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NURS 363 Exam 2 > Psych Exam > Flashcards

Psych Exam Flashcards

1
Q

Are personality traits stable over time?

A

They tend to be

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2
Q

4 parts of personality

A

Cognition
Affectivity
Interpersonal behavior
Impulse control

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3
Q

When do personality disorders typically manifest?

A

Adolescence and early adulthood

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4
Q

Why is it difficult to determine how many people in the population have personality disorders?

A

They do not seek professional help

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5
Q

Women are at increased risk for…

A

Avoidant, paranoid, and dependent personality disorders

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6
Q

Men are at increased risk for…

A

Antisocial personality disorders

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7
Q

Chronic maladaptive pattern of perceiving, thinking, and relating that impairs social or occupational functioning causing inner distress

A

Personality Disorder

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8
Q

Personality disorders occur when personality traits become:

A

Inflexible, maladaptive, cause significant dysfunction and subjective distress

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9
Q

Theory that emphasizes importance of nurturing from immediate caregivers and loved ones for fostering positive personality traits

A

Psychoanalytic

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10
Q

Theory that stressed the influence of genetics combined with environmental exposures for the formation of personality

A

Biological

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11
Q

Theory that people acquire personality characteristics through thought and interaction with their environment

A

Social Learning and Cognitive Perspectives

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12
Q

Cluster A Personality Disorders (Odd & Eccentric)

A

Paranoid, Schizoid, Schizotypal

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13
Q

Cluster B Personality Disorders (Dramatic, Emotional, or Erratic)

A

Antisocial, Borderline, Histrionic, Narcissistic

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14
Q

Cluster C Personality Disorders (Anxious & Fearful)

A

Avoidant, Dependent, Obsessive-Compulsive

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15
Q

Distrust and suspiciousness of others
others motives are interpreted as malevolent.
Quick to take offense.
Do not acknowledge their negative feelings, and project them on others.

A

Paranoid Personality disorder

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16
Q

Patients with this disorder constantly test the honesty of others, and have little or no friends

A

Paranoid personality disorder

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17
Q

Pts with this disorder show indifference to social relationships. They fail to respond to others in a meaningful, emotional way.

A

Schizoid Personality Disorder

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18
Q

These people are intolerance of close relationships. Thought patterns are disturbed, odd behaviors.
Often skip out on ADLs and Nutritional Care.

A

Schizotypal Personality Disorder

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19
Q

Bizarre speech patterns and demonstrate psychotic symptoms when under stress (decompensation), magical thinking, delusions, and depersonalization are all commonly seen in patients with….

A

Schizotypal personality disorder

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20
Q

Similar to my ex boyfriend, these guys have aggressive and irresponsible behaviors, superficially charming, lack genuine warmth.
Patterns of: fights, stealing, substance abuse, exploitative, and manipulative

A

Antisocial personality disorder

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21
Q

Failure to sustain employment, exploiting and manipulating others for personal gain, inconsistent work performance, inability to form long lasting monogamous relationships, and failure to conform to societal norms are all commonly seen in individuals with…..

A

Antisocial Personality Disorder

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22
Q

Characterized by a patter of intense and chaotic relationships with affective instability.
View life experiences and relationships to the extremes of either very good or bad.
View themselves as victims.
Highly impulsive, mood swings, anger, anxiety
May self mutilate if they feel they’re being ignored or become aggressive for attention

A

Borderline Personality Disorder

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23
Q

Splitting

A

Viewing life experiences as either very good or very bad

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24
Q

The most common form of personality disorder

A

Borderline

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25
Q

Characterized by a long standing pattern of emotionally charged interactions and attention seeking behaviors. Strive to be center of attention, speech is superficial, lacks detail. Seductive, insecure, dependent on approval of others, naive, easily influences, low tolerance to frustration, blame disappointments on others, suppress feelings related to past events and lack insight

A

Histrionic Personality Disorder

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26
Q

These individuals are highly distractible, flamboyant in dress and speech, exhibitionistic, easily influenced by others, difficulty forming close relationships, excitable, manipulative, extroverted in behavior, seductive

A

Histrionic Personality Disorder

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27
Q

These guys have life-long patterns of self-centerness, self-absorption, inability to empathize, insensitive of others, exaggerate successes, self-esteem is fragile, oversensitive to comments, envious of others, and believe others envy them.

