controls the sleep and wakefulness cycle and signals muscles to become alert.
49
What does histamine regulate?
Histamine controls alertness, gastric secretions, cardiac stimulation, and peripheral allergic responses.
50
What is deinstitutionalization?
Deinstitutionalization refers to the process of reducing the population of mental health institutions.
51
What are the influencing factors of mental health?
The influencing factors of mental health include individual (personal), interpersonal (relationship), and social/cultural (environmental).
52
What are social factors that influence health?
Nonmedical factors such as a sense of community, access to adequate resources, intolerance of violence, support of diversity, mastery of the environment, education, employment, income and social protection, and food security.
53
What is the DSM-5-TR?
A book for diagnosis published by the American Psychiatric Association that standardizes diagnosis criteria, presents defining characteristics or symptoms, and assists in identifying the underlying causes of disorders.
54
How was sickness viewed in ancient times?
Sickness was seen as displeasure of gods, punishment for sins, and viewed as demonic or divine.
55
What did Aristotle believe about mental illness?
He believed in imbalances of the four humors (blood, water, yellow, and black bile) and that balance could be restored via bloodletting, starving, and purging.
56
How did early Christians view diseases?
All diseases were blamed on demons, and the mentally ill were viewed as possessed, leading to exorcisms and severe measures like incarceration and flogging.
57
What was the treatment of mental illness in the early Renaissance?
People with mental illness were distinguished from criminals; harmless individuals could wander while dangerous ones were imprisoned, chained, and starved.
58
What significant change occurred during the Period of Enlightenment?
The creation of asylums in the 1790s, which marked the beginning of moral treatment for the mentally ill.
59
Who created asylums for the mentally ill?
Dorothea Dix, who began a crusade to reform the treatment of mental illness and was instrumental in opening 32 state hospitals.
60
Who studied mental illness treatment scientifically?
Sigmund Freud.
61
What did Freud challenge society to view?
Human beings objectively.
62
What did Freud study?
The mind, its disorders, and their treatment as no one had done before.
63
When did the development of psychopharmacology begin?
1950.
64
What are psychotropic drugs?
Drugs used to treat mental illness.
65
What effects did psychotropic drugs have?
They actually reduced agitation, psychotic thinking, and depression.
66
What significant movement occurred in 1963?
The community mental health movement.
67
What was a key aspect of deinstitutionalization?
Legislation for disability income supplemental security income (SSI) and Social Security disability income (SSDI).
68
What changes occurred in commitment laws in the early 1970s?
Changes that prevented locking somebody up against their will.
69
What did community mental health centers provide after deinstitutionalization?
Emergency care, inpatient care, outpatient services, partial hospitalization, screening services, and education.
70
What was accomplished by deinstitutionalization?
The release of individuals from long-term stays in state institutions and the development of community-based services.
71
How many adults in the United States have a mental illness?
51.5 million.
72
How many adults actually receive treatment for mental illness?
23 million.
73
How many children and adolescents are diagnosed with a mental disorder?
11 million.
74
What is the economic burden of mental health compared to cancer?
The economic burden of mental illness exceeds the economic burden of cancer.
75
What is the revolving door effect?
Recidivism is the revolving door effect.
76
Which statement best reflects the current state of mental health and mental illness?
A. Mental health care costs exceed the costs for cancer care.
77
What is a major issue with community mental health centers?
Lack of appropriate number of community mental health centers to provide services.
78
What are the characteristics of community support programs?
Availability and quality of services are highly variable; inaccurate anticipation of people's needs.
79
What was the managed care movement designed to control?
The balance between the quality of care provided and the cost of that care.
80
What developed in the 1990s to control insurance expenditures?
Utilization review firms/managed care organizations.
81
What is the reliance for payment if there is no private insurance?
Reliance on counties of residence for payment.
82
Who was the first American psychiatric nurse?
Linda Richards.
83
When was the first psychiatric nursing textbook published?
1920.
84
What was the first school of nursing to include a psychiatric nursing course?
Johns Hopkins in 1913.
85
What did the National League for Nursing require in 1950?
Schools to include an experience in psychiatric nursing.
86
Who is associated with the therapeutic nurse-client relationship?
H. Peplau.
87
What rights do clients retain?
All civil rights afforded to all people.
88
When does a patient not retain their rights?
When they are a danger to themselves or others.
89
What is voluntary commitment?
A person takes themselves there and has insight about their mental illness.
90
What is the Baker Act commitment?
Involuntary commitment for a person who is a danger to themselves or others, neglecting basic needs.
91
What happens if a patient improves during a Baker Act 72-hour hold?
They are released and can go home.
92
What is the Marchman Act?
