X3 - NSG 526 X3 - Extra Flashcards
How many stages are in Piaget’s developmental theory?
four stages
what personality disorder:
Characteristics: suspicious of others; fear others will exploit, harm, or deceive them; fear of confiding in others (fear personal information will be used against them); misread compliments as manipulation; hypervigilant; prone to counterattack; hostile; and aloof. Psychotic episodes may occur in times of stress. Nurses should give straightforward explanations of tests, history taking, and procedures, side effects of drugs, changes in treatment plan, and possible further procedures, to counteract client fear.
Paranoid personality disorder
what personality disorder:
Characteristics: avoids close relationships, is socially isolated, has poor occupational functioning, and appears cold, aloof, and detached. Social awareness is lacking and relationships generate fear and confusion in the client. Nurses should strive for simplification and clarity to help decrease client anxiety.
Schizoid personality disorder
what personality disorder:
Characteristics: ideas of reference; magical thinking or odd beliefs; perceptual distortions; vague, stereotyped speech; frightened, suspicious, blunted affect; distant and strained social relationships. These clients tend to be frightened and suspicious in social situations. Explanations can ease their anxiety.
schizotypal personality disorder
what are the cluster A personality disorders
- paranoid personality disorder
- schizoid personality disorder
- schizotypal personality disorder
What are the cluster B personality disorders?
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- Narcissistic personality disorder
what personality disorder is this:
Characteristics: has superficial charm, violates rights of others, exploits others, lies, cheats, lacks guilt or remorse, is impulsive, acts out, and lacks empathy. As clients these individuals are extremely manipulative and aggressive. Nurses must establish and adhere to a plan of care, and maintain clear boundaries if they are to minimize client manipulation and acting out.
-
antis-
antisocial personality disorder
what personality disorder is this:
Characteristics: unstable, intense relationships; identity disturbances; impulsivity; self-mutilation; rapid mood shifts; chronic emptiness; intense fear of abandonment; splitting; and anger. A major defense is splitting (alternating between idealizing and devaluing). Self-mutilation and suicide-prone behavior are often-used impulsive self-destructive behaviors. Anger is intense and pervasive and help with anger management is an important intervention. Relationship building, safety, and limit setting are other foci.
borderline personality disorder
what personality disorder is this:
Characteristics: center of attention; flamboyant; seductive or provocative behaviors; shallow, rapidly shifting emotions; dramatic expression of emotions; overly concerned with impressing others; exaggerates degree of intimacy with others; self-aggrandizing; preoccupied with own appearance. Experience depression when admiration of others is not given. Suicide gestures may result in client entry into the health care system. A thorough assessment of suicide potential must be undertaken, and support offered in the form of clear parameters of psychotherapy.
Histrionic personality disorder
what personality disorder is this:
Characteristics: grandiosity, fantasies of power or brilliance, need to be admired, sense of entitlement, arrogant, patronizing, rude, overestimates self and underestimates others. This behavior covers a fragile ego. In health care setting demand the best of everything. When client is corrected, when boundaries are defined, or when limits are set on client’s behavior, client feels humiliated, degraded, and empty. To lower anxiety the client may launch a counterattack. The nurse should gently help the client identify attempts to seek and become perfect, exhibit grandiose behavior, and sense of entitlement.
narcissistic personality disorder
what are the cluster C personality disorders?
- avoidant personality disorder
- dependent personality disorder
- obsessive-compulsive personality disorder
what personality disorder:
Characteristics: social inhibition, feelings of inadequacy, hypersensitivity to criticism, preoccupation with fear of rejection and criticism, and self perceived to be socially inept. Low self-esteem and hypersensitivity grow as support networks decrease. Demands of workplace often overwhelming. Project that caregivers will harm them through disapproval and perceive rejection where none exists. Nurses can teach socialization skills, provide positive feedback, and build self-esteem
-
avoi-
avoidant personality disorder
what personality disorder:
Characteristics: inability to make daily decisions without advice and reassurance, need of others to be responsible for important areas of life, anxious and helpless when alone, and submissive. Solicit care taking by clinging. Fear abandonment if they are too competent. Experience anxiety and may have co-existing depression.
-
depen-
dependent personality disorder
what personality disorder:
Characteristics: preoccupied with rules, perfectionist, too busy to have friends, rigid control, and superficial relationships. Complains about others’ inefficiencies and gives others directions.
-
obses-
obsessive-compulsive personality disorder
To receive a diagnosis of __________________, an individual must demonstrate the criteria behaviors persistently and to such an extent that they impair the ability to function socially and occupationally.
-
pers- diso-
personality disorder
__________________ is the capacity to pay attention, non-judgmentally to the present moment. It is derived from teachings of the Buddha, the Zen tradition being perhaps one of its most well-known proponents. _____________ is all about living in the moment, experiencing your emotions and all your senses and being aware of them.
