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Psych Exam
| Question | Answer |
|---|---|
| What is the #1 cause of psychiatric disability in the world and ranked 2nd in the U.S for disability | Depression |
| What are the top ranked psychiatric causes of disability with exception of depression? | alcohol use, bipolar d/o, schizophrenia, OCD |
| What are the 5 models of psychiatric mental healthcare? | public health, systems, medical, nursing, person-centered |
| Through managed care list the criteria necessary for people to recieve services | clinically necessary, medically appropriate, w/in benefit parameters, for set amt of time, compliance w/ quality standards, anticipated and measurable outcomes; THINK: necessary, appropriate, parameters, timelimit, standards and outcomes |
| What are some cost control strategies | discount fee-for service, case rate, capitation, medicare/medicaid |
| Define clinical appropriateness | degree to which type, amt, and level of services promote best clinical outcomes; "More is not better" |
| What are the levels of care and goal in regards to clinical appropriateness | Crisis-stabilization, acute-remission, maintenance-recovery, health promotion-optimal level of wellness |
| Define medical necessity | criteria established for admission to various levels of care |
| What are the levels of care defined in medical necessity | inpatient, partial hospitalization, intensive outpatient, outpatient |
| Define therapeutic impasses. Give examples | blocks in progress of nurse-client relationship. resitance, transference, countertransferenceboundary violations |
| What does the public health model emphasize; what is its focus; interventions? | reducing risk of mental ilness for entire population; groups or populations; community needs assesment, id high risk grps, primary, secondary, tertiary prevention |
| Waht is the emphasis of the Systems model give example of sytems model | coordinated system of care to address human needs, physical needs, needs for tx & rehab; case management& community support system |
| What is case mangemnets major role | linking with needed services |
| What is Biological-medical models emphasis | biological & bain research w/ prevention activities focused on individual pt seen u. in inpt setting; includes dx, i.d cause of disease |
| What does the nursing model emphasize on | "The whole person" focuses on risks, proctetive factors, vulnerablity, & human response |
| What is considered the best practice model. Why | person centered model b/c emphasizes consumers & family participation & decision-making |
| What are the 2 levels of practice for psych nursing | RN & advanced practice (APRN-PMH) |
| What are the 3 domains of psych nursing | 1) irect care- incl case manaemnt, cpounseling, psychotherapy 20 Communication- develop tx plans, documentation, peer review 3.) Management |
| What is the key therapeutic tool the psych nurse must use | Use of self |
| What does the term flight into health mean a & what type of impasse is it? | sudden cooperation and acting like they are well; resistance |
| What is conceptual model of psychoanalytic beliefs & goal | beliefs- d/o are related to unresolved anxiety from childhood experiences that are repressed into the unconscious; Goals- to bring repressed experience to conscious and learn healthy ways of coping |
| What issues is the interpersonal conceptual model effective in dealing with & what is it's goal? | effectiveness in grief, role disputes, role transitions,interpersonal deficits; goal- reduce symptoms, improve social functioning, develop coping mechanisms & adaptive ways of relating to others; focuses on the "here & now" |
| What is the patien and therapist relationship in the interpersonal model | partnership |
| What is hte social conceptual models belief | considers the social enviornment as it affects the person and their life experiences; according to these theorists that social conditions are largely responsible for deviant behavior |
| This model dominates modern psychiatric care its belief consist of that all mental processes derive from operations of the brain and deviant behaior is a symptom of a brain disorder | Medical model |
| What is the relationship of the patient and therapist in the medical model | Physician i.d.'s the probelm, formulates tx plan. The pt has little say but hte physician prescribes therapy |
| What aspects of patient care make up the framework of the Stuart Stress Adapttion Model | biological, psychological, sociocultural, enviornmental, & legal-ethical |
| What are the 5 assumptions of the Stuart Stress Adaptation model | 10 social heirarchy- individual is part of family, grp, community, society & lgr biosphere 2.) nursing care is provided w/in biopsychosocial cultural env. & legal-ethical context |
| Stuart Stree Adaptation Model assumptions cont'd | 3) 2 continuums;health/illness&adaptive/maladaptive have a complemtnary nature of the nursing & medical models4) Primary, 2ndary, & tertiary levels of prevention w/ stages of tx inc crisis, acute, maintenance, & health promotion5)based on nursing process |
| What is the criteria for mental health | (+) attitude toward self, growth, devlpmnt, and self actualization;intergration; autonomy; reality perception; env. mastery |
| The concept of growth, deveolpemnt, and self actualization for mental health means what to an individual | seeks new experiences to more fully explore aspects of oneself; this includes in touch w/ self & able to use resources, free access topersonal feelings & intergrate w/ thoughts & behaviors, interact freely w/ env, share w/ others & grow from exp |
| The concept of intergration in mental health means what fro the individual | A balance btwn what is expressed & repressed, btwn inner & outer conflicts; u. measured by one's ability to withstand & cope w/ anxiety |
