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Behavioral Health > Exam 1 > Flashcards

Exam 1 Flashcards

0
Q

Mental Health is a state of ____________ in which each individual is able to realize his or her own _________, cope with the normal ________ of ________, work _________, and make a _________ to the _________.

A

Well-being, potential, stressors, life, productively, contribution, community

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1
Q

A state of well-being in which each individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community

A

Mental Health

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2
Q

Refers to all mental disorders with definable diagnosis.

A

Mental Illness

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3
Q

Mental illnesses are manifested in significant dysfunction that may be related to ______, ________, or _______ disturbances in mental functioning.

A

Developmental, biological, psychological

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4
Q

The ability and capacity for people to secure the resources they need to support their well-being.

A

Resilience

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5
Q

_________ is essential to the recovery process.

A

Resilience.

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6
Q

Behavior that deviates from socially accepted norms does not indicate mental illness unless there is significant ______ in _________ ________.

A

Disturbance in mental functioning.

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7
Q

Recognizing feelings of stress, readily dealing with them, and earning from the experience rather than falling victim to negative emotions.

A

Resilience

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8
Q

______ defines mental health as going against a norm decided by that particular group.

A

Culture

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9
Q

Drug found to have a calming effect on agitated, out of control patients that was a breakthrough in viewing mental illness as having physical symptoms.

A

Thorazine (chlorpromazine)

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10
Q

NAMI

A

National Alliance on Mental Illness, a group for people with mental illness and their families

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11
Q

Diathesis-stress model

A

The most accepted explanation for mental illness
Diathesis represents biological disposition
Stress represents environmental stress or trauma

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12
Q

_____ % of all Americans will suffer from some type of mental disorder during their lifetime.

A

46

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13
Q

More than ___% of disability is due to ________.

A

30, Depression

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14
Q

QSEN Competencies:

A
  • Patient centered care
  • Teamwork and collaboration
  • Evidence based practice
  • Quality improvement
  • Safety
  • Informatics
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15
Q

The quantitative study of the distribution of mental disorders in human populations

A

Epidemiology

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16
Q

Refers to the number of NEW CASES of mental disorder in a healthy population in a given period of time.

A

Incidence

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17
Q

Describes the TOTAL NUMBER OF CASES, new and existing, in a given population during a specific period of time (regardless of when they became ill).

A

Prevalence

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18
Q

Diseases with short duration (common cold) have a high ____ and low _____.

A

Incidence, prevalence

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19
Q

Chronic diseases have a low ____, and a high____.

A

Incidence, prevalence.

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20
Q

A broad field that examines health and illness at the population level.

A

Clinical epidemiology

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21
Q

DSM-5

A

Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
Official medical guidelines for diagnosing psychiatric disorders
*classifies disorders not people!

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22
Q

ICD-9-CM

A

International Classification of Diseases

Clinical descriptions of mental and behavior disorders

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23
Q

Psychiatric mental health nursing employs a purposeful ___ of ______ as its art and a wide range of nursing, psychosocial, and neurobiological _______ and research ______ as its science, work with people throughout the _____ ______, and employed in a _____ of settings.

A

use of self, theories, evidence, life span, variety

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24
Q

Promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders.

A

Psychiatric mental health nursing

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25
Q

Nurses work in various supervised settings and perform roles such as staff nurse, case manager, home care nurse.

A

Basic Level

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26
Q

Nurse specialists trained to provide individual therapy, group therapy, and provide training for other staff. Have diagnostic privileges, prescriptive authority, and permission to engage in psychotherapy.

A

Advanced Practice

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27
Q

Sensitivity to different cultural view regarding health, illness, and response to treatment

A

Cultural competence

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28
Q

Future challenges and roles for psychiatric mental health nurses: (5)

A 
Educational
Aging population
Cultural diversity
Science, technology and Electronic health care 
Legislative involvement
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29
Q

Freud believed that a vast majority of mental disorders were due to unresolved issues that originated in ______.

A

Childhood

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30
Q

Cathartic method

A

Talk therapy developed by freud. Includes free association (full disclosure and honesty)

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31
Q

All material a person is aware of at any one time including perceptions, memories, thoughts, fantasies, and feelings.

A

Conscious

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32
Q

Material that can be retrieved rather easily through conscious effort.

A

Preconscious

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33
Q

All repressed memories, passions, and unacceptable urges lying deep below the surface. May be placed here because individuals find the memories to painful to deal with.

