VN 42 Mental health Test 7

Question 1

Name the first step in the Nursing Process and when it begins (PG.82)

Answer 1

*Assessment, which begins at the time of clients arrival to the unit

Question 2

Name the steps of the Nursing Process (PG.82)

Answer 2

(ADPIE)
*Assessment (LVN assists, RN does initial assessment)
*Diagnosis (nursing)
*Planning
*Implementation/Intervention
*Evaluation

Question 3

8. When does discharge teaching begin? (PG.92)

Answer 3

*Begins at admissions

Question 4

9. How does a discharge differ from a transfer?

Answer 4

*In a discharge the client is leaving a facility and returning home all together, in a transfer a patient is going from one facility to another.

Question 5

10. What are Defense Mechanisms? List them. (PG. 98)

Answer 5

*Are mental “pressure valves.” The purpose of defense mechanisms is to reduce or eliminate anxiety.
Denial
Repression
Dissociation
Rationalization
Compensation
Reaction Formation (overcompensation)
Regression
Sublimation
Projection
Displacement
Restitution (undoing)
Isolation
Conversion Reaction
Avoidance
Scapegoating

Question 6

11. Define Denial and give an example of it (PG.99)

Answer 6

*Usually the 1st defense learned & used
*Unconscious refusal to see reality
The alcoholic states, “I can quit any time I want to.”
Is not consciously lying.

Question 7

12. Define Dissociation and give an example of it (PG.99)

Answer 7

*Painful events or situations are separated or dissociated from the conscious mind.
*Could be described as an out-of-body experience.
Patient who had been sexually abused as a child describes the situation as if it happened to a friend or sibling.
Police visit parent to inform parent of death of child in car accident. Parent tells police, “That’s impossible. My child is upstairs asleep. You must have the wrong house.”

Question 8

13. Define Compensation (PG.99)

Answer 8

*Making up for something a person perceives as an inadequacy by developing some other desirable trait.
A small boy who wants to be a basketball center; instead becomes an honor roll student.
The physically unattractive person who wants to model instead becomes a famous designer.

Question 9

14. Define Regression and give an example of it (PG.99)

Answer 9

*Emotionally returning to an earlier time in life when there was far less stress.
* Commonly seen in patients while hospitalized. Note: People do not regress to the same developmental age. This is highly individualized.
Children who are toilet trained beginning to wet themselves.
During serious illness, a patient exhibits behavior more appropriate for a younger developmental age, such as excessive dependency.

Question 10

15. Define Projection and give an example of it (PG.99)

Answer 10

*Attributing feelings or impulses unacceptable to oneself to others.
Wife tells patient’s nurse, “My husband is worried about going home.” (Wife is the one who is worried.)
Young soldier is fearful of upcoming deployment and says, “Those other guys are a bunch of cowards.”

Question 11

16.Scapegoating and give an example of it (PG.99)

Answer 11

*Blaming others
“I didn’t get the promotion because you don’t like me.”

Question 12

17. Define Displacement and give an example of it (PG.99)

Answer 12

*The “kick-the-dog syndrome.”
*Transferring anger and hostility to another person or object that is perceived to be less powerful.
Parent loses job without notice; goes home and verbally abuses spouse, who unjustly punishes child, who slaps the dog.

Question 13

3. Describe the 4 different extrapyramidal side-effects (PG.222)

Answer 13

*Akathisia: restlessness, inability to sit still

*Dystonia: muscle rigidity, torticollis (neck turned in awkward angle)

*Oculogyric crisis: uncontrolled rolling back of the eyes

*Pseudoparkinsonism or dyskinesia: stiffness, tremors, shuffling gait

*Tardive dyskinesia: late onset movement disorder that includes lip smacking, grimacing, tongue protrusion

