TERM 3- MY NOTES MENTAL HEALTH NURSING CARE CH.1 "UNDERSTANDING MENTAL HEALTH AND MENTAL ILLNESS" Flashcards
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Mental Health
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UNDERSTANDING MENTAL HEALTHAND MENTAL ILLNESS
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In general, there are seven important characteristics of mental health, and they are Mentally healthy people: • Interpret reality accurately • Have a healthy self-concept • Are able to relate to others • Achieve a sense of meaning in life • Demonstrate creativity/productivity • Have control over their behavior • Adapt to change and conflict
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True
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The ability to accurately determine reality (what really is or exists) is a basic component of mental health.
A)true
B)false
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A healthy self-concept includes first a realistic appraisal of the self (abilities, function, and appearance).
A)true
B)false
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Insight, or self-under-standing, is an important part of relating to oneself, because it allows people to see their own motivations or reasons behind their feelings and behavior.
A)true
B)false
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A person who lacks insight might refuse to take a medication because it causes his mouth to be dry.
A)true
B)false
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With insight, a person could decide that even though he does not like to take the medication, it helps his mental illness, so he will take it.
A)true
B)false
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Insight is critical for positive decision making about health issues.
A)true
B)false
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Love is the most imporrant human emotion.
A)true
B)false
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Normal human development is not possible in isolation
A)true
B)false
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People must be able to interact with and relate to others in order to flourish.
A)true
B)false
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Many people find a sense of meaning in the world through religion. Many others find meaning in nature, philosophy, ethics, or service to others.
A)true
B)false
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Some people think concretely, meaning literally or without creativity. For example, a concrete thinker may say that the proverb “A stitch in time saves nine” means that if you sew something up in time you will save nine stitches.
A more abstract thinker might say it means that if you put a little bit of work into solving a problem early, you will save a lot of trouble in the long term.
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True
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Another aspect of healthy creativity is a sense of productivity or contribution.
A)true
B)false
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Control of behavior means that mentally healthy people can balance conflicts with their instincts, conscience, and reality before they act.
A)true
B)false
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A
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The healrhiesr people have the integrity to act on their values
A)true
B)false
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A
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Adaptability is critical to success as a person. The one consistent thing around us is that everything is changing. Healthy people can compromise, plan, and be flexible. They can manage conflict successfully. Learning to change is not easy, but if people are healthy, they will manage it.
A)true
B)false
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Mental health is really a range of behavior, thoughts, and feelings; it is a relative state instead of an absolute state.
A)true
B)false
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People with chronic physical illnesses such as diabetes or heart disease can still be healthy (within the limits of their abilities) if they choose healthy behaviors and participate in treatment
A)true
B)false
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Just as a person with a physical illness can be relatively healthy, people with mental illnesses can take their medications, choose healthy behaviors within their abilities, and be healthier also.
A)true
B)false
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Mental Disorders
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Mental disorders are illnesses with symptoms related to thinking, feeling, or behavior. They are due to genetic, biological, social, chemical, or psychological influences.
A)true
B)false
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Much research has been done on mental disorders. The definitive source for psychiatrists and other physicians to use for the diagnostic criteria for mental disorders is the DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS ( DSM)
A)true
B)false
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People are not defined by their illnesses. A person wit a disease is just that, a person first, not a diabetic, or a schizophrenic, or "the appendectomy in room 213."
A)true
B)false
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The following is the DSM's five-axis diagnosis system:
Axis I: Clinical Psychiatric Disorders
Axis II: Personality Disorders or Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Problems
Axis V: Global Assessment of Functioning
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CASE EXAMPLE
A 50-year-old male client with a history of major depressive disorder was admitted to the hospital after he told his psychiatrist he was thinking of hurting himself. His wife left him 2 months ago and he lost his job about a month after because he was too depressed to go to work regularly. He has hypertension. He has no close friends. Our client's multiaxial diagnostic statement would be:
Axis 1: Major Depressive Disorder
Axis II: None
Axis Ill: Hypertension
Axis IV: Separation from spouse, loss of job
Axis V: SO (serious symptoms) on Global Assessment of Functioning Scale
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The client's mental and physical diseases, life stressors, and the effects on the person's ability to function are valuable data for planning client care.
A)true
B)false
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Nurses concentrate more on how people are affected by these disorders.
A)true
B)false
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Major depressive disorder is the leading cause of disability in developed countries.