An involuntary act for severe substance abuse, court-ordered, for those without insight.
93
Can a patient refuse meds?
Yes
94
When can't a patient refuse meds?
If they are a danger to themselves or others
95
Before giving involuntary meds, what must you do?
Obtain consent from a proxy
96
What is the spectrum of restrictiveness?
Least to most restrictive
97
Meds without consent are considered what?
Emergency treatment order
## Footnote
Given when a patient is a danger to themselves or others
98
Once you do seclusion or restraints, what must you do?
Get an order within the next hour
## Footnote
In that hour, a physician must come and do a face-to-face evaluation and then every 8 hours (every 4 hours for children). Vitals every 15 minutes. Documented full assessment by nurse every 1 to 2 hours.
99
If you have a Haldol IV order, can you give the same med and dose IM?
No
## Footnote
Need a separate order for each route and new consent each time.
100
How long is a restraint order valid?
4 hours
## Footnote
2 hours for kids.
101
After restraints or seclusion, what must you do?
Conduct a debriefing within 24 hours after release from the restraint or seclusion
## Footnote
Discuss what led to it, triggers, and how to know they are triggered.
102
What is the duty to warn?
A legal and ethical obligation to inform potential victims or authorities when a client poses a credible threat of harm to themselves or others.
103
If a patient in the hospital makes a threat, can you disclose their business?
No
## Footnote
They are not a real risk and must be a specific and realistic threat.
104
What is the M’Naghten Rule?
A person did not know the act was wrong.
105
What is the Durham rule?
A person's criminal conduct is excused.
106
What does irresistible impulse mean?
A person could not control their conduct.
107
If incompetent, can a person stand trial?
No
## Footnote
A judge will say they need treatment and when competent, they can stand trial.
108
What does 'ausalt' mean?
Threat
109
What does 'battery' refer to?
Get physical
110
What is the ID in psychological terms?
Basic/innate pleasure-seeking desires; impulsive; seeks gratification; sexual/aggressive.
111
What is the superego?
Moral/ethical concepts.
112
What is the ego?
Balance between superego and ID
## Footnote
The ego represents mature and adaptive behavior that allows a person to function successfully in the world.
113
What is consciousness?
Perceptions, thoughts, and emotions that exist in the person's awareness.
114
What is the preconscious?
Thoughts and emotions not currently in awareness but can be recalled with effort.
115
What is the unconscious?
Realm of thoughts and feelings that motivates a person without their awareness.
116
What is compensation in psychological terms?
Overachievement in one area to offset real or perceived deficiencies in another area
## Footnote
Example: Napoleon complex.
117
What is conversion?
Expression of an emotional conflict through the development of a physical symptom
## Footnote
Example: A teenager forbidden to see X-rated movies develops blindness.
118
What is denial?
Failure to acknowledge an unbearable condition; failure to admit the reality of a situation
## Footnote
Example: A person with diabetes eating chocolate candy.
119
What is displacement?
Ventilation of intense feelings toward less threatening persons
## Footnote
Example: A person who is mad at their boss yells at their spouse.
120
What is dissociation?
Dealing with emotional conflict by a temporary alteration in consciousness or identity.
## Footnote
Amnesia that prevents recall of yesterday's auto accident.
121
What is fixation?
Immobilization of a portion of the personality resulting from unsuccessful completion of tasks in a developmental stage.
## Footnote
Never learning to delay gratification; Lack of a clear sense of identity as an adult.
122
What is identification?
Modeling actions and opinions of influential others while searching for identity or aspiring to reach a personal, social, or occupational goal.
## Footnote
Nursing student becoming a critical care nurse because this is the specialty of an instructor they admire.
123
What is intellectualization?
Separation of the emotions of a painful event or situation from the facts involved; acknowledging the facts but not the emotions.
## Footnote
Person shows no emotional expression when discussing serious car accident.
124
What is introjection?
Accepting another person's attitudes, beliefs, and values as one's own.
## Footnote
Person who dislikes guns becomes an avid hunter, just like a best friend.
125
What is projection?
Unconscious blaming of unacceptable inclinations or thoughts on an external object.
## Footnote
Man who has thought about same-gender sexual relationship but never had one beats a man who is gay.
126
What is rationalization?
Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-respect.
## Footnote
Student blames failure on teacher being mean.
127
What is reaction formation?
Acting the opposite of what one thinks or feels.
## Footnote
Woman who never wanted to have children becomes a supermom.
128
What is regression?
Moving back to a previous developmental stage to feel safe or have needs met.
## Footnote
A 5-year-old asks for a bottle when new baby is being fed.
129
What is repression?