A

Unconscious

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34
Q

The source of all drives, instincts, reflexes, needs, genetic inheritance, and the capacity to respond.

A

Id

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35
Q

Lacks the ability to problem solve, is not logical, and operates according to the pleasure principle.

A

id

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36
Q

The problem solver ad reality tester.

A

Ego

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37
Q

Able to differentiate subjective experiences, memory images, and objective reality and attempts to negotiate the outside world.

A

Ego

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38
Q

Represents the moral component of personality

A

Superego

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39
Q

Represents the ideal rather than the real, seeks perfection as opposed to seeking pleasure or engaging in reason

A

Superego

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40
Q

Developed by the go to ward off anxiety by preventing conscious awareness of threatening feelings.

A

Defense mechanisms

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41
Q

Two common features of defense mechanisms

A
  1. They all (except suppression) operate on an unconscious level
  2. Deny, falsify, or distort reality to make it less threatening
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42
Q

Freud’s psychosexual Stages of development

A 
Oral (0-1)
Anal (1-3)
Phallic (3-6)
Latency (6- 12)
Genital (12+)
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43
Q

This model helps determine which types of interventions will be effective in nursing.

A

Erikson’s developmental theory

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44
Q

Erikson’s developmental stage- Age 0-1.5 yrs:

A

Trust vs. Mistrust

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45
Q

Erikson’s developmental stage- 1.5- 3yrs:

A

Autonomy vs. Shame/Doubt

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46
Q

Erikson’s developmental stage- 3- 6yrs:

A

Initiative vs. guilt

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47
Q

Erikson’s developmental stage- 6-12yrs:

A

Industry vs Inferiority

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48
Q

Erikson’s developmental stage- 12- 20yrs:

A

Identity vs. Role confusion

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49
Q

Erikson’s developmental stage- 20- 35yrs:

A

Intimacy vs isolation

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50
Q

Erikson’s developmental stage- 35- 65yrs:

A

Generatively vs. Self-absorption

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51
Q

Erikson’s developmental stage- 65yrs+:

A

Integrity vs. Despair

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52
Q

This theorist stated that the purpose of all behavior is to get needs met through interpersonal interactions and to decrease or avoid anxiety.

A

Henry Sullivan

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53
Q

Measures the individual employs to reduce anxiety and enhance security

A

Security Operations (coined by Henry Sullivan)

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54
Q

Term which states that a professional helper cannot be isolated from the therapeutic situation if they are to be effective.

A

Participant observer

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55
Q

Established the foundation for the professional practice of psychiatric nursing.

A

Peplau

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56
Q

Therapy used to reduce or eliminate psychiatric symptoms (depression) by improving interpersonal functioning and satisfaction with social relationships. Includes Identifying the Nature of the problem

A

Interpersonal psychotherapy

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57
Q

Four types of problem areas (nature of problems) in Interpersonal psychotherapy:

A

Grief
Role disputes
Role transition
Interpersonal deficit

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58
Q

Peplau stated self-awareness is part of nursing and that nursing had two parts: the ____ component consisting of care, compassion, and advocacy and the _____ that involves application of knowledge.

A

art, science

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59
Q

______ described three levels of anxiety: _______, _______, and _____.

A

Peplau, Mild, moderate, panic

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60
Q

Pavlov described ______ ________ by using dogs and food and stated that this behavior was _______.

A

Classic conditioning, Involuntary

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61
Q

Involves pairing a behavior with a condition that reinforces or diminishes the behaviors occurrence.

A

Conditioning

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62
Q

Watson developed a school of thought called ______ using an experiment with Little Albert and stated that one could control the ______ to mold behavior.

A

behaviorism, environment

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63
Q

Skinner researched ______ ________ and stated ________ behaviors are learned through ________, either positive or negative.

A

operant conditioning, voluntary, reinforcement.

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64
Q

Modeling, Operant conditioning, systemic desensitization, aversion therapy, and biofeedback are all types of _____ therapy and work best when directed at a ____ _____ and when _____ are well defined.

A

Behavior, specific problem, goals

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65
Q

Operant conditioning is a type of behavior therapy taht uses positive reinforcement to elicit desired behaviors such as in the reward system known as _______ ________.

A

Token Economy

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66
Q

Involves the development of behavior tasks customized to the patient’s specific fears. Integrates learned relaxation techniques.

A

Systematic Desensitization

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67
Q

This behavior therapy is akin to bunishement.

