exam 2

Question 1

what are the 5 stages of grief according to kubler-ross?

Answer 1

1) denial: avoidance, confusion, elation, shock
2) anger: frustration, irritation, anxiety
3) bargaining: overwhelmed, helplessness, hostility
4) depression: struggling to find meaning, reaching out to others, telling ones story
5) acceptance: exploring options, new plans, moving on

Question 2

what is the intimate partner violence cycle? (abuser behavior)

Answer 2

1) honeymoon stage: apologetic, respectful, attentive, promises, improved communication, helpful, gift giving/compliments, spends time
2) tension stage: insults, threats, sarcasm, jealousy, accusations, fault finding, controlling actions, quick mood changes, emotional distance
3) explosion stage: intimidating body language, keeps them from leaving, throwing things, slamming doors, silent treatment, name calling, swearing, yelling

Question 3

dopamine does what? and what type of neurotransmitter it is?

Answer 3

the “feel good” neurotransmitter
thought to be increased in people
with schizophrenia, excitatory transmitter

Question 4

norepinephrine does what? and what type of neurotransmitter it is?

Answer 4

neurotransmitter is associated with “fight or flight”, excitatory transmitter

Question 5

serotonin does what? and what type of neurotransmitter it is?

Answer 5

sleep, mood, memory neurotransmitter can be decreased in depression and anxiety, inhibitory transmitter

Question 6

GABA (gamma-aminobutyric
acid) does what? and what type of neurotransmitter it is?

Answer 6

“calming” neurotransmitter and may be decreased in depression and anxiety, inhibitory transmitter

Question 7

generalized anxiety disorder is defined as?

Answer 7

causes people to experience excessive and persistent worry about everyday things

Question 8

obsessive compulsive disorder is defined as?

Answer 8

-obsessions = recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses
-compulsions = ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety

Question 9

re-uptake means?

Answer 9

what happens after a signal is transmitted: the neurotransmitter, its “work” completed, is reabsorbed back into the cell that previously released it, reuptake is essential for synaptic functioning

Question 10

what is grounding and what is it used for?

Answer 10

technique reminds the patient that they
are in the present and are safe, can be used for anxiety and PTSD

Question 11

what is PTSD defined as?

Answer 11

post traumatic stress disorder, disturbing patterns of behavior demonstrated by someone following a major trauma
beginning at least 3 months after the event or even months or years later

Question 12

what is mild/moderate, up to 3 months, 6 months after end of stressor duration for symptoms disorder called?

Answer 12

adjustment disorder

Question 13

what is severe, few days to maximum 4 weeks, maximum one month duration for symptoms disorder called?

Answer 13

acute distress disorder

Question 14

what is severe, sometimes years, >1 month duration for symptoms disorder called?

Answer 14

PTSD

Question 15

what is sudden memory loss cause by an event

Answer 15

dissociative amnesia disorder

Question 16

whats is a person feels detachment from ones mind or body

Answer 16

depersonalization disorder

Question 17

what is forgetting personal info and taking on a new identity and including moving, but forget fugue state when it ends

Answer 17

dissociative fugue disorder

Question 18

what is the existence of two or more distinct personalities within a distinct individual

Answer 18

dissociative identity disorder

Question 19

what are some nursing interventions for when a client is having a panic attack?

Answer 19

self-awareness of anxiety level, assessment of the client’s anxiety
level, use of short, simple, easy-to-
understand sentences ,de-escalate the client’s anxiety level to moderate or mild before asking them to move on to another
task, low, calm, soothing voice, in panic, safety is primary concern, short-term use of anxiolytics

Question 20

what are some signs of physical abuse?

Answer 20

unexplained cuts, abrasions, bruising or swelling, unexplained burns or scalds, cigarette burns, rope burns or marks on arms, legs, neck, torso, unexplained fractures, strains or sprains; dislocation of limbs, bite marks, dental injuries, ear or eye injuries

Question 21

what is aggression and some characteristics of aggression?

Answer 21

-hostility = verbal aggression, usually when feeling
threatened or powerless
-physical aggression: attack on or injury to another person; destruction of property
-both to harm or punish another person or force into compliance
-clenched jaw, pacing, clenched fists, raised voices, irritability

Question 22

when should a nurse use restraints?

Answer 22

last resort and when patient is a danger to self or others

Question 23

what are the stages for aggression?

Answer 23

1) triggering: an event or circumstances in the environment initiates the clients response, which is often anger or hostility
2) escalation: clients responses represent escalating behaviors that indicate movement toward a loss of control
3) crisis: during a period of emotional and physical crisis, client loses control
4) recovery: client regains physical and emotional control
5) postcrisis: client attempts reconciliation with others and returns to the level of functioning before the aggressive incident and its antecedents

Question 24

what are the levels of anxiety?

Answer 24

-mild: special attention;
increased sensory stimulation;
motivational
-moderate: feeling something is
definitely wrong;
nervousness/agitation;
difficulty concentrating; able to
be redirected
-severe: trouble thinking and
reasoning; tightened muscles;
increased vital signs; restless,
irritable, angry
-panic: fight, flight, or freeze
response; increased vital signs;
enlarged pupils; cognitive
processes focusing on defense

Question 25

what are some things people with OCD do that are related?

Answer 25

-excoriation: skin picking
-trichotillomania: hair-pulling
-onychophagia: chronic nail-biting
-BDD(body dysmorphia): a preoccupation with an imagined or slight defect in physical appearance
-hoarding
-kleptomania: compulsive stealing
-oniomania: compulsive buying
-body identity integrity disorder

Question 26

what is complicated grieving ?

Answer 26

person void of emotion; grieving for prolonged periods; expressions of grief seem disproportionate to event, usually sudden deaths, multiple deaths, suicide or murder

Question 27

what is uncomplicated grieving?

Answer 27

this is also known as normal grieving, a grief process that involves a range of emotions and behaviors that are common after a loss

Question 28

what are some psychoactive medications requiring monitoring (lab draws)?

Answer 28

used to treat mental health disorders, antipsychotics (formerly called
neuroleptics), antidepressants, mood-stabilizing medications, anxiolytics

Question 29

what are the levels to anxiety?

Answer 29

-mild: special attention;
increased sensory stimulation;
motivational
-moderate: feeling something is
definitely wrong;
nervousness/agitation;
difficulty concentrating; able to
be redirected
-severe: trouble thinking and
reasoning; tightened muscles;
increased vital signs; restless,
irritable, angry
-panic: fight, flight, or freeze
response; increased vital signs;
enlarged pupils; cognitive
processes focusing on defense

Question 30

what is disenfranchised grief?

Answer 30

grief over loss that is not or cannot be openly acknowledged, mourned publicly, or supported socially, like a nurse losing their patient

Question 31

neurologic side effects that can be treated with anticholinergic medications (diphenhydramine) are called EPS and include:

Answer 31

acute dystonia, akathisia, pseudoparksonism