Mental Health Concepts

Question 1

Coping mechanisms
Types of adapting

Answer 1

Assess pt ability to adapt to temp or permanent role changes

Adaptive and nonadaptive

Question 2

Crisis intervention

Answer 2

Self harm or harm toward others

Question 3

Defense mechanisms
Projection

Answer 3

Projection: project fault on others

Question 4

Milieu

Answer 4

Where healing happens
Cope and communicate

Question 5

Problem with saying WHY

Answer 5

Always non therapeutic

Question 6

MSE

Answer 6

Mental status exam
Psychological equivalent of a physical exam that describes the mental state and behaviors of the person

It includes
subjective descirptions
Objective observations

Question 7

Why do we do a MSE

Answer 7

Info for diagnosis
Assessment of disorder
Response to tx

Provides snapshot at a point in time

Question 8

What do we need to know about the pt prior

Answer 8

Baseline

Question 9

Components of the MSE (9)

Answer 9

Appearance
Behavior
Speech
Mood
Affect
Thought process
Thought content
Cognition
Insight/judgment

Question 10

Assessment
Perform what as indicated
Can we use touch?
Respect what
Include what type of questions
Include who
Obtain what
Summarize and asl for what

Answer 10

Perform physical assessment as indicated
Touch can be utilized
Respect personal space if they dont want to be touched

Include questions r/t sleep, energy, appetite, depression, anxiety, mood, SI/HI
Include family
Obtain med history
Summarize and ask for feedback

Question 11

Psychosocial hx

Answer 11

Perception of own health, beliefs about illness and wellness

Activity/leisure activites (how they pass time)

Use of substances and hx of it

Client stress level and coping ability
Coping strategies and support system

Question 12

Cultural beliefs and practice

Answer 12

Assess their beliefs.
Assess cultural factors and how they can impact care

Nurse stay away from stereotyping and stigmatizing

Use trained interpreter

Question 13

Spiritual and religious beliefs
Difference
Are they also the same
Assess what

Answer 13

Spirituality: internal values, sense of morality, views of purpose of life

Might not connect spiritual and religion views

Religion: according to an organized set of patterns of worship and rituals

Assess support system

Question 14

MSE LOC

Answer 14

Alert
Lethargic: drowsy
Stuporous: requires pain stimuli to respond
Comatose
Decorticate rigidity: flexion
Decerebrate rigidity: extension

Question 15

Physical appearance

Answer 15

Hygiene
Grooming
Nutritional status
Clothing choice
Looks older than their stated age

Question 16

Behavior
Important to know
Examine what
Mood vs affect

Answer 16

Important to know baseline

Exam voluntary and involuntary body movements and eye contact
(Tremors, tics, ROM, rigidity, gait, agitation, restlessness)

Mood : emotion client is feeling
Affect: objective expression of mood (facial expression)

Question 17

Mood
Definition
Place in what
Labile meaning

Answer 17

Prevalent emotional state pt tells you they feel

Placed in quotes

Labile=unstable (goes from smiling to crying)

Question 18

Affect (types,range,congruency,stability,appropriateness)

Answer 18

Types:
euthymic (normal)
dysphoric(depressed, angry)
Euphoric (elevated, anxious)

Range:
Full (normal), contricted/blunted, Flat, labile

Congruency: does it match the mood
Stability: stabile vs labile
Appropriate to situation

Question 19

Speech

Answer 19

Rate
Rhythm
Volume
Content

Question 20

Thought process

Answer 20

Rate of thoughts and how they connect and flow

Normal: tight, logical, linear, coherent, goal directed

Abnormal: not clear, organized, coherent

Question 21

Thought process examples:

Circumstantial
Tangential
Loose
Flight of ideas
Thought blocking
Perseveration
Word salad

Answer 21

Circumstantial: provides unneccesary detail but eventually gets to the point

Tangential: move from thought to thought never gets to point

Loose: illogical shifting between unrelated topics

Flight ideas: quickly moving from one idea to another

Thought blocking: thoughts are interrupted

Perseveration: repetition of words, phrases or ideas

Word salad: randomly spoken words

Question 22

Delusions

Answer 22

fixed, false beliefs firmly held despite contradictory evidence

Question 23

Control delusions

Answer 23

Outside forces are controlling actions

Question 24

Erotomanic delusions

Answer 24

A person, usually of higher status, is in love with the pt

Question 25

Grandiose delusion

Answer 25

Inflated sense of self-worth, power or wealth

Question 26

Reference delusions

Answer 26

Something happening in the environment is about them

Ex: intials RAM thinking RAM trucks are trying tog to communicate with them

Question 27

Persecutory delusions

Answer 27

Others are trying to cause harm

Question 28

Hallucinations

Answer 28

False sensory perceptions

Auditory: most common
Visual
Tactile
Gustatory
Olfactory

***need to know if it is command hallucinations for safety

Question 29

Illusions

Answer 29

Misperceive or misinterpret real stimuli

Ex: see phone cord and think its a snake

Question 30

De-realization:

Answer 30

Altered perception of the enviornment

Environment feels strange

Question 31

Depersonalization

Answer 31

Altered perception of the self

Feeling outside the body

Question 32

Cognitive and intellectual abilities (4)

Answer 32

Assess:

Orientation to time, person and place

Memory

Ability to think abstractly: interpret cliche (a bird in the hand is worth two in the bush)

(Judgment) based on answers to hypothetical questions:
What would you do if there were a fire in your room?

Question 33

Insight vs judgement

Answer 33

Insight:
Awareness of one’s own illness or situation

Judgement:
Ability to anticipate the consequences of ones behavior and make decisions to safeguard your well being

Question 34

MMSE
SLUMS
Wong Baker FACES

Answer 34

MMSE:
Mini-mental state examination

SLUMS:
Saint Louis University Mental Status Exam

Wong Baker FACES:
Pain assessment