UNITEK MS2 QUIZ 12 MENTAL HEALTH STUDY GUIDE

A wife of a critically injured husband has been at his bedside constantly for 2 days. As the nurse speaks to the wife the wife sobs "This is awful. I can't take it anymore." What is the wife experiencing?

Stress

What is the difference between fear and anxiety?

Fear is a response to specific threat while anxiety is response to a nonspecific threat (fear of the unknown)

A child who is hospitalized begins bedwetting. What is this an example of?

Regression

A patient who has a history of episodes of road rage thinks that she is a very good driver and does not understand why she keeps being told she is a poor driver. She is losing her license now and she tells the nurse that she is feeling very unhappy and abandoned. She feels like she might hurt herself. The nurse realizes that the patient is exhibiting which personality disorder?

Borderline personality disorder

A patient has difficulty remembering about the first few hours after a profoundly disturbing event. What is this an example of?

Dissociative disorder (specifically localized amnesia)

A patient is having grandiose thoughts of being a famous singer. What is this an example of?

Schizophrenia

A patient became blind after witnessing a traumatic car accident that killed many passengers. What is this an example of?

Conversion disorder (Conversion disorder is when psychological stress or trauma manifests as involuntary physical, neurological symptoms)

A client in the emergency department reports a sudden episode of intense fear, heart palpitations, and a 'feeling of impending doom' that started 10 minutes ago. Which condition should the nurse suspect?

Panic disorder

A client has repeated intrusive thoughts that their hands are contaminated with germs and feels compelled to wash their hands over and over for hours to relieve anxiety even though they know it is excessive. What is this an example of?

Obsessive compulsive disorder

A nurse is caring for a client diagnosed with Post-Traumatic Stress Disorder (PTSD) who is experiencing high levels of anxiety and frequent flashbacks. Which nursing action is the priority?

Encourage the patient to use relaxation techniques to help calm themselves and reduce anxiety

What is mild anxiety?

A level of anxiety that can enhance learning increase focus and motivate a person to take action (For example; focusing on CMS)

What is moderate anxiety?

A level of anxiety where the person has a narrowed focus but can still learn and follow directions with assistance

What is severe anxiety?

A level of anxiety where the person has a greatly reduced ability to focus difficulty thinking and impaired problem solving

What is panic disorder?

A condition where a person has recurrent panic attacks, which are episodes of intense fear or apprehension that may feel like terror and are often accompanied by a sense of impending doom.

What is electroconvulsive therapy (ECT)?

A treatment that uses controlled electrical stimulation of the brain to treat severe mental disorders such as depression

What should be included when teaching a client about ECT?

Temporary memory loss and confusion are common side effects, prolonged memory loss can occur, and informed consent is required

For a client with delirium who becomes violent, what is the appropriate nursing intervention?

Ensure safety for the patient and others, escort the client to a room, decrease stimuli, and use restraints only if necessary

What is the best action for a nurse when using therapeutic listening?

Focus on what the client is saying, understand their experience, and avoid interrupting or jumping to conclusions

A client is experiencing disturbed thought processes and believes that their food is being poisoned. What nursing action is appropriate?

The nurse should clarify ("Can you tell me more about why you think your food is being poisoned") and cover the food with wrapping before providing to the client

What is the psychoanalytic approach?

A therapy that focuses on unconscious thoughts feelings and defense mechanisms that influence behavior

Example: A client who experienced childhood trauma denies the event and develops anxiety without understanding why.

What is Milieu therapy

A treatment that uses a structured therapeutic environment to improve behavior and social skills

Example: A client in an inpatient unit follows a daily schedule attends group therapy and practices appropriate interactions with others.

What is the biologic approach?

Treatment of mental disorders using medications that affect the brain

Example: A client with depression is prescribed an antidepressant to improve mood by correcting neurotransmitter imbalance.

What is the interpersonal approach?

A therapy that focuses on improving relationships communication and coping through interaction with others

Example: A client learns to express feelings and resolve conflicts more effectively through therapy sessions.

What are the three components of the interpersonal approach?

1. Anxiety is often communicated interpersonally

2. The patient learns new ways of maturing in a therapeutic relationship

3. Establishing trust is an important first step in working with patients

What is the cognitive-behavioral approach?

A therapy that focuses on how thoughts influence emotions and behaviors and helps change negative thinking patterns

What are the three components of the cognitive behavioral approach?

1. Behavior is learned

2. Behavior increases because of a response to that behavior from the environment

3. The way a person thinks about things influences emotional states and behavior

what is a common side effect of anxiolytics and antipsychotics (medications for schizophrenia)?

Tardive dyskinesia (involuntary tongue movement)

What is the primary focus of nursing care for patients with mental illness?

Helping patients and family cope with and manage mental illness and enhance quality of life

What are the most important characteristics of a therapeutic relationship?

The relationship has boundaries and a clear ending and it develops purposefully

What is localized amnesia?

Loss of memory for a specific event or period of time

Example: A client cannot remember a traumatic car accident but recalls events before and after

What is generalized amnesia?

Loss of memory for one's entire life history

Example: , A client cannot remember their identity family or past life events

What is continuous amnesia?

Inability to form new memories after a specific event

Example: A client remembers past events but cannot remember anything that happens after a head injury

What is selective amnesia?

Loss of memory for some but not all aspects of an event

Example: A client remembers being in an accident but cannot recall the most traumatic parts of it

What disorder is picking on healthy skin?

Excoriation disorder

What is the difference between an illusion and a hallucination?

An illusion is a misinterpretation of a real external stimulus while a hallucination is a perception without any external stimulus

Example: The patient sees a spot on a wall which they see as a spider (Illusion) vs the see a spider and it had no trigger (hallucination)

If a client has auditory hallucinations, what nursing intervention can help compete with them?

Encourage the client to listen to music or use headphones to distract from the voices

What should a nurse ask a client with suicidal ideation?

Ask directly if they have a plan, the means to carry it out, and a timeframe

What are common symptoms of OCD?

Recurrent intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that are time consuming and interfere with functioning. They are aware that the behaviors are excessive or not normal but can't help themselves

What is a nursing care plan for a client with OCD during severe anxiety?

Provide safety and comfort and place the client in a calm quiet environment because they are unable to focus or problem solve during panic-level anxiety

What are the expected findings for a patient with depressive disorders

Episodes of persistent depressed mood, appetite, disturbance, weight loss or gain, problems with initiating sleep, sleeping too much or waking up too early in the morning, loss of interest, and sometimes suicidal ideation

What are positive manifestations of schizophrenia?

Hallucinations, delusions, disorganized speech, and bizarre or disorganized behavior

What are negative manifestations of schizophrenia?

Flat affect, lack of motivation, reduced speech, social withdrawal, and decreased emotional expression