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Mental Health
Test 1
| Question | Answer |
|---|---|
| Who believed that a person's dreams reflect his or her subconscious and have significant meaning, although sometimes the means are hidden or symbolic. | Freud |
| What is Dream analysis ? | Primary technique in the used in psychoanalysis that involved discussing a clients dreams to discover their true meaning and significance. |
| When a therapist tries to uncover the clients true thoughts and feelings by saying a word or asking the client to respond quickly with the first thing that comes to mind. | Free association |
| What are two way to attempt to gain access to a person subconscious? | Free association and Dream analysis |
| What are the four levels of anxiety? | Mid, Moderate, Sever and Panic |
| Who described the 4 levels of anxiety? | Hildegard Paplau |
| This level of anxiety is a positive of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems. The person can take in all available stimuli | Mild anxiety |
| This type of anxiety involves a decreased perceptual field (focus on immediate task only): the person can learn new behaviors or solve problems only with assistance. Another person can redirect the person to the task. | Moderate Anxiety |
| This type of anxiety involves a feeling of dread or terror. The person cannot be redirected to a task. he or she focuses only on scattered details and has physiological symptoms of tachycardia, diaphoresis and chest pain. | Sever Anxiety |
| T or F - A person with sever anxiety may go to the emergency room thinking they are having a heart attack. | True |
| This type of anxiety involves the loss of rational thought, delusions, hallucinations and complete physical immobility and muteness. Person may bolt or run aimlessly, often exposing oneself to injury. | Panic Anxiety |
| This focuses on the immediate thought process. | Cognitive theory |
| Who is credited with with pioneering cognitive therapy in person with depression? | Aaron Beck |
| All _______ _______have the goal of helping the person discover an authentic sense of self. They emphasize personal responsibly for ones self, felling behaviors and choices. | existential theories |
| What are the parts of Freud's conceptual personality structure | Id, ego and superego |
| What is the ID of Freud's conceptual personality structure | Part of ones nature that reflects basic or innate sexual impulses. Seeks instant gratification that causes impulsive unthinking behaviors and has no regard for rules of social conventions |
| What is the Ego of Freud's conceptual personality structure | the balancing and mediating force between the id and the superego. Represents mature and adaptive behaviors that allows a person to function successfully in the world |
| What is the Supego of Freud's conceptual personality structure | part of a persons nature that reflects moral and ethical concepts, values, parental and social expectations. In direct opposition to the ID. |
| What are the 5 roles of nurses in the therapeutic relationship? (6) | stranger, resource person, teacher, leader, surrogate and counselor. |
| Who wrote about the roles of nurses in the therapeutic relationship? | Hildegard Paplau |
| nurses in the therapeutic relationship - offering the client the same acceptance and courtesy that nurse would any stranger. | Stranger |
| nurses in the therapeutic relationship - helping the client learn formally or informally | teacher |
| nurses in the therapeutic relationship - offering direction to the client. | Leader |
| nurses in the therapeutic relationship - serving as a substitute for another such as a parent or sibling. | Surrogate |
| nurses in the therapeutic relationship - promoting experiences leading to health for the client such as expression of feeling | Counselor |
| This involves providing services to people with severe and persistent mental illness to help them live in the community | Psychiatric rehabilitation |
| _____________ __________ focuses on the clients strengths , not just on his or her illness. The client actively participates in program planning | Psychiatric rehabilitation |
| T or F - Psychiatric rehabilitation does not include helping with activities of daily living, socialization or education and hospital care about a persons illness. | F - Psychiatric rehabilitation does these things. |
| These programs are designed to help client manage illness and symptoms, gain access to need services and live successfully in the community | Psychiatric rehabilitation |
| This is a turning point in an individual's life hat produces an overwhelming emotional response. | Crisis |
| What type of crisis - predicable events in the normal course of life, such as leaving home for the first time, getting married , having a baby or beginning a career | Maturation crises |
| What type of crisis - unanticipated or sudden event that threaten the individual 's integrity (death of a loved one, loss of job, or illness | situational crises |
| What type of crisis - includes natural disasters like floods, earthquakes or hurricanes: war, terrorist attacks, riots, rape or murder | Adventitious crises |
| What are the 3 factors that influence whether or not an individual experiences a crisis | 1. individuals perceptions of the event 2. availability of emotional supports 3. availability of adequate coping mechanisms |
