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NU 306 Mental Health > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is an asylum?

A

safe refuge or haven

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2
Q

what does deinstitutionalization mean?

A

shift from institutional care to community care

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3
Q

What were common psychiatric treatments in acnient times?

A

blood letting

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4
Q

What did people think caused mental health issues in the early christian era?

A

demons and exorcisms

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5
Q

How was mental health dealt with in the Renaissance era?

A

they had “lunatic” zoos

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6
Q

What defined mental health treatment in the colonial times?

A

witch hunts

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7
Q

What changes to psychopharmacology occured in the 1950s?

A

thorazine and lithium developed
shorter hospital stays
people coud stabilize
less choatic hospitals

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8
Q

What changes were made to faciliate deinstitutionalization in the 1960s?

A

community mental health center construction act
shift from institutional to community care
SSI income for disabled people
involuntary commitment process harder

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9
Q

What are the healthy people 2020 goals

A

Reduce suicide rate

  • Reduce major depressive episodes
  • Increase number of primary care facilities that treat MH
  • Increase number of persons with MI who are employed
  • Increase treatment for dual diagnosis
  • Increase care of MI for homeless persons
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10
Q

What is the DSM 5?

A

Provides standard “language” for MH

  • Lists defining “characteristics” of disorders
  • Helps identify “underlying” causes of these disorders
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11
Q

What is the diathesis stress model?

A

Diathesis:

  • Biological factor (genes, disordered biochemistry, brain anomalies)
  • Social Factor (maladaptive, upbringing, chronic stress, etc.)
  • Psychological factor (unconscious, conflict poor skills, maladaptive cognitions, etc.)

+

Stress:

  • Biological trigger (onset of a disease, exposure to toxins)
  • Social trigger (traumatic event, major loss)
  • Psychological trigger (perceived, loss of control, violation of a trust)
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12
Q

What does it mean for mental health to exist on a continuom?

A

It means that we acknowledge that mental health does not start and end at a certain point, but can go back and forth between good, bad, and everything in between.

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13
Q

What is acuity?

A

severity of symptoms

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14
Q

What is anhedonia?

A

inability to find joy in the things that they once did

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15
Q

What happens during the orientation phase of Peplau’s model?

A

engage w/ patient
provide explanations and info
answer questions

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16
Q

What happen during the identification phase of Peplau’s model?

A

when the patient works with nurse
expresses feelings
begins to feel stronger

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17
Q

What is the exploitation phase of Penlau’s model?

A

patient makes full use of services

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18
Q

What ist he resolution phase of Penlau’s model?

A

Patient no longer needs professional services

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19
Q

What is cognitive behavioral therapy? (CBT)

A

focuses on faulty thinking
focuses on learned patterns of unhelpful behavior
emphasis on individual being own therapist

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20
Q

What is dilectical behavior therapy? (DBT)

A

clients learn mindfulness
distress tolerance
emotional regulation
interpersonal effectiveness

treats personality disorders

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21
Q

Who is DBT used for?

A

personality disorders
substance dependence
eating disorder
PTSD

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22
Q

Who is ECT used to treat?

A

people with depression

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23
Q

What is ECT?

A

electroconvulsive therapy; electrical impulses are sent to the brain to cause a seizure
it is thought the shock stimulates the brain chemsitry to correct itself

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24
Q

What is light therapy used to treat?

A

Season affective disorder (SAD)

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25
Q

What is transference?

A

occurs when the client views a member of the healthcare team as having characteristics of another person in their life.

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26
Q

What is countertransference?

A

when a health care team member displaces characteristics of people in their past onto a client

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27
Q

What is an auditory hallucination?

A

hearing voices or sounds

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28
Q

What is the biggest concern with auditory hallucinations?

A

The client harming themself or others

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29
Q

What is a visual hallucination?

A

seeing persons or things

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30
Q

What is an olfactory hallucination?

A

smelling odors

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31
Q

What is a gustatory hallucination?

A

Experincing tastes

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32
Q

What is a tactile hallucination?

A

feeling bodily sensations

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33
Q

What is a defense mechanism?

A

A way to manage conflict in response to anxiety

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34
Q

What is beneficence?

A

doing good

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35
Q

What is autonomy?

A

patient’s right to choose

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36
Q

What is justice?

A

fair and equal treatment

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37
Q

what is fidelity?

