NSG 3233 Mental Health — ATI CMS Master Study Guide

Flashcards covering the CORE concepts of the ATI Mental Health CMS exam, following VOCABULARY style with a focus on priority rules, definitions, and emergency medication signs.

Mental Health Priority Order

The hierarchy of intervention starting with Safety (suicide, homicide, violence), followed by Physiological needs, Severe psychiatric symptoms, and finally Psychosocial needs.

Therapeutic Communication

Purposeful, client-centered, goal-directed communication used to build and maintain the therapeutic relationship.

Open-ended questions

A therapeutic technique that uses phrases like "Tell me more about that" to encourage the client to talk.

Reflection

A technique where the nurse directs the client's feelings back to them, such as: "You feel like this situation is overwhelming."

Hallucination

A sensory experience without an external stimulus, which can be auditory, visual, tactile, olfactory, or gustatory.

Command hallucinations

An immediate safety issue where voices tell the client to perform specific actions, such as harming themselves or others.

Delusion

A fixed false belief that the nurse should neither argue with nor agree with, but instead acknowledge feelings and present reality.

Phases of the Therapeutic Relationship

The three major stages identified by ATI as orientation, working, and termination.

Milieu

A supportive therapeutic environment that uses structure and group interaction to help clients feel safe and develop coping skills.

Autonomy

The ethical principle where the patient makes their own decisions.

Beneficence

The ethical principle of doing good.

Nonmaleficence

The ethical principle of doing no harm.

Justice

The ethical principle of treating people fairly.

Fidelity

The ethical principle of keeping promises.

Veracity

The ethical principle of telling the truth.

Involuntary Admission

Admission related to safety concerns involving danger to self, danger to others, or an inability to meet basic needs.

Mild Anxiety

A level of anxiety where the patient can still learn, problem-solve, and focus; nursing focus is on teaching and coping skills.

Panic Level Anxiety

A severe state where the patient may lose touch with reality or become unable to communicate; nursing priorities are safety, staying with the client, and reducing stimuli.

Generalized Anxiety Disorder (GAD)

A condition characterized by excessive ongoing worry, restlessness, fatigue, and muscle tension.

Obsession

A repetitive thought, such as the belief that one's hands are contaminated.

Compulsion

A repetitive action, such as washing hands $50$ times, performed to reduce anxiety.

Denial

A defense mechanism where a person rejects the reality of a situation, such as saying "The doctor made a mistake."

Projection

A defense mechanism where an individual attributes their own unacceptable feelings onto someone else.

Displacement

Taking emotions out on a safer target, such as yelling at a spouse after being made angry by a boss.

Rationalization

Creating an excuse for a failure or behavior, such as blaming an

Regression

A defense mechanism where an adult returns to younger behaviors, such as crying or throwing tantrums.

Reaction Formation

Doing the exact opposite of how one truly feels, such as being excessively nice to someone you dislike.

Sublimation

Turning unacceptable impulses into productive activities, such as an angry person taking up boxing.

Splitting

A defense mechanism common in Borderline Personality Disorder where people or things are viewed as all good or all bad.

SSRIs

First-line medications for anxiety and depression, including Fluoxetine and Sertraline, which work by blocking serotonin reuptake.

Serotonin Syndrome

A life-threatening condition caused by excessive serotonin, manifesting as agitation, confusion, fever, hyperreflexia, and tremors.

Tyramine

A substance in aged cheeses and cured meats that can cause a hypertensive crisis when consumed by patients taking MAOIs.

ECT (Electroconvulsive Therapy)

A treatment for severe or treatment-resistant depression where the priority after the procedure is airway protection.

Suicide Precautions

Includes $1:1$ constant observation and the removal of potentially lethal objects like belts, shoelaces, and glass.

Bipolar I Disorder

A mood disorder characterized by at least one episode of full mania.

Lithium

The gold-standard mood stabilizer for bipolar disorder, requiring serum monitoring due to a narrow safety margin.

Positive Schizophrenia Symptoms

Manifestations added to normal behavior, including hallucinations, delusions, and disorganized speech.

Negative Schizophrenia Symptoms

The loss of normal function, manifesting as flat affect, alogia, avolition, and social withdrawal.

Word salad

A disorganized speech pattern where words are mixed together without any meaningful connection.

Acute Dystonia

An extrapyramidal side effect characterized by sudden muscle spasms of the neck, jaw, tongue, and eyes.

Tardive Dyskinesia

A late-onset involuntary movement disorder involving lip smacking, tongue movements, and facial motions.

Neuroleptic Malignant Syndrome (NMS)

A medical emergency associated with antipsychotics characterized by fever, severe muscle rigidity, tachycardia, and altered consciousness.

Agranulocytosis

A serious side effect of Clozapine involving a dangerous drop in WBC/ANC; monitored via fever and sore throat.

Borderline Personality Disorder

A disorder characterized by unstable relationships, impulsivity, splitting, and a fear of abandonment.

Conversion Disorder

A condition where a patient experiences neurological symptoms, like inability to walk or see, with no neurological cause after a major stressor.

Anorexia Nervosa

An eating disorder focused on restricting intake, characterized by very low weight, bradycardia, and hypotension.

Russell sign

Calluses on the knuckles or hand resulting from repeated self-induced vomiting in bulimia nervosa.

Refeeding Syndrome

A complication of feeding severely malnourished patients too rapidly, causing dangerous shifts in electrolytes like phosphorus.

Delirium

An acute, fluctuating state of confusion often caused by a medical condition like a UTI or dehydration and is frequently reversible.

Dementia

A gradual, progressive, and usually irreversible neurocognitive decline.