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NRSE-3090 Mental Health > Module 1 Exam Blueprint > Flashcards

Module 1 Exam Blueprint Flashcards

1
Q

What part of the brain controls voluntary body movement

A

frontal lobes

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2
Q

What portion of the brain may be injured if the patient experiences changes to mood and character

A

frontal lobes

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3
Q

in clients with schizophrenia, they would have ______ activity in frontal lobes (increased or decreased)

A

decreased

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4
Q

Which portion of the frontal lobes plays a role in regulation and adaption of emotions

A

prefrontal cortex

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5
Q

the frontal lobes can cause what two things to become affected?

A

morality ; conflict resolution

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6
Q

Which lobe of the brain handles somatosensory input?

A

parietal lobes

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7
Q

examples of somatosensory input

A

touch, pain, pressure, taste, temperature, perception of body position, visceral sensations

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8
Q

Language interpretation is associated with the ____ hemisphere of the ____ lobe

A

left ; parietal

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9
Q

How is interpretation of sensory-perceptual information made in the parietal lobes

A

contain associations of fibers linked to primary sensory areas

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10
Q

The upper anterior of the temporal lobes is involved in

A

auditory functions

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11
Q

the lower part of the temporal lobe is dedicated to

A

short term memory

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12
Q

Impulses carried by the olfactory nerves end in the?

A

temporal lobes

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13
Q

Through limbic connections, the temporal lobes play a role in

A

expression of emotions

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14
Q

The temporal lobes can also be involved in?

A

language interpretation

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15
Q

Which lobe is the primary area of visual reception and interpretation

A

occipital lobe

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16
Q

The occipital lobes give us the ability to

A

judge spatial relationships such as distance and see in three dimensions

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17
Q

Visual processing by the occipital lobes also affects

A

language interpretation

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18
Q

Which part of the brain is associated with regulation of emotions

A

limbic system

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19
Q

What are the big three components of the limbic system we should know

A

amygdala, hypothalamus, thalamus

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20
Q

The limbic system controls what three functions?

A

autonomic , endocrine , and somatic functions

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21
Q

Those that have panic disorders/ PTSD will have overstimulation of this portion of the brain

A

amygdala

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22
Q

The limbic system is also known as the ?

A

emotional brain

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23
Q

How does the hypothalamus regulate the autonomic nervous system

A

hormone production and release from pituitary gland

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24
Q

What section of the brain regulates appetite, temperature, thirst, blood pressure, and circadian rhythm?

A

hypothalamus

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25
Q

what structure of the limbic system is involved in signaling the cortex of motivationally significant stimuli

A

amygdala

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26
Q

What does the thalamus do?

A

integrates all sensory input EXCEPT smell and blocks minor sensations to maintain focus on one thing

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27
Q

What structure of the brain can be used to determine if someone is brain dead

A

medulla

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28
Q

Functions of the medulla include regulation of?

A

heart rate, blood pressure, respiration

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29
Q

What portion of the brain contains reflex centers for swallowing, sneezing, coughing, and vomiting

A

medulla

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30
Q

When giving psychotropic drugs, the goal is to effect the

A

neurotransmitters

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31
Q

Neurotransmitters can both ____ and ___ responses

A

inhibit and excite

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32
Q

Where are neurotransmitters stored

A

axon terminals

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33
Q

Norepinephrine activates the _____ ___ _____ response

A

flight or fight

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34
Q

What does dopamine regulate

A

movement and coordination, emotions, voluntary decision making, inhibits release of prolactin (milk production)

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35
Q

Decreased levels of dopamine are associated with

A

Parkinson’s disease and depressionIn

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36
Q

Increased levels of dopamine are associated with

A

mania and schizophrenia

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37
Q

What neurotransmitter is thought to have a role in addiciton

A

dopamineD

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38
Q

Dopamine is inactivated by

A

MAO and COMT

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39
Q

What functions does serotonin play a role in

A

sleep, arousal, libido, appetite, mood, aggression, pain

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40
Q

Serotonin modules

A

intense emotional states

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41
Q

Serotonin is implicated in

A

anxiety states, depression, schizophrenia

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42
Q

Serotonin is catabolized by

A

MAO

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43
Q

Serotonin vs Dopamine

A

serotonin: not addictive, long term, felt above neck, generally shared with other people, tells brain “this feels good, I’ve had enough”
Dopamine: addictive, short term, felt throughout body, generally felt alone, tells brain “this feels good, I want more”

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44
Q

What is beneficence

A

the quality of doing good, can be described as charity

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45
Q

What is justice?

A

fair and equal treatment for all

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46
Q

What is veracity?