| How long does a crises event usually last? What are the 3 possible outcomes | 4 to 6 weeks - futioning at the same level or a higher level - positive - or functioning at a lower level - negative |
| What are social/cultural factors influencing mental health? | - lack of resources - violence -homelessness - poverty - unwarranted negative view of the world - discrimination (stigma, racism, classism, agism and sexism) |
| What are the two types psychotherapy groups? how are they different | Open - ongoing and run indefinitely, allowing members to join or leave the group as needed. Closed - structured to keep the same members in the group for a specified number of sessions. |
| T or F - In open groups if a persons wants to leave the members decide how to handle members who wish to leave the group and the possible addition of new group members. | F - this is in closed groups |
| What are supports groups? | Support groups are organized to help members who share a common problem to cope with it. The group leader explores members’ thoughts and feelings and creates an atmosphere of acceptance so that members feel comfortable expressing themselves. |
| T or F - Support groups often provide a safe place for group members to express their feelings of frustration, boredom, or unhappiness and also to discuss common problems and potential solutions. | True |
| What is one way support group differ from psychotherapy groups? | Rules for support groups differ from those in psychotherapy in that members are allowed—in fact, encouraged—to contact one another and socialize outside the sessions. |
| What is the goal of a psychotherapy group? | For members to learn about their behavior and to make positive changes in their behavior by interacting and communicating with others as a member of a group. Groups may be organized around a specific medical diagnosis or a particular issue, |
| What type of group has the goal to provide information to members on a specific issue—for instance, stress management, medication management, or assertiveness training | Education group |
| Who developed client-centered therapy in which the therapist plays a supportive role, demonstrating unconditional positive regard, genuineness, and empathetic understanding to the client | Carl Rodgers |
| a humanistic American psychologist who focused on the therapeutic relationship and developed a new method of client centered therapy. This person was one of the first to use the term client rather than patient. | Carl Rodgers |
| This focuses on the role of the client, rather than the therapist, as the key to the healing process. | Client-centered therapy - developed by Carl Rodgers |
| What person focused on social and psychological development in the life stages. This was an extension off of Fruad's work of personality development across the life span but focused on social and psychological development in the life stages | Erik Erikson |
| In Erikson's theory a person must complete a life task that is essential to his or her well-being and mental health. These tasks allow the person to achieve life’s virtues. What are the virtues? | hope, purpose, fidelity, love, caring, and wisdom. |
| What stage of Eriksons stages of psychosocial development - Viewing the world as safe and reliable; relationships as nurturing, stable, and dependable | Trust vs mistrust |
| What stage of Eriksons stages of psychosocial development - Achieving a sense of control and free will | Autonomy vs shame and doubt |
| What stage of Eriksons stages of psychosocial development - Beginning development of a conscience; learning to manage conflictand anxiety | Initiative vs. guilt |
| What stage of Eriksons stages of psychosocial development - Emerging confidence in own abilities; taking pleasure in accomplishments | Industry vs inferiority |
| What stage of Eriksons stages of psychosocial development - Formulating a sense of self and belonging | Identity vs. role confusion |
| What stage of Eriksons stages of psychosocial development - Forming adult, loving relationships and meaningful attachments to others | Intimacy vs. isolation |
| What stage of Eriksons stages of psychosocial development - Being creative and productive; establishing the next generation | Generativity vs. stagnation |
| What stage of Eriksons stages of psychosocial development -Accepting responsibility for one’s self and life | Ego integrity vs. despair |
| Laboratory experiments with dogs provided the basis for the development of _____ __________ theory of classical conditioning. | Ivan Pavlov’s |
| What is Ivan Pavlov’s classical conditioning? | positive behavior |
| ______________theorists believe that behavioral deviations result when a person is out of touch with himself or herself or the environment | Existential |
| What is Logotherapy? | A therapy designed to help individuals assume personal responsibility (the search for meaning (logos) in life is a central theme) |
| Counselors and therapists who work with clients in spirituality and grief counseling often use the concepts that ______developed | Frankl |
| Give an example of a primary prevention. | stress management education |
| Give an example of a secondary prevention | early identification of potential mental health problems |
| Give an example of a tertiary prevention | monitoring and coordinating rehabilitation services for the mentally ill. |