A)true
B)false
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CULTURAL PULSE POINTS
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European American is the dominant culture in the United States.
A)true
B)false
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Cultural Factors Related to the Environment and Client Functioning
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for example, in a culture where mental illness has a severe stigma that extends to the entire family (some people may not want to marry into such a family), a client may feel a burden of guilt for affecting the whole family.
A)true
B)false
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Cultural Explanations of the Client's Illness
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Amok is a dissociative episode.
The client may have a period of brooding and feel persecuted, followed by violent behavior directed at people or objects. The client may not remember the episode and will return to usual functioning afterward.
Amok was originally described in Malaysia. A similar condition with different names is found in the Philippines, Laos, Polynesia, and among the Navajo.
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Bilis, colera, or muina results in symptoms of acute nervous tension, headache, trembling, screaming, stomach disturbances, and possibly loss of consciousness caused by strongly experienced anger or rage
Anger is viewed among many Latino groups as a very powerful emotion that can have direct effects on the body. The major effect of anger is to disrupt the body's balance (between the material and spiritual or hot and cold aspects of a person).
True
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Mal de ojo is a concept widely found in Mediterranean cultures and elsewhere in the world. This Spanish phrase means "evil eye" in English. Symptoms include restless sleep, crying without apparent cause, diarrhea, vomiting, and a fever in a child or infant. Children are at higher risk, but adults (especially females) can have the condition.
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Nervios is an expression of distress among Latinos in the United States and Latin America. Several other ethnic groups have similar ideas about"nerves." It refers to a generaI state of vulnerability to stressful life experiences and to a range of symptoms of emotional distress brought on by difficult circumstances.
Common symptoms include headaches that the client may describe as "brain aches," irritability, difficulty sleeping, easy tearfulness, stomach disturbances, trembling, and difficulty concentrating. Nervios tends to be an ongoing problem that has a wide range of expressions
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Five Most Common Mental Disorders in the World
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* Major depressive disorder
* Alcohol abuse
* Schizophrenia
* Self-inflicted injuries
* Bipolar disorder
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Key Facts About the Incidence of Mental Illness in the United States
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(about 1 in every 4 adults) will be affected by a mental disorder.
A)true
B)false
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Mental illness is the leading cause of disability in the United States and Canada for ages 15-44
A)true
B)false
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Most private medical insurance either does not cover mental illness treatment or covers it at a lower level than general medical illness
A)true
B)false
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Stigma of Mental Illness
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Simply talking about mental illness often causes people to laugh nervously because mental illness has a stigma, or "mark of disgrace," in our culture.
A)true
B)false
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People can feel so ashamed of having a mental illness that they refuse to seek treatment
A)true
B)false
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Even physicians sometimes hesitate to give their clients the diagnosis of a mental disorder for fear that the clients will be "labeled" and created badly as a result.
A)true
B)false
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Nurses can take the lead by basing their practice on evidence, not assumptions or stereotypes.
A)true
B)false
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Historical Perspectives
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Mental illness came before psychiatrists and mental health nurses.
A)true
B)false
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In the earliest of recorded times, mental illness was thought to be due to supernatural forces. Mentally ill people were created as though they were affected by either demons or divine influences.
A)true
B)false
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In his "theory of disease" Hippocrates (460-375 B.C.) described the body "humors": blood, phlegm, yellow bile, and black bile. He believed that melancholia (depression) was caused by an excess of black bile. He also thought that bloodletting could relieve this excess
A)true
B)false
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In Europe in the Middle Ages and during the Renaissance (when art and science, but not treatment for the mentally ill, flourished) it was thought that people with mental illness were affected by the moon (the term lunatic comes from the Larin word for moon)
A)true
B)false
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French physician Phillippe Pinel starred "moral treatment" of the mentally ill. He released people from their chains and took a psychological treatment approach. He ordered that the basic needs for food and clothing of people with mental disorders be met
A)true
B)false
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William Tukes applied the same ideas in England. He established the concept of the asylum, which was to be a safe haven for people who had been whipped, beaten, and starved because they were mentally ill.
A)true
B)false
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The Quakers (Friends) in the United States applied the tenets of the Quaker faith to the care of mentally ill people. They believed that treating people with kindness in a pleasant environment could bring recovery.
