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Psychiatric Mental Health > Semester 4 Exam 1 > Flashcards

Semester 4 Exam 1 Flashcards

1
Q

Promotes equality in human relationships and enables us
To act in our own best interests
To stand up for ourselves without undue anxiety
To express honest feelings comfortably
To exercise personal rights without denying the rights of others
Helps us feel good about ourselves and increases our self-esteem

A

Assertive behavior

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2
Q

Basic to assertive behavior and an accurate representation of feelings, opinions, or preferences that are expressed in a manner that promotes self-respect and respect for others

A

honesty

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3
Q

stating what one wants to convey with clarity and candor

A

direct communication

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4
Q

hinting and beating around the bush are ___ forms of communication

A

indirect

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5
Q

in accepting the 10 basic human rights an individual also accepts the ___ that accompany them

A

responsibilities

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6
Q

True or false: rights and responsibilities are reciprocal entities and to experience one without the other is inherently destructive to an individual

A

TRUE

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7
Q

individuals develop ___ of responding to others

  • Watching other people (role-modeling)
  • Being positively reinforced or punished for a certain response
  • We learn how to respond or how not to respond by the way it is received
  • Inventing a response
  • Not thinking of a better way to respond
  • Not developing the proper skills for a better response
  • Consciously choosing a response style
A

patterns

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8
Q

what are the four common response patterns

A
  • nonassertive
  • assertive
  • aggressive
  • passive-aggressive
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9
Q

individuals who use this kind of behavior seek to please others at the expense of their own basic rights
sometimes called passive

A

nonassertive

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10
Q

individuals who use this kind of behavior

  • Stand up for their own rights while protecting the rights of others.
  • Feelings are expressed openly and honestly
  • Self-respect and respect for others are maintained.
A

assertive

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11
Q

individuals who use this kind of behavior

  • Defend their own basic rights by violating the basic rights of others.
  • Feelings are often expressed dishonestly and inappropriately.
A

aggressive

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12
Q

individuals who use this kind of behavior

  • Respond to others by appearing passive and accept other’s demands while behaving in ways that suggest anger and resentment are their true feelings
  • Sometimes called indirect aggression, the behavior takes the form of passive, nonconfrontational action.
A

passive-aggressive

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13
Q

this pattern of communication is dishonest, manipulative, and sly and it undermines others with behavior that expresses the opposite of what they are feeling
This style of communication is associated with extremely low self-confidence

A

passive-aggressive

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14
Q 
Two patients disagree on what movie to watch during free activity time. One patient says to the other, “I would like to watch the comedy instead of the murder mystery.” The nurse recognizes this as which form of communication response pattern?
A. Nonassertive
B. Assertive
C. Aggressive
D. Passive-Aggressive
A

B.

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15
Q

this assertive behavioral component conveys the message that one is interested in what is being said

A

intermittent eye contact

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16
Q

this assertive behavioral component of assertive behavior includes Sitting and leaning slightly toward other person in a conversation and suggests active interest in what is being said

A

body posture

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17
Q

this assertive behavioral component of assertive behavior describes the
Appropriate physical distance is culturally determined.
Invasion of personal space may be interpreted by some individuals as aggressive.

A

distance/physical contact

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18
Q

this assertive behavioral component of assertive behavior adds meaning to spoken word such as emphasis, warmth, depth, or power

A

gestures

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19
Q

this assertive behavioral component of assertive behavior can convey different messages but in assertive communication it is congruent with the verbal message

A

facial expression

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20
Q

this assertive behavioral component of assertive behavior conveys a message by its loudness, softness, amount and placement of emphasis, and evidence of emotional tone.
In assertive communication this conveys an acceptable volume to communicate confidence without being too loud or forceful

A

voice

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21
Q

A nurse is conducting an assertiveness training class. Which of the following characteristics of assertive behavior should the nurse include?
A. Eye contact should be steady and continuous.
B. Invasion of intimate space can be interpreted as assertive behavior.
C. While interacting, individuals should turn slightly away from the other person.
D. The facial expression is congruent with the verbal message.

