Test 1 Blueprint (5)

Question 1

What are some important points about EGO DEFENSE MECHANISMS?

Answer 1

• Normal responses to anxiety and serve to reduce anxiety
• Become problematic if over-used and become a way to avoid reality or interfere with ADL or health needs (refuse to take med, etc)
• Can operate consciously or unconsciously
• Not to be confused with coping mechanism

Question 2

What are 13 examples of ego defense mechanisms?

Answer 2

• altruism
• sublimation
• suppression
• rePression
• displacement
• reaction formation
• undoing
• rationalization
• dissociation
• splitting
• projection
• denial
• reGression

Question 3

What is a mood disorder causing a persistent feeling of sadness and loss of interest?

Answer 3

Major depression

Question 4

What are 5 signs of major depression?

Answer 4

Hypersomnolence
Anorexia
Overeating
Anhedonia
Anergia

Question 5

What are 3 nursing diagnoses for major depression?

Answer 5

1) Risk for suicide (priority intervention)
2) Low self-esteem
3) Spiritual distress

Question 6

What are 2 medical interventions for major depression?

Answer 6

• psychosocial intervention (therapy)

- antidepressant meds

Question 7

What do we need to watch for in pts on antidepressants (esp. SSRI’s)?

Answer 7

Increased risk of suicidality

Question 8

What are some common risk factors for suicide?

Answer 8

SAD PERSON
Sex - males higher risk
Age - adolescents, elderly
Depression
Previous attempt
ETOH/barbituate use
Rational thinking loss
Social support decrease
Organized plan
No spouse - single high risk
Sickness

Question 9

What does gender have to do with suicide?

Answer 9

Women attempt more (often use pills)

Men succeed more b/c they are more lethal (guns, hangings, etc)

Question 10

What demographic is at greatest risk of suicide?

Answer 10

White men > 80 years old

Question 11

Who is more at risk for suicide regarding socioeconomic status?

Answer 11

very high and very low

Question 12

What ethnicity is highest for suicide?

Answer 12

White

then AA, Native American and Asian American

Question 13

What is the most common risk factor for suicide?

Answer 13

MOOD DISORDER!

Question 14

Why is severe insomnia a risk for suicide?

Answer 14

1 in 5 manic individuals will commit suicide.

Question 15

Nursing interventions for suicide?

Answer 15

• do not leave alone (“line of sight”)
• establish a “no-suicide contract” with client
• enlist help of family/friends
• schedule frequent appts
• establish rapport and trust
• BE DIRECT: talk matter-of-factly about suicide
• discuss current stressors/crisis situation
• give meds (antidepressants)

Question 16

Signs and symptoms of bipolar disorder:

Answer 16

• mood swings (profound depression to mania)

- periods of normalcy inbetween

Question 17

Bipolar I or II? Client experiencing a syndrome of manic or mixed symptoms; episodes of depression

Answer 17

Bipolar I

Question 18

Bipolar I or II? Bouts of major depression with episodic occurrence of hypomania; never met criteria for full manic episode.

Answer 18

Bipolar II

Question 19

Nursing interventions for bipolar disorder:

Answer 19

• SAFETY!!!
• recognize the purpose these behaviors have for the client
• set limits on manipulative behaviors
• do not argue, bargain, or try to reason with client
• provide positive reinforcement for non-manipulative behaviors
• help client recognize that he/she must accept the consequences of own behaviors

Question 20

Nursing diagnoses for bipolar?

Answer 20

• risk for injury

- risk for violence: self-directed or other-directed

Question 21

Is there a cure for bipolar?

Answer 21

No

Question 22

How is bipolar treated?

Answer 22

Medications:

• antidepressants - treat from below
• antipsychotics - treat from above

Question 23

What is a good plan for offering food to a person experiencing hypomania?

Answer 23

Small bites and food on the go