Module 1 Exam Blueprint Flashcards
1
Q
What part of the brain controls voluntary body movement
A
frontal lobes
2
Q
What portion of the brain may be injured if the patient experiences changes to mood and character
A
frontal lobes
3
Q
in clients with schizophrenia, they would have ______ activity in frontal lobes (increased or decreased)
A
decreased
4
Q
Which portion of the frontal lobes plays a role in regulation and adaption of emotions
A
prefrontal cortex
5
Q
the frontal lobes can cause what two things to become affected?
A
morality ; conflict resolution
6
Q
Which lobe of the brain handles somatosensory input?
A
parietal lobes
7
Q
examples of somatosensory input
A
touch, pain, pressure, taste, temperature, perception of body position, visceral sensations
8
Q
Language interpretation is associated with the ____ hemisphere of the ____ lobe
A
left ; parietal
9
Q
How is interpretation of sensory-perceptual information made in the parietal lobes
A
contain associations of fibers linked to primary sensory areas
10
Q
The upper anterior of the temporal lobes is involved in
A
auditory functions
11
Q
the lower part of the temporal lobe is dedicated to
A
short term memory
12
Q
Impulses carried by the olfactory nerves end in the?
A
temporal lobes
13
Q
Through limbic connections, the temporal lobes play a role in
A
expression of emotions
14
Q
The temporal lobes can also be involved in?
A
language interpretation
15
Q
Which lobe is the primary area of visual reception and interpretation
A
occipital lobe
16
Q
The occipital lobes give us the ability to
A
judge spatial relationships such as distance and see in three dimensions
17
Q
Visual processing by the occipital lobes also affects
A
language interpretation
18
Q
Which part of the brain is associated with regulation of emotions
A
limbic system
19
Q
What are the big three components of the limbic system we should know
A
amygdala, hypothalamus, thalamus
20
Q
The limbic system controls what three functions?
A
autonomic , endocrine , and somatic functions
21
Q
Those that have panic disorders/ PTSD will have overstimulation of this portion of the brain
A
amygdala
22
Q
The limbic system is also known as the ?
A
emotional brain
23
Q
How does the hypothalamus regulate the autonomic nervous system
A
hormone production and release from pituitary gland
24
Q
What section of the brain regulates appetite, temperature, thirst, blood pressure, and circadian rhythm?
A
hypothalamus
25
what structure of the limbic system is involved in signaling the cortex of motivationally significant stimuli
amygdala
26
What does the thalamus do?
integrates all sensory input EXCEPT smell and blocks minor sensations to maintain focus on one thing
27
What structure of the brain can be used to determine if someone is brain dead
medulla
28
Functions of the medulla include regulation of?
heart rate, blood pressure, respiration
29
What portion of the brain contains reflex centers for swallowing, sneezing, coughing, and vomiting
medulla
30
When giving psychotropic drugs, the goal is to effect the
neurotransmitters
31
Neurotransmitters can both ____ and ___ responses
inhibit and excite
32
Where are neurotransmitters stored
axon terminals
33
Norepinephrine activates the _____ ___ _____ response
flight or fight
34
What does dopamine regulate
movement and coordination, emotions, voluntary decision making, inhibits release of prolactin (milk production)
35
Decreased levels of dopamine are associated with
Parkinson's disease and depressionIn
36
Increased levels of dopamine are associated with
mania and schizophrenia
37
What neurotransmitter is thought to have a role in addiciton
dopamineD
38
Dopamine is inactivated by
MAO and COMT
39
What functions does serotonin play a role in
sleep, arousal, libido, appetite, mood, aggression, pain
40
Serotonin modules
intense emotional states
41
Serotonin is implicated in
anxiety states, depression, schizophrenia
42
Serotonin is catabolized by
MAO
43
Serotonin vs Dopamine
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"
44
What is beneficence
the quality of doing good, can be described as charity
45
What is justice?
fair and equal treatment for all
46
What is veracity?
one's duty to always be truthful
47
What is autonomy
individuals have the right to make independent choices
48
What is nonmaleficence
to not harm clients either intentionally or unintentionally
49
What is an ethical dilemma
requires the nurse to make a choice between two equally balanced alternatives
50
When dealing with an ethical dilemma, taking no action is considered?
taking an action
51
Hospitals have a formal committee to explore and analyze
ethical issues from several points
52
during an ethical dilemma, evidence exists to support
both moral rightness and moral wrongness
53
Patients have a right to refuse treatment unless
immediate intervention is required to prevent death or harm to another person
54
What are requirements for a client to be involuntarily hospitalized
at risk of harm to themselves or others and do not recognize the severity
55
to protect client rights, specific criteria must be met to ensure what?
involuntary hospitalization is justified
56
In an emergency case, can sedative medicine be administered without consent?
yes
57
For a sedative medication to be administered without consent, must requirements must be met
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
58
can a psychiatric hospital deny a client treatment once hospitalized?
No
59
the AHA client bill of rights:
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
60
Do clients have right to least restrictive treatment alternative
yes
61
Should clients who can be adequately treated in an outpatient setting be hospitalized?