A

one’s duty to always be truthful

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47
Q

What is autonomy

A

individuals have the right to make independent choices

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48
Q

What is nonmaleficence

A

to not harm clients either intentionally or unintentionally

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49
Q

What is an ethical dilemma

A

requires the nurse to make a choice between two equally balanced alternatives

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50
Q

When dealing with an ethical dilemma, taking no action is considered?

A

taking an action

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51
Q

Hospitals have a formal committee to explore and analyze

A

ethical issues from several points

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52
Q

during an ethical dilemma, evidence exists to support

A

both moral rightness and moral wrongness

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53
Q

Patients have a right to refuse treatment unless

A

immediate intervention is required to prevent death or harm to another person

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54
Q

What are requirements for a client to be involuntarily hospitalized

A

at risk of harm to themselves or others and do not recognize the severity

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55
Q

to protect client rights, specific criteria must be met to ensure what?

A

involuntary hospitalization is justified

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56
Q

In an emergency case, can sedative medicine be administered without consent?

A

yes

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57
Q

For a sedative medication to be administered without consent, must requirements must be met

A
  1. client exhibiting behavior that is dangerous to self or others
  2. med must have a reasonable chance of providing help
  3. client must be incompetent enough to evaluate benefits of treatment
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58
Q

can a psychiatric hospital deny a client treatment once hospitalized?

A

No

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59
Q

the AHA client bill of rights:

A
  1. right to high quality care
  2. right to clean environment
  3. right to have privacy protected
  4. to get help when leaving hospital
  5. get help with billing claims
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60
Q

Do clients have right to least restrictive treatment alternative

A

yes

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61
Q

Should clients who can be adequately treated in an outpatient setting be hospitalized?

A

NO

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62
Q

IF clients who can be adequately treated in an outpatient setting are hospitalized, what should we ensure

A

they are not sedated, restrained, or secluded

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63
Q

What does right to least restrictive treatment mean?

A

we will try other de-escalation techniques before placing in restraints/using sedatives

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64
Q

What are examples of de-escalation we can use?

A

dim lights, get a sitter, distract them

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65
Q

What is tort law?

A

violation of a civil law in which an individual has been wronged

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66
Q

What is an example of an intentional tort

A

touching someone without their permission (assault, battery, false imprisonment)

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67
Q

What are examples of unintentional torts?

A

malpractice and negligence

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68
Q

What individuals have a right to observe client or look at medical information

A

only those involved in the client’s medical care

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69
Q

What is known as ‘breaking the glass’ in an EHR

A

gaining access to a restrictive medical record

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70
Q

What act protects clients medical records

A

HIPAA

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71
Q

Can pertinent medical history be released without consent in a life-threatening situation

A

yes

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72
Q

What is the Doctrine of Protection. Who does it apply to?

A

transfer of information between psychiatrists and attorneys for legal purposes

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73
Q

What is the only exception to breaking confidentiality

A

A duty to warn

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74
Q

What criteria meet the Duty to Warn law?

A

someone expresses they are going to harm someone else. (notifying police may be necessary)

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75
Q

the nurse may be considered __ if she does not report under the Duty to Warn law

A

negligent

76
Q

When giving an informed consent, who speaks and who witnesses the signature?

A

provider speaks, nurse witnesses

77
Q

If an individual is deemed incompetent, consent is obtained from?

A

a legal guardian

78
Q

IF client is psychotic, unconscious, inebriated, consent is obtained from?

A

nearest relative or court appointed conservator

79
Q

what does an informed consent include?

A
  1. treatment alternatives
  2. outcomes of alternatives
  3. why this treatment was selected
  4. possible outcomes of this treatment
  5. outcome if client declines all treatment
80
Q

What is the definition of restraint

A

any manual method or medication used to restrict a client’s freedom of movement

81
Q

What is seclusion

A

a type of physical restraint in which client is confined in a room and unable to leave

82
Q

During an emergency, the client has a right to freedom from

A

restraint or seclusion

83
Q

Is a trial release legal?

A

NO

84
Q

Can we put clients in a restraint if it is an emergency

A

yes, must obtain order afterwards

85
Q

What is a ligature risk?

A

something that could be used to hang themselves (ex is curtain)

86
Q

When our client is on restraints and needs to toilet, eat, or drink, we should remove them?

A

one at at time

87
Q

What is false imprisonment

A

deliberate and unauthorized confinement of a confident person by mechanical restraints or chemical restraints

88
Q

What criteria must be met for involuntary hospitalization?

A

dangerous to themselves, danger to others, unable to take care of their basic needs

89
Q

What is involuntary outpatient commitment

A

court ordered mechanism used to compel a person with mental illness to submit to treatment on an outpatient basis

90
Q

For involuntary outpatient commitment, the person must NOT be

A

legally comittable to a hospital or dangerous

91
Q

What are the four requirements for involuntary outpatient commitment?