A

Narcissistic Personality Disorder

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28
Q

These individuals mood can easily change because of fragile self-esteem.
Criticism from others may cause them to respond with rage, shame, and humiliation.
They are everly self-centered, and sensitive to what others think. insensitive to others needs and lack empathy.

A

Narcissistic personality disorder

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29
Q

Pattern in early adulthood of social discomfort, timid, fear of rejection and negative feedback, will only form relationships if acceptance is guaranteed, self-perceived unattractiveness, inferior, feelings of shame, embarrassment, ridicule trying new activities.

A

Avoidant Personality Disorder

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30
Q

Individuals with this disorder are often awkward and uncomfortable in social situations
They desire close relationships but avoid them because of their fear of being rejected
They have inappropriate displays of anger, disassociative, paranoid ideation, and are preoccupied with being criticized and rejected

A

Avoidant Personality Disorder

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31
Q

Excessive need to be taken care of, clinging behaviors, fear of separation, difficulty making independent decisions and starting projects, lack trusts in ones judgments, relationships are based on being cared for.

A

Dependent Personality Disorder

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32
Q

These people exhibit a pattern of negative attitude and passive resistance. React badly to demands for adequate performance in social and occupational situations.

A

Passive Aggressive Personality Disorder

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33
Q

Individuals with this disorder have a notable lack of self-confidence.
They may be overly generous and thoughtful, while underplaying their own attractiveness and achievements, assume passive and submissive roles in relationships, avoid positions of responsibility

A

Dependent Personality Disorder

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34
Q

These people exhibit passive resistance, general obstructiveness, switch among the roles of martyr, disrespected, distressed, guilt-ridden, sickly, and overworked.
Able to vent anger and resentment subtly while gaining the attention reassurance and dependency they crave

A

Passive Aggressive Personality Disorder

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35
Q

Treatments for Personality Disorders (6 Things)

A 
Interpersonal Psychotherapy
Psychoanalytical psychotherapy
milieu or group therapy
cognitive/behavioral therapy
case management
psychopharmacology
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36
Q

Nursing Goals for Cluster A Personality Disorders

A

Solve immediate crisis and complete social skills training

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37
Q

Nursing Goals for Cluster B Personality Disorders

A

Prevent suicide, improve coping, gain insight into feelings and behaviors and unrealistic expectations/fears

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38
Q

Nursing Goals for Cluster C Personality Disorders

A

Enhance social functioning, solve immediate crisis, assertiveness training, cognitive reconstruction

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39
Q

Approaches to Guarded, Suspicious, Argumentative Behavior

A

Do not debate or agree with patients perception
focus attention on treatment
be respectful

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40
Q

Approaches to dealing with Aloof & Uninvolved patients

A

Demonstrate understanding and respect privacy.
Explain rationale for personal questioning,
Do not push for social interaction

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41
Q

Approach to dealing with Idiosyncratic, Eccentric patients (Cluster A)

A

Consistent approach addressing complaints and beliefs

do not challenge or reinforce perspectives

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42
Q

Approaches to deal with Demanding patients

Cluster B

A

Set limits - minimize excessive or realistic demands

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43
Q

Approaches to dealing with Dramatic, Emotionally Involved, Seductive Patients
(Cluster B)

A

Supportive attitude

maintain professional boundaries to prevent unprovoked response

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44
Q

Approaches to dealing with cluster B patients that feel they are superior

A

recognize and support strengths
show interest in opinions
demonstrate competence

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45
Q

Approaches to dealing with sociopathic patients (Cluster B)

A

set realistic limits on visits

develop treatment plan to address aggressive behaviors

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46
Q

Approaches to Orderly, Controlled/Controlling Cluster C’s

A

Clearly state treatment approaches
give as much detail as possible
avoid struggle of who is in charge.

