Final Review

Question 1

what does the client with a life-threatening illness worry or fear about?

Answer 1

symptoms of illness and pain they need to endure
what will happen to their spouse, partner, and familay

Question 2

reasons a person will use alcohol

Answer 2

• to produce a feeling of well-being
• to depress the CNS
• to avoid problems or bolster confidence
• increase in ability to tolerate
• deny problems

Question 3

defense mechanisms

Answer 3

Compensation - overemphasizing a characteristic to compensate for real or imagined deficiency

Denial - Refusal to acknowledge painful realities, feelings, or experiences. Offers temporary escape

Displacement - taking emotions out on people who are not responsible for those emotions

Projection - attributing one’s own thoughts or impulses to another individual as if they had originated in the other person

Rationalization - justifying behavior by offering an explanation other than a truthful response.

regression - attempt to go back to an earlier stage of development to escape fear, anxiety, or conflict

repression - unconscious blocking from awareness material that is threatening or painful

supression - is the conscious or unconscious attempt to keep threatening material out of consciousness. Deliberately refusing to acknowledge something that causes mental pain or suffering.

sublimation - redirecting a socially unacceptable impulse into socially acceptable behavior

undoing - canceling out a behavior or trying to make amends.

Question 4

anticipatory grief

Answer 4

grieving process prior to actual loss

Question 5

hospice

Answer 5

focus is comfort care and management of pain and symptoms

the goal is dying at peace and with dignity

Question 6

what role does age have with dealing with grief?

Answer 6

infants: only know when someone is not there to care for them

toddlers: confused, cannot distinguish animate from inanimate

children (3-5 years): death is reversible

children (6-10 years): curious about death

adolescents: fascination and fear about death

adults: sense that loss poses a threat to pattern of living

older adults: grieve aging process, grieve for friends who have died, and fear loss of independence

Question 7

bipolar disorder

Answer 7

major depression; manic-depressive

extreme heights of mania and severe lows (hypomania)

Question 8

palliative care

Answer 8

relieves or alleviates symptoms without curing

Question 9

how does the client that has a serious diagnosis feel?

Answer 9

anger

a fear of symptoms and pain, but not death

Question 10

type of medications usually prescribed for a client that is terminal?

Answer 10

analgesics = pain
sedatives = sleep
meds for disease
antidepressants
tranquilizers
O2

Question 11

clients with life-threatening illness will miss what most?

Answer 11

privacy/independence

Question 12

what circumstances make it easier to work through grief?

Answer 12

acceptance (?)

Question 13

when a person is told they have a life-threatening illness, do they still have hope or is it the end?

Answer 13

usually the end AND hope should be maintained

Question 14

phases of life-altering illness + terms used

Answer 14

chronic illness where death is inevitable = life-threatening

life-altering v life-threatening = fine line. distinction is perception of the illness.

Question 15

phases of violence

Answer 15

1: tension building
2: abuse occurs
3: calm returns / honeymoon

Question 16

four types of abuse and defense mechanisms used

Answer 16

intimate partner violence, child abuse, abuse of older adults, rape

• rationalization
• displacement

Question 17

addiction

Answer 17

physiological or psychological dependence on a substance that is beyond voluntary control

Question 18

Dread

Question 19

who should make decisions for the dying client?

Answer 19

the client - whatever is in their advance directive, living will, etc.

Question 20

Dr. George L. Engel’s stages of grief

Answer 20

1: experiencing disbelief or shock over the loss
2: realizing loss occurred
3: acknowledging loss in realistic manner

Question 21

be able to express how a child that has been abused feels

Answer 21

sense of self is low

Question 22

marijuana

Answer 22

AKA cannabis

• reduces nausea and vomiting
• chemo
• effective for seizures

Schedule I: little or no benefit, high potential for abuse

Question 23

Dr. Elisabeth Kübler-Ross’ stages of grief

Answer 23

1: denial
2: anger
3: bargaining
4: depression
5: acceptance

Question 24

dependency and codependency

Answer 24

excessive use of drug –> disapproval –> self recrimination –> guilt –> rationalization –> denial –> back to excessive use of drug

Question 25

is a health care provider able to help move a person from the various stages of grief?

