Abnormal Psychology & Psychiatric Nursing Care – Lecture Review

A comprehensive set of question-and-answer flashcards covering thought and speech disturbances, mood and affect, memory disorders, suicide risk, mood disorders, aggression management, psychotic symptoms, anxiety, and abuse interventions from the lecture on abnormal psychology and psychiatric nursing care.

What is tangentiality in thought disturbances?

A communication pattern where the client wanders off topic, lacks focus, and does NOT answer the original question.

How does circumstantiality differ from tangentiality?

The client gives excessive, unnecessary details yet eventually answers the question asked.

Define flight of ideas.

Rapid, continuous speech that jumps from one topic to another with some logical connection; speech is pressured.

What characterizes looseness of association?

Thoughts are fragmented with little or no logical connection; normal speech rate but absent meaningful links.

Explain thought insertion.

The false belief that others are putting thoughts into the client’s mind.

Explain thought withdrawal.

The belief that others are removing thoughts from the client’s mind.

What is thought blocking?

A sudden stop in the middle of a thought or sentence, leaving the client unable to continue.

Define thought broadcasting.

The belief that one’s thoughts are audible to or known by others.

Describe ‘word salad.’

Jumbled, incoherent words or phrases with no meaningful sentences.

What is clang association?

Speech in which ideas are connected by sound or rhyme rather than meaning; rhythm present, meaning absent.

Define verbigeration.

Automatic repetition of stereotyped phrases with or without meaning.

Define perseveration (speech).

Persistent adherence to a single idea or topic despite new questions or conversation.

What is stilted language?

Overly formal, pompous, flowery, or poetic speech that sounds unnatural.

Define neologism.

Creation of new, idiosyncratic words understood only by the patient.

Differentiate echolalia and palilalia.

Echolalia = repeating others’ words; Palilalia = repeating one’s own words rapidly.

Mood vs. Affect – what is the key difference?

Mood = internal emotional state; Affect = observable outward expression of emotion.

What is a broad (full-range) affect?

Displays the entire range of emotional expressions considered normal.

Describe a flat affect.

No observable emotional expression.

What is restricted (constricted) affect?

Shows only one type or a very narrow range of emotional expression.

Define blunt affect.

Minimal but discernible emotional expression.

What is inappropriate affect?

Emotional response opposite or unrelated to the situation.

Define labile affect.

Sudden, unpredictable shifts of emotion.

What is anterograde amnesia?

Inability to form new memories after the onset of the condition.

State a key nursing intervention for anterograde amnesia.

Provide frequent reorientation (time, place, person, situation).

Define retrograde amnesia.

Loss of memories formed before the onset of the condition.

What is confabulation and in which disorder is it common?

Fabrication of stories to fill memory gaps; common in dementia.

Priority nursing action for a withdrawn patient who rejects interaction.

Offer self and use therapeutic silence to show willingness to stay.

List three characteristics of therapeutic activities for withdrawn patients.

Achievable, non-competitive, self-esteem–enhancing.

Initial nursing approach when a depressed patient refuses to talk.

Offer self and maintain silence while remaining present.

Why are highly structured, simple, achievable activities used with depressed patients?

They distract from negative self-talk, require minimal planning, and build self-esteem through success.

Differentiate active and passive suicidal ideation.

Active: has specific plan/intent to die; Passive: wishes to die but no specific plan.

Give two behavioral warning signs from GCASH AIL that indicate suicide risk.

Examples: Giving away valuables, sudden cheerfulness/energy after depression, cancelling appointments, apologetic behavior, etc.

What is the nurse’s first action when a patient reveals a suicide plan?

Directly assess the plan (confront and clarify details) to determine lethality.

Key components of a suicide safety contract.

Patient agrees to seek staff when suicidal thoughts intensify and to avoid self-harm without telling staff.

During suicide precautions, what is the safest level of observation?

One-to-one monitoring with the nurse within 1 meter at all times.

Name two major biological risk factors for Major Depressive Disorder.

Low serotonin and low norepinephrine levels.

Define anhedonia.