A
  1. must have mental illness
  2. capable of surviving safely in the community
  3. in need of treatment in order to prevent further deterioration
  4. current mental status does not have ability to seek voluntary admission
92
Q

What is negligence?

A

failure to exercise the care towards others that a reasonable person would

93
Q

what is malpractice

A

defined as an act or conduct of a professional that does not meet competency standards and that results in provable damages to their clients

94
Q

What is a breach of duty?

A

when someone of your same job explains what they would have done if given the same scenaro

95
Q

When shared client information is detrimental to their reputation, malicious and false, the healthcare worker can be liable for

A

defamation of character

96
Q

What is libel?

A

defamation in writing

97
Q

What is slander

A

oral defamation

98
Q

What is the invasion of privacy lawsuit

A

charge that may result when an individual is searched without probable cause

99
Q

What is an assault lawsuit

A

an act that results when a person is threatened to receive bodily harm

100
Q

What is a battery charge

A

an act that is the nonconsensual touching of another person (actually receiving bodily harm)

101
Q

When an individual receives treatment against their wishes (outside of an emergency situation), can charges be filed

A

yes

102
Q

Can charges be filed without someone receiving bodily harm

A

yes

103
Q

What are boundary violations

A

actions that overstep the established boundaries to meet the needs of the nurse

104
Q

Can a nurse take personal food from a patient or their family

A

NO, they can share it with everyone

105
Q

What is the priority task in relationship development

A

establishing rapport

106
Q

Establishing rapport may be accomplished by discussing

A

non-healthcare related topics

107
Q

What is the role of the nurse in relationship development?

A
108
Q

What is transference?

A

client unconsciously displaces to the nurse feelings formed toward a person from their past

109
Q

What is countertransference?

A

nurse transfers feelings about past experiences or people onto the client

110
Q

What does SOLER stand for?

A

sitting, open posture, leaning towards patient, eye contact, relax (make patient feel relaxed)

111
Q

What is informal hospitalization

A

client is free to leave at any time

112
Q

What is voluntary hospitalization

A

client or guardian chooses admission

113
Q

What is temporary emergency admission?

A

client is admitted “against their will” due to inability to make care decisions

114
Q

What pneumonic can be used to remember the components of the Mental status examination?

A

A appearance/behavior
S speech
E emotion (mood and affect)
P perception (auditory/visual hallucinations)
T thought content (suicidal/homicidal) and process
I insight and judgement
C cognition

115
Q

What symptoms can we see with ‘Perceptual disturbances’ on the MSE

A

illusions, auditory and visual hallucinations, depersonalization, derealization

116
Q

‘Recent memory’ on the MSE addresses the individual’s ability to

A

remember the past few days

117
Q

‘Remote memory’ on the MSE addresses the individual’s ability to

A

remember occurrences of the distant past

118
Q

‘Confabulation’ on the MSE means that memory

A

is being filled with experiences that have no basis in fact

119
Q

auditory hallucinations

A

hearing things

120
Q

visual hallucinations

A

seeing things

121
Q

tactile hallucinations

A

feelings things on skin that aren’t there

122
Q

olfactory hallucinations

A

smelling things that aren’t there

123
Q

gustatory hallucinations

A

tasting things not in their mouth

124
Q

What are illusions? (a type of perceptual disturbance)

A

seeing something but thinking its something else

125
Q

What is depersonalization (type of perceptual disturbance)

A

feeling outside of their body ; visualizing themselves from afar

126
Q

What is derealization (a type of perceptual disturbance0

A

environment feeling unreal or changed

127
Q

What is tangential thought process (for MSE)

A

lengthy responses, never reach an intended point

128
Q

What is circumstantial thought process (for MSE)

A

lengthy and tedious responses, numerous details, delayed in reaching intended point

129
Q

What is perseveration thought process (part of MSE)

A

repetition of words or phrases not socially appropriate

130
Q

What is flight of ideas thought process (part of MSE)

A

verbalizations are continuous and rapid, flow from one to another

131
Q

What is neologism thought process (part of MSE)

A

making up nonsensical words that only have meaning to them

132
Q

What is loose associations thought process (part of MSE)

A

verbalizations shift from one unrelated topic to another

133
Q

what is word salad thought process (part of MSE)

A

mixing words that have no relationship to each other

134
Q

What is linear/goal directed thought process (part of MSE)

A

linear thoughts without straying from subject at hand

135
Q

What is thought blocking thought process (part of MSE)

A

abrupt stopping of speech with no reason

136
Q

What is incoherent thought process (part of MSE)

A

lack of coherent connections between thoughts

137
Q

assertive behavior and communication promote positive self-esteem by encouraging

A

open and honest expression of one’s own needs

138
Q

Basic goal of assertiveness training

A

teach individuals to express what they feel and need without being defensive

139
Q

Example of using assertiveness in conversation

A

“I don’t want to stay and work an extra shift today. It is someone else’s turn”

