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Test #1 Flashcards

Fundamentals Treatment Modalities Framework Cultural Competence

1
Q

In ancient times, mental illness was seen as….

A

Punishment

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2
Q

This person lobbied to build state hospitals for the mentally ill in the 18th century

A

Dorthea Dix

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3
Q

Known as the “Father of Psychiatry”

A

Benjamin Rush

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4
Q

Stressed the importance of early childhood experiences on later behavior

A

Sigmund Freud

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5
Q

First generation antipsychotic drug that changed our ability to care for individuals with mental illness

A

Thorazine

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6
Q

True or False: There is a universal definition of mental health

A

False - Mental health can mean different things to different people

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7
Q

Mental Health is defined as…

A
  1. Ability to adjust
  2. Ability to handle personal problems
  3. Having enough energy to be a constructive member of society
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8
Q

Characteristics that are often considered reflective of mental health include…

A
  1. Self-awareness/Self-directive
  2. Flexibility
  3. Can delay gratification of needs
  4. Reasonably worry free
  5. ABILITY TO COPE
  6. Responsible/Functions well in society
  7. Able to solve problems
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9
Q

Mental Illnesses are defined as…

A

Medical conditions that DISRUPT a person’s thinking, feeling, mood, ability to relate to others, and daily functioning that often results in a DIMINISHED CAPACITY FOR COPING with the ordinary demands of life

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10
Q

Characteristics that are often considered reflective of mental illness include…

A
  1. Unable to maintain satisfying relationships
  2. Unable to adapt to change
  3. No ability to delay gratifications of needs
  4. Poor self-concept and judgement
  5. Unable to communicate effectively
  6. Inaccurate perceptions of reality
  7. Can’t set realistic goals
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11
Q

Risks to Mental Health include…

A
  1. Persistent socio-economic pressures (poverty, lack of education, social exclusion)
  2. Psychological and personality factors
  3. Biological influences (brain chemistry, genetics)
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12
Q

Being able to adapt to life’s misfortunes and setbacks is known as…

A

Resilience

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13
Q

Goal of anti-stigma campaigns

A

Improve mental health through prevention and by ensuring access to appropriate, quality mental health services

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14
Q

Axis I includes….

A

Clinical psychiatric diagnoses (Schizophrenia, bipolar, eating disorder)

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15
Q

Axis II includes…

A

Personality disorder and Mental Retardation

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16
Q

Axis III includes…

A

Medical Diagnoses

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17
Q

Axis IV includes…

A

Psychosocial stressors

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18
Q

Axis V includes….

A

GAF (Global Assessment of Functioning)

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19
Q

Types of psychiatric admissions

A
  1. Voluntary
  2. Informal
  3. Involuntary
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20
Q

The major difference between voluntary and informal admissions is..

A

The discharging (Voluntary = request in writing and agency must respond in 72 hours; Informal = request verbal/written and by law must be discharged)

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21
Q

Key component to involuntary admission

A

Must demonstrate a danger to self or others

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22
Q

What did Kendra’s Law establish?

A

Court mandated case management and outpatient treatment

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23
Q

Making efforts to keep a patient from leaving or keeping them in seclusion when no threat of harm is present is known as…

A

False Imprisonment

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24
Q

Tarasoff is also known as…

A

Duty to Warn

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25
Q

What must be present for a nurse to perform Tarasoff/Duty to Warn?

A

A specific person named with a plan

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26
Q

What did Timothy’s Law establish?

A

Prevents discrimination by prohibiting insurance companies from limiting coverage for mental illness

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27
Q

Cornerstone for all psychiatric-mental health nursing practice

A

Communication

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28
Q

When the non-verbal fits with the verbal

A

Congruent

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29
Q

When the nonverbal DOES NOT fit with the verbal

A

Incongruent

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30
Q

Proxemics is….

A

Personal space for social interactions

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31
Q

A person standing 1.5 feet away or closer is in…

A

Intimate space

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32
Q

A person standing 1.5 to 4 feet away is in…

A

Casual space

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33
Q

A person standing 4 to 12 feet away is in…

A

Social space

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34
Q

A person standing greater than 12 feet away is in..

A

Public space

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35
Q

The single most important tool of a psychiatric nurse is…

A

Therapeutic communication (development of TRUST)

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36
Q

Some therapeutic communication techniques include…

A
  1. Silence
  2. Giving recognition
  3. Making observations
  4. Exploring
  5. Clarifying
  6. Focusing
  7. Restatement/Reflection
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37
Q

Some ineffective therapeutic communication techniques include…

A
  1. Parroting
  2. Changing the subject
  3. False reassurance
  4. DOUBLE OR MULTIPLE QUESTIONS
  5. Belittling
  6. Probing
  7. Imposing values/SHARING PERSONAL INFORMATION
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38
Q

Foundation upon which psychiatric nursing is established

A

Nurse-Patient Relationship

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39
Q

Can a social relationship with a patient co-exist with a therapeutic relationship?

