mental health exam 1

Crisis: What is happening in the condition, and what key duration or definition should you know?

A stressor overwhelms usual coping and supports. This is acute, not automatically mental illness.

Crisis: What are the signs and symptoms?

Anxiety rises; anger, pacing, clenched fists, yelling, threats or destructive behavior may appear.

Crisis: What should the nurse assess?

Immediate danger, baseline function, the stressor, perception, supports and coping skills.

Crisis: What should the nurse do?

Protect safety. Use therapeutic communication and mobilize supports. Aim for at least pre-crisis functioning and improved coping

Generalized anxiety disorder (GAD): What is happening in the condition, and what key duration or definition should you know?

Persistent worry keeps the body aroused. Difficult-to-control worry lasts at least six months.

Generalized anxiety disorder (GAD): What are the signs and symptoms?

excessive worry, restlessness, fatigue, poor concentration, irritability, muscle tension and poor sleep.

Generalized anxiety disorder (GAD): What should the nurse assess?

Safety, severity, daily function, substances and possible medical causes.

Generalized anxiety disorder (GAD): What should the nurse do?

Communicate calmly. Teach cognitive behavioral therapy (CBT) skills, coping and sleep routines. Track worry and function.

Panic disorder: What is happening in the condition, and what key duration or definition should you know?

Body sensations and catastrophic interpretations amplify fear; avoidance reinforces it. Recurrent unexpected attacks cause at least one month of concern or avoidance.

Panic disorder: What are the signs and symptoms?

Sudden intense fear, racing heart, sweating, trembling, breathlessness, chest discomfort or dizziness.

Panic disorder: What should the nurse assess?

Airway, breathing, vital signs and possible medical causes of new symptoms.

Panic disorder: What should the nurse do?

Stay with the patient. Reduce stimulation and use brief directions. Coach paced breathing; no paper bag. Teach after recovery.

Obsessive-compulsive disorder (OCD): What is happening in the condition, and what key duration or definition should you know?

Obsessions cause anxiety. Compulsions briefly relieve it, reinforcing the ritual.

Obsessive-compulsive disorder (OCD): What are the signs and symptoms?

Intrusive unwanted thoughts; washing, checking, counting or other rituals

Obsessive-compulsive disorder (OCD): What should the nurse assess?

Time spent on rituals, anxiety, function, insight, sleep, appetite and skin injury.

Obsessive-compulsive disorder (OCD): What should the nurse do?

Use compassion and a written routine. Support exposure with response prevention. Teach family support without reinforcing rituals.

Somatic symptoms: What is happening in the condition, and what key duration or definition should you know?

Anxiety-related arousal can create bodily symptoms. Medical illness can coexist; symptoms alone do not establish somatic symptom disorder.

Somatic symptoms: What are the signs and symptoms?

pain, fatigue, palpitations, abdominal pain

Somatic symptoms: What should the nurse assess?

New symptoms, urgent warning signs, medical causes and effect on function.

Somatic symptoms: What should the nurse do?

Validate the experience. Arrange consistent follow-up and support coping. Do not dismiss symptoms as imaginary.

Major depressive disorder (MDD): What is happening in the condition, and what key duration or definition should you know?

Multiple biological and psychological factors affect mood. Depressive episodes last at least two weeks.

Major depressive disorder (MDD): What are the signs and symptoms?

Loss of pleasure, worthlessness, slowed activity or agitation, poor self-care and suicidal thoughts.

Major depressive disorder (MDD): What should the nurse assess?

Suicide risk first; then mood, sleep, food, fluids, self-care and functioning.

Major depressive disorder (MDD): What should the nurse do?

Protect against self-injury. Support meals, sleep and daily activities. Teach adherence, recurrence signs and reporting suicidal thoughts.

Persistent depressive disorder: What is happening in the condition, and what key duration or definition should you know?

Chronic depressive symptoms: at least two years in adults or one year in children and adolescents.

Persistent depressive disorder: What are the signs and symptoms?

Low mood most days, low energy, poor self-esteem, poor concentration, hopelessness and sleep or appetite changes.

Persistent depressive disorder: What should the nurse assess?

Suicide risk and baseline daily functioning.

Persistent depressive disorder: What should the nurse do?