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47
Q

Approaches to dealing with Anxiously Avoidant, Clinging, Dependent cluster C’s

A

Demonstrate patience and empathy toward fears
frequent brief encounters
forewarn of any mileu changes

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48
Q

Approaches to dealing with Controlling, Avoidant, Dependent Cluster C’s

A

Directly address concerns about behaviors
identify underlying feelings about their illness and treatment
avoid feeling resentful about “Acting Out” behaviors

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49
Q

Nursing Considerations for Patients with Personality Disorders

A

Safety, trust, hygiene and nutrition, communication and social skills, normal communication skills are compromised by emotions

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50
Q

A group of conditions in which the affected person experiences persistent anxiety that cannot be dismissed. Coping mechanisms are ineffective. Interferes with ADLs

A

Anxiety Disorder

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51
Q

How are Anxiety and Fear different

A

Anxiety is an emotional response

Fear is a cognitive response

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52
Q

Effects of Severe Anxiety

A

perceptions become increasingly distorted, scattered, and disorganized

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53
Q

Effects of Mild Anxiety

A

Heightens sensations, sight, hearing, able to learn and verbalize rationally

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54
Q

Effects of Panic

A

Perception is grossly distorted, cannot differentiate real from imaginary stimuli
Get the person to focus on ONE thing

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55
Q

When does anxiety require interventions

A

When it prevents fulfillment of professional, personal, or social roles.

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56
Q

Most common psychiatric illness

A

Anxiety Disorders

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57
Q

Maladaptive Coping Mechanisms for Anxiety (4)

A

Withdrawl or retreat from provoking situations
acting out the discharge of anxiety through aggression
physiological expression of anxiety
avoidance and evasive behaviors

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58
Q

Adaptive Coping Mechanism for Anxiety

A

Problem solving - systematic method for addressing difficult situations

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59
Q

Barriers to treatment of Anxiety

A

Lack of knowledge related to nature and prevalence
lack of knowledge of the positive response to treatments
social stigma
misdiagnosed and untreated

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60
Q

Intense apprehension, terror without any real threat accompanied with somatic or cognitive symptoms

A

Panic

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61
Q

Symptoms of Panic Attack

A

chest pain, choking, dizziness, sweating, vertigo, fainting, hot and cold flashes, fear of dying, going crazy

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62
Q

Disorder characterized by recurrent panic attacks, onset of which are unpredictable, and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort

A

Panic Disorder

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63
Q

Agorophobia

A

Fear of being in places and situations from which escape might be difficult or embarrassing or help might not be available in the event that a panic attack should occur

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64
Q

Disorder characterized by chronic, unrealistic, and excessive anxiety and worry for at least 6 months

A

Generalized Anxiety Disorder

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65
Q

Disorder that causes so much discomfort it interferes with ADLs and relationships

A

Generalized Anxiety Disorder

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66
Q

Symptoms of Generalized Anxiety Disorder

A

Feeling on edge, persistent and chronic s/s of muscle tension, autonomic hyperactivity, and apprehension, unable to concentrate, chronic fatigue, impaired sleep patterns, depression

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67
Q

Persistent irrational fear attached to an object or situation that objectively does not pose a danger

A

Phobia

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68
Q

Characteristics of Phobias

A

They are always anticipated, may be simple and specific to certain situations, events or objects.

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69
Q

Compelling fear and desire to avoid situations that involve strangers or scrutiny from others, including fear of speaking in front of others, eating, and using public restrooms.

A

Social Phobia

70
Q

Goals for Treating Anxiety Disorders

A

The client should be able to recognize signs of escalating anxiety and intervene so that it does not reach panic.

Discuss a long term plan to prevent anxiety, practice relaxation, and engage in physical exercise 3x a week

71
Q

Recurrent, intrusive, persistent ideas, thoughts, impulses, cognitively invasive.

A

Obsessions

72
Q

Ritualistic behaviors, clients are compelled to perform them, to prevent or reduce anxiety

A

Compulsions

73
Q

Obsessive Compulsive disorder can be so uncomfortable if left untreated it leads to…

A

Suicide or Depression

74
Q

This occurs within the first month of exposure to extreme trauma (Combat, rape, physical assault)

A

Acute Stress Disorder

75
Q

Symptoms of Acute Distress Disorder

A

Dissociation, a state of detachment, dream state, poor memory, esp r/t event.