A

Aversion therapy

68
Q

Proposes a dynamic interplay between individuals and the environment, that thoughts come before feelings and actions, and thoughts about the world are based on ones own perspective despite reality.

A

Cognitive Theories (Beck, Ellis)

69
Q

Developed by Ellis, aim to eradicate core irrational beliefs by helping people recognize thoughts that are not accurate, sensible or useful.

A

REBT- Rational-Emotive Behavior Therapy

70
Q

A therapeutic tool used to change the way individuals think and therefore change behaviors and reduce symptoms

A

CBT- Cognitive-behavioral therapy (Beck)

71
Q

Unique assumptions that a person has about oneself. Can be negative or positive.

A

Schemas (Beck)

72
Q

Theory of self-actualization

A

Maslow’s Hierarchy of needs

73
Q

Maslow’s hierarchy of needs:

A 
Physiological
Safety
Belonging/Love
Esteem
Self-actualization
74
Q

Emphasized on the human potential and the patient’s strength as the key to a successful nurse-patient relationship.

A

Maslow

75
Q

Model that focuses on neurological, chemical, biological, and genetic issues and seeks to understand how the body and brain interact to create emotions, memories and perceptual experiences.

A

Biological Model

76
Q

Use of the total environment to treat patients.

A

Milieu therapy

77
Q

Milieu recognizes the ____, the _____, the _____, and the ______ climate as important to healing.

A

people, setting, structure, emotional

78
Q

Sense of responsibility, shame, and being flawed associated with a disorder.

A

Stigma

79
Q

Deterioration of mental health

A

Decompensation

80
Q 
Outpatient or Inpatient: 
Primary Care
Community Clinic
Assertive Community Treatment (ACT)
Milieu
Psychosocial rehabilitation 
Patient-centered health/Medical homes
A

All but Milieu are outpatient

81
Q

When selecting a facility in which to obtain treatment, the ____ _____ _____, or setting that provides the necessary care allowing the greatest personal freedom is very important.

A

Least restrictive environment

82
Q

Type of prevention that screens for predisposal to mental illness and taking action to prevent it. Helps “at risk” individuals from developing an illness.

A

Primary

83
Q

Type of prevention that identifies and treats illness promptly to prevent worsening of illness.

A

Secondary prevention

84
Q

Type of prevention such as rehabilitation that prevents serious complications of established illnesses

A

Tertiary prevention

85
Q

Admission criteria for Impatient psychiatric care:

A

1-Imminent danger of harming self
2-Imminent danger of harming others
3-Unable to care for basic needs and/or gross impairment of judgement that places the individual at imminent risk based on inability to protect oneself.

86
Q

Moves the individual beyond stabilization toward recovery and a higher quality of life

A

Psychosocial rehabilitation (community-based program)

87
Q

Comprises of the shared beliefs, values and practices that guide a group’s members in patterned ways of thinking and acting.

A

Culture

88
Q

Connected with economic and social standing in society more than with cultural identity.

A

Minority status

89
Q

Groups that have a common heritage and history.

A

Ethnicity

90
Q

A system for thinking about how the world works and how people should act.

A

Worldview

91
Q

In Psychiatric mental health nursing we should focus on _____ rather than _____.

A

Culture, race

92
Q

In Western tradition, one’s identity is found in one’s _______, which inspires the valuing of _____, independence, and self-reliance. ____ and _____ are seen as two separate entities.

A

Individuality, autonomy, Mind, Body

93
Q

In Eastern tradition, ______ is the basis of one’s identity, leading to interdependence and group decision making. ____-______-______ are seen as a single entity.

A

Family, Body, Mind, Spirit

94
Q

Places significance on humans in the natural world.

A

Indigenous culture

95
Q

The culture’s worldview, beliefs, values, and practices transmitted to its members.

A

Enculturation

96
Q

Differences outside the range of normal in a culture are viewed as….

A

Mental illness

97
Q

The universal tendency of humans to think their way of thinking and behaving is the only correct and natural way.

A

Ethnocentrism

98
Q

Imposing cultural norms on members of other cultural groups.

A

Cultural imposition

99
Q

Populations at risk of mental illness and inadequate care:

A

Immigrants
Refugees
Cultural minorities.

100
Q

Five steps to becoming culturally competent:

A 
Cultural awareness
Cultural knowledge
Cultural encounters
Cultural skill
Cultural desire
101
Q

Involves examining beliefs, values, and practices of one’s own culture.