A

NO!

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40
Q

Phases of a therapeutic relationship

A
  1. Orientation
  2. Working
  3. Termination
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41
Q

Biggest part of the orientation phase of a therapeutic relationship

A

Building trust

Start to develop mutually acceptable goals

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42
Q

Biggest part of the working phase of a therapeutic relationship

A

Interventions are designed to help patient achieve goals

PROMOTE CHANGE

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43
Q

Biggest part of the termination of a therapeutic relationship

A

Summarize/evaluation of progress

NO NEW TOPICS

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44
Q

Feelings stirred up in the PATIENT that are put onto the nurse

A

Transference

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45
Q

Feelings stirred up in the NURSE that are put onto the patient

A

Counter-transference

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46
Q

Phenomenon in which patients either directly or indirectly oppose changing their behavior or refuse to discuss, remember, or think about presumably clinically relevant experiences

A

Psychological resistance

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47
Q

Stigma is about…

A

Disrespect

48
Q

Use of helping skills to facilitate experience of safe, meaningful, sustainable, interpersonal connections

A

Caring

49
Q

Assuring that needs and rights of mentally disordered people are not overlooked

A

Advocacy

50
Q

When taking a personal history of a psychiatric patient it is particularly important to…

A

VERIFY information given

51
Q

Important family histories with increased risk for mental illness

A
  1. Mental illness
  2. Suicide
  3. Substance abuse
52
Q

Structured way of observing and describing a client’s CURRENT state of mind (Snapshot of the PRESENT)

A

Mental Status Exam (MSE)

53
Q

Important components of a mental health assessment in addition to a general history (11)

A
  1. General appearance, behavior, attitude
  2. Characteristics of speech
  3. Emotional state
  4. Thought content (SUICIDE ASSESSMENT!)
  5. Orientation (person, place, time)
  6. Memory (immediate, remote, recent)
  7. Abstract thinking (proverb)
  8. General intellectual level
  9. Insight (check anniversary reactions)
  10. Judgement (stamped envelope on sidewalk)
  11. Family situation (support?)
54
Q

What the patient says they are feeling

A

Mood

55
Q

What you are seeing when the patient is speaking

A

Affect

56
Q

Spontaneous narrative report that never happened

A

Confabulation

57
Q

Collection of people who come together in some way that makes them inter-dependent

A

Group Therapy

58
Q

When facilitating a group therapy session, it is important for the nurse to encourage talking about feelings, but not…

A

Act out feeling

59
Q

Are self help groups therapy groups?

A

No!

60
Q

Phases of group development

A
  1. Forming
  2. Storming
  3. Norming
  4. Performing
61
Q

What occurs during the storming portion of group development?

A

Members engage in CONFLICT and are RESISTANT to the group task

62
Q

During this phase of group development, cohesion begins and members start to determine what is and what is not acceptable from the members of the group

A

Norming

63
Q

When the goals of the group are being accomplished, they are in the… of group development

A

Performing phase

64
Q

Using the environment to promote positive change in the client

A

Milieu Therapy

65
Q

Most important part of milieu therapy

A

SAFETY! Limit the setting with the least restrictive method.

66
Q

Some examples of somatic treatments include…

A
  1. ECT
  2. Light therapy
  3. Acupuncture
  4. Biofeedback
67
Q

The most important nursing intervention for a patient who has just had ECT is…

A

Do NOT allow them to eat until their gag reflex has returned!

68
Q

Common complaints of patients who have just been treated with ECT are…

A
  1. Confusion
  2. Fatigue
  3. Headache
  4. Short-term memory loss
69
Q

These drugs are used for the TREATMENT of a mental illness

A

PsychoTROPIC drugs

70
Q

These drugs are used to ALTER the functioning of the brain

A

PsychoACTIVE drugs

71
Q

The goals of Psychopharmacology are…

A
  1. Maximum efficiency
  2. Minimum toxicity
  3. Form client is willing to take
  4. Affordable
    (Doesn’t cure but will provide functionality)
72
Q

Do psychotropic drugs cure mental illness?

A

NO!

73
Q

Number one reason for hospital readmission with mental illness is…

A

Non-compliance

74
Q

Number one reason for non-compliance in mental illness is…

A

Lack of education

75
Q

What is an important question to ask when admitting a client with mental illness who has a history of being aggressive?

A

What he/she would like the staff to know that will help him/her control aggressive thoughts/behavior

76
Q

A major defusion strategy for an aggressive patient is…

A

Lower your voice

77
Q

Assumes that anxiety is the motivator of all behavior and that all behavior has meaning

A

Sigmund Freud

78
Q

What does Freud think is the only way for the human mind to truly forget?