| The concept of autonomy in mental health means what for the indiv. | balance btwn dependence & independence & acceptance of one's own consequences of one's actions; involves self-determination |
| The concept of reality perception in mental health means what top the individual | ability to test assumptions about world by empirical thought; ability to change perceptions w/ new info and a respect for feeling & attitudes of others |
| The concept of enviormental mastery in mental health menas what for the individual | enables person to feel successin approved role in society; ability to take on variety of roles w/ flexibility |
| What are the biopsychosocial compents of the Stuart Stress Adaption Model | 1)Risk factor- biological-genetics, nutrition, sensitivites; psych- intelligence, verbal skills, morale; socio-age, gender education $$ 2) Precipitaing stressors-stimuli that is chalenging/threatening can be internal or external |
| Biopsychosocial components cont'd | 3) Appraisal of event- determines meaning of & understanding impact of stressor |
| What are the tx stages & their goals in the Stuart Stress Adaptaion Model | 1)Crisis-stabilaztio (no harm) 2) Acute- remission(symptom relief)3) Maintenance- complete recovery 40 Health promotion- optimal level of wellness |
| What action dimensions does a nurse use in a client-nurse relationship | 1)Confrontation-expression of perceived discrepancies & invovles timing2)Immediacy-involves focusing on current interactionof client & nurse3)self-disclosure-true personal statments about self used to model/educate |
| Nusing action dimensions cont'd | 4) Catharsis-pt encouraged to talk which brings fears&feelings to open5)role playing |
| What are the legal roles of the nurse | 1)Provider2)Employee3)Citizen |
| What did the New Freedom Commission on Menatal Health do for mental health? | Provided recommendationsto transform MH ; MH is essential to overall health, consumer & family driven, disparities elimin, early screenin, assess & refer, excellent care &research accelerated, technology used to access info & care |
| What are the other two doccuments that impacted MH | Reopt from Surgeon General(USDHHS,1999) & Healthy people 2010 |
| What are the 4 primary prevention strategies with examples | 1)Health Education-awareness of issues, increasing understanding of stressors,alternative coping, resources, abilitis of indiv in grp2)Env Change--economic, work, housing, familiy sit 3)Social support-support grps4)Stigma reduction-advocay,education |
| What were major outcomes of deinstuitionalization | 1) community resources not in place20assumption of community reintergration3)assumption of cost effectiveness |
| What were the major consequences of deinstitutionalization | families now primary caretakers, people w/ MI homeless, in nursing homes, care homes, prison |
| What is the function of ADHS | responsible for implementing funded BH svcs; manages delivery sys thru 4 Regional BH Authorities & 3 Tribal Regional BH Authorities |
| How is Arizona State divided for services? | 6 geographic service areas(GSAs) & county lines; |
| Which RBHA serves Maricopa county | ValueOptions (VO) |
| What are the characteristics of a healthy family | Complete life cycle tasks, tolerate conflict& adapt to adverse circumstance, maintains emotional contact, avoids overcloseness, conflicts resolved, differences valued, children have age-appropriate responsibilities & enjoy age-approp privileges, open comm |
| Name the components of a family assessment | culture, family hx, resources, decision-making, nurturing, emotional exp, time, space, & $$ |
| What are maladaptive family characteristics | "problem" member, overprotective/distant, overfxn/underfxn, Maintains "peace" at any price, role reversal, poor generational boundaries, substance, physical, sexual, emo abuse, child is scapegoat |
| What is the competence paradigm focus &goal in regards to family | Focus:strengths, resources &competencies Goal: empowerment |
| What is the pathology paradigms focus &goal in regards to family | Focus: deficits & illness Goal: Tx of pathology/dysfunction |
| What are barriers to family involvemtent for tx of a loved one | 1)Profesional bias-suggest families cause illness Family Attitude- (-)past experinces w/ profession 3) Professional fears- alliance w/ family will endanger confidentiality of indiv 4) Adminiatrative Restraints-Managed care |
| What is the difference in MHRN and and adv practice MHRN | MHRN give family ed, support & skill building; adv MHRN family couple therapy |
| What are known resources fro families who have family member w/ serious MI | NAMI, MHA, MIKID |
| Define a group | collection of people who have relationship w/ ea other, are interdependant, and may have common norms |
| WHat are the characteristics of a therapeutic group | focus on grp relations, interactions among members, focus on here & now like behaving and coping |
| Describe maintenace roles in grp dynamics give examples | involves grp processes & functions; Encourager-positive influence, harmonizer-keeps peace, compromiser-minmizes conflict |
| Describe the use of task roles & give examles | Deal's w/ completing grp's task; leader-sets direction, questioner-clarify issues& info, facilitator-keeps grp focused, summarizer-states current position of grp, evaluator- assess performance, initiator-begins grp discussion |
| Describe what individual roles are and give examples | not r/t task or maintenance roles; seen as self-centerd &distracting for grp; victim-deflect responsibilty, monoploizer-actively seek control by talking, seducer-maintains distance to gain attention, mute-seeks control through passive silence |
Created by:
jrmcderm
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