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Health and Illness Concepts II Nursing: N2310 > Psychiatric/Mental Health (Exam Three) > Flashcards

Psychiatric/Mental Health (Exam Three) Flashcards

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1
Q

In psychiatry, work with clients and families often takes the form of _______.

A

Groups

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2
Q

In what setting do clients tend to learn from each other?

A

Group setting

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3
Q

A collection of individuals whose association is founded on commonalities of interest, values, norms, or purpose is known as what?

A

Group

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4
Q

List the eight different functions that groups serve for their members.

A
  • Socialization
  • Support
  • Task completion
  • Camaraderie
  • Information sharing
  • Normative influence
  • Empowerment
  • Governance
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5
Q

Which group function assists group members in gaining a feeling of security?

A

Support

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6
Q

T/F: Groups may serve more than one function and usually serve different functions for different members of the group.

A

True

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7
Q

Which three types of groups do nurses most often participate?

A
  • Task groups
  • Teaching groups
  • Supportive/therapeutic groups
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8
Q

What is the goal and the focus of task groups?

A
  • Goal: accomplish a specific outcome or task

- Focus: solving problems and making decisions to achieve the goal

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9
Q

In which group might conflict be smoothed over or ignored in order to focus on the priority at hand?

A

Task groups

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10
Q

List the types of teaching groups in which nurses may be involved?

A
  • Medication education
  • Childbirth education
  • Breast self-examination
  • Parenting classes
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11
Q

A form of psychosocial treatment in which several clients meet together with a therapist for purposes of sharing, gaining personal insight, and improving interpersonal coping strategies is known as what?

A

Group therapy

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12
Q

Leaders of group therapy generally require what?

A

Advanced degrees

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13
Q

Leaders of group therapy and therapeutic groups must be knowledgeable about ________ ________ and _______ _________.

A
  • Group processes

- Group content

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14
Q

Which type of group is run by members, and the leadership often rotates from member to member?

A

Self-help groups

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15
Q

Alcoholics Anonymous, Weight Watchers, Reach to Recovery, and Adult Children of Alcoholics are all examples of what type of groups?

A

Self-help groups

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16
Q

A patient expresses a desire to begin attending the self-help group Alcoholics Anonymous (AA). Which nursing response gives the patient pertinent information about this type of group?
A. In this type of group, membership is always within a fixed time frame
B. Group members receive comfort and advice from others undergoing similar experiences
C. The purpose of this type of group is to convey information to a number of individuals
D. The function of this group is to accomplish a specific outcome

A

B. Group members receive comfort and advice from others undergoing similar experiences

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17
Q

What amount of group members provides a favorable climate for optimal group interaction and relationship development?

A

7 or 8 members

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18
Q

________ _________ are those in which members leave and others join at any time while the group is active.

A

Open groups

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19
Q

Closed groups are comprised of what type of individuals?

A

Those with common issues or problems they wish to address

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20
Q

Provide an example of a closed group.

A

Grief group

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21
Q

By observing the progress of others in a group with similar problems, a group member garners hope that their problems can also be resolved. Which curative factor does this describe?

A

Instillation of Hope

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22
Q

Describe the curative factor universality.

A

Individuals come to realize they are not alone in their current problems, thoughts, or feelings

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23
Q

Describe the curative factor altruism.

A

Individuals assist and support each other, helping create a positive self-image and promote self-growth

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24
Q

Through interaction with and feedback from other group members, individuals are able to correct maladaptive social behaviors and learn and develop new social skills. Which curative factor does this describe?

A

Development of socializing techniques

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25
Q

Describe the curative factor catharsis.

A

Group members can express both positive and negative feelings

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26
Q

Describe the curative factor imparting of information.

A

Group members share their knowledge with each other

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27
Q

List expectations or responsibilities of the group leader during Phase 1: Initial/Orientation phase of group development.

A
  • Establish rules of the group
  • Ensure that the rules do not interfere with the goals of the group
  • Emphasize the need for and importance of maintaining confidentiality within the group
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28
Q

In what phase of group development are group members complementary to the leader and compete for different positions within the group?

A

Phase 1: Initial/Orientation phase

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29
Q

The leader becomes less of a leader and more of a facilitator during the ________ phase.

A

Working

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30
Q

During what phase of group development is trust established amongst is members?