140
Q

What is abstract thought? (on MSE)

A

the ability to understand a sentence beyond the literal meaning ; explain similarities between objects

141
Q

Example of having correct abstract thinking

A

recognizing “its raining cats and dogs” does not literally mean cats and dogs

142
Q

How can therapeutic groups provide socialization

A

allows them to connect with other members

143
Q

How can therapeutic groups provide support

A

individuals feel a sense of security from the groupHow c

144
Q

What is task completion in therapeutic groups

A

group works together on a task (individual couldn’t do alone)

145
Q

How can therapeutic groups have camaraderie

A

joy and pleasure

146
Q

Information sharing and therapeutic groups

A

helps to hear other peoples stories and learn ways they can help themselves

147
Q

What is normative influence and therapeutic groups

A

as they interact, they influence each other on expected norms for communication and behavior

148
Q

How do therapeutic groups empower clients

A

provide improvement to individual members seeking change

149
Q

Governance and therapeutic groups

A

oversight of function and activities

150
Q

What is a therapeutic group

A

focus on group relationships and interactions between group members (different from group therapy)

151
Q

Should we ever ask patients why?

A

no

152
Q

How can we use exploring to encourage therapeutic communication

A

we can ask them “please explain that situation in more detail” to gather more information. This allows the patient to develop awareness and understanding

153
Q

Verbal communication

A

stated out loud/ talking to patient

154
Q

The SOLER acronym represents nonverbal behaviors as facilitative skills for

A

active listening

155
Q

What does open posture mean

A

arms and legs uncrossed

156
Q

asking why, asking irrelevant personal questions, giving approval or disapproval, offering personal opinions, giving false reassurance, and minimizing feelings are all examples of

A

creating barriers to effective communication

157
Q

it’s important to remember that crisis is

A

specific to the client

158
Q

During crisis intervention, the focus is on managing

A

immediate needs of the client, minimizing negative consequences

159
Q

mild anxiety symptoms include

A

increase pulse and gi upset

160
Q

During panic, anxiety can rise causing

A

fight or flight to kick in

161
Q

What three things should we monitor for emergency medical care

A

vital signs, maintain airway, gastric lavage/ activated charcoal

162
Q

Goals for crisis management

A

stabilize condition, safety and security, restore level of function, enhance personal growth

163
Q

Catastrophising example

A

“tell me in your mind what is the worst scenario. What would you do?

164
Q

What is the point of catastrophising

A

guide through problem solving process

165
Q

Example of someone who is low risk for suicide

A

thought about it before but not in a very long time

166
Q

Example of someone who is high risk for suicide

A

thinking about suicide but has no plan

167
Q

Example of someone who is imminent risk for suicide

A

note written, plan set in place

168
Q

The more detailed a suicide plan indicates

A

the more imminent the risk

169
Q

Is someone considered safe if they have SI and are in the hospital?

A

NO! can occur inside of the hospital

170
Q

What should we complete on every client admitted to the hospital

A

a suicide risk assessment

171
Q

What drugs are anxiolytics

A

benzodiazepines (valum, xanax, medazolam)

172
Q

What drugs are antidepressants

A

SSRIs

173
Q

When assessing someone for suicide and we get a gut feeling something is not right, what should we do?

A

believe our instinct

174
Q

What questions can assess seriousness of intent of suicide

A

how frequent are thoughts? do they have a plan? do they have the means to carry out the plan? how lethal is it? do they intend on carrying it out? have they attempted before?

175
Q

What is the highest indicator for serious suicide intent

A

previous attempting

176
Q

acronym for presenting symptoms of suicide

A

I ideation current and active
S substance use
P lack of purpose
A anger, rage
T trapped in situation
H hope is lacking
W withdrawn from others
A anxiety, agitation, no sleep
R reckless behavior, regardless of consequence
M mood shifts, dramatic

177
Q

For suicide interventions, it is important to create a _____ environment for the client

A

safe

178
Q

For clients at risk for SI, should the nurse round at regular intervals

A

No

179
Q

Anger is a warning sign for

A

potential threat or trauma

180
Q

What is cycle of battering

A

cycle of repeated behaviors and outcomes for abuse or neglect victims

181
Q

What are the phases of the cycle of battering?

A

tension building, acute battering, honeymoon

182
Q

With each cycle, the stages of the cycle of battering become

A

shorter

183
Q

If a child abuses animals or pets, this could be a sign of

A

physical abuse

184
Q

Extremes in behavior, delays in emotional development, unable to develop emotional bonds are signs of

A

emotional absue

185
Q

frequent absences, begging for food, lack of immunizations, body odor, insufficient clothing are indicators for

A

neglect

186
Q
A

NRSE-3090 Mental Health (3 decks)

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