Answer 25

no

Question 26

is self-care important for those that care for clients with life-threatening illnesses?

Answer 26

yes

Question 27

is it acceptable for a health care provider to show their emotions to clients?

Answer 27

no

Question 28

bullying

Answer 28

unwanted aggressive behavior that invokes a real or perceived power imbalance

Question 29

what is the client's view about death when they have a life-threatening illness?

Answer 29

anger, fear of symptoms, worry of what happens to the things they will leave behind

Question 30

substance abuse / dependence

Answer 30

abuse: substance use for 12-months that leads to significant impairment of one or more of the following --> recurrent use,. continued use, legal problems, psychological problems dependence: significant impairment of two or more of the following --> tolerance, withdrawal, larger amounts, persistent desire, time increased in obtaining them, diminished activities, continued use in spite of problems

Question 31

be able to recognize what displaced anger looks like

Answer 31

looks like client clamming the door who is angry at the provider for not explaining the procedure completely - provider is the one being slammed

Question 32

paranoia

Answer 32

psychosis of fear that is related to a feeling of being victimized can cause irrational or compulsive behavior

Question 33

how many states mandate reporting of IPV?

Answer 33

6 states mandate reporting and a majority of states have enacted laws

Question 34

what type of loss causes the most grief?

Answer 34

unresolved

Question 35

when is it necessary to set limits with clients?

Question 36

type of opioids

Answer 36

- control pain - hydrocodone, oxycodone, morphine, codeine

Question 37

dysthmia

Answer 37

persistent depressive disorder a LESS severe form of minor depression

Question 38

what behaviors do patients with Alzheimer's show?

Answer 38

memory loss, confusion

Question 39

assisted death law

Answer 39

someone provides the means for a person to end their life

Question 40

Patient Self-Determination Act and who is mandated to inform clients of this

Answer 40

physicians and health care providers establish written policies and procedures on advance directives, allowing individuals the right to identify clear choices of their death

Question 41

what happens with unresolved grief?

Answer 41

can cause unexpected somatic responses, some stress-related medical disease, altered relationships. inability to cope is disruptive to physiological and psychological functioning

Question 42

medical detoxification and next steps

Answer 42

rid body of substance administration of meds, treatment with monitoring, counseling, and support

Question 43

resentment

Answer 43

chronic form of anger that is long lasting

Question 44

what is an advanced directive?

Answer 44

written policies and procedures allowing individuals the right to identify clear choices in their death

Question 45

steps you should take when you feel hostility towards clients

Answer 45

examine feelings and discuss response with someone who can help you sort through your reaction continuous giving to others can drain you and you must be relatively free of anxiety to be therapeutic

Question 46

what are the different types of rape?

Answer 46

angry power (most common) sadistic

Question 47

depression, the various types, and treatments

Answer 47

- Major and Minor Depression - Persistent Depressive Disorder - Reactive Depression - Bipolar Disorder (BPD) - Major Depressive Disorder/Seasonal Pattern Disorder - Major Depression Disorder with Peripartum Onset - Psychotic Depression psychotherapy, talk therapy, antidepressant meds, light therapy/phototherapy, cognitive behavioral therapy. interpersonal psychotherapy

Question 48

terror

Answer 48

occurs when individual is overwhelmed with feeling of impending danger may cause illogical reaction and form of a panic attack

Question 49

therapeutic responses - anger - avoidance - disgust - objectivity

Answer 49

anger: calm, don't get angry back, deescalate, allow clients to express, avoidance: balancing a neutral curiosity with ongoing optimism disgust: acceptance, seeking clarification, reflecting, voicing doubt objectivity: giving options, summarizing,

Question 50

suicide

Answer 50

the taking of ones life 4 stages 1: anger/hostility 2: panic 3: helplessness is communicated 4: preparation and carrying out act

Question 51

how to handle clients that continually drop treatment programs?

Answer 51

with the 5 C's... I did not Cause the disease I cannot Cure the disease I cannot Control the disease or substance dependent client And if I try to, I Contribute to the problem and I go Crazy become educated be alert do not be discouraged do not believe you can "fix it"