A)true
B)false
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The Quaker philosophy formed the foundation for milieu therapy (in which the environment is considered parr of rhe therapy), which is still used today
A)true
B)false
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In the early l9th century, schoolteacher Dorothea Dix became aware of the horrible conditions of the mentally ill in the United States when she volunteered to reach Sunday school at the East Cambridge jail in Massachusetts.
Her efforts eventually resulted in the establishment of hospitals in the United States, Canada, Scotland, and Japan
A)true
B)false
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In 1882 the McLean Asylum in Somerville, Massachusetts, opened the first training school in the world for mental health nurses. The plan was to "medicalize the care of the insane." They called their inmates "patients" and the attendants "nurses".
A)true
B)false
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In the 1930s somatic therapies (physical therapies) were becoming popular. These therapies included deep sleep (coma) therapy, insulin shock, and electroshock therapy.
A)true
B)false
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In 1946, the United Stares Congress passed the National Mental Health Act, establishing the National Institute of Mental Health (NIMH). This act provided federal funding for research and education in all areas of psychiatric care. Graduate education programs for mental health nurse specialists were established as a result of this act
A)true
B)false
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A revolution in psychiatric care occurred in the 1950s with the invention of psychotropic drugs (drugs that treat mental illness). Chlorpromazine (Thorazine) and lithium were the first to be widely used. Over the next decade, drugs were developed to treat anxiety and depression.
A)true
B)false
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Chlorpromazine (Thorazine) and lithium were the first drugs to be widely used for depression and anxiety
A)true
B)false
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psychosis means (loss of realistic thinking)
A)true
B)false
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Deinstintionalization of clients began in the 1950s. In this movement, people were discharged from psychiatric institutions and then the institutions were closed. Approximately 92% of the people who would have been living in public psychiatric hospitals in 1955 were not there in 1994.
A)true
B)false
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Two ideas were behind this movement:
1. People should be treated in the lease restrictive environment possible.
2. It is cheaper to treat people in the community than in a state hospital.
True for deinsitulition
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Unforrunarely, the result of this giant social experiment is that 2.2 million severely mentally ill people in the United States do not receive any psychiatric treatment
A)true
B)false
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There is housing discrimination and lack of insurance coverage due to insurance discrimination. Mental illness is often not covered as well as physical illness by medical insurance.
A)true
B)false
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The 1990s were declared to be "the decade of the brain." Research developed new diagnostic studies and new drugs for mental illnesses.
A)true
B)false
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Healthy People 2010 Mental Health Objectives
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- Reduce suicides
- Reduce the proportion of homeless adults who have serious mental illness
- Reduce the relapse rate for persons with eating disorders, including anorexia nervosa and bulimia nervosa
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Nurses' Role in Mental Health Promotion
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The first seep in prevencion of mental illness is to recognize what the risk factors are and work to minimize them. Some facrors, such as biological predisposition, cannot be changed. Others, such as inadequate resources or lack of knowledge, are modifiable risks.
A)true
B)false
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PREVENTION
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Primary prevention starts with healthy people and prevents them from being affecced by a disorder.
An example is drug abuse education with children. They learn to avoid drug use before they ever have a problem.
A)true
B)false
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Secondary prevention involves people who are already affected by a disorder. They are identified and treated early to prevent the negative outcomes of the disorder.
An example is depression screening, when people are tested and cases of depression are identified early, before the people have experienced loss of jobs, despair, or even attempted suicide.
A)true
B)false
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Tertiary prevention serves people who are already severely affected by a mental disorder. The goal is to help them recover and prevent further disability.
An example of tertiary prevention is a community walk-in clinic where people with schizophrenia can come to learn socializing, independent living, and medication management skills that will help them stay out of institutions and in their homes.
A)true
B)false
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Nurses' Role in Mental Health Promotion
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* Prevention :of mental illness (primary, secondary, and tertiary)
* Treatment :in the acute phase of illness
* Rehabilitation :of clients after they have recovered from the acute phase of illness
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Nurses' Role in Mental Health Promotion
• Prevention
• Treatment
• Rehabilitation
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Vulnerability of the Mentally Ill
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People with mental illnesses are among the most vulnerable in our society. They are often too severely affected by their disease processes to be able to speak effectively for themselves. The disheveled homeless person stirs less sympathy from charitable contributors than children or even homeless animals
A)true
B)false
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clinical ALERT
One of the most important roles of nurses in mental health care is client advocacy. Mentally ill people are very vulnerable and often have difficulty speaking for themselves.