-
mindf-
Mindfulness
mindfulness is a tool used in what form of therapy and used in to treat what specific disorder
DB-, treats BP-
DBT,
treats BPD
are considered the “right” patterns of behavior for a society
norms
should be included for problem-solving therapy for a child with conduct disorder.
even- inter-
event interpretation
can promote the greatest change in an adolescent’s behavior.
fam- ther-
family therapy
describes a family’s progression through the lifecycle.
-
dev- theo- appr-
developmental theoretical approach
Most children will adopt the same world view as ____________
their parents (ex. If a child was brought up by parents who thought the world was hostile they would most likely adopt this view as they grow older.
uses books and a librarian as resources.
-
biblio-
bibliotherapy
allows the child to play out their fears and frustrations.
-
pl- ther-
play therapy
help the most in evaluating outcomes of child therapy.
-
obj- obs-
objective observations
Schizoid personality disorder -_____________ is the appropriate modality to use with this disorder.
-
indiv- psy-
individual psychotherapy
In BPD, _________________ is mainly due to fear of abandonment or the increase of independence
-
self-mutil-
self mutilation
_______ personality disorder is often characterized by an inability to tolerate perceived rejection
borderline
The best response by the PMHNP when speaking with a client with BPD who has been in counseling for management of self-harm behaviors who now wants to cut themselves is to assist the client to identify an _____________
appropriate coping strategy
Clients with BPD have not successfully achieved the developmental stage of __________
separation-individuation
do not trust others easily, and it’s best to use a respectful neutral approach.
paranoid personality disorder
Personality disorder?:
critical of others because they project blame for their own shortcomings onto others
do not trust others easily, and it’s best to use a respectful neutral approach.
Paranoid personality disorder
DBT helps to replace _____________ thoughts
irrational
BPD: A major defense is _________ (alternating between idealizing and devaluing).
splitting
stored bodies of knowledge that interact with incoming information to influence selective attention and memory search
schemas
an expressive therapy which involves using child and adolescent literature to help the child express feelings in a supportive environment, gain insight into feelings and behavior, and learn new ways to cope with difficult situations.
bibliotherapy
Form of therapy:
child-centered and typically builds on the foundation of the psychodynamic, object-relations, and attachment theories.
play therapy
when does play therapy start? (what age)
Age 3
in children this form of therapy is useful for:
posttraumatic stress disorder, disruptive behavior disorders, mood disorders, and reactive attachment disorder.
play therapy
is normally viewed as the best way to begin play therapy. Structured play is rarely used until nondirective play has enabled a full assessment of relevant themes and issues, and the child’s trust around anxiety-laden issues has been developed.
nondirective play
_____________ in play therapy such as aggressive behavior toward a father doll) can have several meanings and should never be interpreted in a standardized fashion
symbols
This method is selected when interactions among family members need attention in order to address specific problems exhibited by the child. The goal is to increase the likelihood that improvements in the child’s mental health will occur and will be supported in the home with consistent and sustained family patterns
Family therapy
During family therapy sessions, a nurse realizes that the mother frequently allies with her daughter against the father. This is an example of which of Bowen’s concepts of family functioning?
A. Multigenerational transmission of anxiety
B. Differentiation of self
C. Emotional triangles
D. Genogram generation
C. emotional triangles
- During the first family therapy session, the mother of a child being treated for truancy and
emotional outbursts asks the nurse, “Why are you bothering to ask the rest of us questions? My
son is the one with the problems.” The best response for the nurse would be:
a. Well get more accurate information if the entire family is involved.
b. It may seem strange to you, but well get better results doing it this way.
c. When one family member is sick, the whole family system is sick as well.
d. Every family members perceptions are very important to the total picture.
D. every family members perceptions are very important to the total picture
- A 5-year-old girl on a behavior modification program is admitted to the unit. The nurse
would expect to participate in which activity based on this approach?
a. Firmly challenging the child’s irrational thoughts
b. Including the child in the creation of a behavioral contract
c. Family therapy with every member present for each session
d. Play therapy with dolls representing every member of the family
B. including the child in the creation of a behavioral contract
- A child was admitted to the childrens unit, having been sexually abused by an acquaintance of
her family. The child refuses to talk and participate in unit activities, choosing to stay in her
room with her stuffed animals. Which therapeutic intervention will best help the child release
pent-up feelings about the abuse?
a. Family therapy
b. Play therapy
c. Individual communication with the nurse
d. Role-play with other children on the unit
B. play therapy
- An adolescent was arrested for prostitution and assault on a parent. The adolescent says, I hate
my parents. They focus all attention on my brother, who’s perfect in their eyes. Which type of
therapy might promote the greatest change in the adolescent’s behavior?
a. Family therapy
b. Bibliotherapy
c. Play therapy
d. Art therapy
A. family therapy
- While planning care for a preschool child who has been physically and sexually abused, the
nurse includes play therapy because it assists the child to:
a. Learn adaptive behaviors through acting.
b. Express feelings that cannot easily be verbalized.
c. Act out aggression in a sociably acceptable manner.
d. Interact with other children in the appropriate age group.