A

loyalty and faithfulness

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38
Q

What is veracity?

A

honesty

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39
Q

What is assault/battery?

A

treatment without consent

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40
Q

What is it your duty to warn about?

A

homicidal ideations

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41
Q

What is your duty to report?

A

any abuse

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42
Q

What is informed consent?

A

education prior

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43
Q

What is confidentiality?

A

protected PHI

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44
Q

What is voluntary admit?

A

meets criteria
may request AMA discharge

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45
Q

What is an involuntary admission?

A

court hold up to 60 days
Client admitted to hospital becuase they are a threat to others or themselves

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46
Q

What is seclusion?

A

involuntary confinement

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47
Q

What is restraint?

A

physical, mechanical or chemical method to restrict physical movement

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48
Q

What are some examples of nonverbal communication?

A

facial expression
eye contact
gestures
personal space
silence
sounds
restlessness

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49
Q

What are some examples of therapeutic communication?

A

accpeting
broad openings
exploring
focusing
general leads
making observations
voicing doubt
silence
clarification

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50
Q

What are examples of nontherapeutic techniques?

A

advising
belittling
challenging
defending something
rejecting client experience
disapproving or giving approval
interpreting for client
changing topic or probing

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51
Q

What are some examples of defense mechanisms?

A

altruism
regression
suppression
denial
rationalization
(this is not every example)

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52
Q

What is the CAGE assessment used for?

A

substance abuse

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53
Q

What is the BECK assessment used for?

A

depression

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54
Q

What is the HAMILTON A assessment used for?

A

Anxiety

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55
Q

What is the HAMILTON D assessment used for?

A

depression

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56
Q

What is the AIMS assessment used for?

A

abnormal movements

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57
Q

What is the CIWA assessment used for

A

withdrawal

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58
Q

What is anergia?

A

lack of energy

59
Q

What is anhedonia?

A

inability to find pleasure in things they used to enjoy

60
Q

What is avolition?

A

lack of follow through/no motivation

61
Q

What is alogia?

A

few words

62
Q

What is affective blunting

A

minimal facial expressions

63
Q

What is aphasia?

A

cant find the right word

64
Q

What is agnosia?

A

dont recognize familiar objects anymore

65
Q

What is aphraxia?

A

loss of purposeful movement

66
Q

What is anosognosia?

A

no knowlesge of illness

67
Q

What is apathy?

A

loss of initiative

68
Q

What assessment is used for suicide risk?

A

SAD PERSONS

69
Q

What assessment is used to objectively assess a clients cognitive status?

A

MMSE (mini mental state examination)

70
Q

What does the SAD PERSONS acronym stand for?

A

Sex
Age
Depression
Previous attempts
Excessive alcohol or substance abuse
Rational thinking loss
Social supports lacking
Organized plan or serious attempt
No spouse

71
Q

What are delusions?

A

a false belief

72
Q

What is affirmation?

A

Therapeutic communication technique used to empower client behavior and decision making

73
Q

How long can seclusion last for 18+

A

4-hour limit

74
Q

How long can seclusion last for 9-17y/o?

A

2 hours

75
Q

How long can seclusion last for 9y/o?

A

1 hour

76
Q

What kind of observation is required for seclusion/restraint?

A

1:1 the entire time

77
Q

What does ADPIE stand for?

A

Assessment (tools, observations)
Diagnosis (nursing diagnosis)
Planning (creating a care plan)
Interventions (using the care plane)
Evaluations (assess for efficacy)

78
Q

T or F, A client can be admitted to a mental health clinic in spite of a physical health crisis

A

False, the physical health of a client ALWAYS takes priority

79
Q

What is the Mini Mental Status Exam for?

A

to assess vitals of the brain

80
Q

What is a person’s affect?

A

What your face looks like

81
Q

What’s an example of poor insight?

A

Dr Harrington says Jack’s coffee is good for you because “it’s a dairy product”.

82
Q

What is an example of insight?

A

Dr. Harrington knows that Jack’s coffee is bad for you and can tell you why.

83
Q

What is an example of impaired judgement? (Take this with a grain of salt)

A

Dr. Harrington knows that Jack’s coffee is bad for you, but drinks it anyway.

84
Q

What is the Global Assessment of Functioning used for?

A

Impairments across multiple areas

85
Q

What is included in the general appearance field for mental health assessments?