Loss of interest or pleasure in almost all activities.

Hallmark cognitive feelings of Major Depressive Disorder.

Hopelessness, helplessness, and worthlessness.

Environmental setting recommended for a manic patient.

Quiet, safe, private room with minimal external stimuli.

Best food type for a manic patient and why.

High-calorie finger foods to ensure nutritional intake while on the move.

Suitable physical activities for a manic patient.

Non-competitive, gross-motor activities such as walking.

Main difference between Bipolar I and Bipolar II disorder.

Bipolar I includes full mania with possible delusions; Bipolar II involves hypomania without delusions.

Neurotransmitter changes linked to manic episodes.

Increased norepinephrine and serotonin.

List the four phases of the anger (assault) cycle.

Triggering, Escalation, Crisis, Recovery, Post-crisis.

Key nursing intervention during the triggering phase of anger.

Encourage verbalization and validate feelings; redirect to non-competitive physical activity if possible.

What is the priority during the escalation phase of aggression?

Set firm limits, remain calm, move patient to a quiet area, offer PRN anxiolytics.

When is seclusion or restraint indicated in the anger cycle?

During the crisis phase when there is imminent or actual physical harm.

Maximum continuous restraint time for a healthy adult.

4 hours.

How many staff are needed to safely apply restraints?

At least 4–6 staff: one for each limb, one for head, one for torso.

Recommended sequence for removing four-point restraints.

One limb at a time every 10 minutes; dominant hand is removed last.

Primary focus during the recovery phase after aggression.

Explore alternative coping strategies with the patient when they are ready.

Define grandiose delusion.

False belief of exaggerated importance, power, or identity (e.g., ‘I’m invincible’).

What is a persecutory delusion?

False belief that one is being harmed, followed, or conspired against.

Describe a somatic delusion.

False belief of having a physical defect or medical condition.

Define nihilistic delusion.

Belief that oneself, part of the body, or the world does not exist or has been destroyed.

What is an erotomanic delusion?

False belief that another person, usually of higher status, is in love with the patient.

Explain ‘ideas of reference.’

Belief that unrelated events or remarks are specifically directed at oneself.

State the ‘CAVE’ approach to managing delusions.

Clarify feelings, Acknowledge emotions, Voice doubt (present reality), Engage in reality-based activity; avoid challenging or arguing.

Differentiate illusions from hallucinations.

Illusions = misinterpretations of real external stimuli; Hallucinations = perceptions with no external stimulus.

Which hallucination type is most dangerous and why?

Command auditory hallucinations because they may order the patient to harm self or others.

Tactile hallucinations are commonly associated with which condition?

Alcohol withdrawal (e.g., formication).

Explain the HARDER mnemonic for hallucination management.

H – Acknowledge Hallucination; A – Assess content; R – Reinforce Reality; D – Divert attention; E – Engage in reality activity; R – Reintegrate socially.

Genetic risk of schizophrenia if both parents are affected.

Approximately 35% chance.

Primary neurotransmitter implicated in positive symptoms of schizophrenia.

Excess dopamine.

Give two positive (hard) symptoms of schizophrenia.

Examples: Delusions, hallucinations, flight of ideas, looseness of association, echopraxia, bizarre behavior.

Give two negative (soft) symptoms of schizophrenia.

Alogia, avolition, anhedonia, apathy, asociality, flat/blunt affect.

Nursing intervention priority for a patient in panic-level anxiety.

Ensure safety, stay with the patient, move to a quiet low-stimulus area, use calm voice; consider PRN IM anxiolytics.

Legal responsibility of the nurse regarding suspected child abuse.

Must report suspicion to authorities (e.g., Bantay Bata 163); certainty is NOT required.

What type of injury pattern in a child strongly suggests abuse?

Serious injuries with inconsistent history or varying stages of healing.

First nursing priority when caring for an abuse victim.

Address and treat physical injuries before psychosocial interventions.

Key elements of a safety plan for patients experiencing intimate-partner violence.

Identify escape route, have emergency contacts/hotline numbers, prepare essential documents and funds, know where to go.