A

Cultural awareness

102
Q

Three cultures that intersect during a cultural encounter:

A

Culture of patient
Culture of nurse
Culture of setting

103
Q

Learning by attending cultural events and programs, forging friendships with diverse cultural groups, and studying to help establish rapport, ask culturally relevant questions, and identify cultural variables to be considered.

A

Cultural knowledge

104
Q

Deters nurses form stereotyping, helps nurses gain confidence in cross-cultural interactions, and helps nurses avoid or reduce cultural pain.

A

Cultural encounters

105
Q

Ability to perform a cultural assessment in a sensitive way to achieve a mutually agreeable plan of care.

A

Cultural skill

106
Q

Cultural skill involves three outcomes for planning:

A

Cultural preservation/maintenance
Cultural accommodation/negotiation
cultural re patterning/restructuring

107
Q

Genuine concern for a patient’s welfare, willingness to listen until a patient’s viewpoint is understood, and utilizing patience, consideration and empathy.

A

Cultural desire

108
Q

The study of philosophical beliefs about what is considered right or wrong in society.

A

Ethics

109
Q

The duty to act to benefit or promote the good of others.

A

Beneficence

110
Q

Respecting the rights of others to make their own decisions

A

Autonomy

111
Q

The duty to distribute resources or care equally, regardless of personal attributes

A

Justice

112
Q

Maintaining loyalty and commitment to the patienta nd doing no wrong to the patient

A

Fidelity/nonmaleficence

113
Q

One’s duty to communicate truthfully

A

Veracity

114
Q

Conflict between two or more courses of action, each with favorable and unfavorable consequences

A

Ethical dilemma

115
Q

Temporary admission is used for 2 reasons:

A
  1. People who are confused or demented and cannot make decisions on their own
  2. People who are so ill they need emergency admission
116
Q

When a patient (or guardian) applies in writing for admission to the facility

A

Voluntary

117
Q

Admission to a facility without the patient’s consent.

A

Involuntary admission

118
Q

Usually requires outpatient treatment for a specified period to determine the patient’s adherence with medication protocols, ability to meet basic needs, and ability to reintegrate into the community.

A

Conditional release

119
Q

The termination of a patient-institution relationship

A

Unconditional release

120
Q

Treatment seems beneficial but there is no compelling reason to seek an involuntary continuance of stay.

A

Release against medical advice (AMA)

121
Q

Confining a patient alone in an area or rom and preventing the patient from leaving.

A

Seclusion

122
Q

Is this seclusion:
Person restrained in an open room?
Patient in unlocked room but will be punished if they leave?

A

No, Yes

123
Q

Exceptions to confidentiality:

A

Duty to warn and protect third parties

Child and elder abuse reporting

124
Q

Injury to a person, property, or reputation.

A

Tort

125
Q

Intentional torts:

A 
Assault (Threats to physically injure)
Battery (Physically injuring) 
False imprisonment
Invasion of Privacy
Defamation of character:
Slander (verbal)
Libel (printed)
126
Q

Unintentional Torts:

A

Negligence

Malpractice

127
Q

Five requirements of malpractice:

A
  1. Duty
  2. Breach of duty
  3. Cause in fact (Absence or presence of opposite action would have prevented harm)
  4. Proximate cause (actions/lack of action that caused harm)
  5. Damages
128
Q

Primary sources for assessment

A

Patient

129
Q

Secondary sources for assessment

A

Family, friends, neighbors, police, health care workers, medical records

130
Q

Includes caretaker, interview and observation, acting, anatomically correct dolls, story telling, picture drawing, or games.

A

Child Assessment

131
Q

Involves disclosing confidentiality, as it is important to this age group, and use of HEADSSS interview technique.

A

Adolescent assessment

132
Q

Takes into consideration any physical limitations, sensory conditions, motor conditions, or medical conditions and accommodates to them.

A

Older Adult assessment

133
Q

Interpreter vs Translator:

A

Interpreter interprets patients words and inserts his/her own understanding while a translator avoids this.

134
Q

Gives subjective data that focuses on the patient’s perceptions and recollections of current lifestyle and life in general

A

Psychosocial Assessment

135
Q

Aids in collecting objective data such as a patient’s behavior, nonverbal communication, appearance, speech patterns, mood, thought content, perceptions, and cognitive ability.

A

MSE- Mental Status Examination

136
Q

Refers to memory from years ago

A

Remote memory

137
Q

Refers to memories recently such as yesterday or last week.