B. express feelings that cannot be easily verbalized
Parents ask a nurse why their child will be engaged in play therapy, as “our child can play at home.” Which of the following is the most appropriate response?
A. “Play therapy is guided by the therapist, helping the child use specific toys to work through specific issues”
B. “Play therapy involves the child and parents in a psychodynamic situation that is observed by the therapist”
C. “Play therapy gives the child complete freedom to express emotions the child cannot express verbally so that the therapist can help the child work through them.”
D. “Play therapy encourages the child to verbalize thoughts and feelings as the therapist asks the child whathis or her imaginative play means.”
C. play therapy gives the child complete freedom to express emotions the child cannot express verbally so that the therapist can help the child work through them
In keeping with the mandate to treat patients in the least restrictive environment possible, how should nursing staff respond when a patient with borderline personality disorder erupts in anger and threatens to harm herself?
A. A single staff member should approach the patient to avoid startling or intimidating her.
B. One member of the staff should distract the patient by shouting at her while several others grab her from behind and wrestle her to the ground, where they pin her until she calms down.
C. Several staff members should approach the patient and ask firmly that she adhere to behavioral guidelines; if she does not, she should be placed in wrist and ankle restraints and released when the nurse in charge determines the patient is no longer at risk.
D. Several staff members should approach the patient and make clear they will not allow her to harm herself; if she does not de-escalate her behavior, she should be placed in restraints or seclusion sufficient to ensure her safety, and the nurse should obtain and order for a restraint
D. Several staff members should approach the patient and make clear they will not allow her to harm herself; if she does not de-escalate her behavior, she should be placed in restraints or seclusion sufficient to ensure her safety, and the nurse should obtain and order for a restraint
- Which of the following personality disorders have female gender as a risk factor?
A. Borderline personality disorder
B. Narcissistic personality disorder
C. Schizotypal personality disorder
D. Antisocial personality disorder
A. borderline personality disorder
- A physician describes a patient as having a Cluster C personality disorder. The patient could have which of the following (select all that apply)?
A. Obsessive-compulsive personality disorder
B. Paranoid personality disorder
C. Avoidant personality disorder
D. Borderline personality disorder
E. Narcissistic personality disorder
A. obsessive-compulsive personality disorder
C. avoidant personality disorder
When treating a patient with borderline personality disorder, the nurse might ethically establish an anti-self- harm contract with that patient in order to:
A. Establish legal protection in case of patient self-harm.
B. Set up this patient to be a role model for other patients in a group home or inpatient setting.
C. Empower the patient by allowing the patient to participate in setting expectations.
D. Reduce the risk of suicide so that the health care staff do not have to monitor the patient as closely.
C. empower the patient by allowing the patient to participate in setting expectations
An adolescent has not been living with her parents and in particular has difficulty getting along with her mother. She describes her mother as constantly bragging about imaginary accomplishments and demanding that other family members agree with her in all matters. The nurse would most appropriately educate the client about which of the following?
A. Antisocial personality disorder
B. Narcissistic personality disorder
C. Dependent personality disorder
D. Bipolar disorder
B. Narcissistic personality disorder
A patient expresses a belief that co-workers have been scheming against him and takes the nurse’s question “Do you think you might have a mental health issue?” as a personal attack, but the patient does not have hallucinations. The nurse would most appropriately consider exploring which of the following with the patient?
A. Paranoid schizophrenia
B. Paranoid personality disorder
C. Schizoid personality disorder
D. Social phobia
b. paranoid personality disorder
- When working with a patient with a dependent personality disorder, a nurse would most likely engage in which of the following therapeutic interventions?
A. Help the patient to verbalize feelings assertively and with confidence.
B. Help the patient to complete tasks in a timely manner.
C. Adopt a matter-of-fact tone in response to patient expressions of emotions.
D. Clarify consequences for stealing from other patients
A. help the patient to verbalize feelings assertively and with confidence
- What nursing diagnosis might be given to a patient with schizoid personality disorder?
