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PsychNur Test 1
Basic Concepts in Psychiatric/Mental Health Nursing
| Question | Answer |
|---|---|
| What is a common result for extended periods of repressed severe anxiety? | psychoneurotic patterns of behaving |
| What are 3 examples of psychoneurotic responses? | Anxiety Disorders, Somatoform Disorders, Dissociative Disorders. |
| With which level of anxiety is learning enhanced and the person functions at his or her optimal level? | Mild Anxiety |
| With which level of anxiety are misperceptions common and the patient may experience hallucinations or delusions? | Panic Anxiety |
| With which level of anxiety will the patient exhibit signs and symptoms such as increased muscular tension and restlessness? The pt. may need assistance with problem solving. | Moderate Anxiety |
| With which level of anxiety do physical symptoms typically include headaches, palpitations or insomnia? | Severe Anxiety |
| With which level of anxiety could the patient experience emotional symptoms such as confusion, dread and horror? | Severe Anxiety |
| which level of anxiety is chracterized by wild and desperate actions or extreme withdrawal? | Panic Anxiety |
| With which level of anxiety does the pt. typically fear that they are "going crazy" or losing control? | Panic Anxiety |
| What are some common coping behaviors for mild anxiety? | sleeping, eating, physical exercise, smoking, crying, pacing, foot swinging, fidgeting, yawning, drinking, daydreaming, laughing, cursing, nail biting, finger tapping, talking to someone with whom one feels comfortable. |
| What are used either consciously or unconsciously as protective devices for the ego in an effort to relieve mild to moderate anxiety? | Defense mechanisms |
| At what point do defense mechanisms become maladaptive? | When they are used by an individual to such a degree that there is interference with the ability to deal with reality, with effective interpersonal relations, or with occupational performance. |
| A handicapped boy who is unable to participate in sports works hard and becomes a great scholar - this is an example of which defense mechanism? | Compensation |
| Individuals continuing to smoke cigarettes even though they have been told of the health risk involved is an example of which defense mechanism? | Denial |
| A boy who is teased and hit by the class bully on the playground comes home after school and kicks the dog - is an example of which defense mechanism? | Displacement |
| A teenage girl emulates the mannerisms and style of dress of a popular female rock star - is an example of what defense mechanism? | Identification |
| A young Psych professor receives a letter from his fiancee breaking up with him. He shows no emotion and instead analyzes his fiancees behavior reasoning the relationships failure - is an example of which defense mechanism? | Intellectualization |
| A psychiatric client claims to be the Son of God, drapes himself in sheet and blanket and refuses to respond unless addressed as Jesus Christ - is an example of what defense mechanism? | Introjection |
| A young woman describes being attacked and raped by a street gang. She displays an apathetic expression and no emotional tone - is an example of what defense mechanism? | Isolation |
| A young soldier who has an extreme fear of participation gin military combat tells his sergeant that the others in his unit are "a bunch of cowards" - is an example of what defense mechanism? | Projection |
| A young man is unable to afford the sports car he wants. He tells the salesperson, "I'd buy this car but I'll be getting married soon. This is really not the car for a family man." - is an example of what defense mechanism? | Rationalization |
| The young soldier who has an extreme fear of participating in military combat volunteers for dangerous front-line duty. - is an example of what defense mechanism? | Reaction Formation |
| A person who is depressed may withdraw to his or her room, curl up in a fetal position on the bed, and sleep for long periods of time. - is an example of what defense mechanism? | Regression |
| A women cannot remember being sexually assaulted when she was 15 years old. - is an example of what defense mechanism? | Repression |
| A teenage boy with strong competitive and aggressive drives becomes the star football player on his high school team. - is an example of which defense mechanism? | Sublimation |
| A young woman who is depressed about a pending divorce tells the nurse, "I just don't want to talk about the divorce. There's nothing I can do anyway." - is an example of which defense mechanism? | Suppression |
| A man who is anxious about giving a presentation at work yells at his wife during breakfast. He buys her flowers on his way home from work that evening. - this is an example of which defense mechanism? | Undoing |
| A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness - is a definition of what? | Anxiety |
| A subjective state of emotional, physical, and social responses to the loss of a valued entity - is a definition of what? | Grief |
| What is adaptation determined by? | the degree to which the thoughts, feelings, and behaviors interfere with an individual's functioning |
| What are the five levels of Maslows? | 1. Physiological needs, 2. Safety and Security, 3. Love and belonging, 4. Self-esteem of others, 5. Self-Actualization |
| What are Kubler-Ross's five stages of grief? | 1. Denial, 2. Anger, 3. Bargaining, 4. Depression, 5. Acceptance |
| When a person experiences a significant loss however does not experience the emotional pain associated with the loss and anxiety disorders are evident, is an example of what maladaptive grief response? | Delayed or Inhibited Response |