A

D.

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22
Q

techniques that promote assertive behavior

“I have the right to express my opinion”

A

Standing up for one’s basic human rights

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23
Q

techniques that promote ___ behavior have been shown to be effective in responding to criticism and avoiding manipulation by others

A

assertive

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24
Q

techniques that promote assertive behavior

Saying I don’t want to go out with you tonight instead of saying I can’t

A

Assuming responsibility for ones own statements

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25
Q

techniques that promote assertive behavior

-assertively accepting negative aspects about oneself and admitting when an error has been made

A

agreeing assertively

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26
Q

techniques that promote assertive behavior persistently repeating in a calm voice what is wanted

A

responding as a broken record

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27
Q

techniques that promote assertive behavior

seeking additional information about critical statements

A

inquiring assertively

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28
Q

techniques that promote assertive behavior
changing the focus of the communication from discussing the topic at hand to analyzing what is actually going on in the interaction

A

shifting from content to process

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29
Q

techniques that promote assertive behavior

concurring with the critic’s argument without becoming defensive and without agreeing to change

A

clouding or fogging

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30
Q

techniques that promote assertive behavior

putting off further discussion with an angry individual until he or she is calmer

A

defusing

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31
Q

techniques that promote assertive behavior

putting off further discussion with another individual until one is calmer

A

delaying assertively

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32
Q

techniques that promote assertive behavior
Man: I bet you’re one of them so called women’s libbers aren’t you
Woman: Why yes thank you for noticing

A

Responding assertively with irony

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33
Q

techniques that promote assertive behavior

this allows an individual to take ownership for their feelings rather than saying they are caused by another person

A

using “I” statements

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34
Q

The individual practices interrupting negative thought processes with the word, “stop,” and shifting his or her thoughts to ones that are considered
Intended to eliminate intrusive, unwanted thoughts
pleasant and desirable.

A

thought-stopping techniques

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35
Q

assertive communication if part of a larger set of competencies referred to as

A

emotional intelligence

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36
Q

what are 4 sets of competencies included in emotional intelligence

A
  1. self-awareness
  2. social awareness
  3. self-management
  4. relationship management
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37
Q

what is the difference between self-concept and self-esteem

A

self-concept describes individuals’ thoughts and beliefs about themselves and self-esteem describes how individuals feel about themselves

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38
Q

what are the 3 components of self-concept

A
  • body image
  • personal identity
  • self-esteem
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39
Q

this is the cognitive or thinking component of the self that evolves through dynamic interactions in the environment and personal reflection to develop a set of beliefs about oneself

A

self-concept

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40
Q

this is the degree of regard or respect that individuals have for themselves and is a measure of worth that they place on their abilities and judgements

A

self-esteem

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41
Q

True or False

The development of self-esteem is is largely influenced by perceptions about how one is viewed by significant others

A

TRUE

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42
Q

A patient with a new ileostomy tells the nurse, “I’m disgusting. This ileostomy makes me so ugly.” Which correctly written nursing diagnosis would be appropriately assigned to address this patient’s problem?
A. Situational low self-esteem related to disturbed body image evidenced by client statement “I’m disgusting”
B. Risk for complicated grieving related to loss of normal GI function evidenced by expressions of anger
C. Disturbed thought processes related to ileostomy evidenced by altered body image
D. Anxiety related to cancer of the colon evidenced by ileostomy

A

A.

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43
Q

Individuals who had ____ stability had higher self-esteem than those who had unstable emotions

A

emotional

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44
Q

Those with a desire to be thoughtful, careful, and to do the right thing, are associated with higher self-esteem

A

conscientiousness

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45
Q

the sense that one has a control over the forces affecting ones life and can differentiate between what they can control and the things out of their control are associated with high self-esteem

A

a high sense of mastery

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46
Q

true or false

low risk taking is correlated with higher self-esteem

A

TRUE

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47
Q 
After his wife left him, the husband, diagnosed with depression, is admitted to a psychiatric unit. He states that he was proud of receiving job commendations that led to a promotion. Which condition that would affect self-esteem has contributed to the patient’s depression?
A. The lack of power
B. The lack of significance
C. The lack of virtue
D. The lack of competence
A

B.

