Psych

Question 1

What are the ethical principles? (5)

Answer 1

1. Autonomy- their decision
2. Beneficence- one’s duty to benefit or promote the good of others
3. Nonmaleficence- do no harm to their clients, either intentionally or unintentionally
4. Justice- treated equally regardless of race, sex, marital status, medical diagnosis, social standing, economic level, or religious belief
5. Veracity- one’s duty to always be truthful

Question 2

What is the first stage of grief?

Answer 2

Denial-“No, it cant be true!”

Question 3

What is the second stage of grief?

Answer 3

Anger- “Why me?” or “It’s not fair!”

Question 4

What is the third stage of grief?

Answer 4

Bargaining- “If God will help me get through this, i’ll go to church every sunday.”

Question 5

What is the fourth stage of grief?

Answer 5

Depression- Full impact of loss is experienced.

Question 6

What is the fifth stage of grief?

Answer 6

Acceptance- Peace. Quiet expectation and resignation.

Question 7

What is the role of confidentiality in psychiatric nursing?

Answer 7

Must adhere to HIPAA laws. Only exception is if the client plans to cause harm to himself or others (duty to warn).

Question 8

How is milieu therapy structured? (6)

Answer 8

1. The health of the client is encouraged to grow
2. Every interaction is an opportunity for therapeutic interventions
3. The client must own responsibility for his own environment and behaviors
4. Peer pressure is a powerful tool
5. Inappropriate behaviors are dealt with as they occur.
6. Restrictions ad punishment are to be avoided.

Question 9

What do you do when a client acts out?

Answer 9

1. Remain calm and talk down “I see your angry, lets talk about it “.
2. Set verbal limits on behavior.
3. Don’t touch client
4. Be a good role model.
5. Help the client determine true source of anger and help him find alternate ways to release tension.

Question 10

How do AIDS affect a patient cognitively?

Answer 10

As AIDS progresses, dementia gets worse.

Question 11

What are 2 characteristics of paranoia?

Answer 11

1. Extreme suspiciousness

2. Delusions and hallucinations of a threatening nature.

Question 12

Whats important when you come to a question asking about cognitive symptoms?

Answer 12

Do not pick out a physical symptom!

Question 13

Nursing interventions for a client with generalized anxiety disorder: (4)

Answer 13

1. Low stimuli environment
2. Stay with client to promote safety and reassurance
3. Use simple and clear speech.
4. Teach S/S of escalating anxiety and ways to interrupt that process (i.e relaxation techniques).

Question 14

Nursing interventions for anorexia nervosa: (3)

Answer 14

1. Weigh client daily immediately upon arising and following first voiding. Strict I&O.
2. Help develop realistic body image (perfection is impossible).
3. Encourage a food diary

Question 15

Guidelines for using restraints (3)

Answer 15

1. In emergency, restraints/seclusion may be used with no order but within one hour an order must be obtained.
2. Must be reordered every: 4 hrs. for adults; 2 hrs. ages 9-17; and every hour children younger than 9.
3. Client must be assessed every 10-15 mins for circulation, respiration, nutrition, hydration, and elimination.

Question 16

Nursing diagnosis for a patient with conduct disorder: (4)

Answer 16

1. Risk for others directed violence
2. Impaired social interaction
3. Defensive coping
4. Low self-esteem

Question 17

Post-trumatic stress disorder nursing diagnosis. (2)

Answer 17

1. Post-trama syndrome related to distressing event outside rage of usual human experience.
2. Complicated grieving related to loss of self as perceived before trauma.

Question 18

Most important discharge teaching for a psychiatric patient?

Answer 18

Referral to support groups in his community

Question 19

Highest risk for suicide? (8)

Answer 19

1. Over 50
2. Males
3. Whites
4. Single, divorced, or widowed
5. Upper and lowest class (greater risk than middle class)
6. Health care professionals / business executives / police / attorneys / mechanics.
7. Protestants.
8. Individual or family history of suicide.

Question 20

Short-term goal for body dysmorphic disorder:

Answer 20

Client will verbalize understanding that changes in bodily structure or function are exaggerated out of proportion to what actually exists.

Question 21

How to respond to a patient with dementia?

Answer 21

1. Don’t cut them off or ignore them.

2. Let them expressive themselves

Question 22

Lorazepam (Ativan): Use? Important info?

Answer 22

1. Used for anxiety.
2. Don’t use if lactating
3. SE: Dizzy, lethargic, GI upset, dependence.

Question 23

Lithium carbonate: Use? Important info?

Answer 23

• serum levels are drawn 12 hours after taking dose
  1. Mood stabilizer for bipolar disorder
  2. Anti-cholinergic effects and GI upset, Polyuria and dehydration, Weight gain
  3. Fine hand tremors

Question 24

Side effects of Haloperidol (Haldol):

Answer 24

Lowers seizure threshold. Dry mouth, blurred vision, orthostatic Hypo., Extrapyramidal symptoms, sedation.