Support psychotherapy, consistent routines and prescribed treatment. Reassess mood, safety and function.

Bipolar disorder: What is happening in the condition, and what key duration or definition should you know?

Mood regulation shifts into mania or hypomania and depression. Bipolar I requires mania; bipolar II has hypomania plus major depression without mania.

Bipolar disorder: What are the signs and symptoms?

High or irritable mood, less need for sleep, grandiosity, racing thoughts and risky behavior; depression may also occur.

Bipolar disorder: What should the nurse assess?

Injury and suicide risk, sleep, fluids, nutrition, judgment and functioning.

Bipolar disorder: What should the nurse do?

Prevent injury. Reduce stimulation. Offer rest, fluids and easy-to-eat food. Set brief, clear limits and monitor medication.

Suicidal ideation and behavior: What is happening in the condition, and what key duration or definition should you know?

a spectrum of thoughts, plans, and actions related to self-harm and ending one's life

Suicidal ideation and behavior: What are the signs and symptoms?

Warnings of intent, past attempts, risky behavior or access to lethal means.

Suicidal ideation and behavior: What should the nurse assess?

Ask directly about thoughts, intent, plan, means and past attempts. Assess lethality.

Suicidal ideation and behavior: What should the nurse do?

Stay with the patient, activate precautions, remove hazards, notify the team, and reassess. Use a safety plan, not a promise.

Attention-deficit and hyperactivity disorder (ADHD): What is happening in the condition, and what key duration or definition should you know?

condition involving altered executive function and dopamine dysregulation, shaped by genetic, neurobiological, and environmental factors. Lasts for at least 6 months and begins before the age of 12.

Attention-deficit and hyperactivity disorder (ADHD): What are the signs and symptoms?

Inattention, fidgeting, blurting answers, unfinished tasks and difficulty following directions.

Attention-deficit and hyperactivity disorder (ADHD): What should the nurse assess?

Injury risk, school and social function, sleep, appetite and family coping.

Attention-deficit and hyperactivity disorder (ADHD): What should the nurse do?

Use structure, consistent rewards, and short instructions. Combine behavioral and school supports with prescribed treatment.

Autism spectrum disorder (ASD): What is happening in the condition, and what key duration or definition should you know?

Neurodevelopmental differences affect social communication and repetitive behavior.

Autism spectrum disorder (ASD): What are the signs and symptoms?

Differences in reciprocal interaction, communication, gestures, play or repetitive movements.

Autism spectrum disorder (ASD): What should the nurse assess?

Individual communication, strengths, developmental needs and safety

Autism spectrum disorder (ASD): What should the nurse do?

Use predictable, individualized care. Coordinate family, school and language/developmental therapies. Medication targets specific symptoms, not a cure.

Intellectual developmental disorder: What is happening in the condition, and what key duration or definition should you know?

Intellectual and adaptive skills are impaired; onset is before age eighteen.

Intellectual developmental disorder: What are the signs and symptoms?

Difficulty with communication, self-care, learning, relationships or safe daily living.

Intellectual developmental disorder: What should the nurse assess?

Assess intellectual ability and adaptive skills separately. Identify actual strengths and limitations.

Intellectual developmental disorder: What should the nurse do?

Match instructions to abilities, involve family and promote independence.

Oppositional defiant disorder (ODD): What is happening in the condition, and what key duration or definition should you know?

Genes, temperament and social conditions may interact; persistent opposition differs from occasional defiance.

Oppositional defiant disorder (ODD): What are the signs and symptoms?

Defiant, disobedient or hostile behavior toward authority

Oppositional defiant disorder (ODD): What should the nurse assess?

Safety, behavior, daily function, coexisting ADHD or other problems.

Oppositional defiant disorder (ODD): What should the nurse do?

Use parent-management training; have consistent limits. Support family strengths. Medication may treat ADHD, not ODD.

What are the four phases of a crisis in order?

Stressor occurs. Usual coping fails, and anxiety rises. All resources are mobilized. Lastly, major disorganization can occur.

What three factors determine the response to a crisis?

Perception of the event, available supports and coping skills.

What are the six crisis types, and how do they differ?

Dispositional: external stressor.

Anticipated transition: expected life change feels uncontrollable.

