Psych Quiz 1 Study Guide

What does MSE stand for and what is it used for?

Mental Status Examination; a critical assessment tool for objectively evaluating a client's current mental state

What are the components assessed in the MSE?

Appearance, perceptual disturbances, level of consciousness, mood vs affect, memory, cognitive abilities

What is the difference between mood and affect?

Mood is the subjective emotion the client feels; affect is the objective expression of that mood

What type of memory is assessed by asking a client to repeat a series of numbers?

Immediate memory

What type of memory is assessed by asking a client to recall visitors from earlier in the day?

Recent memory

What type of memory is assessed by asking verifiable facts from the past like a birth date?

Remote memory

What does the MMSE assess and how is it different from the MSE?

The MMSE is a scored worksheet used to assess cognitive status (orientation, calculation, recall, language, attention span); the MSE is an observational clinical assessment

What are the criteria for involuntary admission?

The client poses a threat to themselves or others OR is greatly disabled and cannot perform basic self-care needs due to mental illness

How many physicians are required to confirm an involuntary commitment?

Two physicians

Can a voluntary patient be discharged at any time?

Yes; a voluntary patient signs themselves in and can sign themselves out at any time

When can a voluntary admission become involuntary?

When the patient poses a threat to themselves or others

What type of admission is used when a client poses an imminent threat to themselves or others and requires a court hearing?

Emergency admission

What ethical principle refers to being truthful and honest with patients?

Veracity

What ethical principle refers to respecting a patient's right to make their own healthcare decisions?

Autonomy

What ethical principle refers to promoting good and the best patient outcomes?

Beneficence

What ethical principle refers to avoiding causing harm?

Nonmaleficence

What ethical principle refers to treating all patients fairly and equally?

Justice

What ethical principle refers to keeping promises and being faithful and loyal?

Fidelity

What type of communication often has a greater impact than words and includes posture

expressions, eye contact, and personal space?, Nonverbal communication

What therapeutic communication technique involves repeating the client's exact words to confirm understanding?

Restating

What therapeutic communication technique involves directing focus back to the client so they can examine their own feelings?

Reflecting

What therapeutic communication technique involves restating the client's feelings and thoughts in your own words to confirm them?

Paraphrasing

What therapeutic communication technique is used to help a client focus on what is actually happening and dispel hallucinations or delusions?

Presenting reality

What does "offering self" mean in therapeutic communication?

Demonstrating a willingness to spend time with the client to show genuine concern

Give an example of offering self.

"You seem scared, so I will wait here with you until your procedure is over"

What are nontherapeutic communication barriers the nurse should avoid?

Giving advice, offering personal opinions, giving false reassurance, asking "why" questions, minimizing feelings, approval or disapproval, changing the subject

Why should nurses avoid asking "why" questions?

They can make a client feel defensive

Why is saying "everything will be okay" considered nontherapeutic?

It is giving false reassurance

What is a defense mechanism?

A conscious or unconscious coping mechanism used to decrease anxiety

What defense mechanism involves refusing to accept reality?

Denial

What defense mechanism involves creating reasonable excuses for unacceptable behavior?

Rationalization

What defense mechanism involves attributing one's own unacceptable feelings to someone else?

Projection

What defense mechanism involves shifting feelings from a threatening object to a less threatening one?

Displacement

What defense mechanism involves demonstrating the exact opposite behavior of what is actually felt?

Reaction Formation

What defense mechanism involves using childlike behaviors that do not match the person's developmental level?

Regression

What defense mechanism involves voluntarily putting aside unpleasant thoughts ("I'll deal with it later")?

Suppression

What defense mechanism involves the unconscious forgetting of unpleasant thoughts?

Repression

What defense mechanism involves avoiding uncomfortable emotions by focusing only on facts and logic?

Intellectualization

What defense mechanism involves trying to "make up" for unacceptable behavior (e.g.

gifts after abuse)?, Undoing

What defense mechanism involves a mental separation from reality with memory gaps?

Dissociation

What defense mechanism involves seeing things as all good or all bad (e.g.

love to hate instantly)?, Splitting

What defense mechanism involves making up for a weakness by excelling elsewhere?

Compensation

What defense mechanism involves focusing on strengths to compensate for perceived weaknesses?

Compensation

What defense mechanism involves adopting the traits or behaviors of others?

Identification

What defense mechanism is always considered healthy?

Altruism and sublimation

What personality disorder is splitting most commonly associated with?

Borderline personality disorder

What defense mechanism involves developing physical symptoms (like deafness) due to stress rather than physical illness?

Conversion

What are the four levels of anxiety in order from lowest to highest?

Mild, Moderate, Severe, Panic-level

What level of anxiety is part of normal everyday living and actually increases one's ability to perceive reality?

Mild anxiety

What are the signs and symptoms of mild anxiety?

Restlessness, irritability, increased motivation, mild tension-relieving behaviors

What level of anxiety is characterized by selective inattention and a narrowed focus where problem-solving can still occur with direction?

Moderate anxiety

What are the signs and symptoms of moderate anxiety?

Tachycardia, increased respiratory rate, GI discomfort, muscle tension, concentration difficulties

What level of anxiety is characterized by a greatly reduced perceptual field where learning and problem-solving do not occur?

Severe anxiety

What are the signs and symptoms of severe anxiety?

Aimless activity, feelings of impending doom, hyperventilation, tachycardia, confusion

What level of anxiety is characterized by disturbed behavior

loss of touch with reality, delusions, and hallucinations?, Panic-level anxiety

What nursing interventions are used for mild to moderate anxiety?