A

Phase II: Middle/Working phase

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31
Q

Problem-solving and decision-making occur during which phase of group development?

A

Phase II: Middle/Working phase

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32
Q

What is the goal of the nurse during Phase III: Final/Termination phase of group development?

A

Guide the members in processing their feelings about termination of the group

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33
Q

What type of feelings are often triggered for members during Phase III: Final/Termination phase of group development?

A
  • Abandonment

- Grief

34
Q

Which leadership style conveys the message, “We will do it my way, my way is best” and solely focuses on the leader?

A

Autocratic leadership

35
Q

Productivity is high, but morale is low with which type of leadership?

A

Autocratic leadership

36
Q

Democratic leadership style focuses on the _________ of the group.

A

Members

37
Q

Members are encouraged to participate fully in solving problems that affect the group, including taking action to effect change. This describes which type of leadership style?

A

Democratic leadership

38
Q

Productivity is low and morale is low with which type of leadership?

A

Laissez-faire leadership

39
Q

In which leadership style are no decisions made, no problems solved, and no action taken?

A

Laissez-faire leadership

40
Q

Describe the task role of orienter within a group.

A

Maintains direction

41
Q

Describe the task role of coordinator within a group.

A
  • Foster relationships

- Clarifies ideas and suggestions

42
Q

Describe the maintenance role of gatekeeper within a group.

A
  • Encourages acceptance

- Encourages participation

43
Q

Describe the personal role of aggressor within a group.

A
  • Express negativism
  • Express hostility
  • Use sarcasm to degrade others
44
Q

Describe the personal role of recognition seeker within a group.

A

Talks about personal accomplishments to gain attention for self

45
Q

Describe the personal role of dominator within a group.

A
  • Manipulates others to gain control

- Behaves in authoritarian manner

46
Q

Describe the personal role of monopolizer within a group.

A

Maintains control of group by dominating conversation

47
Q

Which roles contribute to the success or effectiveness of the group?

A
  • Task role

- Maintenance role

48
Q

___________ roles satisfy the needs of the individual member.

A

Personal

49
Q

Describe the roles of group members in a psychodrama.

A
  • Patients become “actors” in life-situation scenarios
  • Patient is the protagonist
  • Group members are the audience
  • Group members may play the roles of people with whom the protagonist has unresolved issues
50
Q

What is the purpose of a psychodrama?

A

Provide the patient with a safe place to confront unresolved conflicts to progress towards a resolution

51
Q

List therapeutic groups that may only be lead by an APRN or a physician.

A
  • Psychotherapy

- Psychodramatists

52
Q

The psychiatric nurse considers this a key factor when it comes to interacting with patients and milieu therapy.

A

Every interaction is an opportunity for a therapeutic interaction

53
Q

Describe a milieu.

A
  • Group of people sharing the same space

- What occurs on a daily basis within the group atmosphere

54
Q

A scientific structuring of the environment in order to effect behavioral changes and improve the psychological health and functioning of the individual is known as what?

A

Milieu therapy

55
Q

In which settings or for which individuals has milieu therapy proved to be successful?

A
  • Prison setting

- Schizophrenia patients

56
Q

What is the nurses role in a milieu setting?

A

Manager of the milieu

57
Q

List conditions that promote a therapeutic community.

A
  • Containment
  • Structure
  • Involvement
  • Support
  • Validation
58
Q

Within the milieu, how are medications administered to patients?

A
  • Patients required to ask for medications

- Patients required to retrieve their medications at appropriate time

59
Q

List members of the disciplinary team.

A
  • Psychiatrist
  • Clinical psychologist
  • Psychiatric clinical nurse specialist
  • Psychiatric nurse
  • Mental health technician
  • Psychiatric social worker
  • Occupational therapist
  • Recreational therapist
  • Art/Music therapist
  • Dietitian
  • Chaplain
60
Q

The essence of patient centered care emphasizes what two aspects?

A
  • Patient involvement

- Patient decision-making authority

61
Q

List the nursing interventions for establishing a therapeutic milieu.

A
  • Orientating new patient to environment
  • Explaining his/her rights and responsibilities within the milieu
  • Explain structured activities
  • Explain any limits or restrictions needed to maintain safety
62
Q

List the nurses responsibilities within a milieu.

A
  • Medication administration
  • Development of one-on-one relationship
  • Setting limits on behavior
  • Patient education
63
Q

List concrete statements that are aimed at developing trust between the patient and the nurse.