Traumatic stress: unexpected overwhelming event.

Developmental: life-stage tasks are not mastered.

Psychopathology: a psychiatric condition influences the crisis.

Psychiatric emergency: functioning is severely impaired.

What makes an event a disaster?

Local resources are overwhelmed and community safety is threatened.

How may adults and children respond to a disaster?

Adults: fear, anger, sadness, disbelief, poor sleep or increased substance use.

Children: separation anxiety, nightmares or poor concentration.

What must a person process in traumatic bereavement, and what should the nurse assess?

Process both the sudden loss and how it happened. Guilt and fear are common; assess ongoing post-traumatic stress symptoms.

How do mild and moderate anxiety affect learning, and how should teaching change?

Mild can improve learning.

Moderate narrows attention; simplify teaching.

What are the nursing priorities for severe and panic-level anxiety?

Severe limits concentration; reduce stimulation.

Panic causes terror and disorganization; stay present and protect safety. Detailed teaching waits.

How do CBT, exposure, response prevention and medication differ in anxiety treatment?

CBT changes unhelpful thoughts and behavior.

Exposure confronts avoidance.

OCD response prevention delays or avoids the ritual.

Maintenance medication takes weeks;

selected benzodiazepines provide brief relief.

Which communication techniques help, and which should the nurse avoid?

Explore, clarify, reflect, restate and present reality.

Avoid advice, belittling, arguing, probing and false reassurance. Direct safety questions come first when risk is present.

What are content, context and nonverbal process, and what should the nurse do when messages conflict?

Content is the words

context is the situation

nonverbal process adds meaning.

Clarify conflicting verbal and nonverbal messages.

How should the nurse begin and conduct a therapeutic communication session?

Introduce yourself, agree on the relationship, ask the preferred name and identify the main concern. Listen actively and respect culture, space and touch preferences.

What communication distances are listed in the lecture?

Intimate: 0-18 inches. Personal: 18-36 inches. Social: 4-12 feet. Public: 12-25 feet. therapeutic distance: 3-6 feet.

How do assertive, passive, aggressive and passive-aggressive communication differ?

State needs honestly and respectfully using calm I statements. Passive does not express needs clearly; aggressive disregards rights; passive-aggressive resists indirectly. Broken record means calmly repeating a consistent statement.

What five types of touch are listed, and what should the nurse check before using touch?

Functional-professional, social-polite, friendship-warmth, love-intimacy and sexual-arousal.

How do mania and hypomania differ in duration and severity, and what do anhedonia and rumination mean?

Mania: at least one week, or less if hospitalization is needed. Hypomania: at least four days, without marked impairment, hospitalization or psychosis. Anhedonia is loss of pleasure; rumination is repetitive thinking.

How do postpartum blues, depression and emergency symptoms differ?

Blues are mild and usually resolve within two weeks. Persistent severe depression needs treatment. Hallucinations, delusions, confusion or mania require emergency protection of parent and infant.

What ADHD screening scales and elimination-disorder age cutoffs are listed, and how does conduct behavior differ from ODD?

ADHD scales: SNAP-IV and Conners; screening is not a diagnosis. ODD is defiance.

What are excoriation, trichotillomania and onychophagia, and what should the nurse assess?

Excoriation: skin picking with lesions. Trichotillomania: hair pulling and loss. Onychophagia: nail biting. Assess injury and function;

How do body dysmorphic disorder and hoarding differ, including safety priorities?

Body dysmorphic disorder: distress about a slight or absent perceived flaw; assess suicide risk. Hoarding: difficulty discarding causes unsafe clutter; assess fire and fall hazards.

What do kleptomania, oniomania and BIID mean in the lecture?

Kleptomania: compulsive stealing. Oniomania: compulsive buying. BIID: lecture body-identity mismatch term. Assess harm; do not assume the same drug regimen as OCD.

How do cyclothymia, DMDD, seasonal depression, PMDD and substance-related mood changes differ?

Cyclothymia: prolonged subthreshold highs and lows. DMDD: chronic childhood irritability and outbursts, ages six to eighteen in the lecture. Seasonal depression follows a season. PMDD improves after menses. Assess exposure timing for substance-related mood symptoms.