76
Q

Acute Stress Disorder usually resolves in _________ days

A

2-28

77
Q

Post-traumatic Stress Disorder

A

Symptoms of stress disorder continue greater that 1 month

78
Q

Functional impairments of stress

A

Generalized Anxiety, intrusive thoughts, flashbacks, nightmares, sleep disturbances, need to avoid triggers

79
Q

Clinical Signs and Symptoms of PTSD

A

Substance use/abuse, barbiturate and benzo dependence, chronic relationship difficulties, negative outlook, frequent healthcare services for somatic complaints, obsessive compulsive behaviors, eating disorders

80
Q

Treatment for PTSD

A

cognitive behavior therapy, relaxation, psychopharmacology, benzodiazepines

81
Q

What is Cognitive behavior therapy

A

recognizing thoughts that cause anxiety. gain insight and learn new responses.

82
Q

1 Reason for non-adherance to psychotropic medication

A

Unpleasant distressing side effects

83
Q

SSRI (Selective Serotonin Reuptake Inhibitors)

A

inhibit the reuptake of serotonin by blocking the presynaptic neuron and increase the concentration of serotonin

84
Q

Tricyclic Antidepressants (TCA’s)

A

block norepinephrine and serotonin and acetylcholine, which controls the parasympatetic nervous system.

85
Q

Alcohol with TCAs causes….

A

sedation and ataxia. Give elderly 1/2 dose.

86
Q

TCA dose for elderly patients….

A

Should be 1/2 adult dose

87
Q

TCA’s for suicidal patients

A

Bad Idea…they can overdose and die

88
Q

TCA Classification Reminder

A

All drugs end in -ine

But some drugs that are not TCA’s end in -ine too

89
Q

Monoamine oxidase inhibitors (MAOIs)

A

inhbit MAO, and enzyme that breaks down serotonin, nor epinephrine and others, increasing their activity

90
Q

MAOI interaction with Tyramine causes….

A

Hypertensive crisis

91
Q

MAOI’s with SSRI’s

A

DONT DO IT!

92
Q

Onset of Lithium

A

5-7 days (maybe 2 weeks)

93
Q

Therapeutic blood levels for Lithium

A

0.8 - 1.5

94
Q

Lithium Toxicity happens when…

A

Na+ levels decrease.

95
Q

Anticonvulsants

A

used as mood stabilizers: they reduce repetitive firing of action potentials in the nerves.

96
Q

Check blood levels if taking these meds:

A

lithium, valproate, and carbamazepine need to have blood levels checked

97
Q

Important things to teach pts taking mood stabilizers

A

must maintain adequate fluid intake, balanced diet, normal sodium, and discontinue if toxicity symptoms occur

98
Q

Buspirone (Buspar)

A

Antianxiety med that binds to serotonin receptor

*Contraindicated in patients with renal or liver impairment, and lactating women

99
Q

Benzodiazepines

A

sedation, muscle relaxant, elevate seizure threshold. *Work directly on GABA receptors to dampen neural overstimulation

100
Q

Meds that end in -lam or -pam

A

Probably Benzo’s

also: chlordiazepoxide

101
Q

Nonbenzodiazepines

A

Buspirone and zolpidem - no CNS depressant effects or abuse potential

102
Q

Repeated use of a drug that leads to functional problems without compulsive or withdrawal indicators

A

Substance Abuse

103
Q

Painful physical and or psychological symptoms that follow the discontinuance of the substance

A

Withdrawal

104
Q

When a person uses a substance despite extreme negative consequences and impairments to daily living

A

Substance Dependence

105
Q

Requiring more and more of a substance to get the desired effect

A

Tolerance

106
Q

Do people with an addiction have a high tendency for relapse?

A

Yes

107
Q

What percentage of people with mental illness also have substance abuse disorder at some point in their life?

A

50%

108
Q

Theory that states specific effects on selected neurotransmitters, NIH-specific genes increase risk for addiction. Physiologic mechanisms for compulsion despite consequences

A

Biological Theory of Addiction

109
Q

This theory suggests that addiction is a defense against anxiety, dependency, and self-medication for depression hallucinations, thought disorders, PTSD, stress response, and coping styles

A

Psychological Theory of Addiction

110
Q

Inability to learn new information, recall remote information, unsteady gait, and myopathy

A

Wernicke’s encephalopathy

111
Q

Gait disturbances, confabulation, disorientation, ST memory impairment

A

Korsakoff’s Psychosis

112
Q

Wernicke’s Encephalopathy and Korsakoffs Psychosis are bother related to deficiences in what?