NO
62
IF clients who can be adequately treated in an outpatient setting are hospitalized, what should we ensure
they are not sedated, restrained, or secluded
63
What does right to least restrictive treatment mean?
we will try other de-escalation techniques before placing in restraints/using sedatives
64
What are examples of de-escalation we can use?
dim lights, get a sitter, distract them
65
What is tort law?
violation of a civil law in which an individual has been wronged
66
What is an example of an intentional tort
touching someone without their permission (assault, battery, false imprisonment)
67
What are examples of unintentional torts?
malpractice and negligence
68
What individuals have a right to observe client or look at medical information
only those involved in the client's medical care
69
What is known as 'breaking the glass' in an EHR
gaining access to a restrictive medical record
70
What act protects clients medical records
HIPAA
71
Can pertinent medical history be released without consent in a life-threatening situation
yes
72
What is the Doctrine of Protection. Who does it apply to?
transfer of information between psychiatrists and attorneys for legal purposes
73
What is the only exception to breaking confidentiality
A duty to warn
74
What criteria meet the Duty to Warn law?
someone expresses they are going to harm someone else. (notifying police may be necessary)
75
the nurse may be considered __ if she does not report under the Duty to Warn law
negligent
76
When giving an informed consent, who speaks and who witnesses the signature?
provider speaks, nurse witnesses
77
If an individual is deemed incompetent, consent is obtained from?
a legal guardian
78
IF client is psychotic, unconscious, inebriated, consent is obtained from?
nearest relative or court appointed conservator
79
what does an informed consent include?
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
What is the definition of restraint
any manual method or medication used to restrict a client's freedom of movement
81
What is seclusion
a type of physical restraint in which client is confined in a room and unable to leave
82
During an emergency, the client has a right to freedom from
restraint or seclusion
83
Is a trial release legal?
NO
84
Can we put clients in a restraint if it is an emergency
yes, must obtain order afterwards
85
What is a ligature risk?
something that could be used to hang themselves (ex is curtain)
86
When our client is on restraints and needs to toilet, eat, or drink, we should remove them?
one at at time
87
What is false imprisonment
deliberate and unauthorized confinement of a confident person by mechanical restraints or chemical restraints
88
What criteria must be met for involuntary hospitalization?
dangerous to themselves, danger to others, unable to take care of their basic needs
89
What is involuntary outpatient commitment
court ordered mechanism used to compel a person with mental illness to submit to treatment on an outpatient basis
90
For involuntary outpatient commitment, the person must NOT be
legally comittable to a hospital or dangerous
91
What are the four requirements for involuntary outpatient commitment?
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
What is negligence?
failure to exercise the care towards others that a reasonable person would
93
what is malpractice
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
What is a breach of duty?
when someone of your same job explains what they would have done if given the same scenaro
95
When shared client information is detrimental to their reputation, malicious and false, the healthcare worker can be liable for
defamation of character
96
What is libel?
defamation in writing
97
What is slander
oral defamation
98
What is the invasion of privacy lawsuit
charge that may result when an individual is searched without probable cause
99
What is an assault lawsuit
an act that results when a person is threatened to receive bodily harm
100
What is a battery charge
an act that is the nonconsensual touching of another person (actually receiving bodily harm)
101
When an individual receives treatment against their wishes (outside of an emergency situation), can charges be filed
yes
102
Can charges be filed without someone receiving bodily harm
yes
103
What are boundary violations
actions that overstep the established boundaries to meet the needs of the nurse
104
Can a nurse take personal food from a patient or their family
NO, they can share it with everyone
105
What is the priority task in relationship development
establishing rapport
106
Establishing rapport may be accomplished by discussing
non-healthcare related topics
107
What is the role of the nurse in relationship development?
108
What is transference?
client unconsciously displaces to the nurse feelings formed toward a person from their past
109
What is countertransference?
nurse transfers feelings about past experiences or people onto the client
110
What does SOLER stand for?
sitting, open posture, leaning towards patient, eye contact, relax (make patient feel relaxed)
111
What is informal hospitalization
client is free to leave at any time
112
What is voluntary hospitalization
client or guardian chooses admission
113
What is temporary emergency admission?
client is admitted "against their will" due to inability to make care decisions
114
What pneumonic can be used to remember the components of the Mental status examination?