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48
Q

Warren’s focus areas for parents and others who work with children to encourage self-esteem

  • A sense of competence
  • ___ love
  • A sense of survival
  • Realistic goals
  • A sense of responsibility
  • Reality orientation
A

unconditional

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49
Q 
A mother berates her child for breaking a cup and says, “You are bad and so destructive.” This statement discourages the development of positive self-esteem by not meeting which parenting focus as described by Warren?
A. A sense of competence
B. Unconditional love
C. A sense of survival
D. Realistic goals
A

B.

50
Q

What are Erikson’s eight transitional or maturational crises

A 
Trust versus mistrust
Autonomy versus shame and doubt
Initiative versus guilt
Industry versus inferiority
Identity versus role confusion
Intimacy versus isolation
Generativity versus stagnation
Ego integrity versus despair
51
Q

One of Erikson’s crises
Development of trust results in a feeling of confidence in the predictability of the environment
Failure to achieve this results in the person experiencing emotional dissatisfaction with the self and suspicious of others

A

Trust vs. Mistrust

52
Q

One of Erikson’s crises
The child begins active exploration and experimentation; achievement of this allows for a feeling of self-confidence in one’s ability to perform

A

autonomy vs. shame and doubt

53
Q

One of Erikson’s crises
Positive self-esteem is gained through initiative when creativity is encouraged and performance is recognized and positively reinforced
Children develop a conscience and label behaviors as good or bad

A

initiative vs. guilt

54
Q

One of Erikson’s crises
Self-confidence is gained at this stage through learning, competing, performing successfully, and receiving recognition from significant others

A

industry vs. inferiority

55
Q

One of Erikson’s crises
Positive self-esteem in adolescence occurs when individuals are allowed to experience independence by making decisions that influence their lives

A

Identity vs. role confusion

56
Q

One of Erikson’s crises
Intimacy is achieved when one is able to form a lasting relationship or a commitment to another person, a cause, institution or a creative effort

A

Intimacy vs. isolation

57
Q

One of Erikson’s crises
Generativity promotes positive self-esteem through gratification from personal and professional achievements and from meaningful contributions to others

A

Generativity vs. Stagnation

58
Q

One of Erikson’s crises
Ego integrity results in a sense of self-worth and self-acceptance as one reviews life goals, accepting that some were achieved and some were not
Individual has little desire to change how their life has progressed

A

Ego integrity vs. despair

59
Q

Behaviors that reflect low self-esteem manifest themselves according to three types of stimuli which are

A
  1. focal stimuli
  2. contextual stimuli
  3. residual stimuli
60
Q

this is the immediate concern that is causing the threat to self-esteem and the stimulus that is causing the current behavior
ex: termination of a relationship or job

A

focal stimuli

61
Q

these are all the other stimuli present in the person’s environment that contribute to the behavior being caused by the focal stimulus
ex: preoccupation with guilt about the effects a divorce may have on one’s children

A

contextual stimuli

62
Q

these are previous experiences that influence one’s maladaptive behavior in response to focal and contextual stimuli
ex: being reared in an atmosphere of ridicule and deprecation may affect current adaptation to divorce

A

residual stimuli

63
Q

define and differentiate an individual’s physical and psychological space from the physical and psychological space of others.
Sometimes referred to as limits

A

boundaries

64
Q 
these are all types of physical  \_\_\_ 
Physical closeness
Touching
Sexual behavior
Eye contact
Privacy
Pollution
A

boundaries

65
Q 
these are all types of \_\_\_ boundaries 
Beliefs
Feelings
Choices
Needs
Time alone
Interests
Confidences
Individual differences
Spirituality
A

psychological

66
Q

boundaries can be ___, ___ or ___

A

rigid, flexible, or enmeshed

67
Q

individuals who have ___ boundaries have a hard time trusting others
Occur when people have a very narrow perspective and reject new ideas of experiences