A

Thyamine (Malnutrition)

113
Q

Is brain damage permanent or temporary with alcoholic dementia?

A

It may be permanent

114
Q

When do symptoms of withdrawal peak?

A

24 - 48 hours (then rapidly disappear)

115
Q

Signs and Symptoms of Withdrawal

A

Hyper-alertness, Jerky movements, Irritability, easily startled, “shaking inside”

116
Q

How to reduce anxiety in patients going through withdrawal

A

Orient them to time and place, clarify illusions to reduce clients terror

117
Q

What is withdrawal delirium

A

A medical emergency that can result in death

118
Q

When does alcohol withdrawal delirium peak?

A

2 to 3 days after cessation of alcohol and lasts 2 to 3 days

119
Q

Signs and Symptoms of Withdrawal delirium

A

Tachycardia, diaphoresis, elevated BP, disorientation and clouding or changes in level of consciousness, visual or tactile hallucinations, hyper-excitability to lethargy, paranoid delusions, agitation, fever

120
Q

Dilation of pupils, darting eye movements, avoidance or intense eye contact, dry oronasal cavity, sniffling, excessive motor activity, rapid speech and flight of ideas are all common signs of the use of what 3 drugs

A

Cocaine, Crack, Amphetamines

121
Q

Two main effects of Crack/Cocaine on the body

A

Anesthetic and Stimulant

122
Q

The imbalance of neurotransmitters from crack/cocaine produces what?

A

Severe cravings

123
Q

Depression, paranoia, lethargy, anxiety, insomnia, nausea, vomiting, sweating, chills are all withdrawal symptoms of what drugs?

A

Crack / Cocaine

124
Q

Adverse effects of Ecstacy

A

Hyperthermia, heart failure, kidney failure, acute dehydration

125
Q

Date rape drugs effects

A

Dis-inhibition, relaxation of voluntary muscles, anterograde amnesia loss of ability to create new memories after event, inability to recall sudden trauma

126
Q

Aim of treatment for substance abuse

A

Self-responsibility

127
Q

Challenges of Substance Abuse Treatment

A

Matching the client with types of treatment considering various needs

128
Q

4 behaviors to be address in substance abuse treatment

A

Dysfunctional anger, Manipulation, Impulsiveness, Grandiosity

129
Q

Primary intervention for substance abuse treatment

A

Health Teaching

130
Q

Interventions for Substance Abuse

A

Dual-diagnosis principle treat concurrently, psychotherapy, relapse prevention, self-help group, 12-step programs, residential programs, intensive outpatient programs, outpatient drug-free programs, employee assistance programs

131
Q

Trexan, Revia (naltrexone)

A

Blocks opiate receptors, interferes with mechanisms of reinforcement, reduces or eliminates alcohol cravings

132
Q

Campral (acamprosate)

A

Helps client abstain from alcohol, mechanisms not well understood

133
Q

Antabuse (disulfiram)

A

Works on classical conditioning principle, alcohol-disulfiram reaction causes unpleasant physical effects

134
Q

Dolophine (methadone)

A

Synthetic opiate blocks craving for, and effects of, heroin. Only medication currently approved to treat pregnant opioid addict

135
Q

LAAM (L- x - acetylmethadol)

A

An alternative to methadone

136
Q

Naltrexone (Trexan Revia)

A

Antagonist that blocks euphoric effects of opioids

137
Q

Clonidine (Catapres)

A

Nonopioid suppressor of opioid withdrawal symptoms, effective somatic treatment when combined with naltrexone.

138
Q

Consistently consuming less that or more than that bodies caloric needs

A

Eating Disorder

139
Q

Eating disorders are often accompanied by __________ & ____________

A

Anxiety and Guilt

140
Q

Life threatening condition of disturbed body image leads to emaciation with the intense fear of becoming obese

A

Anorexia Nervosa

141
Q

Recurrent pattern of uncontrollable consumption of large amounts of food followed by attempts to eliminate the body of excess calories (purging)

A

Bulimia Nervosa

142
Q

Compulsive over-eating with no inappropriate compensatory behaviors, 2 days a week longer than 6 months

A

Binge eating disorder

143
Q

With Binge eating disorders eating is associated with (3 things)

A

Fat consumption, eating alone, guilt

144
Q

What percentage of obese individuals report binge eating?