A. Risk for self-directed violence related to unpredictable and erratic behavior as evidence by impulsivity
B. Risk for other-directed violence related to pervasive disregard for the rights of others related to absence of empathy
C. Chronic low self-esteem related to identity disturbance as evidenced by fear of abandonment
D. Impaired social interaction related to emotional detachment as evidenced by disinterest in close relationships
C. chronic low self-esteem related to identity disturbance as evidenced by fear of abandonment
- What nursing outcomes would be appropriate for a patient diagnosed with avoidant personality disorder? The patient will:
A. Refrain from injuring self
B. Demonstrate reality-based thoughts
C. Demonstrate self-restraint with others
D. Verbalize positive statements about self and life
D. verbalize positive statements about self and life
- The patient with antisocial personality disorder is learning appropriate outlets for anger and tension. The nurse will know that more teaching is necessary if the patient says:
A. “Just put me in restraints if I get out of control.”
B. “I will practice my deep breathing to help calm me.”
C. “Taking time-outs from stressful situations may help me regain control.”
D. “If the other interventions aren’t working I can take a PRN medication as ordered by my nurse
practitioner.”
A. just put me in restraints if i get out of control”
- The patient reports to the nurse that he has self-mutilated by cutting his arm. Which nursing interventions should be implemented (select all that apply)?
A. Provide care to wounds
B. Obtain an order for tranquilizing medications
C. Work with the patient to determine triggers
D. Provide empathy
E. Positively reinforce the behavior
F. Assist with social skills
G. Perform a risk assessment
A. provide care to the wounds
C. work with the patient to determine triggers
G. perform a risk assessment
The patient diagnosed with narcissistic personality disorder demands at 2 a.m. to speak with the nurse practitioner about the treatment plan. Which nursing statement is appropriate?
A. “Please be quiet and go back to bed. You are waking the other clients.”
B. “I can give you medication to help your anxiety.”
C. “I can see that you are angry. However, this is not an appropriate time to address your issues.”
D. “I will try to page her for you.”
C. “I can see that you are angry. However, this is not an appropriate time to address your issues.”
- The nurse provides education to a family about personality disorders. Which of the following statements by the family indicates that education has been effective?
A. “This is a long-term problem and change will be slow.”
B. “I am so happy that there is a medication for personality disorders.”
C. “I feel bad that our family life has caused these problems.”
D. “We could not have avoided this from developing as it directly caused by genetics.”
A. “This is a long-term problem and change will be slow.”
- The nurse provided education about problem solving to the patient with a personality disorder. The nurse will know that the patient requires additional teaching based on which of the patient’s following statements:
A. “The first step for me will be to figure out what the problem is.”
B. “I will try not to focus on the consequences of my actions.”
C. “I will try to come up with alternative ways to deal with situations.”
D. “I will evaluate how I did with my new way of coping.”
B. “I will try not to focus on the consequences of my actions.”
- The nurse is completing an initial assessment on a patient diagnosed with obsessive-compulsive personality disorder. What would the nurse expect to see?
A. Impulsivity and need for immediate gratification
B. Fear of abandonment
C. Perfectionism and rigidity
D. Suspiciousness and feeling of being plotted against
C. perfectionism and rigidity
- A Puerto Rican American patient uses dramatic body language when describing emotional
discomfort. Which analysis most likely explains the patients behavior? The patient:
a. has a histrionic personality disorder.
b. believes dramatic body language is sexually appealing.
c. wishes to impress staff with the degree of emotional pain.
d. belongs to a culture in which dramatic body language is the norm.
d. belongs to a culture where dramatic body language is the norm
The psychiatric advanced practice nurse is developingthe care plan for an 8-year-old child with intermittentexplosive disorder. Based on Piaget, which of thefollowing goals would be appropriate? The child will:
a) connect consequences of his behavior with the behavior itself.
b) generalize the consequences of his anger and aggression to different situations
c) identify situations in which he is likely to feel abandoned.
d) experience an increase in autonomous behavior.
A. connect consequences of his behavior with the behavior itself’
who invented theory of cognitive development
piaget
Piaget identified how many major developmental stages that children progress through when moving from infancy and continuing into early adolescence?
four
what are the four stages of cognitive development according to piaget?
- sensorimotor - birth to 2 years
- preoperational - 2-7 years
- Concrete operation - 7-12 years
- formal operational - 12 years- adulthood
what is the first stage of cognitive development (Piaget)
sensorimotor - birth to 2 years
key components - circular reactions, object permanence
what is the second stage of cognitive development (piaget)
preoperational - 2-7 years
key components - symbolic play, magical thinking
what is the third stage of cognitive development (piaget)
concrete operational - 7-12 years.
key components - reversibility, conservation
what is the last (fourth) stage of cognitive development (piaget)
formal operational- ages 12 to adulthood
key components - abstract thinking and logical thinking
Efforts to prevent an injury or illness from ever occurring.
primary prevention
Efforts to limit the effects of an injury or illness that you cannot completely prevent.