A
  • “If you are frightened, I will stay with you”
  • “If you are cold, I will bring you a blanket”
  • “If you are thirsty, I will bring you a drink of water”
64
Q

_____________ in enforcing the consequences of violating the established limits is essential for learning to be reinforced.

A

Consistency

65
Q

List Skinners seven basic assumptions on which a therapeutic community is based.

A
  • Individual health is to be realized and encouraged to grow
  • Every interaction is an opportunity for therapeutic intervention
  • Patient owns his or her environment
  • Each patient owns his or her behavior
  • Peer pressure is a useful and powerful tool
  • Inappropriate behaviors are death with as they occur
  • Avoid restrictions and punishments
66
Q

Any stressful situation can precipitate a _________.

A

Crisis

67
Q

A sudden event in ones life that disturbs homeostasis during which the usual coping mechanisms cannot resolve the problem is referred to as what?

A

Crisis

68
Q

List the five characteristics of a crisis according to Aguilera and Caplan.

A
  • Occur in all individuals at some time or another
  • Precipitated by specific, identifiable events
  • Personal in nature
  • Acute events
  • Contains potential for psychological growth or deterioration
69
Q

Describe the four phases in the development of a crisis according to Caplan.

A
  • Individual is exposed to a precipitating stressor
  • If previous problem-solving techniques do not resolve the stressor, anxiety increases
  • All internal and external resources are used to resolve the problem and relieve the discomfort
  • If resolution does not occur in the previous phases, major disorganization of the individual occurs and results are drastic
70
Q

Aguilera spoke of three ______ _________ that affect how an individual perceives and responds to a precipitating stressor.

A

Balancing factors

71
Q

Describe Aguilera’s three balancing factors on whether individuals will experience a crisis in response to stressful situations.

A
  • Individual’s perception of the event
  • Availability of situational supports
  • Availability of adequate coping mechanisms
72
Q

List Baldwin’s six classes of emotional crisis.

A
  • Dispositional crisis
  • Crises of anticipated life transitions
  • Crises resulting from traumatic stress
  • Maturational/developmental crisis
  • Crises reflecting psychopathology
  • Psychiatric emergencies
73
Q

Provide an example of a dispositional crisis.

A
  • Individual who is having difficulties at work, exploded at home and becomes abusive to his wife and child
  • Wife takes the child to the ED, not knowing what else to do
74
Q

Provide an example of a crises of anticipated life transitions.

A

A college student is placed on probationary status because of his failing grades due to having to work overtime to support his wife and new baby

75
Q

Provide an example of a crises resulting from traumatic stress.

A
  • A waitress is abducted by armed men, raped, and beaten

- She can no longer be alone, is constantly fearful, has flashbacks and dreams, and is unable to eat, sleep, or work

76
Q

Provide an example of a maturational/developmental crises.

A

A new mother who is overwhelmed by life may threaten to leave her child and partner because she is unable to cope

77
Q

Individuals with what preexisting psychopathology’s are at an increased risk for having crises reflecting psychopathology?

A
  • Personality disorders
  • Anxiety disorders
  • Bipolar disorders
  • Schizophrenia
78
Q

Provide an example of a crises reflecting psychopathology.

A
  • A women diagnosed with bipolar is informed that her therapist will be moving and she will need to seek out a new therapist
  • As a result the woman wanders into traffic of a busy expressway
79
Q

List examples of a psychiatric emergency.

A
  • Acute suicide risk
  • Drug overdose
  • Reactions to hallucinogenic drugs
  • Acute psychoses
  • Uncontrollable anger
  • Alcohol intoxication
80
Q

What is the primary goal of crisis intervention?

A
  • Resolution of an immediate crisis
  • Restore functioning
  • Enhance personal growth
81
Q

List questions a nurse in crisis intervention might ask during the assessment phase?

A
  • “Can you describe the crisis?”
  • “Have you experienced this crisis before? What type of coping methods did you use?”
  • “Have you tried any coping methods for this crisis?”
  • “How did previous coping methods work?”
82
Q

List considerations a crisis nurse might make during the planning of therapeutic interventions.

A
  • Type of crisis
  • Individuals strengths
  • Desired choices
  • Available resources

Health and Illness Concepts II Nursing: N2310 (10 decks)

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