Mental health exam #3

What are the three stages of Selye’s General Adaptation Syndrome?

Alarm, resistance, and exhaustion

What characterizes the alarm phase of stress?

Acute sympathetic response to a stressor; tachycardia, tachypnea, and hypervigilance

What characterizes the resistance phase of stress?

Successful adaptation to ongoing stress while maintaining physiological stability

What characterizes the exhaustion phase of stress?

Prolonged stress overwhelms adaptation, suppresses immunity, and increases illness risk

What is the diathesis-stress model?

Genetic or biological vulnerabilities interact with environmental stressors to increase the risk of mental health symptoms

What are manifestations of severe or panic-level anxiety?

Intense physiological arousal, nausea, pounding headache, rapid speech, and feelings of impending doom

What are modifiable risk factors for generalized anxiety disorder?

Cigarette smoking, illicit substance use, interpersonal stress, and recent job loss

What are nonmodifiable risk factors for anxiety?

Genetic vulnerability, family history of anxiety, parental separation, and adverse childhood experiences

What are risk factors for adverse childhood experiences?

High parenting or economic stress, weak caregiver bonds, inconsistent discipline, low supervision, and family conflict

What characterizes generalized anxiety disorder?

Excessive, persistent worry about multiple aspects of life

What characterizes social anxiety disorder?

Avoidance of situations involving scrutiny or being the center of attention

What characterizes excoriation disorder?

Compulsive skin picking that causes tissue damage

What characterizes hoarding disorder?

Persistent difficulty discarding possessions, causing clutter and impaired functioning

What are priority nursing interventions for panic-level anxiety?

Guide mindful deep breathing, dim the lights, and use active listening

What are common cues of moderate anxiety?

Tachycardia, psychomotor agitation, impaired concentration, rumination, persistent worry, and social isolation

How can separation from family during hospitalization increase anxiety?

It can trigger panic symptoms such as increased heart rate, hand-wringing, and nervousness

What outcomes indicate effective anxiety management?

Reduced physiological arousal, improved social engagement, better concentration, and decreased reported anxiety

What characterizes illness anxiety disorder?

Preoccupation with having or developing a serious illness despite minimal or absent symptoms

How should nurses care for clients with anxiety and medical-surgical concerns?

Assess and address both physiological and psychological manifestations while prioritizing physical needs

What statement may indicate depression comorbid with illness anxiety disorder?

“I feel like everything would be easier if I were dead.”

What characterizes illness anxiety disorder in a client with generalized anxiety disorder?

Severe anxiety and preoccupation about potential causes of symptoms or serious illness

What are treatment options for illness anxiety disorder?

Psychotherapy, especially cognitive behavioral therapy, and medication when indicated

What support should nurses provide for illness anxiety disorder?

Explain the mind-body connection, teach coping skills, validate concerns, and identify support systems

What are priorities when planning care for dissociative identity disorder?

Promote safety, teach coping strategies, and encourage adequate sleep

What characterizes the discrimination attachment stage?

Around 7–11 months, infants prefer their primary caregiver and experience separation anxiety

What is the key characteristic of reactive attachment disorder?

Withdrawal from caregivers and failure to seek comfort

What is a concerning adolescent outcome of toxic stress?

Increased risk-taking behaviors

What is the first diagnostic criterion for PTSD?

Exposure to actual or threatened death, serious injury, or sexual violence

How long must PTSD symptoms persist for diagnosis?

More than one month

When does acute stress disorder occur?

Symptoms begin after trauma and last from 3 days up to 1 month

What is neuroplasticity?

The brain’s ability to reorganize and form new neural pathways

What is historical trauma?

Trauma with cumulative effects that can contribute to intergenerational disparities

What occurs during the response phase of disaster management?

Triage, rescue, and immediate lifesaving interventions

What is the foundational principle of trauma-informed care?

Safety, including physical and psychological safety

What defense mechanism involves minimizing a serious diagnosis?

Denial

What is the primary goal of crisis intervention?

Stabilize the client and allow emotional expression

Is attachment to multiple caregivers normal in a 2-year-old?

Yes, forming multiple attachments is developmentally expected

What conditions are associated with chronic toxic stress?

Depression, diabetes, COPD, and ischemic heart disease

What does violence reenactment during a child’s play suggest?

An intrusive manifestation of PTSD

What does delayed expression of PTSD mean?

Full diagnostic criteria are not met until at least 6 months after trauma

What are dissociative features of PTSD?

Depersonalization, or feeling detached from oneself, and derealization, or feeling the world is unreal

What is regression after trauma in a child?

Returning to an earlier developmental behavior, such as bed-wetting

What is concerning after an adolescent experiences a disaster?

Substance use and withdrawal

What should nurses do before procedures in trauma-informed care?

Explain each step and obtain consent

What are safe communication strategies in trauma-informed care?

Explain procedures, offer choices, promote safety, and communicate clearly before acting

How should nurses promote safety after trauma?

Reduce environmental stimuli, limit unnecessary personnel, and create a predictable environment

What is displacement?

Redirecting emotions from a threatening source toward a safer target

What are the four PTSD symptom clusters?

Intrusion, negative cognition/mood, avoidance, and arousal/reactivity

What characterizes complex trauma?

Repeated interpersonal trauma over time, often causing long-term emotional and relational difficulties

What are key principles of trauma-informed care?

Safety, trustworthiness, collaboration, and empowerment

What should disaster nurses prioritize according to Maslow’s hierarchy?

Physiological survival needs, including shelter, food, and water

How can nurses address implicit bias?

Practice ongoing self-reflection, seek feedback, and deliberately adjust practice

How can nurses manage emotional exhaustion and irritability?

Recognize personal triggers, seek peer support, and use supervision

What is an appropriate validating response during a crisis?

“I’m sorry this feels overwhelming. Tell me more about what’s happening.”

What is prolonged exposure therapy?

A PTSD treatment that gradually reduces avoidance through repeated, supported exposure to trauma cues

What are the four stages of crisis escalation?

Stage 1: Anxiety; Stage 2: Defensive behavior; Stage 3: Acting-out behavior; Stage 4: Tension reductio