| ___________ __________ may practice therapy and often have the primary responsibility for working with families, community support, and referral. | Social workers |
| ___________ ________ focuses on the functional abilities of the client and ways to improve client functioning, such as working with arts and crafts and focusing on psychomotor skills. | Occupational therapy |
| The primary function of the psychiatrist is what? | diagnosis of mental disorders and prescription of medical treatments |
| ______ ______ includes determining clients’ interests and abilities and matching them with vocational choices. Clients are also assisted in job-seeking and job-retention skills as well as in pursuit of further education, if that is needed and desired. | Vocational rehabilitation |
| What are the signs of Lithium Toxicity? | - sever diarrhea - vomiting - drowsiness - muscle weakness - lack of coordination |
| What can happen if lithium is continued with signs of lithium toxicity? | Untreated, the symptoms worsen and can lead to renal failure, coma, and death |
| controls complex movements, motivation, cognition, regulation of emotional response | Dopamine |
| changes in attention, learning, memory, sleep, wakefulness, mood regulation | Norepinephrine |
| causes flight-or-fight response | Epinephrine |
| an excitatory amino acid that can have major neurotoxic effects at high levels | Glutamate |
| controls food intake, sleep, wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions | Serotonin |
| affects sleep-and-wakefulness cycle; signals muscles to become alert | Acetylcholine |
| modulation of other neurotransmitters | GABA |
| neuromodulator that is involved in peripheral allergic responses such as gastric secretions, cardiac stimulation, and alertness. | Histamine |
| Chemical substances to facilitate neurotransmission | Neurotrasmitters |
| What type of drug and what is it used for? Blocks Dopamine receptors | Antisychotic (neuroleptics) |
| What generation of antipsychotic? Chlorpromazine (Thorazine) | Typical/First Generation/Conventional |
| What generation of antipsychotic? Fluphenazine (Trilafon | Typical/First Generation/Conventional |
| What generation of antipsychotic? Thioridazine (Mellaril) | Typical/First Generation/Conventional |
| What generation of antipsychotic? Haloperidol (Haldol) | Typical/First Generation/Conventional |
| Classify the drug: Chlorpromazine (Thorazine) | antipsychotic - Typical/First Generation/Conventional |
| Classify the drug: Fluphenazine (Trilafon | antipsychotic - Typical/First Generation/Conventional |
| Classify the drug: Thioridazine (Mellaril) | antipsychotic - Typical/First Generation/Conventional |
| Classify the drug: Haloperidol (Haldol) | antipsychotic - Typical/First Generation/Conventional |
| What generation of antipsychotic: Clozapine (Clozaril) | Atypical/Second Generation |
| What generation of antipsychotic: Risperidone (Risperdal) | Atypical/Second Generation |
| What generation of antipsychotic: Olanzapine (Zyprexa) | Atypical/Second Generation |
| Classify the drug: Clozapine (Clozaril) | antipsychotic - Atypical/Second Generation |
| Classify the drug: Risperidone (Risperdal) | antipsychotic - Atypical/Second Generation |
| Classify the drug: Olanzapine (Zyprexa) | antipsychotic - Atypical/Second Generation |
| How do Atypical/Second Generation antipsychotics work? | Work by blocking Serotonin receptors, and act on cholinergic and histamine receptors |
| Classify the drug: Aripiprazole (Abilify) | antipsychotic - Third Generation |
| How do third generation antipsychotics work? | partial dopamine system stabilizers - can act as an agonist or antagonist, depending on the concentration of a specific neurotransmitter. |
| _______________ are the chemical substances manufactured in the neuron that aid in the transmission of information throughout the body. | Neurotransmitters |
| What are the client teaching for antisychotics? | - Adherence to regimen - Manage SE --Thirst/dry mouth (sugar-free candy, liquids) --Constipation (dietary fiber, stool softeners) -Sedation (safety measures) - Missed dose ( w/in 4 hours of usual time) - Weekly bld draw - CBC, ANC W/ Chlozapine |
| What are antidepressants used for? | major depressive illness, anxiety disorders, depressed phase of bipolar disorder, psychotic depression |
| Classify the drug: Tricyclic (TCAs) | antidepressant |
| Classify the drug:Selective Serotonin Reuptake Inhibitors (SSRIs) | antidepressant |
| Classify the drug: MAO inhibitors (MAOIs) | antidepressant |
| Classify the drug:(Venlafaxine (Effexor), | antidepressant |
| Classify the drug: Bupropion (Wellbutrin) | antidepressant |
| Classify the drug: Duloxetine (Cymbalta | antidepressant |
| Classify the drug: Trazodone (Desyrel) | antidepressant |
| Classify the drug: Nefazodone (Serzone) | antidepressant |
| How do antideprssants work? | interact with monoamine neurotransmitter systems, especially norepinephrine and serotonin |
| What class of drug: interact with monoamine neurotransmitter systems, especially norepinephrine and serotonin | antidpressants |
| What are the preferred drugs for clients at high risk for suicide, carries no risk of lethal overdose | SSRI’s are preferred - antidepressant |
| What are the client teaching for Antidepressants? | -Time of dosage - SSRI first thing in morning, TCAs at night -Actions for missed dose --SSRI up to 8 hours after missed dose --TCAs within 3 hours of missed dose -Safety measures -Dietary restrictions if taking MAOI |