A)true
B)false
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The National Alliance for the Menrally Ill (NAMI) is a strong, yet underfunded organization that acts as an advocate for people with mental illness and their families.
A)true
B)false
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Consumers: rather than client or patient, is the term used ro describe a person in the community who uses mental health services.
A)true
B)false
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There are more charitable donations to benefit
homeless animals than for homeless people
A)true
B)false
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Educating adolescents about avoiding drug abuse is a primary prevention strategy for mental illness.
A)true
B)false
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KEY TERMS
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Adaptability means ability to compromise, plan, and be flexible
A)true
B)false
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Deinsitutionalization means the movement to discharge people from psychiatric institutions to treat them in the community
A)true
B)false
A
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Insight means self-understanding
A)true
B)false
A
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Psychotropic drugs are drugs that affect thinking and treat mental illness
A)true
B)false
A
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Reality means what really is or exists
A)true
B)false
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Psychosis means disorganization of the personality and impaired ability to interpret reality; to relate to self and others and to function; may include hallucinations and delusional thinking
A)true
B)false
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Somatic therapies involves the body such as electroshock therapy
A)true
B)false
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Stigma means mark of disgrace
A)true
B)false
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KEY Points
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-Mental disorders are classified; people are not.
• Deinstitutionalization of the mentally ill resulted in many homeless and untreated mentally ill people.
• The stigma of mental illness prevents many people from obtaining the treatment they need.
• Nurses can promote the mental health of clients in any setting.
• The mentally ill are a very vulnerable group.
• Asking for a mental health consultation is an important act of client advocacy by a nurse.
True
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NCLEX PREP
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Which of the following statements indicates that the speaker is missing an important aspect of a mentally healthy life?
1. "I am responsible for my reactions to situations; others have no control over my emotions."
2. "My goal in life is to always treat other people as I want to be treated."
3. "I am self-sufficient; I do not need personal relationships with other people."
4. "I see each problem as a challenge and a source of creative growth."
3
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Which of the following is a false statement about mental health?
1. There are degrees of mental health.
2. There is no universally accepted definition of mental health.
3. All people have the potential for improving their own mental health.
4 . A person with a diagnosed mental illness may not achieve a mentally healthier state
4
103
Which of the following is a true statement about the current edition of the DSM?
1. It provides a holistic assessment of mental illness.
2. It is specific to mental health issues in the United States.
3. It is a classification of people with mental disorders.
4. It takes into consideration only clinical psychiatric and personality disorders.
1
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According to the Global Assessment of Functioning Scale, a 40-year-old male with an antisocial personality disorder who has difficulty maintaining close personal relationships or holding a job for long is experiencing:
1. Minimal symptoms, good functioning in all areas.
2. Moderate symptoms or moderate difficulty in social,
occupational, or school functioning.
3. Some mild symptoms, but generally functioning pretty well.
4. Serious symptoms or serious impairment in social, occupational, or school functioning
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Which of the following is the most common mental illness globally?
1. Alcohol abuse
2. Schizophrenia
3. Major depressive disorder
4. Bipolar disorder
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A homeless person with schizophrenia has been admitted to a medical unit with pneumonia. The nurse would suspect that this client's living circumstance is a result of:
1. The experiment with deinstitutionalization.
2. Failure of psychotropic drugs to control the
symptoms.
3. Not enough federal funding for housing.
4. The client not caring enough to obtain treatment.
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Recommending that a client with schizophrenia be referred for a psychiatric consult to be considered for the
community walk-in clinic and treatment program is an example of:
1. Primary prevention.
2. Secondary prevention.
3. Tertiary prevention.
4. Active intervention.
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Why do people with a mental illness need the advocacy of nurses?
1. They are not very articulate.
2. They often cannot speak for themselves because of their illness.
3. They really do not understand their healthcare needs.
4. They are afraid to speak.
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Where can families of people with mental illnesses go to find out about the illnesses and family support services?
1. National Alliance for the Mentally Ill
2. National Foundation for Mental Science
3. American Family Help Plan
4. Centers for Disease Control
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Which of the following risk factors for the development of mental illness could be modified by the nurse as part of primary prevention? (Select all that apply.)