Excluding emotionally painful or anxiety-provoking thoughts and feelings from conscious awareness.
## Footnote
Person has no memory of the mugging they suffered.
130
What is resistance?
Overt or covert antagonism toward remembering or processing anxiety-producing information.
## Footnote
Nurse is too busy with tasks to spend time talking to a dying client.
131
What is sublimation?
Substituting a socially acceptable activity for an impulse that is unacceptable.
## Footnote
Person who has quit smoking sucks on hard candy when the urge to smoke arises.
132
What is substitution?
Replacing the desired gratification with one that is more readily available.
## Footnote
Person who would like to have their own children opens a day care center.
133
What is suppression?
Conscious exclusion of unacceptable thoughts and feelings from conscious awareness.
## Footnote
Student decides not to think about a parent's illness to study for a test.
134
What is undoing?
Exhibiting acceptable behavior to make up for or negate unacceptable behavior.
## Footnote
Person who cheats on a partner brings the partner a bouquet of roses.
135
What is transference?
Transference occurs when the client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships.
## Footnote
An adolescent client working with a nurse who is about the same age as the teen's parents might react to the nurse just as they react to their parents.
136
What is countertransference?
Occurs when the therapist displaces onto the client attitudes or feelings from their own past.
## Footnote
A nurse who has teenage children and who is experiencing extreme frustration with an adolescent client may respond by adopting a parental or chastising tone.
137
How can nurses deal with countertransference?
By examining their own feelings and responses, using self-awareness, and talking with colleagues.
138
What is the anal stage of development?
18-36 months, associated with potty training.
139
What is the phallic/oedipal stage?
3-5 years, where the genital area is the focus of interest, stimulation, and excitement. The penis is the organ of interest for both sexes, and kids are attached to the opposite sex parent.
140
What is the latency stage of development?
5-11 years old, where children explore their differences from others not in their family and the superego forms.
141
What is the genital stage?
11-13 years, marked by puberty, true intimacy, and the experience of orgasm.
142
What are Erikson's eight psychosocial stages of development?
They include trust vs mistrust, autonomy vs shame and doubt, initiative vs guilt, industry vs inferiority, identity vs role confusion, intimacy vs isolation, generative vs stagnation, and ego integrity vs despair.
143
What is the trust vs mistrust stage?
Infant stage where a crying infant needs someone to comfort them.
144
What is the autonomy vs shame and doubt stage?
Toddler stage where the child is allowed to learn and do things on their own.
145
What is the initiative vs guilt stage?
Preschooler stage focused on managing conflict and anxiety through activities like playing and coloring.
146
What is the industry vs inferiority stage?
School age stage where children seek awards and recognition; feelings of not being celebrated can lead to feelings of inferiority.
147
What is the identity vs role confusion stage?
Adolescence stage characterized by hormonal changes and the need to fit in and belong.
148
What is the intimacy vs isolation stage?
Young adult stage where individuals form deeply personal relationships, marry, and begin families.
149
What is the generative vs stagnation stage?
Middle adult stage focused on creativity, productivity, and establishing the next generation.
150
What is the ego integrity vs despair stage?
Older adult stage where individuals accept responsibility for themselves and their life.
151
What are Piaget's cognitive stages of development?
They include sensorimotor, preoperational, concrete operational, and formal operational.
152
What is the sensorimotor stage?
Birth to 2 years, where the child develops a sense of self and object permanence.
153
What is the preoperational stage?
2 to 6 years, where the child expresses self with language and understands symbolic gestures.
154
What is the concrete operations stage?
6 to 12 years, where the child applies logic to thinking and understands spatiality and reversibility.
155
What is the formal operations stage?
12 to 15 years and beyond, where the child learns to think abstractly and achieves cognitive maturity.
156
What is Sullivan's infancy stage?
Birth to onset of language, where the primary need is for bodily contact and tenderness.
157
What is Sullivan's childhood stage?
Language to age 5, where parents are viewed as sources of praise and acceptance.
158
What is Sullivan's juvenile stage?
Ages 5-8, where children think about themselves and others, seeking approval and acceptance.
159
What is Sullivan's preadolescence stage?
8-12 years, where children move towards genuine intimacy with same-sex friends.
160
What is Sullivan's adolescence stage?
From puberty to adulthood, where new social opportunities lead to self-esteem consolidation or self-ridicule.
161
What are Peplau's stages?
They include orientation, working (identification/exploitation), and termination.
162
What occurs in the orientation stage?
Patient's problems and needs are clarified, and hospital routines are explained.
163
What occurs in the identification stage?
Patient responds to helpful persons, feels stronger, and expresses feelings while working interdependently with the nurse.