A

General appearance
Dress
Posture
Hygiene
Movements

86
Q

What is included mood and affect field for mental heatlh assessments?

A

Mood can be what client says or labeled
Affect: how their face looks
( blunted, broad, flat, inappropriate, restricted)

87
Q

What is included in the though processes/contennt field for mental health assessments?

A

Speech and thought disturbances
Flight of ideas
Loose associations
Thought blocking
Word salad
Cognitive distortions
Paranoia
Ruminations
Clanging
Neologisms

88
Q

What is included in the harm to self/others field?

A

Must as directly (are you planning on killing yourself?)
Ask about their harm plans
Duty to warn (warn possible targets)
Contract for safety (will you let staff know if you plan to harm yourself?)

89
Q

What is included in the sensorium/intellectural processes field?

A

Memory
Concentration
Abstract thinking
Concrete thinking
Intellectural functioning

90
Q

What is included in the sensory field?

A

Things you feel

91
Q

What is included in the self concept field?

A

Patient’s self worth
Coping skills
Body image

92
Q

What is included in the roles and relationships field?

A

Client support/stress
Client perceptio and satisfaction with services

93
Q

What is a delusion?

A

A false fix belief
( Dr Harrington is a famous rockstar even though she has never put out a record etc.)

94
Q

What is a hallucination?

A

Things that you feel with your body, but aren’t real (they think it is real, ex; hearing voices)
A sensory disturbance

95
Q

What is a cognitive distortion?

A

Automatic thought (usually not true)

96
Q

What is sundowning?

A

Personality changes when the sun goes down (not sure about this one)

97
Q

What is echolalia/exchopraxia?

A

They mirror your words and actions

98
Q

What is rumination?

A

Going over something over and over in your mind

99
Q

What is impulsivity?

A

No pause between thought and action
Contract to safety often fails here

100
Q

What is hypervigilance rooted in?

A

Paranoia/fear

101
Q

What are some mood descriptors?

A

Euphoric/labile/full range/dysphroic

102
Q

What are examples of types of thinking?

A

Abstract
Concrete

103
Q

What is concrete thinking?

A

you get the exact answer based on the words you said
(You: what brought you to the hospital?
Patient: ….The ambulance?)

104
Q

What is abstract thinking?

A

Use strange words to describe things
(Dr. Harrington said she’d run to her office but you took that literally when she actually walked)

105
Q

What is a contract for safety?

A

When you and the client agree that they will contact a staff member if they have thought of harming themselves

106
Q

Why don’t we ask people “why questions”?

A

It can make them defensive

107
Q

What does the Mental Status Exam assess? (NOT the mini!)

A

orientation
ability to interpret proverbs
math calculation
memorization
short-term recall
( cognitive abilities )

108
Q

Who is the mental status exam for?

A

dementia patients
also depressed or psychotic patients

109
Q

What is a psychosocial assessment?

A

used to determine clients
emotional state
mental capacity
behavioral function
(similiar to basic bedside)

110
Q

What is voluntary admission?

A

A client admits themselves and agrees to treatment

111
Q

What is court ordered admission?

A

most common among persons with severe and persistent mental illness who have had frequent and multiple contacts with mental health, social welfare, and criminal justice agencies

112
Q

What is an emergency hold?

A

A person can be detained in a psychiatric facility for 48 to 72 hours on an emergency basis until a hearing can be conducted to determine whether or not they should be committed to a facility for treatment for a specified period

113
Q

What is ACT; Assertive Community Treatment?

A

Case management – services/resources to reduce
rehospitalization

114
Q

What is the basis for involuntary admission? (why are they there?)

A

Based on need for care due to risk for harm to self or others or inability to care for
self.

115
Q

Can involuntary admits refuse treatment?

A

these clients are still considered competent and can refuse treatment – unless
deemed incompetent – a guardian needs to be appointed.
* This right to refuse treatment can be temporarily suspended if the client is an active
threat to self or others (PRN medication administration).

116
Q

What is required to make someone an involuntary admit? (legality)

A

Requires legal “commitment” but usually limited to 60 days and then must have
review

117
Q

T or F, a guardian can sign in a voluntary admit

A

True

118
Q

What is a SMART goal? (think about the acronym)

A

Specific
Measureable
Attainable
Relevant
Time-Bound

119
Q

What patient would the Columbia Suicide Severity Rating be for?