| Which maladaptive grief response is characterized by the individual turning anger inward on the self, consumed with overwhelming despair, and is unable to function in normal ADL's? | Distorted Response |
| What are the two major, primary responses to stress? | Anxiety and grief |
| Phobias, obsessions, compulsions, hypochondriasis, conversion disorders, multiple personalities, amnesia and fugue are examples of what type of severe anxiety responses? | Psychoneurotic Responses |
| Schizophrenia, schizoaffective disorder, delusional disorders are examples of what response to panic anxiety? | Psychotic Responses |
| What are the five axis that individuals are evaluated on for psychiatric diagnoses by the American Psychiatric Association? | 1. Major Mental disorders, 2. Personality disorders/developmental level, 3. general medical conditions, 4. psychosocial and environmental problems, 5. level of functioning |
| What are the initial stress response steps of the "fight or flight syndrome"? | Stressor activates the Hypothalamus, stimulates the sympathetic nervous system which innervates body systems. |
| what are the steps for the sustained stress response for the "fight or flight syndrome"? | Hypothalamus stimulates the Pituatary Gland which releases Adrenocorticotropic hormone (ACTH), Vasopressin (ADH), Growth Hormone, Thyrotropic hormone, gonadotropins |
| At what age does Erikson's stage for Trust vs. Mistrust apply? | Infancy (birth - 18 months) |
| At what age does Erikson's stage for Autonomy vs. Shame apply? | Early Childhood (18 months - 3 years) |
| At what age does Erikson's stage for Initiative vs. Guilt apply? | Late Childhood (3-6 years) |
| At what age does Erikson's stage for Industry vs. Inferiority apply? | School Age (6-12 years) |
| At what age does Erikson's stage for Identity vs. Role confusion apply? | Adolescence (12-20 years) |
| At what age does Erikson's stage for Intimacy vs. isolation apply? | Young adulthood (20 - 30 years) |
| At what age does Erikson's stage for Generativity vs. stagnation apply? | Adulthood (30 - 65 years) |
| At what age does Erikson's stage for Ego integrity vs. despair apply? | Old age (65 years - death) |
| What is the result of Increased levels of Acetylcholine? | Depression |
| What are possible results of decreased levels of Acetylcholine? | Alzheimer's disease, Huntington's disease, Parkinson's disease |
| What is the result of decreased levels of Norepinephrine? | Depression |
| What are possible results of increased levels of Norepinephrine? | Mania, anxiety states, schizophrenia |
| What are possible results for decreased levels of Dopamine? | Parkinson's disease and depression |
| What are possible results for increased levels of Dopamine? | mania and schizophrenia |
| What is a possible result from decreased Serotonin? | Depression |
| What is the possible result from increased Serotonin? | Anxiety states |
| What is the possible result from decreased levels of histamine? | depression |
| What is the result of Decreased levels of the Amino Acid known as GABA (Gamma-amino-butyric acid)? | Huntington's disease, anxiety disorders, schizophrenia, and various forms of epilepsy. |
| What is the result of decreased levels of the the Amino Acid, Glycine? | spastic motor movements |
| What is the result of increased levels of the amino acid, Glutamate and Aspartate? | Huntington's disease, temporal lobe epilepsy, spinal cerebellar degeneration |
| What are some behaviors associated with hypersecretion of cortisol (cushing's)? | depression, mania, psychosis, and suicidal ideation |
| What are some behaviors associated with hyposecretion of cortisol (Addison's)? | mood changes with apathy, social withdrawal, impaired sleep, decreased concentration, and fatigue |
| What are the three stages of Selye's general adaptation syndrome for stress? | 1. Alarm reaction stage, 2. Stage of resistance, 3. Stage of exhaustion |
| Who is considered to be the first Psych nurse? | Linda Richards |
| What are the six indicators that Jahoda suggests are a reflection of mental health? | 1. A positive attitude toward self, 2. Growth development and the ability to achieve self-actualization, 3. Integration, 4. Autonomy, 5. Perception of reality, 6. Environmental Mastery |
| Services aimed at reducing the incidence of mental disorders within the population - is a definition for which prevention? Primary, secondary or Tertiary | Primary prevention - geared mainly towards reducing the number of people who will get mental illness through education |
| Services aimed at reducing the residual defects that are associated with severe and persistent mental illness - is a definition for which prevention? Primary, secondary or Tertiary | Tertiary prevention - Goal is to help the pt. cope and manage their mental illness. Outpatient therapy |
| Interventions aimed at minimizing early symptoms of psychiatric illness and directed toward reducing the prevalence and duration of the illness - is a definition of which prevention? Primary, secondary or tertiary | Secondary prevention - pt. is diagnosed through primary services with mental illness and and attempt to reduce symptoms through therapy and medications is made. |
| What are Peplau's four stages of development before becoming a successful personality? | 1. Learning to count on others, 2. Learning to delay satisfaction, 3. Identifying oneself, 4. Developing skills in participation |
| What is it called when a patient looks at you and thinks you are someone from their past? For example, a mistress who caused their husband to divorce them? | Transference |
| What is it called when the nurse starts believing that he/she can do know wrong and believes they are the only one who can help the patient? | Countertransference |
| What are the four basic goals for the nurse/patient relationship? | Healthy self-perception, Trust, Client change, Goal attained/Closure |