Secondary prevention
actions taken to contain damage once a disease or disability has progressed beyond its early stages
tertiary prevention
type of crises:
Describes unfavorable person-environment relationships that relate to maturational events, such as leaving home for the first time, completing school, or accepting the responsibility of adulthood.
maturational
type of crises:
- Occurs whenever a specific stressful event threatens a person’s biopsychosocial integrity and results in some degree of psychological disequilibrium.
situational
type of crises:
Initiated by an unexpected unusual events that can affect an individual or a multitude of people. National and natural disasters.
During an __________ crisis (e.g., flood, hurricane, forest fire) that affects the well-being of many people, the interventions of the PMH-APRN will be a part of the community’s efforts to respond to the event.
Adventitious crises
The goal for people experiencing a crisis is to _____________
return to the pre-crises level of functioning
A________ is a sudden ecological or man-made phenomenon that is of sufficient magnitude to require external help to address the psychosocial needs as well as the physical needs of the victims.
disaster
Mass casualty incident triage category:
Injuries are extensive and chances of survival are unlikely even with definitive care. Separate and provide comfort
o Unresponsive patients with penetrating head wounds, high spinal cord injuries, wounds involving multiple anatomical sites and organs, 2nd/3rd degree burns in excess of 60% of body surface area, seizures or vomiting within 24hr after radiation exposure, profound shock with multiple injuries, agonal respirations; no pulse, no BP, pupils fixed and dilated
Expectant
Mass casualty incident triage category:
Injuries are life-threatening but survivable with minimal intervention. Individuals in this group can progress rapidly to expectant if treatment is delayed.
o Sucking chest wound, airway obstruction secondary to mechanical cause, shock, hemothorax, tension pneumothorax, asphyxia, unstable chest and abdominal wounds, incomplete amputations, open fractures of long bones, and 2nd/3rd degree burns of 15%-40% total body surface area.
Immediate
Mass casualty incident triage category:
Injuries are significant and require medical care but can wait hours without threat to life or limb. Individuals in this group receive treatment only after immediate casualties are treated.
o Stable abdominal wounds without evidence of significant hemorrhage; soft tissue injuries; maxillofacial wounds without airway compromise; vascular injuries with adequate collateral circulation; genitourinary tract disruption; fractures requiring open reduction, débridement, and external fixation; most eye and CNS injuries
Delayed
Mass casualty incident triage category:
Injuries are minor and treatment can be delayed hours to days. Individuals in this group should be moved away from the main triage area. o Upper extremity fractures, minor burns, sprains, small lacerations without significant bleeding, behavioral disorders or psychological disturbances.
Minimal
The ABCs of psychological first aid include focusing on
A - ?
B - ?
C - ?
A (arousal),
B (behavior)
C (cognition).
mental health problem that can occur in the first 2 days to one month after a traumatic event
Acute stress disorder
first line treatment of patients with ASD
multiple session, trauma-focused cognitive behavioral therapy
mental health problem that can occur for longer than 1 month after at traumatic event
PTSD
______ is a psychosocial treatment developed by Marsha M. Linehan specifically to treat individuals with borderline personality disorder.
DBT
The capacity to pay attention, non-judgmentally to the present moment. All about living in the moment, experiencing your emotions and all your senses and being aware of them.
Mindfulness
Focuses on situations where the objective is to change something (e.g., requesting that someone do something) or to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect
Interpersonal Effectiveness
Identifying and labeling emotions; Identifying obstacles to changing emotions; Reducing vulnerability to emotion mind; Increasing positive emotional events; Increasing mindfulness to current emotions; Taking opposite action; Applying distress tolerance techniques
Emotional Regulation
DBT intervention:
The ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.
Distress tolerance
Cognitive therapy is the modality that prioritizes a client’s _______
Schema
__________ therapy advocates that, rather than trying to bring the person with dementia back to our reality, it is more positive to enter their reality.
Validation Therapy
___________ and ___________ are useful interventions for elders who are experiencing self-esteem disturbance, grief, hopelessness, powerlessness, altered role performance, and social isolation
Reminiscence therapy and life review
____________ uses the recall of past events, feelings, and thoughts to facilitate pleasure, quality of life, adaptation to present circumstances, or distraction.
Reminiscence
____________ is a structured process involving the recall of past events in one’s life in an effort to find meaning in those events. The process systematically reviews remote memories and addresses the expression of related feelings and the recognition of conflicts.
Life review
*** useful in earlier stages of dementia
__________ is used to facilitate the elder’s ability to interact with others and to renew interest in his or her surroundings
–emphasis is on stimulating interest in the environment and relationships with others.
Resocialization
a time limited response lasting 4 to 6 weeks
crisis
initiated by internal or external demands that are perceived as a threat to a persons physical or emotional functioning. Precipitating event is stressful and unusual or rare.
crisis
pharmacological choice for PTSD
SSRI
falsely attributing to others their own unacceptable feelings, impulses, or thoughts
projective identification
describes a family’s progression through the lifecycle.