A

rigid

68
Q

healthy boundaries are __ . Individuals let go of their boundaries when appropriate and they must be aware of who is considered safe and when it is safe to let others invade their personal space

A

flexible

69
Q

These boundaries occur when two people’s boundaries are so blended together that neither can be sure where one stops and the other begins
An individual is unable to differentiate his or her wants and needs from those of the other person.

A

enmeshed

70
Q

True or false: Seclusion or restraint is discontinued as soon as possible regardless of when the order is scheduled to expire

A

TRUE

71
Q

Orders for restraint or seclusion must be renewed every __ hours for adult

A

4

72
Q

Orders for restraint or seclusion must be renewed every ___ hours for children and adolescents 9-17

A

2

73
Q

Orders for restraint or seclusion must be renewed every ___ hour for children <9

A

1

74
Q

An in-person evaluation needs to be conducted within __ hour of initiating restraint or seclusion

A

1

75
Q

TRUE OR FALSE

Anger and aggression are the same thing

A

NO

76
Q

This is an emotional state that varies in intensity from mild irritation to intense fury and rage

A

Anger

77
Q
  • this can be a behavioral response to anger intended to threaten or injure the victim’s security or self-esteem
  • response aimed at inflicting pain or injury to objects or persons
  • always designed to punish
A

Aggression

78
Q

When anger is turned inward on oneself it can result in ___ and ___-___

A

depression and low self-esteem

79
Q

when anger is expressed inappropriately it interferes with ____

A

relationships

80
Q

when anger is suppressed in can turn into ___ which manifests in negative, passive-aggressive behavior

A

resentment

81
Q

anger is a normal emotion and becomes a problem during what two scenarios

A
  1. when it is not expressed

2. when expressed aggressively

82
Q

these are the fundamental points about ___
Anger is not a primary emotion; it is learned.
Anger is physiological arousal. (it instills feelings of power)
Anger and aggression are significantly different.
The expression of anger is learned.
The expression of anger can come under personal control.

A

anger

83
Q

A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display of emotion?
A. Anger is a primary emotion that is automatically experienced.
B. Anger is a psychological arousal.
C. Expression of anger can come under personal control.
D. Expression of anger and aggression are closely related.

A

C.

84
Q
  • one of the strongest forms of learning.

- Evidence supports the role of television and video violence as a predisposing factor to later aggressive behavior.

A

role modeling

85
Q

anger and aggression can be learned through ___ ___ which occurs when a specific behavior is positively or negatively reinforced

A

operant conditioning

86
Q

a response to the specific behavior that is pleasurable or produces the desired results.

A

positive reinforcement

87
Q

a response to the specific behavior that prevents an undesirable result from occurring.

A

negative reinforcement

88
Q 
Loss of function in the cortex
Brain tumors
Brain trauma
Encephalitis
Have all been implicated in predisposition to \_\_\_ and violent behavior
A

aggression

89
Q 
After repeated requests for a patient to unpack and get settled on the psychiatric unit, the patient states, “I have no intention of unpacking and staying on this unit.” To avoid a confrontation, the nurse unpacks the patient’s belongings. Which nursing behavior is exemplified?
A. Positive role modeling
B. Negative operant conditioning
C. Assertiveness
D. Aggressiveness
A

B.