A

a suicidal patient

120
Q

What is Peplau’s nurse-patient relationship in order? (probably not on the test; included in case its helpful)

A

Orientation
Identification
Exploitation
Resolution

121
Q

“Yes.”

“I follow what you said.”

Nodding

These are examples of what therapeutic technique?

A

accepting

122
Q

“Is there something you’d like to talk about?”

“Where would you like to begin?”

These are examples of what therapeutic technique?

A

Broad openings

123
Q

“Tell me whether my understanding of it agrees with yours.”

“Are you using this word to convey that…?”

These are examples of what therapeutic technique?

A
124
Q

“Was it something like…?”

“Have you had similar experiences?

These are examples of what therapeutic technique?

A

Encouraging comparison

125
Q

“Tell me when you feel anxious.”

“What is happening?”

“What does the voice seem to be saying?”
What type of therapeutic communication is this?

A

encouraging description of perceptions

126
Q

“What are your feelings in regard to…?”

“Does this contribute to your distress?”

What type of therapeutic communication is this an example of?

A

Encouraging expression

127
Q

“Tell me more about that.”

“Would you describe it more fully?”

“What kind of work?”

What kind of therapeutic technique is this?

A

Exploring

128
Q

“This point seems worth looking at more closely.”

“Of all the concerns you’ve mentioned, which is most troublesome?
What type of therapeutic technique is this?

A

focusing

129
Q

“What could you do to let your anger out harmlessly?”

“Next time this comes up, what might you do to handle it?
What kind of therapeutic technique is this?

A

formulating a plan of action

130
Q

“Go on.”

“And then?”

“Tell me about it.”
What kind of therapeutic technique is this?

A

general leads

131
Q

“My name is…”

“Visiting hours are…”

“My purpose in being here is…”
What kind of therapeutic communication is this?

A

giving information

132
Q

“Good morning, Mr. S…”

“You’ve finished your list of things to do.”

“I notice that you’ve combed your hair.”

What kind of therapeutic communication is this?

A

Giving recognition

133
Q

“You appear tense.”

“Are you uncomfortable when…?”

“I notice that you’re biting your lip.”

What kind of therapeutic information is this?

A

making observations

134
Q

“I’ll sit with you awhile.”

“I’ll stay here with you.”

“I’m interested in what you think.”

What kind of therapeutic communication is this?

A

offering self

135
Q

“What seemed to lead up to…?”

“Was this before or after…?”

“When did this happen?”

What kind of therapeutic communication is this?

A

placing event in time or sequence

136
Q

“I see no one else in the room.”

“That sound was a car backfiring.”

“Your mother is not here; I am a nurse.”

This is an example of what therapeutic communication?

A

presenting reality

137
Q

Client: “Do you think I should tell the doctor…?”

Nurse: “Do you think you should?”

Client: “My brother spends all my money and then has nerve to ask for more.”

Nurse: “This causes you to feel angry?”

This is an example of what type of therapeutic communication?

A

Reflecting

138
Q

Client: “I can’t sleep. I stay awake all night.”

Nurse: “You have difficulty sleeping.”

Client: “I’m really mad, I’m really upset.”

Nurse: “You’re really mad and upset.”

This is an example of what kind of therapeutic communication?

A

Restating

139
Q

Nurse says nothing but continues to maintain eye contact and conveys interest.

What kind of therapeutic communication is this?

A

Silence

140
Q

“Perhaps you and I can discuss and discover the triggers for your anxiety.”

“Let’s go to your room, and I’ll help you find what you’re looking for.”

What kind of therapeutic communication is this?

A

suggesting collaboration

141
Q

Have I got this straight?”

“You’ve said that…”

“During the past hour, you and I have discussed…”
What kind of therapeutic communication is this?

A

summarizing

142
Q

Client: “I’m dead.”

Nurse: “Are you suggesting that you feel lifeless?”

Client: “I’m way out in the ocean.”

Nurse: “You seem to feel lonely or deserted.”

What kind of therapeutic communication is this?

A

translating into feelings

143
Q

lient: “I can’t talk to you or anyone. It’s a waste of time.”

Nurse: “Do you feel that no one understands?”

What kind of therapeutic communication is this?

A

verbalizin the implied

144
Q

“Isn’t that unusual?”

“Really?”

“That’s hard to believe.”

What kind of therapeutic communication is this?

A

voicing doubt

NU 306 Mental Health (13 decks)

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