The developmental theoretical approach
- Which of the following is not an example of a patient experiencing a crisis?
A. A retail store clerk is at work when a man draws a gun and demands the contents of the cash register
B. A senior in college has several final exams and a final class paper due this week as well as the oral exam for his senior thesis, which he has been writing all year
C. A family’s home burns down, and few of their belongings could be saved
D. Siblings are removed from their mother’s care due to neglect and placed in different foster homes
B. a senior in college has several final exams and a final class paper due this week as well as the oral exam for his senior thesis, which he has been writing all year
which caplan phase of crisis:
A problem arises that contributes to increase in anxiety levels. The anxiety stimulates the implementation of usual problem-solving techniques of the person.
phase 1
which caplan phase of crisis:
The usual problem-solving techniques are ineffective. Anxiety levels continue to rise. Trial-and-error attempts are made to restore balance.
phase 2
what caplan phase of crisis:
The trial-and-error attempts fail. The anxiety escalates to severe or panic levels. The person adopts automatic relief behaviors.
phase 3
what caplan phase of crisis
When these measures do not reduce anxiety, anxiety can overwhelm the person and lead to serious personality disorganization, which signals the person is in crisis.
phase 4
- A teenager who has been thrown out of his parents’ home has exhausted the hospitality of his friends and has turned to hustling to make money is in which of Caplan’s phases of crisis?
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4
C. phase 3
Which of the following is not a goal of crisis intervention?
A. Establishing long-term therapeutic support for the patient
B. Resolving the patient’s psychological trauma
C. Alleviating the patient’s acute physical and mental distress
D. Enabling the patient to return to independent functioning
A. Establishing long-term therapeutic support for the patient
- When a nurse tells a child survivor that the nurses, police officers, and firefighters are doing everything possible to make the situation better, the nurse is using which crisis support strategy?
A. Acting as a role model
B. Assessing for signs of psychosocial distress
C. Fostering expression of feelings
D. Providing verbal reassurance
D. providing verbal reassurance
While all individuals can be affected in some way by a community disaster, which group(s) is/are at greater than average risk for needing long-term mental health support after the disaster?
A. Children
B. Women
C. First responders
D. A and C
E. All of the aforementioned
D - A and C
A. children
C. first responders
Mental health nurses can play an important role in community disasters by:
A. Reporting to the disaster site as soon as they learn of the crisis
B. Becoming familiar with their community’s and agency’s disaster plans
C. Participating in local classes that offer certification in disaster training
D. All of the aforementioned
E. B and C
E. B and C
B. Becoming familiar with their community’s and agency’s disaster plans
C. Participating in local classes that offer certification in disaster training
During the initial response to a large-scale natural disaster, which ethical principle is given highest priority?
A. Utilitarianism—do the greatest good for the greatest number of people
B. Autonomy—allow each individual to make choices and decisions that seem best
C. Justice—provide equal treatment to every victim of the disaster
D. Fairness—divide available resources evenly among all disaster victims
A. Utilitarianism—do the greatest good for the greatest number of people
- When initially approaching a client who is experiencing an acute mental health crisis, the mental health nurse should:
A. Mirror the patient’s nonverbal body language
B. Smile warmly throughout the conversation
C. Use a clear, calm voice along with a relaxed posture
D. Hold the client’s hand or touch the shoulder
C. Use a clear, calm voice along with a relaxed posture
___________ is a helpful technique if a child feels self-blame regarding their parents divorce
therapeutic drawing
in geriatric therapy:
__________ is defined as the use of specifically selected animals as a treatment modality in health and human service settings.
Animal Assisted Therapy (AAT)
Transcranial magnetic stimulation has been researched in patients with the following disorders:
A. Body dysmorphic disorder
B. Posttraumatic stress disorder
C. Generalized anxiety disorder
D. Social anxiety
B. Posttraumatic stress disorder
When a patient presents with symptoms of dementia, specifying a clear cause of the dementia is frequently difficult or impossible.
True False
True
A nurse caring for patients with dementia engages in validation therapy. Which of the following describes this therapy?
A. The nurse asks a patient’s daughter to bring a family photo album, and then the nurse and daughter engage the patient in remembering the people and events in the photos.
B. The nurse responds with nonjudgmental affirmation to the emotional state of a patient who believes that she is in her childhood home and strangers are there who should not be.
C. The nurse places an easy-to-read label on the bathroom door and a large clock and calendar on the wall, and she regularly mentions the date, city, and state to patients.
D. The nurse ensures that patients do not become fatigued and that they are not asked to multitask.
A. a nurse asks a patient’s daughter to bring a family photo album and then the nurse and daughter engage the patient in remembering the people and events in the photos
A client diagnosed with a neurocognitive disorder is exhibiting behavioral problems daily at the change of shift. The client’s behavior becomes increasingly agitated. According to the Progressively Lowered Stress Threshold (PLST) Model, which action should a nurse implement in this situation?
