Chapter 6

Question 1

Holistic psychiatric mental health nursing care requires assessment of biological, psychological, sociocultural health status

Answer 1

Integrated care

Question 2

What two patient characteristics influence the mental status exam?

Answer 2

patient’s educational and sociocultural background

Question 3

detects changes or abnormalities in intellectual functioning, thought content, judgement, mood, and affect

Answer 3

mental status examination

Question 4

overtly communicated information

Answer 4

content

Question 5

how communication occurs, including feelings, intuition, behaviors that accompany speech and thought

Answer 5

process

Question 6

Are content and process always congruent?

Answer 6

No- patient may deny feeling depressed but appear sad, tearful

Question 7

What are the categories of mental status exam?

Answer 7

General description, emotional state, experiences, thinking, sensorium and cognition

Question 8

Why would a nurse assess pupil constriciton or dilation?

Answer 8

Dilated pupils= drug intoxication

Constricted pupils= narcotic addiction

Question 9

Stooped posture is often common in _____ patients

Answer 9

depressed

Question 10

This type of patient would likely dress in colorful and unusual attire

Answer 10

Manic patient

Question 11

What do speech disturbances generally indicate?

Answer 11

A specific brain disturbance

Question 12

Mumbling is common in patients with _____

Answer 12

Huntington’s chorea

Question 13

Slurred speech is common in ______ patients

Answer 13

intoxicated

Question 14

_______ patients often show pressured speech

Answer 14

manic

Question 15

_______ people are often reluctant to speak at all.

Answer 15

Depressed

Question 16

What kind of body movements would a patient with anxiety, mania, or stimulant abuse likely exhibit?

Answer 16

Excessive body movement

Question 17

What kind of body movements would a patient with depression, organic disorder, catatonic schizophrenia, or drug-induced stupor display?

Answer 17

Decreased body movement

Question 18

What do tics and grimaces suggest a patient has?

Answer 18

Side effects of medications

Question 19

What disorder do repeated motor movements or compulsions indicate?

Answer 19

Obsessive compuslive disorder

Question 20

If a patient is repeatedly picking lint or dirt from clothing, what could the real problem be?

Answer 20

Delirium or toxic conditions

Question 21

patient’s self report of prevailing emotional state

Answer 21

Mood

Question 22

Most people with ____ report feeling hopeless

Answer 22

Depression

Question 23

What 3 disorders commonly have suicidal ideation

Answer 23

Depression, anxiety disorders, schizophrenia

Question 24

How would a nurse judge a patient’s suicidal or homicidal risk?

Answer 24

Assess patient’s plans, ability to carry out those plans (availability of guns)

Question 25

Patient's apparent emotional tone

Answer 25

Affect

Question 26

the absence of emotional expression, as seen by a patient who reports significant life events without showing any emotional response

Answer 26

flat affect

Question 27

frequent changes from one affective response to another

Answer 27

lability

Question 28

labile affect is often seen in which disorder?

Answer 28

mania

Question 29

____ affect and _____ affect are often seen with schizophrenia

Answer 29

flat and incongruent

Question 30

What are the categories of hallucinations?

Answer 30

Auditory, visual, tactile, gustatory, olfactory

Question 31

Which type of hallucination is most common?

Answer 31

Auditory ("hearing voices")

Question 32

tell patient to do something: to kill oneself, harm another, or join someone in afterlife

Answer 32

command hallucinations

Question 33

Which disorder do auditory hallucinations suggest?

Answer 33

Schizophrenia

Question 34

Visual hallucinations suggest....

Answer 34

organicity

Question 35

tactile hallucinations suggest what 3 disorders?

Answer 35

organic mental disorders, cocaine abuse, delirium tremors

Question 36

_________ thinking may be a sign of defensiveness or paranoid thinking

Answer 36

circumstantial

Question 37

_________ associations and ___________ suggest schizophrenia or other psychotic disorders

Answer 37

loose/neologisms

Question 38

new word or words created by the patient often a blend of other words

Answer 38

neologisms

Question 39

overproductive speech characterized by rapid shifting from one topic to another and fragmenting ideas- common in schizophrenia

Answer 39

flight of ideas

Question 40

What are two thought content symptoms that are commonly associated with anxiety disorders?

Answer 40

Obsessions and phobias

Question 41

Which thought content symptoms suggest schizophrenia? (3)

Answer 41

delusions, depersonalization, ideas of reference

Question 42

refers to the "how" of a patient's self-expression

Answer 42

thought process

Question 43

How is thought process observed?

Answer 43

through speech patterns or forms of verbalization rather than content

Question 44

What is a clinical implication of a thought process problem often associated with brain damage and psychotic disorders?

Answer 44

Perseveration

Question 45

What example of thought process disorder represents the highest level of thought disorganization?

Answer 45

Word Salad

Question 46

A patient with this type of mental disorders may give grossly inaccurate answers when asked questions to assess orientation

Answer 46

Organic Mental Disorders

Question 47

Which level of orientation remains in tact the lognest?

Answer 47

Orientation to person

Question 48

ability to recall past events

Answer 48

memory

Question 49

recall of events, information, people from distant past

Answer 49

Remote memory

Question 50

recall of events, information, people from past week or so

Answer 50

Recent memory

Question 51

recall of information or data to which person was just exposed

Answer 51

immediate memory

Question 52

Which disorders can present with a loss of memory?

Answer 52

organic disorders, dissociative disorders, conversion disorder

Question 53

How do anxiety and depression affect memory?

Answer 53

impair immediate retention, recent memory

Question 54

ability to pay attention

Answer 54

concentration

Question 55

ability to do simple math

Answer 55

calculation

Question 56

includes talents people express in the arts, athletics, ability to work cooperatively with people, self-definition

Answer 56

intelligence

Question 57

what skills are assessed in a typical intelligence test?

Answer 57

verbal and mathematical

Question 58

involves making constructive and adaptive decisions

Answer 58

judgement

Question 59

ability to understand facts and draw conclusions from relationships

Answer 59

judgement

Question 60

What aspects are used to evaluate judgement?

Answer 60

evaluated by exploring involvement in activities, relationships, and vocational choices

Question 61

How would a nurse evaluate judgement?

Answer 61

present hypothetical situations

Question 62

Which mental disorders have an element of impaired judgement?

Answer 62

organic mental disorders, schizophrenia, psychotic disorders, intoxication, borderline or low IQ, manic patients, those with personality disorders

Question 63

patient's understanding of problem/illness

Answer 63

insight

Question 64

In which mental disorders is insight impaired?

Answer 64

organic mental disorders, psychosis, substance abuse, eating disorders, personality disorders, borderine or low IQ

Question 65

When should a quote from the patient be included in documentation?

Answer 65

When he/she adds important information to support nurse's assessment

Question 66

simplified, scored form of cognitive mental status examination that concentrates only on cognitive aspects of mental functions (excludes questions concerning mood, abnormal psycholgical experiences, content or process thinking)

Answer 66

Mini-Mental Status Exam

Question 67

battery of tests usually administered to provide comprehensive information

Answer 67

personality tests

Question 68

What are the names of some common personality tests?

Answer 68

Rorschach test, TAT, Bender Gestalt Test, MMPI

Question 69

What are some commonly used intelligence tests for adults and children?

Answer 69

WAIS for adult and WISC for children

Question 70

Measure extent of patient's problems, help make accurate diagnosis, track patient's progress over time, document effectiveness/success of treatment

Answer 70

Behavioral Rating Scale