A

20 - 30%

145
Q

Theory that states that the etiology of eating disorders is most likely influenced by multiple factors

A

Transactional Model of Stress/Adaptation

146
Q

Theory that eating disorders are caused by low-self esteem, self-doubts about personal worth, problems with separation, or problems with sexuality

A

Psychological Models

147
Q

Theory that eating disorders may originate in the hypothalamic, hormonal, neurotransmitters, or biochemical disturbances

A

Biological Theory

148
Q

OCD, anorexia, bulimia, are associated with excessive levels of ________________ which is released during physical and emotional stress

A

Vasopressin

149
Q

Conflict avoidance

A

Families may promote & maintain psychosomatic symptoms, including anorexia nervosa, in an effort to avoid spousal conflict.

150
Q

Parental Criticism and Eating disorders

A

Promotes increase in obsessive and perfectionist behavior on the part of the child, who continues to seek love, approval, and recognition

151
Q

With Anorexia Nervosa weight loss is usually more than _____% of expected weight

A

15%

152
Q

Symptoms of Anorexia

A

Amenorrhea, hypothermia, bradycardia, hypotension, edema, lanugo, and a variety of metabolic changes. There may by an obsession with food.

153
Q

Emergencies related to Anorexia/Bulimia Nervosa

A

Dehydration and electrolyte imbalances, physiological disorders related to starvation, kidney and liver disorders

154
Q

Eating Disorders: for the program to be successful the client must perceive that he or she is in _____________ of the treatment.

A

Control

155
Q

Medication for binge-eating disorder with obesity

A

Topiramate (Topamax)

156
Q

Medications used for anorexia nervosa or bulimia

A

Anxiety and Depression medications

157
Q

Metabolic Syndrome (Syndrome X)

A

Collection of health-related problems representing a gene-environment interaction. Main feature is insulin resistance, apple shape body, low activity, HTN, and potentially lethal CVD

158
Q

Obesity

A

BMI over 30

159
Q

Overweight

A

BMI 25 - 30

160
Q

SSRI’s use

A

Depression, OCD, Anxiety, PTSD, obesity, bulimia

161
Q

SSRI Side Effects

A

headache, nausea, insomnia, fatigue, dizziness, diarrhea, sexual dysfunction, suicidal thoughts

162
Q

Medication Contraindication with Lithium Use

A

Diuretics - because lithium causes sodium depletion

163
Q

Lithium Use

A

Mood stabilizer used to control manic episodes of bipolar psychosis

164
Q

Lithium Side Effects

A

Dizziness, hand tremors, impaired vision

165
Q

Nursing Considerations for Lithium

A

Monitor pts blood levels 2 -3 times a week when started, and monthly while on maintenance

166
Q

Antipsychotic Side effects

A

Extrapyramidal reactions (muscle rigidity, tremors, tongue protrusion, slowing of voluntary movement, abnormal posturing), Tardive dyskinesia, blurred vision, dry mouth

167
Q

Nursing Considerations for Antipsychotics

A

dystonic reactions treated with IV diphenhydramine

168
Q

Tricyclic Antidepressants Use

A

Mood elevator used to treat depression

169
Q

TCA’s Adverse Effects

A

blurred vision, constipation, weight gain, orthostatic hypotension, insomnia, agitation, cardiac dysrhythmias, GI distress, urinary retention, seizures, tachycardia, photosensitivity, nausea, sedation, dry mouth, panic attacks

170
Q

TCA Nursing Considerations

A

Monitor patient for suicidal behaviors. frequent oral hygiene and sips of liquid, administer with food, monitor BP, pulse rate & rhythm

171
Q

MAOI side effects

A

Dizziness, insomnia, orthostatic hypotension, dysrhythmias, HYPERTENSIVE CRISIS

172
Q

People taking MAOI’s should not consume what foods?

A

Aged cheese, beer, red wine, dry sausage, sauerkraut, or liver because they are high in tyramine

NURS 363 Exam 2 (2 decks)

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