Mental Health Tutor Study Guide

What are levels of consciousness in MSE?

1. Alert

2. Lethargic (drowsy)

3. Stuporous (requires painful stimuli)

4. Comatose (no response)

What is decorticate rigidity?

Flexion & internal rotation of arms/legs

What is decerebrate rigidity?

Extension of neck/elbows with flexed wrists/fingers

Difference between mood and affect?

Mood = what client feels

Affect = what nurse observes

What is immediate memory?

Ability to recall numbers or lists immediately

What is recent memory?

Recall of events from same day

What is remote memory?

Recall of past facts (DOB, names)

What is HEADSSS assessment?

Home, Education, Activities, Drugs, Sexuality, Suicide, Safety

What is DSM-5 used for?

Diagnosing criteria for mental disorders

What is serious mental illness?

Chronic disorder affecting ADLs with remissions/exacerbations

What is milieu therapy?

Safe structured therapeutic environment

What is counseling in mental health?

Therapeutic communication + problem solving + crisis intervention

What are psychobiological interventions?

Medications + monitoring + teaching

What is case management?

Coordination of holistic care services

List basic client rights

1. Consent

2. Refuse treatment

3. Confidentiality

4. Humane care

5. Informed Communication

What is beneficence?

Doing good

What is autonomy?

Client’s right to choose

What is justice?

Fair treatment

What is fidelity?

Loyalty to client

What is veracity?

Truthfulness

Criteria for involuntary admission?

Danger to self/others + inability to meet needs

Restraint time limits (adult)?

4 hours

Restraint time limits (9–17)?

2 hours

Restraint time limits (≤8)?

1 hour

What must be documented during restraints?

Behavior, interventions, vitals, food/fluids, time

What is assault?

Threat to harm

What is battery?

Harmful touching

What is negligence?

Failure to provide proper care

What is malpractice?

Professional negligence

What is intrapersonal communication?

Self-talk

What is interpersonal communication?

One-on-one interaction

What is therapeutic silence?

Allows reflection

What is active listening?

Full attention + understanding

Open-ended questions?

Encourage discussion

Closed-ended questions?

Yes/no answers

What is paraphrasing?

Restating client thoughts

What is reflecting?

Directing feelings back to client

What is summarizing?

Review key points

List communication barriers (What to avoid)

• Give personal advice

• “why” questions

• false reassurance

• judgment

• topic change

What are healthy defense mechanisms?

Altruism: Dealing stress by helping others

Sublimation: Redirecting unacceptable impulses into acceptable behavior

Difference between repression and suppression?

Repression = unconscious; Suppression = conscious

What is displacement?

Redirecting emotions to another target

What is regression?

Return to earlier developmental behavior

What is reaction formation?

Opposite behavior of true feelings

What is rationalization?

Making excuses

What is splitting?

Seeing people as all good or all bad

Mild anxiety characteristics?

Enhances learning

Moderate anxiety?

Decreased concentration

Severe anxiety?

Narrow focus

Panic-level anxiety?

Loss of reality

Interventions for severe anxiety?

Stay with client, calm environment, simple directions

What is transference?

Client projects feelings onto nurse

What is countertransference?

Nurse projects feelings onto client

Therapeutic Relationship: Orientation

The phase where the nurse and client meet and begin building a therapeutic relationship.

Therapeutic Relationship: Orientation Main Goals

• Establish trust

• Define roles and expectations

• Identify problems and goals

Therapeutic Relationship: Orientation: What a nurse should do

• Introduces self and role

• Explains confidentiality (and its limits)

• Sets a contract (time, place, length of interaction)

• Establishes boundaries

• Performs initial assessment

• Identifies client needs, concerns, and goals

Therapeutic Relationship: Working Phase

The main therapeutic phase where actual change and progress occur.

Therapeutic Relationship: Working Phase: Main goals

• Promote insight

• Encourage behavior change

• Help client solve problems

Therapeutic Relationship: Working Phase: What a nurse should do

• Uses therapeutic communication techniques

• Encourages expression of feelings

• Helps client explore stressors and behaviors

• Teaches coping skills

• Implements interventions

• Reassesses and modifies care plan as needed

Therapeutic Relationship: Termination Phase

The phase where the relationship is ended and progress is reviewed.

Therapeutic Relationship: Termination Phase: Main Goals

• Evaluate goal achievement

• Promote independence

• Provide closure

Therapeutic Relationship: Termination Phase: What a Nurse should do

• Summarizes progress and achievements

• Reviews goals that were met (or not met)

• Discusses follow-up care/resources

• Encourages expression of feelings about ending relationship

Primary prevention?

Health promotion

Secondary prevention?

Early detection

Tertiary prevention?

Rehabilitation

What is ACT?

Community program for severe mental illness

What is psychoanalysis?

Focus on unconscious + past

What is CBT?

Change thoughts to change behavior

What is systematic desensitization?

Exposure + relaxation

What is aversion therapy?

Negative stimulus to stop behavior

ECT uses?

Depression, bipolar, suicide

ECT side effects?

Memory loss, confusion

ECT nursing care?

NPO, monitor vitals, airway support

What is TMS?

Noninvasive brain stimulation

What is VNS?

Implanted device stimulation

GAD duration?

≥6 months

Panic attack duration?

15–30 min

What is OCD?

Obsessions + compulsions

First-line anxiety meds?

SSRIs

Benzodiazepines used for?

Short-term anxiety

Buspirone use?

Long-term anxiety

MDD criteria?

≥5 symptoms for 2 weeks

What is anhedonia?

Loss of pleasure

SAD treatment?

Light therapy

Mania duration?

≥1 week

Hypomania duration?

≥4 days

What is rapid cycling?

≥4 episodes/year

Positive symptoms of schizophrenia?

Hallucinations, delusions

Negative symptoms?

Flat affect, avolition

What is thought broadcasting?

Belief others hear thoughts

What is thought insertion?

Belief thoughts are inserted

What is echolalia?

Repeating words

What is word salad?

Jumbled speech

What is catatonia?

Extreme motor disturbance

What is AIMS scale?

Monitors tardive dyskinesia

Anorexia key signs?

Low weight, lanugo, amenorrhea

Bulimia?

Binge + purge

Binge eating disorder?

Binge without purge

Criteria for inpatient eating disorder?

Weight <80%, electrolyte imbalance, arrhythmia

What is somatic symptom disorder?

Physical symptoms without cause