What psychotherapy and depression-screening methods are named in the lecture?

cognitive therapy addresses distorted thinking. Zung and Beck are self-report scales; Hamilton is clinician-rated.

What somatic depression treatments are named, and does nonsuicidal self-injury eliminate suicide risk?

ECT, transcranial magnetic stimulation, magnetic seizure therapy, deep brain stimulation and vagal nerve stimulation. Nonsuicidal self-injury still requires wound and suicide assessment.

What can contribute to intellectual disability, how should function be assessed, and what does the lecture say about ASD and MMR?

Intellectual disability causes may include hereditary conditions, prenatal alcohol, malnutrition, hypoxia, infection, trauma, lead or limited stimulation. Assess intellectual and adaptive skills separately. ASD is not linked to MMR vaccination in the lecture.

How do childhood learning, coordination, stereotypic movement and communication problems differ?

Learning disorders affect academics. Coordination problems affect daily activity. Stereotypic movements may injure. Communication disorders affect language or speech. Use individual strengths and family or school supports.

What signs distinguish anger from aggression, and what follow-up and support matters after suicidal behavior?

Anger: frowning, clenched fists, yelling. Aggression: threats, pacing or destruction. Suicide follow-up is emphasized after attempts, especially early. Support families without blame; recognize staff grief and use colleague support.

Alprazolam (Xanax) | Benzodiazepine: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Brief anxiety or panic relief. Life-threatener: Respiratory depression, especially with opioids. Nursing first: Check breathing, alertness and other sedatives. Patient warning: Do not mix with alcohol or stop regular use abruptly.

Lorazepam (Ativan) | Benzodiazepine: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Brief anxiety or acute distress relief. Life-threatener: Respiratory depression; rapid intravenous use may cause apnea. Nursing first: Check breathing and sedation; monitor closely during intravenous use. Patient warning: Do not mix with alcohol or stop regular use abruptly.

Buspirone (BuSpar, historical) | Nonbenzodiazepine anxiolytic: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Ongoing anxiety; benefit builds over weeks, not immediate rescue. Life-threatener: Serotonin syndrome with interacting drugs. Nursing first: Review MAOI and serotonergic interactions. Patient warning: Do not use as an as-needed rescue; take consistently with or without food.

Hydroxyzine (Vistaril) | Sedating antihistamine: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Symptomatic anxiety relief; may cause dry mouth and sedation. Life-threatener: Dangerous QT-related rhythm disturbance. Nursing first: Review QT risk, other drugs and sedation. Patient warning: Do not mix with alcohol or drive until effects are known.

Clonidine (Catapres; Kapvay) | Central alpha-two agonist: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Reduces sympathetic symptoms; anxiety use is off-label. Certain extended-release products treat ADHD. Life-threatener: Severe hypotension or bradycardia. Nursing first: Check actual blood pressure and pulse. Patient warning: Do not stop suddenly; rebound hypertension can occur.

Propranolol (Inderal) | Nonselective beta blocker: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Reduces physical anxiety symptoms, not the underlying worry. Life-threatener: Bronchospasm, especially with asthma. Nursing first: Check blood pressure, pulse and asthma or wheezing history. Patient warning: Do not stop abruptly; report wheezing or fainting.

Fluoxetine (Prozac; Sarafem) | SSRI antidepressant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Depression treatment over weeks; long half-life stands out. Life-threatener: Serotonin syndrome; monitor worsening suicidality too. Nursing first: Assess suicide and mania risk; review MAOI interactions. Patient warning: Do not start an MAOI until at least five weeks after stopping, per prescribed plan.

Sertraline (Zoloft) | SSRI antidepressant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Depression, OCD or panic treatment; benefit takes weeks. Life-threatener: Serotonin syndrome; monitor worsening suicidality too. Nursing first: Assess suicide and mania risk and interacting drugs. Patient warning: Do not stop without a plan; report new suicidal thoughts or agitation.

Paroxetine (Paxil) | SSRI antidepressant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Depression and indicated anxiety or panic; withdrawal and pregnancy precautions stand out. Life-threatener: Serotonin syndrome; monitor worsening suicidality too. Nursing first: Assess suicide and mania risk; discuss pregnancy plans. Patient warning: Do not stop abruptly; discuss pregnancy promptly.