A

To first fully remember it

79
Q

The pleasure principle that has no delay of gratification of needs

A

The Id

80
Q

The censoring force that develops through socialization process

A

Superego

81
Q

The reality principle that can postpone the gratification of needs

A

Ego

82
Q

States that mental illness is due to an IMBALANCE of the psychic forces

A

Freudian Theory

83
Q

Why do we use defense mechanisms?

A

To decrease anxiety

84
Q

Examples of major defense mechanisms include…

A
  1. Conversion
  2. Denial
  3. Displacement (“kick the dog”)
  4. Dissociation
  5. Repression (subconscious mind)
  6. Suppression (Conscious mind)
  7. Projection
85
Q

Developed the idea of Interpersonal Theory and believes that behavior and personality are the direct result of INTERPERSONAL RELATIONSHIPS (can’t change the past, but can change the future)

A

Sullivan

86
Q

Developed the idea of nursing as an interpersonal process and that human needs must be met to achieve and maintain a healthy state

A

Hildegard Peplau

87
Q

Foundation of nursing care

A

Therapeutic relationships

88
Q

A close, helping relationship is based on…

A

TRUST

89
Q

A trusting therapeutic relationship with a client, will assist the nurse in working collaboratively to…

A
  1. Solve problems
  2. Cope more effectively
  3. Achieve developmental goals
90
Q

Reinforced behavior that is LEARNED

A

Behavior Therapy

91
Q

Explores the relationship between a persons THOUGHTS and BEHAVIOR

A

Cognitive Therapy

92
Q

Cognitive Behavioral Therapy (CBT) is..

A
  1. Active
  2. Structured (homework assignments)
  3. Focused
  4. Present-centered
93
Q

The focus of CBT is…

A

To achieve beneficial change vs. mere explanation or “insight”

94
Q

Why do cognitive and behavioral therapies work?

A

Neuroplasticity (ability to change the structure and function of neurosystem)

95
Q

Study of biochemical foundations of thought, mood, emotion, and behavior

A

Psychobiology

96
Q

“Scientific” side of the brain

A

Left

97
Q

“Artistic” side of the brain

A

Right

98
Q

The executive functions of the brain are carried out in…

A

Frontal Lobe

99
Q

Emotional brain is part of…

A

Limbic system

100
Q

Electrical impulse goes from the axon to the dendrite

A

Neuro-transmission

101
Q

A psychotropic AGONIST will…

A

Initiate a response (Activate)

102
Q

A psychotropic ANTAGONIST will…

A

Block the response

103
Q

Major neurotransmitters that are implicated in psychiatric disorders include…

A
  1. Norepinephrine (Monoamine) - Excitory
  2. Serotonin (Monoamine) - Excitory
  3. GABA (amino acid) - Inhibitory
  4. Acetylcholine - Excitory
104
Q

How to psychotropic medications regulate/treat neurotransmission?

A
  1. Block or activate receptor sites
  2. Change sensitivity of receptor sites
  3. Terminate activation of neurotransmitters
  4. Block reuptake of neurotransmitters
105
Q

The idea that the nervous system and the immune system interact directly

A

Psychoimmunology

106
Q

Stages of Change

A
  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Adaptation/Maintenance
  6. Evaluation
107
Q

In this stage of change, the patient has no intention to change and is often unaware of a problem

A

Pre-contemplation

108
Q

In this stage of change, the patient is aware that a problem exists and is seriously evaluating options, but has made no commitment to take action

A

Contemplation

109
Q

In this stage of change, the patient intends to take action and makes small changes, but needs to set goals and priorities

A

Preparation

110
Q

In this stage of change, the patient dedicates a considerable amount of time and energy and makes overt and visible changes. He/She also starts to develop strategies to deal with barriers.

A

Action

111
Q

In this stage of change, the patient works to adapt and adjust to facilitate maintenance of change

A

Adaptation and Maintenance

112
Q

In this stage of change, the patient does assessment and feedback to continue the dynamic change process

A

Evaluation

113
Q

Motivation interviewing assumptions are….

A
  1. Change often takes a long time
  2. The pace of change is variable
  3. KNOWLEDGE IS USUALLY NOT SUFFICIENT TO MOTIVATE CHANGE
  4. Relapse is normal
114
Q

Framework for facilitating change (puts responsibility for change on the patient)

A

Motivational Interviewing (MI)

115
Q

6 components of MI

A

F - Feedback on personal Impairment
R - Responsibility
A - Advice
M - Menu of alternative options or choices
E - Empathy
S - Self-efficacy or removal of barriers to achieving goals

116
Q

MI Interviewing techniques

A

O - Open-ended questions
A - Affirm
R - Reflective listening***
S - Summarize

117
Q

How can a nurse develop ambivalence to assist in developing a therapeutic patient relationship?

A 
D - Develop discrepancy
E - Empathize 
A - Avoid arguments
R - Roll will resistance 
S - Support self-efficacy

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