A. Transfer the client to a higher level of care
B. Medicate the client with PRN anxiolytic medications
C. Assess environment for triggers
D. Anticipate the behavior and begin behavior-modification techniques
C. Assess environment for triggers
The Progressively Lowered Stress Threshold (PLST) Model
A. Emphasizes modifying the environment to reduce stress for the patient with dementia
B. Is associated with increased caregiver burden due
C. Suggests that multiple stimuli is needed to minimize disruptive behaviors
D. Encourages frequent change in caregiver to avoid boredom
A. Emphasizes modifying the environment to reduce stress for the patient with dementia
A patient with PTSD that has not responded to a combination of psychopharmaceutical and talk therapies says that he has heard “a new eye movement therapy” might help. Which of the following would be an accurate response by the nurse?
A. “Eye movement desensitization and reprocessing (EMDR) is a new therapy that is highly recommended for many anxiety disorders but not for PTSD. It involves having you focus on troubling thoughts and certain physical stimuli at the same time.”
B. “Eye movement desensitization and reprocessing (EMDR) is a variation on the established therapy of biofeedback. It may be effective, but it is too expensive and trained therapists are too rare for it to be practical for most patients.”
C. “Eye movement desensitization and reprocessing (EMDR) is a new therapy that is highly controversial. It involves moving your eyes while accessing troubling memories, and it is not supported by e-“
D. “Eye movement desensitization and reprocessing (EMDR) is a new therapy that the Department of Veterans Affairs and the Department of Defense highly recommend for PTSD. It involves having you focus on troubling memories or triggers and certain physical stimuli at the same time.”
D. “Eye movement desensitization and reprocessing (EMDR) is a new therapy that the Department of Veterans Affairs and the Department of Defense highly recommend for PTSD. It involves having you focus on troubling memories or triggers and certain physical stimuli at the same time.”
Which nursing intervention is most appropriate for a patient experiencing an acute stress response arising from a specific phobia?
A. Reexposure to the specific phobia
B. Providing an environment that has direct sunlight
C. Maintaining a calm, reassuring approach
D. Providing psychoeducation
C. Maintaining a calm, reassuring approach
A patient is being treated for the effects of combat-related PTSD in a virtual, three-dimensional environment. This is known as:
A. Deep brain stimulation
B. Eye movement desensitization and reprocessing
C. Virtual reality exposure therapy
D. Biofeedback
C. Virtual reality exposure therapy
A psychologist describes a 10-year-old child as struggling with industry versus inferiority in terms of Erikson’s stages of development. What difficulties might one expect this child to have? (select all that apply)
A. Not completing homework for school unless a parent sits with him
B. Struggling to withstand peer pressure and taking on different identities in different groups
C. Feeling utterly dependent on caretakers and being unable to entertain himself alone
D. Being preoccupied with death and a feeling of futility
E. Attaching no significance to rewards such as praise or allowance money in return for getting good grades or completing chores
A. not completing homework for school unless a parent sits with him
E. attaching no significance to rewards such as praise or allowance money in return for getting good grades
Which of the following is a key difference between how depression appears in children versus adults?
A. The DSM criteria used to diagnose depression
B. The possibility that the patient with depression may commit suicide
C. The causal role of family history of depression and stressful events
D. The way the patient expresses feelings of hopelessness and despair
D. The way the patient expresses feelings of hopelessness and despair
In differentiating oppositional defiant disorder (ODD) from conduct disorder (CD), the mental health care provider considers which of the following?
A. The child’s degree of impulse control
B. Whether the child talks excessively and interrupts others
C. Whether the child hurts property, animals, or people
D. The child’s tendency to resist adult authority and express anger toward adults
C. Whether the child hurts property, animals, or people
The causes of autism, which are diverse are well understood due to the many studies that have been conducted.
True False
False
A mother brings her 8-year-old son to the clinic because she is concerned about his development. Specifically, he gets teased a lot at school because he only wants to talk to his classmates about airplanes. He also throws tantrums over any perceived disruption to his focus on a task or his routine. Which of the following would be the most appropriate diagnosis to explore?
A. Autism
B. Asperger’s disorder
C. Conduct disorder
D. Attention-deficit disorder
B. Asperger’s disorder
An advanced practice nurse notes that an 8-year-old is developmentally appropriate in terms of Sullivan’s stages of development. Which of the following is a characteristic task of this age?
A. Forming opposite-sex relationships
B. Learning to delay gratification
C. Forming peer relationships
D. Developing self-identity
C. Forming peer relationships
Which of the following is a key difference between how depression appears in children versus adults?