90
Q

these are the predisposing factors to anger and aggression

  • modeling
  • operant conditioning
  • neurophysiological factors
  • biochemical factors
  • socioeconomic factors
  • ____ factors
A

environmental

91
Q

which hormone is identified as playing a key role in aggression

A

testosterone

92
Q

true or false

poverty and exposure to violence has an impact on future tendencies toward aggression

A

TRUE

93
Q

patients with a history of ___ are at risk to have more problems with anger and aggression

A

epilepsy

94
Q

what 3 environmental factors have been shown to increase risk for aggression

A
  1. crowding
  2. discomfort in environmental temperature
  3. noise
95
Q

abuse of these substances has been associated with ___

  • cocaine
  • steroids
  • bath salts
  • amphetamines
  • weed
  • PCP
A

aggression

96
Q

what are the 3 best predictors of violent behavior are

A
  1. Alcohol intake
  2. History of childhood abuse
  3. History of violent acts with criminal activity or arrests
97
Q

the goal of ___ management is to reduce both the emotional feelings and the physiological arousal that anger engenders

A

anger

98
Q

true or false
when patients are angry try to empathize with their feelings and get them to speak about their feelings
“can you explain to me why you’re feeling…”

A

TRUE

99
Q

When ___ is expressed passively aggressive or aggressive that is when it can result in conflict

A

anger

100
Q

true or false

accidents that lead to unintentional harm or destruction are not considered aggression

A

TRUE

101
Q

___ is key to managing aggressive or violent behavior

A

prevention

102
Q

(risk factors)
schizophrenia, major depression, bipolar disorder and substance use disorders have a strong correlation with ___ behavior

A

violent

103
Q

what are the 3 risk factors in identifying extent of risks for anger and aggression aggression

A
  1. past history of violence
  2. client diagnosis
  3. current behavior
104
Q

Characterized by anxiety and tension, verbal abuse and profanity, and increasing hyperactivity which often leads to assaultive behavior

A

prodromal syndrome

105
Q

Behaviors associated with this ___ stage
Rigid posture; clenched fists and jaws; grim, defiant affect
Talking in a rapid, raised voice; arguing and demanding
Using profanity and threatening verbalizations; agitation and pacing; and pounding and slamming

A

prodromal

106
Q

what are some nursing diagnosis for clients expressing anger or aggression

A
  • ineffective coping

- risk for self-directed or other directed violence

107
Q

An angry patient states to the nurse, “You red-headed skinny witch. You can’t tell me what to do.” Which appropriate intervention would the nurse implement during this outburst?
A. Reprimand the patient for poor judgment and derogatory remarks.
B. Respond to angry expressions with matching verbalizations.
C. Offer support by the use of empathy and therapeutic touch.
D. Ignore initial derogatory remarks.

A

C.

108
Q

evaluation of the following is used to determine the success of working with a patient exhibiting inappropriate expression of anger

A

Is the patient able to recognize when they are angry?
Can the patient take responsibility for these feelings and keep them in check without losing control?
Does the patient seek out staff or a support person to talk about feelings of anger when they occur?

109
Q

as nursing intervention should you touch a patient when they become angry

A

NO

-client may view this as threatening and could become violent

110
Q

after dealing with a situation in which a patient loses control it is important for staff to do what

A

debrief

111
Q

the following is discussed in the ___

  • factors that lead to the crisis
  • factors that lead to the failure of less restrictive interventions
  • staff thoughts about interventions
  • discuss the situation with the client and others clients who saw the situation
A

debriefing

112
Q

how often should the client be monitored to ensure circulation when they have restraints on

A

every 15 minutes

113
Q

trust vs. mistrust develops during what years

A

birth to 18 months (infant)

114
Q

autonomy vs. shame and doubt develops during what years

A

18 months to 3 years (toddler)

115
Q

initiative vs. guilt develops during what years

A

3 to 6 years (preschool)

116
Q

industry vs. inferiority develops during what years

A

6 to 12 years (school age)

117
Q

identity vs. role confusion develops during what years

A

12 to 20 years (adolescence)

118
Q

intimacy vs. isolation develops during what years

A

20 to 30 years

119
Q

generativity vs. stagnation develops during what years

A

30 to 65 years

120
Q

ego integrity vs. despair develops during what years

A

65 years and older

Psychiatric Mental Health (6 decks)

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