A

Recent memory

138
Q

Refers to memories from now such as 5 minutes ago or 20 minutes ago

A

Immediate

139
Q

Three dimensions of spirituality:

A

Cognitive
Experiential
Behavioral

140
Q

Standardized outcomes that provide a mechanism for communicating the effect of nursing interventions on the well-being of patients, families, and communities. Has an associated group of indicators used to determine patient status in relation to the outcome

A

NOC- Nursing Outcomes Classification

141
Q

Principles when planning care: (4)

A

Safe
Compatible/Appropriate
Realistic/Individualized
Evidence-based

142
Q

Research-based standardized listing of interventions reflective of current clinical practices the nurse can use to plan care.

A

NIC- Nursing Interventions Classification

143
Q

5 Basic Level Interventions:

A 
Coordination of Care
Health teaching and promotion
Milieu therapy
Pharmacological, biological, and integrative therapies 
Use of therapeutic relationship
144
Q

Advanced Practice Interventions:

A

Prescriptive authority and treatment
Psychotherapy
Consultation

145
Q

Use of personality consciously and i full awareness to attempt to establish relatedness and to structure nursing interventions is the ______ ____ ___ ______

A

Therapeutic use of self.

146
Q

Social relationships meet ______ needs and communication is _______.

A

Mutual, Superficial

147
Q

Therapeutic relationship meet ______ needs, _____ are established, _______-______ approaches are taken, ______ change is encouraged, and new _____ _____ are developed.

A

patient’s, boundaries, problem-solving, behavioral, coping skills

148
Q

Nursing behaviors at the foundation of a therapeutic nurse-patient relationship include: (5)

A 
Accountability (Responsibility)
Focus on patient's needs (Advocate)
Clinical competence (EBP)
Delayed judgement (avoiding ethnocentrism) 
Supervision (to develop competence)
149
Q

A brief relationship that may be substantial, useful, and important for the patient.

A

Therapeutic Encounter

150
Q

Three types of boundaries:

A

Physical
Contract
Personal space

151
Q

Two circumstances in which boundaries are blurred:

A
  1. When the relationship slips into social context

2. When nurse’s needs are met at the expense of the patient’s needs

152
Q

Patient unconsciously and inappropriately displaces feelings and behaviors on the nurse.

A

Transference

153
Q

Nurse displaces feelings on the patient.

A

Countertransference

154
Q

Four phases of the nurse-patient relationship:

A
  • Pre-orientation phase
  • Orientation phase
  • Working phase
  • Termination phase
155
Q

Our values and beliefs are: (3)

A
  1. Reflect our own culture/subculture
  2. Derived from a range of choices
  3. Chosen for ourselves from a variety of influences and role models
156
Q

Phase in nurse-patient relationship- Happens before the nurse and patient meet

A

Pre-orientation phase

157
Q

The first time the nurse and patient meet where the nurse conducts the initial interview

A

Orientation phase

158
Q

Includes establishing rapport, parameters of the relationship, formal/informal contract, confidentiality, and terms of termination

A

Orientation phase

159
Q

Involves maintaining a relationship, gathering further data, promoting that patient’s problem-solving skills, self-esteem, and use of language.

A

Working phase

160
Q

Phase in which the nurse and patient together identify and explore areas that cause problems in the patient’s life.

A

Working phase

161
Q

Discussed during the first interview, working phase, and where the patient is discharged (or clinical ends).

A

Termination phase

162
Q

Involves summarizing goals and objectives achieved, discussing ways for patient to incorporate new skills, and review of relationship and memories.

A

Termination phase

163
Q

Factors that help the nurse-patient relationship (6)

A 
Consistency
Pacing
Listening
Initial impressions
Promoting comfort
Trust/participation (patient factors)
164
Q

_____ is understanding the feelings of others where as ______ is feeling the feelings of others.

A

Empathy, Sympathy

165
Q

Implies respect, Ability to view another person as being worthy of caring about and as someone who has strengths and achievement potential

A

Positive regard

166
Q

Factors that promote patient growth

A

Genuineness
Empathy
Positive regard (attitudes and actions)

167
Q

actions of positive regard (3):

A

Attending
Suspending judgements
Helping patient’s develop resources

168
Q

A special kind of listening that refers to an intensity of presence or just being with the patient. Includes being there, posture, eye contact, and body language.

A

Attending

Behavioral Health (6 decks)

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