A. The DSM criteria used to diagnose depression
B. The possibility that the patient with depression may commit suicide
C. The causal role of family history of depression and stressful events
D. The way the patient expresses feelings of hopelessness and despair
D. The way the patient expresses feelings of hopelessness and despair
A 14-year-old saw her brother shot and killed outside their father’s home and since then has complained of stomachaches and headaches and has been truant from school. The nurse would most appropriately explore which of the following in the therapeutic relationship with this patient?
A. Psychosomatic illness
B. Oppositional defiant disorder (ODD)
C. Depression
D. Posttraumatic stress disorder (PTSD)
D. Posttraumatic stress disorder (PTSD)
To address concerns about overdiagnosis of childhood bipolar disorder, which diagnosis is now used for children aged 12 years and under with persistent irritability and frequent episodes of behavioral dyscontrol?
A. Oppositional defiant disorder (ODD)
B. Conduct disorder (CD)
C. Disruptive mood dysregulation disorder (DMDD)
D. Pica
C. Disruptive mood dysregulation disorder (DMDD)
Children with PTSD often exhibit symptoms differently than adults. Rather than verbally, children may display which of the following behaviors?
A. Eating substances with no nutritional value
B. Repetitively crashing cars together following a car accident
C. Jumping from one activity to another
D. Regurgitating food following a meal
B. Repetitively crashing cars together following a car accident
The nurse is working with the parents of a child with a mental health problem in developing a system of rewards and punishments for the child’s behavior. The nurse is demonstrating integration of which theorist?
A. Freud
B. Pavlov
C. Skinner
D. Erikson
B. Pavlov
A nurse is interviewing a child diagnosed with a conduct disorder. Which of the following would the nurse expect to assess?
A. Repetitive, stereotypical behaviors
B. Difficulty organizing tasks
C. Lack of follow-through with directions
D. Bullying behaviors
D. Bullying behaviors
A child is diagnosed with ADHD. When reviewing the child’s history, which of the following would the nurse expect to find?
A. Exposure to a traumatic event
B. Difficulty engaging in quiet leisure activities
C. Frequent losses of temper
D. Previous diagnosis of oppositional defiant disorder
B. Difficulty engaging in quiet leisure activities
A group of nursing students is reviewing information about adjustment disorders in children. The students demonstrate a need for additional study when they identify which of the following as a possible stressor?
A. Witness to the death of a parent
B. Moving away of a close friend
C. Parental divorce
D. Bullying by a classmate
A. Witness to the death of a parent
Which of the following statements made by an older adult client poses the greatest concern for the nurse conducting an assessment regarding the client’s adjustment to the aging process?
A. “I use to enjoy dancing and jogging so much, but now I have arthritis in my knees so that it’s hard to even walk”
B. “I’ve given my grandchildren money for college so they can live a better life than I had.”
C. “Growing old certainly presents all sorts of challenges. I wish I knew then what I know now.”
D. “As I age I’ve found it’s harder to do the things I love doing, but I guess it will all be over soon enough.”
D. “As I age I’ve found it’s harder to do the things I love doing, but I guess it will all be over soon enough.”
Of the following options, which is the greatest barrier to providing quality health care to the older adult client?
A. Poor client compliance resulting from generalized diminished capacity
B. Inadequate health insurance coverage for the group as a whole
C. Insufficient research to provide a basis for effective geriatric health care
D. Preconceived assumptions regarding the lifestyles and attitudes of this group
D. Preconceived assumptions regarding the lifestyles and attitudes of this group
When administering a mental status examination to a patient with delirium, the nurse should
A. Give the examination when the patient is well rested
B. Choose a place without distracting environmental stimuli
C. Reorient the patient as needed during the examination
D. Medicate the patient first to reduce anxiety
B. Choose a place without distracting environmental stimuli
Used in the elderly population:
____________________ is a 30-item screening instrument that assesses orientation, registration, attention and calculation, recall, and language. It requires 5–10 minutes to administer.
The Mini-Mental State Examination
If a family is permeable and has vague boundaries it is considered ________
open
Psychiatrist _________ developed the family systems approach, also known as family systems therapy
Murray Bowen
Tommy is scared of snakes, he hates them and runs away when he sees one. His therapist brings a mouse in a cage to the office. Tommy is not allowed to look away, and he can not run out of the room. this is an example of what kind of therapy
flooding
who should be involved in teaching adolescents about drug use?
peers
____________ disorder includes a frequent and ongoing pattern of anger, irritability, arguing and defiance toward parents and other authority figures. ___________ also includes being spiteful and seeking revenge, a behavior called vindictiveness
Oppositional defiant disorder (ODD)
A person with borderline personality disorder may use _________ in the following ways: People will be seen as ‘perfect’ or ‘evil’ Something will ‘always’ or ‘never’ go right. Someone will ‘always’ or ‘never’ be loving.
splitting
