Chapter 6 - Mental Health Assessment

Question 1

What is the leading cause of disability worldwide?

Answer 1

depression

Question 2

The suicide rate in indigenous communities is ___ higher than the rest of the population

Answer 2

2x (first nations) 6-11x (inuit)

Question 3

How does the DSM-5 define PTSD?

Answer 3

a trauma related disorder where symptoms begin or worsen after the event

Question 4

What do individual responses to trauma depend on?

Answer 4

1) nature of the trauma
2) characteristics of the individual
3) the environment of the individual

Question 5

What is considered a positive screen for the Primary Care PTSD Screen?

Answer 5

-indicating you have had a traumatic experience
-answering yes to at least 3/5 of the following questions

Question 6

Mental Health (positive) Definition

Answer 6

capacity to feel, think, express emotions and behave in ways that enhance ability to manage challenges and adapt

Question 7

Mental Disorder Definition

Answer 7

the medical term for mental illness that is defined and diagnosed according to DSM-5

Question 8

Concurrent Disorder Definition

Answer 8

co-occurrence of a mental health disorder and a problematic substance use disorder

Question 9

40-__% of people with mental illness develop a substance use disorder at some point

Answer 9

60%

Question 10

What are the 6 Dimensions of Recovery-Oriented Practice?

Answer 10

1. Creating culture and language of hope
2. Recovery is personal (unique)
3. Recovery occurs in the context of ones life (encourage connection to family, friends, culture, spirit)
4. Respond to the diverse needs of everyone
5. Working with FNMI
6. Recovery is about transforming services and systems

Question 11

Stigma Definition

Answer 11

an attribute associated with difference that is deemed less desirable by one person in relation to another

Question 12

Elements of Stigma

Answer 12

-labelling
-stereotyping
-“othering’’ us vs. them
-discrimination
-power dynamics that affect ones ability to access resources

Question 13

What is important for the nurse to assess about themselves before conducting a mental health assessment?

Answer 13

the factors in their own life that may impact the nurse-patient relationship AND their own understanding of mental health and wellness

Question 14

Relational practice is ________, _________, and reflexive

Answer 14

respectful, nonjudgemental

Question 14

What must the nurse understand about the patient?

Answer 14

-mental health and wellness
-illness beliefs and experiences
-challenges with daily living
-strengths and resources

Question 15

What combined elements help gather information during a mental health assessment?

Answer 15

-observation
-interview
-examination
-physical assessment
-collaboration

Question 16

When should you observe the patient?

Answer 16

-at different times of day
-in different situations
-with various people

Question 17

What is the purpose of interviewing?

Answer 17

-building rapport
-clarify perceptions and meaning
-gather factual knowledge

Question 18

Mental Health Interview Components

Answer 18

-complete health history
-source of info
-ID
-reason for seeking care
-past health
-family health history
-developmental considerations
-present health (allergies, meds, etc.)

Question 19

Mental Health Observation Components

Answer 19

-mood
-appearance
-behaviour
-cognitive function (AOx4)
-thought

Question 20

Mental Health Physical Assessment

Answer 20

-ADLs
-nutrition patters
-sleep patterns
-activity/mobility
-elimination
-relationships
-self-esteem
-culture
-spirituality
-coping and stress management
-smoking
-alcohol
-drug use
-home environment

Question 21

What is the distinguishing component of the mental status assessment?

Answer 21

mental status examination (included in physical assessment)

Question 22

Mental Status Examination: Appearance

Answer 22

general presentation to others

Question 23

Mental Status Examination: Behaviour

Answer 23

-mood and affect
-speech ability

Question 24

Mental Status Examination: Cognition

Answer 24

-consciousness (aware of thoughts, feelings, emotions)
-orientation
-memory
-attention and concentration
-comprehension and abstract reasoning (deeper meaning beyond literal)

Question 25

Immediate Memory

Answer 25

on the spot recall

Question 26

Recent Memory

Answer 26

day-to-day events

Question 27

Remote Memory

Answer 27

years of experiences

Question 28

Mental Status Examination: Thinking

Answer 28

-perception (awareness of objects via 5 senses)
-content (thoughts, ideas, beliefs)
-process (the way someone thinks)
-insight (awareness to reality)
-judgement (ability to be logical)

Question 29

When is it necessary to perform a mental health assessment?

Answer 29

-family members concerned about memory or social interactions
-Brain lesions (trauma, tumour, stroke)
-Aphasia
-Symptoms of mental illness are evident

Question 30

What can affect interpretation and should be noted?

Answer 30

-health problems like alcoholism or renal disease
-medications that can cause confusion or depressing
-normal education and behaviour
-responses that indicate stress, sleep habits, substance use

Question 31

What questions should you begin a mental health assessment with? WHY?

Answer 31

-Identification (name, dob, gender, relationship status, education, employment, etc.)
-These are usually nonthreatening questions

Question 32

What are notable childhood trauma elements?

Answer 32

-head trauma
-abuse/neglect
-chronic illness
-birth trauma
-obstetrical history

Question 33

What to inquire in family history?

Answer 33

-age and current health of close relatives
-if a death is reported ask when, how, and the effect on the patient
-illnesses that run in the family

Question 34

How long does the Mini Cog take to complete?

Answer 34

3 mins

Question 35

What does the Mini Cog consist of?

Answer 35

-3 item recall test
-clock drawing test