| What are the dietary restrictions if taking MAOI antidepressants? give examples | food with tyramine - red wine, cheese, aged meat, beer |
| Of particular concern with MAOIs is the potential for a life-threatening ___________ crisis if the client ingests food that contains tyramine or takes sympathomimetic drugs. | hypertensive |
| What can be cause by taking MAOIs and SSRIs | Serotonin Syndrome |
| What are the s/s of seratonin syndrome? | Agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia |
| Classify the drug: Lithium | Mood-Stabilizing |
| Classify the drug: Carbamazepine (Tegretol) | Mood-Stabilizing |
| Classify the drug: Valproic Acid (Depakote) | Mood-Stabilizing |
| Classify the drug: Gabapentin (Neurontin) | Mood-Stabilizing |
| Classify the drug: Topiramate (Topamax), | Mood-Stabilizing |
| Classify the drug: Oxcarbazepine (Trileptal) | Mood-Stabilizing |
| Classify the drug: Lamotrigine (Lamictal)) | Mood-Stabilizing |
| What mood stabilizer: Normalize reuptake of certain neurotransmitters | Lithium |
| What mood stabilizers: Increase levels of GABA | Valproic Acid (Depakote), Topiramate (Topamax)) |
| What are the side effects of mood stabilizers Carbamazepine and Valproic Acid. | -drowsiness - sedation - dry mouth - blurred vision |
| What are the client teaching for mood stabilizers? | -Periodic monitoring of blood levels -12 hours after last dose taken (peak and trough) - Drug with meals - Safety measures |
| What type of drugs are Benzodiazepines, Buspirone (Buspar)? | Antianxiety Drugs |
| How does the antianxiety drugs benzodiazepine work? | Mediation of GABA |
| How does the antianxiety drugs buspirone work? | Partial agonist activity at serotonin receptors |
| What are the client teaching for antianxiety drugs? | - Safety measures - Avoidance of alcohol - Avoidance of abrupt discontinuation |
| What drug: treatment of ADHD in children and adolescents, residual attention-deficit disorder in adults, narcolepsy | Stimulants |
| What type of drug: Amphetamines (methylphenidate amphetamine, dextroamphetamine) | Stimulants |
| What are the client teaching for stimulants? | - Dose after meals to avoid anorexia and nausea - Avoidance of caffeine, sugar, chocolate - Proper storage out of reach of children |
| What is the mechanism of action for stimulants? | - Cause release of norepinephrine, dopamine, serotonin presynaptically - Direct agonist effects postsynaptically - Block reuptake of neurotransmitters |
| What type of drug is used for aversion therapy for alcoholism? | Disulfiram (Antabuse) |
| What is the mechanism of action for Disulfiram (Antabuse) | inhibition of enzyme involved with alcohol metabolism |
| What are the side effects of Disulfiram (Antabuse)? | fatigue, drowsiness, halitosis, tremor, impotence |
| What are the client teaching for Disulfiram? | -avoidance of alcohol, including common products that may contain it (Shaving cream, deodorant, OTC cough preparations) |
| sympathy or empathy - feelings of concern or compassion; focus shifting to nurse’s feelings | Sympathy |
| What are the components of therapeutic relationships? | - Trust - Genuine interest - Empathy - Acceptance - Positive regard |
| What are values? | sense of right and wrong, code of conduct for living |
| What are beliefs? | the ideas that one holds to be true |
| The use of aspects of personality, experience, values, feelings, intelligence, needs, coping skills, perceptions to establish relationships beneficial to clients. Who developed this concept | H. Peplau (nurse-client relationships) |
| What are the 4 patterns of knowing? | Empirical, Personal, Ethical, Aesthetic |
| Understanding where knowledge comes from and how it affects behavior helps the nurse become more __________” | self aware |
| ways one person expects another to behave or speak; a roadblock to authentic relationships | Preconceptions |
| What type of relationship? Superficial communication; shifting roles; outcomes rarely assessed | Social |
| What type of relationship: Emotional commitment of two persons Individual needs met; assistance with helping each other meet needs | Intimate |
| What type of relationship? Focus on needs, experiences, feelings, ideas of client only Use of communication skills, personal strengths, understanding of human behavior by nurse Joint agreement on areas to work on; outcome evaluation | Therapeutic |
| What are the phase of establishing a therapeutic relationship | orientation working termination |
| In what phase of establishing a therapeutic relationship is it possible for transference or counter transference to occur? | the working phase |
| transference vs countertransference | transference (patient to nurse)/ countertransference (nurse to patient) |
| What are some behaviors that diminish therapeutic relationships | -Inappropriate boundaries (relationship becomes social or intimate) -Feelings of sympathy, encouraging client dependency -Nonacceptance of client, avoidance |
| What are the therapeutic roles of a nurse?? | - teacher - caregiver - advocate - surrogate |
| What are the goals of therapeutic communication? | -Establish therapeutic relationship Identify patient’s most important concerns Facilitate patient’s expression of emotions Teach pt, family necessary self-care skills Recognize pt’s needs; Guide pt toward acceptable solutions |
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