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
What symptoms can we see with 'Perceptual disturbances' on the MSE
illusions, auditory and visual hallucinations, depersonalization, derealization
116
'Recent memory' on the MSE addresses the individual's ability to
remember the past few days
117
'Remote memory' on the MSE addresses the individual's ability to
remember occurrences of the distant past
118
'Confabulation' on the MSE means that memory
is being filled with experiences that have no basis in fact
119
auditory hallucinations
hearing things
120
visual hallucinations
seeing things
121
tactile hallucinations
feelings things on skin that aren't there
122
olfactory hallucinations
smelling things that aren't there
123
gustatory hallucinations
tasting things not in their mouth
124
What are illusions? (a type of perceptual disturbance)
seeing something but thinking its something else
125
What is depersonalization (type of perceptual disturbance)
feeling outside of their body ; visualizing themselves from afar
126
What is derealization (a type of perceptual disturbance0
environment feeling unreal or changed
127
What is tangential thought process (for MSE)
lengthy responses, never reach an intended point
128
What is circumstantial thought process (for MSE)
lengthy and tedious responses, numerous details, delayed in reaching intended point
129
What is perseveration thought process (part of MSE)
repetition of words or phrases not socially appropriate
130
What is flight of ideas thought process (part of MSE)
verbalizations are continuous and rapid, flow from one to another
131
What is neologism thought process (part of MSE)
making up nonsensical words that only have meaning to them
132
What is loose associations thought process (part of MSE)
verbalizations shift from one unrelated topic to another
133
what is word salad thought process (part of MSE)
mixing words that have no relationship to each other
134
What is linear/goal directed thought process (part of MSE)
linear thoughts without straying from subject at hand
135
What is thought blocking thought process (part of MSE)
abrupt stopping of speech with no reason
136
What is incoherent thought process (part of MSE)
lack of coherent connections between thoughts
137
assertive behavior and communication promote positive self-esteem by encouraging
open and honest expression of one's own needs
138
Basic goal of assertiveness training
teach individuals to express what they feel and need without being defensive
139
Example of using assertiveness in conversation
"I don't want to stay and work an extra shift today. It is someone else's turn"
140
What is abstract thought? (on MSE)
the ability to understand a sentence beyond the literal meaning ; explain similarities between objects
141
Example of having correct abstract thinking
recognizing "its raining cats and dogs" does not literally mean cats and dogs
142
How can therapeutic groups provide socialization
allows them to connect with other members
143
How can therapeutic groups provide support
individuals feel a sense of security from the groupHow c
144
What is task completion in therapeutic groups
group works together on a task (individual couldn't do alone)
145
How can therapeutic groups have camaraderie
joy and pleasure
146
Information sharing and therapeutic groups
helps to hear other peoples stories and learn ways they can help themselves
147
What is normative influence and therapeutic groups
as they interact, they influence each other on expected norms for communication and behavior
148
How do therapeutic groups empower clients
provide improvement to individual members seeking change
149
Governance and therapeutic groups
oversight of function and activities
150
What is a therapeutic group
focus on group relationships and interactions between group members (different from group therapy)
151
Should we ever ask patients why?
no
152
How can we use exploring to encourage therapeutic communication
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
Verbal communication
stated out loud/ talking to patient
154
The SOLER acronym represents nonverbal behaviors as facilitative skills for
active listening
155
What does open posture mean
arms and legs uncrossed
156
asking why, asking irrelevant personal questions, giving approval or disapproval, offering personal opinions, giving false reassurance, and minimizing feelings are all examples of
creating barriers to effective communication
157
it's important to remember that crisis is
specific to the client
158
During crisis intervention, the focus is on managing
immediate needs of the client, minimizing negative consequences
159
mild anxiety symptoms include
increase pulse and gi upset
160
During panic, anxiety can rise causing
fight or flight to kick in
161
What three things should we monitor for emergency medical care
vital signs, maintain airway, gastric lavage/ activated charcoal
162
Goals for crisis management
stabilize condition, safety and security, restore level of function, enhance personal growth
163
Catastrophising example
"tell me in your mind what is the worst scenario. What would you do?
164
What is the point of catastrophising
guide through problem solving process
165
Example of someone who is low risk for suicide
thought about it before but not in a very long time
166
Example of someone who is high risk for suicide
thinking about suicide but has no plan
167
Example of someone who is imminent risk for suicide
note written, plan set in place
168
The more detailed a suicide plan indicates
the more imminent the risk
169
Is someone considered safe if they have SI and are in the hospital?
NO! can occur inside of the hospital
170
What should we complete on every client admitted to the hospital
a suicide risk assessment
171
What drugs are anxiolytics
benzodiazepines (valum, xanax, medazolam)
172
What drugs are antidepressants
SSRIs
173
When assessing someone for suicide and we get a gut feeling something is not right, what should we do?
believe our instinct
174
What questions can assess seriousness of intent of suicide
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
What is the highest indicator for serious suicide intent
previous attempting
176
acronym for presenting symptoms of suicide
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
For suicide interventions, it is important to create a _____ environment for the client
safe
178
For clients at risk for SI, should the nurse round at regular intervals
No
179
Anger is a warning sign for
potential threat or trauma
180
What is cycle of battering
cycle of repeated behaviors and outcomes for abuse or neglect victims
181
What are the phases of the cycle of battering?
tension building, acute battering, honeymoon
182
With each cycle, the stages of the cycle of battering become
shorter
183
If a child abuses animals or pets, this could be a sign of
physical abuse
184
Extremes in behavior, delays in emotional development, unable to develop emotional bonds are signs of
emotional absue
185
frequent absences, begging for food, lack of immunizations, body odor, insufficient clothing are indicators for
neglect
186