Question 14

4. Name the antipsychotic medication best used with pts who are non-compliant.

Answer 14

• Prolixin decanoate

Question 15

5. Which side effect of antianxiety agents is very concerning? (PG 108.)

Answer 15

*Depression

Question 16

8. Pts taking MAOIs must avoid what? What foods contain this and should be avoided? (PG.111)

Answer 16

(Avoid foods that contain tyramine)
*Aged cheese (cheddar, Swiss, provolone, blue cheese, parmesan)
*Avocados (guacamole)
*Yogurt, sour cream
*Chicken and beef livers, pickled herring, corned beef
*Bean pods
*Bananas, raisins, and figs
*Smoked and processed meat (salami, pepperoni, and bologna)
*Yeast supplements
*Chocolate
*Meat tenderizers (MSG), soy sauce
*Beer, red wines, and caffeine

Question 17

9. What is Lithium used to treat

Answer 17

*Manic phase of bipolar disorder
*Sometimes for other depressive or schizoaffective disorders

Question 18

9. Lithium patient teaching

Answer 18

*Encourage patients to keep all appointments for blood work and evaluation of drug effectiveness. Therapeutic serum levels are between 0.5 and 1.2 mEq/L for most patients (1.0 to 1.5 in acute mania).
*Keep appts to monitor kidney & liver functions
*Lithium toxicity (>1.5mEq/L) : severe diarrhea, persistent N/V, muscle weakness, tremors, blurred vision, slurred speech & seizures
*If woman is in childbearing years, check w/HCP before becoming pregnant
*Dehydration and fevers can cause increased danger of toxicity.
*Adequate fluid & Na+ intake is essential. Do not decrease dietary intake of Na+ unless instructed to do so by HCP
*Report to provider immediately if you become ill
*Hard, sugarless candy can be helpful to decrease dry mouth and thirst, but consult your health-care provider.

Question 19

13. Describe ECT and what its used for (PG.123, 129)

Answer 19

*Electroconvulsive therapy (ECT), or electroshock therapy
*Depression or schizophrenia that does not respond to other treatments.

Question 20

14. Who is at risk to commit suicide? Who should the nurse be most concerned about? (PG.125, 126)

Answer 20

*A person in crisis (people who may be experiencing a crisis are those who have lost a job suddenly or were divorced recently, are in an abusive relationship, have experienced the death of a loved one, or are contemplating or attempting suicide).
*Ensuring safety & making sure patient is not left alone, remove any items that may be of use to patient to cause themselves harm.

Question 21

18. Describe the difference between Alternative Medicine and Complementary Medicine (PG.132)

Answer 21

*Alternative medicines replace those of conventional/Western medicine.
*Complementary medicine methods are used together with conventional treatments.

Question 22

19. Describe Biofeedback, include how its done, and for what purpose (PG.133, 134)

Answer 22

*Biofeedback is a training program designed to develop one’s ability to control the autonomic nervous system.
*The primary purpose of biofeedback training is to teach patients to be aware of tension within the body and to respond with relaxation
series of 1-hour sessions, sometimes spaced 1 week apart.
patient is taught to obtain a deep level of relaxation as a means to control a light, buzzer, image, or a video game, to which he or she is attached by electrodes and cables.
The machine is then gradually adjusted to greater sensitivity, and the patient learns improved control
When training is completed, all the patient needs to do to obtain relaxation and symptom resolution at any time or place is to recall the particular thought and feeling that worked in the clinic.

Question 23

20. What is Aromatherapy, and how does it work? (PG.134)

Answer 23

*Related to herbal therapy, aromatherapy provides treatment by both the direct pharmacological effects of aromatic plant substances and the indirect effects of certain smells on mood and affect.

Question 24

Shiatsu (PG.140):

Answer 24

is a Japanese form of acupressure that uses pressure from the fingers to free energy flow.

Question 25

Rolfing (PG.136):

Answer 25

is a therapy designed to realign the body with gravity through fascial manipulation, a vigorous form of bodywork that is finding increasing acceptance.

Question 26

What is Reiki (PG.140):

Answer 26

is representative of methods of touch healing that are often associated with massage.

Question 27

What does the term “Reiki” mean? What does it refer to? (PG.140)

Answer 27

*Is a term that means “universal life energy” and refers to the process whereby this energy is drawn along the body’s meridians.