Active listening, open-ended questions, calm presence, evaluate coping mechanisms, offer problem-solving options, encourage exercise

What nursing interventions are used for severe to panic-level anxiety?

Prioritize safety, meet physical needs, remain with client in quiet environment, use firm/short/simple statements, reality orientation; medications or restraints as last resort

Why should you NOT offer problem-solving to a client with severe or panic-level anxiety?

These clients have severely reduced perceptual fields and cannot learn or problem-solve

What are the five social determinants of mental health?

Life-course, households, community, local services, country-level (global) factors

Give an example of a community-level protective factor for mental health.

A playground in the neighborhood

Give an example of a country-level protective factor for mental health.

National policies that protect against cyberbullying

What is transference in psychotherapy?

Feelings that the client has developed toward the therapist in relation to similar feelings toward significant persons from the client's early childhood

What is countertransference in psychotherapy?

The unconscious feelings that the healthcare worker has toward the client, often because the client reminds them of someone from their past

What therapy is based on the idea that thoughts come before feelings and actions

and focuses on changing thoughts to change behavior?, Cognitive therapy

What therapy is based on the theory that behavior is learned and has consequences?

Behavioral therapy

What therapy is effective for treating anxiety and trauma-related disorders by having the client reconnect traumatizing memories in a safe environment using adaptive defense mechanisms?

Eye Movement Desensitization and Reprocessing (EMDR)

What therapy uses both cognitive and behavioral approaches to assist with anxiety management?

Cognitive-behavioral therapy (CBT)

What therapy is a CBT approach specifically for clients with personality disorders who exhibit self-injurious behavior

focusing on emotional regulation and mindfulness?, Dialectical behavior therapy (DBT)

What therapy assists clients in identifying negative thoughts

examining their cause, and replacing negative self-talk with supportive ideas?, Cognitive reframing

What therapy involves planned

progressive exposure to anxiety-provoking stimuli while the client uses relaxation techniques?, Systematic desensitization

What therapy is systematic desensitization used to treat?

Phobias that produce anxiety

What therapy involves clients receiving positive rewards for positive behavior?

Operant conditioning (positive reinforcement)

What is free association in psychotherapy?

Spontaneous, uncensored verbalization of whatever comes to a client's mind

What leadership style in group therapy supports group interaction and decision-making to solve problems?

Democratic leadership

What leadership style in group therapy has no direction or control by the leader?

Laissez-faire leadership

What leadership style in group therapy has the leader completely controlling the direction without group interaction?

Autocratic leadership

What is the primary focus of the planning phase of group therapy?

Identify group characteristics like member inclusion, group name, seating configuration, and schedule

What is the primary focus of the orientation phase of group therapy?

Define the purpose and goals of the group

What is the primary focus of the working phase of group therapy?

Promote problem-solving skills to facilitate behavioral changes

What seating configuration emphasizes equality in group therapy?

Circular seating

What is scapegoating in family therapy?

A family member with little power is blamed for problems within the family

What is triangulation in family therapy?

A third party is drawn into an unstable two-person relationship

What are enmeshed boundaries in a dysfunctional family?

Thoughts, roles, and feelings blend so much that individual roles are unclear

What are rigid boundaries in a dysfunctional family?

Rules and roles are completely inflexible; members isolate themselves and communication is minimal

What are the physiological signs of acute stress (fight or flight)?

Increased respiratory rate, heart rate, cardiac output, blood pressure; increased metabolism and glucose use; depressed immune system; decreased appetite

What are the effects of prolonged/maladaptive stress?

Chronic anxiety, depression, chronic pain, sleep disturbances, weight gain/loss, increased risk for MI and stroke, increased risk for infection, fatigue, poor diabetes control

What relaxation technique involves purposefully tensing specific muscle groups and then relaxing them progressively?

Progressive muscle relaxation

What relaxation technique involves guiding the client through a series of calming images?

Guided imagery

What exercise promotes relaxation by releasing endorphins that lower anxiety and have antidepressant effects?

Physical exercise (yoga, walking, biking)

What does ECT stand for and how does it work?

Electroconvulsive therapy; it uses electrical current to induce brief seizure activity while the client is anesthetized

What neurotransmitters does ECT theoretically enhance?

Serotonin, dopamine, and norepinephrine

What is the typical course of ECT treatment for depression?

Two to three times per week for a total of 6 to 12 treatments

What cardiovascular conditions are contraindications for ECT?

Recent myocardial infarction, hypertension, heart failure, cardiac arrhythmias

What cerebrovascular conditions are contraindications for ECT?

History of stroke, brain tumor, subdural hematoma

What is OCD?

A disorder where the client has intrusive thoughts of unrealistic obsessions and tries to control them with compulsive behaviors (e.g., repetitive handwashing)

Which hoarding disorder differs from other OCD-related disorders in terms of gender prevalence?

Hoarding disorder has a higher prevalence among males; most other anxiety/OCD disorders are more common in females

What are the four or more manifestations present during a panic attack?

Palpitations, shortness of breath, choking/smothering sensation, chest pain, nausea, depersonalization, fear of dying or insanity, chills or hot flashes

What is generalized anxiety disorder (GAD)?

Uncontrollable, excessive worry for the majority of days over at least 6 months causing significant impairment in functioning

What are the manifestations of GAD?

Restlessness, muscle tension, avoidance of stressful activities, increased prep time for stressful events, procrastination in decision-making, sleep disturbance

What drug class is the first-line treatment for anxiety and OCD?

SSRIs (Selective serotonin reuptake inhibitors)