1. Lack of information about treatment options
2. Inadequate rest and sleep
3. Unhealthy self-concept
4. Genetic predisposition to mental illness
5. Inadequate coping skills
1 2 3 5
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The mentally healthy person realizes the need for relationships with others. maximum mental health ca not be archived in isolation
A)true
B)false
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With medication and healthier behavior choices, the person with a chronic mental illness may become mentally healthier
A)true
B)false
A
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DSM-4-TR takes into account psychiatric disorders, general medical conditions, and psychosocial and environmental problems as well as the global assessment. This provides a basis for holistic assessment of mental illness
A)true
B)false
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DSM-4-TR provides a basis for holistic assessment of mental illness
A)true
B)false
A
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The failed experiment is discharging clients from psychiatric institutions or deinstitutionalzations resulted in homeless for many people. With mental disorders
A)true
B)false
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Tertiary prevention involves rehabilitation after the resolution of the acute phase of the disease for those clients. The goal is to prevent further disability
A)true
B)false
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Primary prevention begins with preventing mentally healthy people from being affected.
A)true
B)false
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Secondary prevention involves identifying and treating people already affected by a mental disorder to prevent negative outcomes
A)true
B)false
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Active intervention is not an acceptable psychiatric nursing term for mental health promotion
A)true
B)false
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People with mental illness often cannot speak For themselves because of their illness. They may be out of touch with reality, depressed or otherwise unable to speak about their needs
A)true
B)false
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Education about treatment options And the need for adequate rest and sleep would be important nursing interventions for a client with these risk factors
A)true
B)false
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Promoting healthy coping behaviors and encouraging a healthy self-concept Are other ways the nurse can help with modifications of risk factors.
A)true
B)false
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The nurse has no influence over genetic predisposition to mental illness
A)true
B)false
A
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Which of the following factors most influence definitions of mental illness and mental health and must be taken into consideration when developing a nursing care plan for a client?
A)Cultural and societal attitudes and expectations.
B)false
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Which of the following statements by a client indicate that he or she has insight?
A)"The medication makes me gain weight, but I take it to even my moods."
B)false
A
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While reviewing the charts of assigned clients with physical illness as well as mental illness, you notice that the psychiatrist has listed the five axes of the current diagnostic and statistical manual published by the American Psychiatric Association and has filled in information on each axis. Which axis would you find the general medical conditions listed?
A)Axis III
B)Axis II
A
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Nurses in all settings need to prepare themselves to care for people with depression mainly for which of the following reasons?
A)Depression is the leading cause of disability in developed countries.
B)false
A
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The school nurse is wondering why parents of a child who has symptoms of a mental disorder refuse to take the child to a psychiatrist, a psychologist, or a psychiatric clinical nurse specialist. Which of the following reasons is most likely for the parent's refusal, and suggests the parents need the nurse to provide some education?
A)The stigma of mental illness causes the parents to be resistant.
B)false
A
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In order to understand attitudes toward mental illness, it is important for nurses to understand the historical perspectives that have evolved in recognizing and treating mental illnesses. In the middle ages and the Renaissance Period of time, people with mental illness were treated in which of the following ways?
A)Treated as evil, restrained, beaten, and poorly fed and clothed
B)false
A
130
The nurse manager on the medical unit has just finished making the client care assignments. One of the nurses begins to complain that she has been assigned a "crazy, whacked out" person who tried to commit suicide last night and she does not want to take care of any clients who are "bonkers" or "psycho." Which of the following responses would be most appropriate response by a nurse peer?
A)Talk with the nurse about the stigma of mental illness
B)false
A
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The parent of a young adult with a diagnosis of schizophrenia asks the nurse why the state mental hospitals don't take care of the mentally ill like they did in the 1950s and earlier. The nurse explains the failure of deinstitutionalization in treating clients with mental illnesses by moving them out of the hospital and into the community. This experiment resulted in the establishment of current admissions criteria. Which of the following reasons was one of the two major reasons behind deinstitutionalization?
A)Society pushed for the "least restrictive setting for treatment" of the mentally ill
B)false
A
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When the psychiatric nurse and the treatment team carry out which of the following treatment modalities, they are following the model set by the Quakers for treating the mentally ill in the early days of this country?
A)Therapeutic milieu
B)false
A
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If a nurse is going to assume an active role in mental health promotion in the realm of primary prevention, which of the following activities would be included? Indicate all that apply.
A)Educate children about the dangers of drug abuse.
B)Recognize which clients have obvious risk factors that could predispose them to developing a mental illness
A B