Duloxetine (Cymbalta) | SNRI antidepressant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Depression and GAD; also used for certain pain conditions. Life-threatener: Severe liver injury. Nursing first: Check liver history, alcohol use, blood pressure and suicide risk. Patient warning: Do not use substantial alcohol; report jaundice or dark urine.

Bupropion (Wellbutrin) | Norepinephrine-dopamine reuptake inhibitor: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Depression; seizure-risk screening distinguishes it from SSRIs. Life-threatener: Seizures. Nursing first: Check seizure and anorexia or bulimia history; blood pressure. Patient warning: Do not double doses or crush sustained-release or extended-release tablets.

Lithium carbonate (Lithobid) | Mood stabilizer: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Controls mania and prevents bipolar recurrence. Life-threatener: Lithium toxicity. Nursing first: Review timed level, kidney function, hydration and sodium. Patient warning: Do not suddenly change salt or fluid intake; report vomiting, coarse tremor or confusion.

Carbamazepine (Tegretol; Equetro) | Anticonvulsant; mood stabilizer: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: treats acute bipolar I manic or mixed episodes. Life-threatener: Agranulocytosis or aplastic anemia. Nursing first: Review CBC, liver tests, sodium and indicated HLA screening. Patient warning: Do not ignore fever, sore throat, bruising, jaundice or rash; report promptly.

Lamotrigine (Lamictal) | Anticonvulsant; bipolar maintenance agent: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Prevents recurrence; not rapid treatment for acute mania. Life-threatener: skin reaction. Nursing first: Verify slow titration, interactions, missed doses and any rash. Patient warning: Do not restart after an interruption without guidance; report any new rash.

Quetiapine (Seroquel) | Second-generation antipsychotic: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Indicated bipolar episodes; extended release may augment MDD treatment. Life-threatener: Neuroleptic malignant syndrome. Nursing first: Check blood pressure, sedation, metabolic and movement baseline. Patient warning: Do not ignore fever with rigidity or abnormal movements; rise slowly.

Clozapine (Clozaril; Versacloz) | Second-generation antipsychotic: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Resistant schizophrenia and specific recurrent suicidal-behavior indication; not routine MDD. Life-threatener: Severe neutropenia and infection. Nursing first: Check ANC, bowel function, blood pressure and cardiac symptoms. Patient warning: Do not skip monitoring; report fever, sore throat, chest pain or constipation.

Methylphenidate (Ritalin; Concerta) | Central nervous system stimulant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Primary ADHD exemplar; improves attention and impulse control. Life-threatener: Serious cardiovascular events in susceptible patients. Nursing first: Check cardiac history, blood pressure, pulse, growth, sleep and appetite. Patient warning: Do not share; secure it and follow formulation-specific instructions.

Fluvoxamine (Luvox) | SSRI; antiobsessive agent: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Reduces OCD obsessions and compulsions over weeks; not Fluoxetine. Life-threatener: Serotonin syndrome. Nursing first: Check suicide and mania risk and major drug interactions. Patient warning: Do not confuse with Fluoxetine or stop without a prescribed plan.

Venlafaxine (Effexor XR) | SNRI antidepressant: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Second-line off-label OCD option; extended release also connects to panic. Life-threatener: Serotonin syndrome; sustained hypertension is another key risk. Nursing first: Check blood pressure, suicide risk and interactions. Patient warning: Do not crush extended-release products or stop abruptly.

Risperidone (Risperdal) | Second-generation antipsychotic: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Selected off-label augmentation for resistant OCD; watch prolactin effects. Life-threatener: Neuroleptic malignant syndrome. Nursing first: Check movements, blood pressure, weight, glucose and lipids. Patient warning: Do not ignore rigidity, involuntary movements or unexpected milk production.

Aripiprazole (Abilify) | Second-generation antipsychotic; dopamine partial agonist: Recall the unique trigger, life-threatener, nursing first and patient warning.

Unique trigger: Selected resistant-OCD augmentation; restlessness and compulsive urges stand out. Life-threatener: Neuroleptic malignant syndrome. Nursing first: Check movements, metabolic baseline and impulse-control history. Patient warning: Do not hide new gambling, shopping, sexual or binge-eating urges; report them.