| Which defense mechanism is defined as covering up a real or perceived weakness by emphasizing a trait one considers more desirable? | Compensation |
| Which defense mechanism is defined as refusing to acknowledge the existence of a real situation or the feelings associated with it? | Denial |
| Which Defense mechanism is defined as the transfer of feelings from one target to another that is considered less threatening or that is neutral? | Displacement |
| Which defense mechanism is defined as an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires? | Identification |
| Which defense mechanism is defined as an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis? | Intellectualization |
| Which defense mechanism is defined as integrating the beliefs and values of another individual into one's own ego structure? | Introjection |
| Which defense mechanism is defined as separating a thought or memory from the feeling, tone, or emotion associated with it? | Isolation |
| Which defense mechanism is defined as attributing feelings or impulses unacceptable to one's self to another person? | Projection |
| Which defense mechanism is defined as attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors? | Rationalization |
| Which defense mechanism is defined as preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors? | Reaction Formation |
| Which defense mechanism is defined as retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning? | Regression |
| Which defense mechanism is defined as involuntarily blocking unpleasant feelings and experiences from one's awareness? | Repression |
| Which defense mechanism is defined as rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive? | Sublimation |
| which defense mechanism is defined as the voluntary blocking of unpleasant feelings and experiences from one's awareness? | Suppression |
| Which defense mechanism is defined as symbolically negating or canceling out an experience that one finds intolerable? | Undoing |
| Which developmental theorist focuses mainly on psychosexual theory? | Freud's |
| What is the main focus for Piaget's developmental theory? | Cognitive |
| Which developmental theorist focused his theory mainly on psychosocial theory? | Erikson |
| What type of delusion is it when the client states: "Within one month I am going to be a billionaire and own 14 houses and 20 cars. I will be so rich and successful that Bill Gates will call me for financial advice." | Grandiosity |
| What type of delusion is it when a pt. states: "My neighborhood wants me dead or alive. They think I hold all of their secrets. They have tapped my phone and peek through my windows 24 hours a day." | Persecution |
| What type of delusion is it when a pt states: "My mother put a voodoo curse on me. She can control all of my thoughts and emotions through a remote control car. I am completely under her spell." | Control |
| What type of delusion is it when a pt. states: "God told me that I am his Chosen One. I can perform miracles. I know this is real because my rosary beads revealed this to me." | Religious |
| What type of delusion is it when a pt. states: "I can have any guy I want. Matt Damon called me last night but I couldn't go out because i already had a date with Tom Cruise." | Erotomanic |
| What type of delusion is it when a pt. states: "I can't do anything right. I always mess everything up. I had so many friends from school but now no one will come and see me because I am a failure." | Sin and guilt |
| What type of delusion is it when a pt states: "I ahve a hammer in my heart. It pounds daggers in it all day long. Don't you hear it? Someday soon it is going to pound so hard that my heart will come flying out of my chest." | Somatic |
| What type of delusion is it when a pt states: "The headline of the NEW YORK TIMES told me that I have been assigned to stop crime. I am issuing a nationwide bulletin telling people to turn in their guns and knives. I take my assignments very seriously." | Ideas of reference |
| What type of delusion is it when a pt states: "I don't have to tell you that. You already know because you can read my mind." | Thought broadcasting |
| What type of delusion is it when a pt. states: "I'm trying to tell you something but I keep losing it because someone keeps stealing my thoughts." | Thought withdrawal |
| What type of delusion is it when a pt states: "You think this is me talking, but it really isn't. My husband keeps putting these thoughts in my head." | Thought insertion |
| When is self-disclosure used in principles of therapeutic communication? | it is used cautiously and only when the disclosure has a therapeutic purpose. |
| What sets the tone of the therapeutic relationship between nurse and client? | A professional attitude |
| What are six phases of a therapeutic relationship? | 1. Preinteraction 2. Orientation 3. Working 4. Termination 5. Transference 6. Countertransference |
| Give four goals of a therapeutic relationship. | 1. Self-perceptions 2. trust 3. client change 4. Goal attained/closure |
| What are seven boundaries in the nurse and client relationship? | 1. Social 2. Personal 3. Professional 4. Self-disclosure 5. Gift-giving 6. Touch 7. Friendship or romantic association |
| What is the acronym that represents active listening and what does it stand for? | SOLER - Sit squarely, Open posture, Lean forward, Eye contact, Relax (dont fidget) |
| What is paralanguage? | It is the gestural component of th spoken word. The expression placed on words by means of pitch, tone, and loudness of the spoken message |
| What are three goals for patients in Milieu therapy? | 1. coping skills to be able to face life's stressors 2. Show them appropriate role models 3. Develop healthy relationship skills |
Created by:
Tomiamto
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