164
What is exploitation in the context of patient behavior?
Patient makes full use of available services. Goals such as going home and returning to work emerge. Patient's behaviors fluctuate between dependence and independence.
165
What does resolution (termination) mean in patient care?
Patient gives up dependent behavior. Services are no longer needed by patient. Patient assumes power to meet own needs, set new goals, and so forth.
166
What characterizes mild anxiety?
A positive state of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems.
167
What is moderate anxiety?
Involves a decreased perceptual field; the person can learn new behavior or solve problems only with assistance.
168
What are the symptoms of severe anxiety?
Feelings of dread or terror, inability to be redirected to a task, focus on scattered details, and physiologic symptoms like tachycardia, diaphoresis, and chest pain.
169
What is panic anxiety?
Can involve loss of rational thought, delusions, hallucinations, and complete physical immobility and muteness.
170
What is the first level of Maslow's Hierarchy of Needs?
Physiological needs, including food, water, sleep, shelter, sexual expression, and freedom from pain.
171
What does the safety level in Maslow's Hierarchy of Needs involve?
Safety and security needs, which include protection, security, and freedom from harm or threatened deprivation.
172
What are social esteem needs in Maslow's Hierarchy?
Love and belonging needs, which include enduring intimacy, friendship, and acceptance.
173
What is self-actualization in Maslow's Hierarchy?
The need for beauty, truth, and justice.
174
What is Pavlov's theory of classical conditioning?
Behavior can be changed through conditioning with external or environmental conditions or stimuli.
175
What is Skinner's operant conditioning?
A learning process where behavior is shaped by rewards or punishments, increasing or decreasing the likelihood of that behavior recurring.
176
How can conditioned responses like phobias be treated?
Systematic desensitization can help clients overcome irrational fears and anxiety associated with phobias.
177
What is cognitive therapy?
Focuses on immediate thought processing—how a person perceives or interprets their experience.
178
What is cognitive behavioral therapy (CBT)?
Focuses on faulty thinking and learned patterns of unhelpful behavior, improving coping skills and quality of life.
179
What is dialectical behavior therapy (DBT)?
A specific type of CBT designed to treat clients with borderline personality disorders, focusing on mindfulness and emotional regulation.
180
What is a crisis?
A turning point in an individual's life that produces an overwhelming emotional response.
181
What are maturational crises?
Predictable events in the normal course of life, such as leaving home, getting married, or having a baby.
182
What are situational crises?
Unanticipated events that threaten the individual's integrity, such as the death of a loved one or loss of a job.
183
What is an adventitious crisis?
Sometimes called social crises, they include natural disasters like floods, earthquakes, or hurricanes; war; terrorist attacks; riots; and violent crimes such as rape or murder.
184
What should we ask a patient during a crisis?
What happened, how did you deal in the past.
185
What is the difference between abstract and concrete thinking?
Abstract thinking involves understanding the meaning, while concrete thinking takes things literally.
## Footnote
Example: 'It's raining cats and dogs.'
186
What does acceptance mean in a nursing context?
Avoiding judgments of the person, no matter what the behavior. By being clear and firm without anger or judgment, the nurse allows the client to feel intact while still conveying that certain behavior is unacceptable.
## Footnote
Example: A nurse might say, 'J., do not place your arm on me. We are working on your relationship with your significant other, and that does not require you to touch me. Now, let's continue.'
187
What is hardiness?
The ability to resist illness when under stress, characterized by commitment, control, and challenge, believing you control what happens to you.
188
How do you find out a patient's cultural preference?
Ask them.
189
How should you set up your placement with a patient?
3-6 feet apart, in a quiet private environment but not completely hidden, with open body language and open-ended, clear questions.
190
What does exploring mean in a therapeutic context?
Delving further into a subject or an idea.
## Footnote
Example: 'Tell me more about that.'
191
What is focusing in therapy?
Concentrating on a single point.
## Footnote
Example: 'This point seems worth looking at more closely.'
192
What is restating?
Repeating the main idea expressed.
## Footnote
Example: Client: 'I'm really mad, I'm really upset.' Nurse: 'You're really mad and upset.'
193
What does reflecting mean in therapy?
Directing client actions, thoughts, and feelings back to the client.
## Footnote
Example: Client: 'Do you think I should tell the doctor...?' Nurse: 'Do you think you should?'
194
What is silence in a therapeutic context?
Absence of verbal communication, which provides time for the client to put thoughts or feelings into words, to regain composure, or to continue talking.
195
How do we ask about suicidal thoughts?
Use a directive role with direct yes-or-no questions, usually for clients with suicidal thoughts, in crisis, or who are out of touch with reality.
