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NUR 185 Test 1
test material on flash cards
| Question | Answer |
|---|---|
| Which defense mechanism is known as covering up a real or perceived weakness by emphasizing a trait one considers more desirable? | Compensation |
| Which defense mechanism is refusing to acknowledge the existence of a real situation or the feelings associated with it? | Denial |
| Which defense mechanism is the transfer of feelings from one target to another that is considered less threatening or that is neutral? | Displacement |
| Which defense mechanism is an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires? | Identification |
| Which defense mechanism is an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis? | Intellectualization |
| Which defense mechanism integrates the beliefs and values of another individual into one's own ego structure? | Introjection |
| Which defense mechanism separates a thought or memory from the feeling, tone, or emotion associated with it? | Isolation |
| Which defense mechanism attributes feelings or impulses unacceptable to one's self to another person? | Projection |
| Which defense mechanism attempts to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors? | Rationalization |
| Which defense mechanism prevents unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors? | Reaction Formation |
| Which defense mechanism is a form of retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning? | Regression |
| Which defense mechanism involuntarily blocks unpleasant feelings and experiences from one's awareness? | Repression |
| Which defense mechanism re-channels drives or impulses that are personally or socially unacceptable into activities that are constructive? | Sublimation |
| Which defense mechanism in the voluntary blocking of unpleasant feelings and experiences from one's awareness? | Suppression |
| Which defense mechanism symbolically negates or cancels out an experiences that one finds intolerable? | Undoing |
| Why does mental illness seem to occur? | Because of a failure to adapt to a stressful situation |
| What is GAS and who developed it? | GAS- General Adaptation Syndrome. Developed by Hans Selye |
| What is the basic principle behind the General Adaptation Syndrome? | You either fight and fix the stressful situation to get back to where you were or you don't and exhaustion takes over, disease develops and, at times, the body can die as an extreme |
| What is the RLCQ? | The Recent Life Changes Questionnaire where a high score means a person could be at greater susceptibility to physical or psychological illness |
| What is considered a high score in the RLCQ for a six month period? | 300 LCU's (Life Change Units) |
| What is considered a high score in the RLCQ for a 12 month period? | 500 LCU's (Life Changes Units) |
| With the transaction theory, what is considered a primary appraisal? | How a client perceives a stressor, whether it's positive or negative |
| With the transaction theory, what is considered a secondary appraisal? | Basically what a client knows what they can do and what their resources are |
| What is considered a MILD level of anxiety? | The client is focus enhanced |
| What is considered a MODERATE level of anxiety? | The client's focus is impaired but they are still able to follow directions |
| What is considered a SEVERE level of anxiety? | The client's focus is very limited, they are fixated on a single detail |
| What is considered a PANIC level of anxiety? | The client has zero focus because they have shut down. They aren't thinking and judgement is impaired |
| What is our goal with psych patients? | To see if they have used a positive coping strategy in the past or to help them acquire new coping strategies |
| What was the name of the person during the Civil War Era that began to care for the mentally ill? | Dorothea Dix |
| Who was the first American psychiatric nurse? | Linda Richards |
| Name Maslow's Hierarchy of Needs from bottom to top | Physiological Needs, Safety & Security, Love & Belonging, Self-Esteem & Esteem of Others, Self-Actualization |
| What are the six indicators of Jahoda? | 1. A positive attitude toward self 2. Growth, development, and the ability to achieve self-actualization 3. Integration 4. Autonomy 5. Perception of reality 6. Environmental mastery |
| Who came up that mental health is defined as relative to the situation and that mental illness is never absolute or fixed? | The APA |
| What is the DSM-IV-TR and who uses it? | Diagnostic & Statistical Manual of Mental Disorders, 4th Ed. Text Revision and it's used my doctors |
| What is Axis I of the DSM-IV-TR? | What the pt is being treated for; their focus of care |
| What is the Axis II of the DSM-IV-TR? | Personality disorders and mental retardations |
| What is the Axis III of the DSM-IV-TR? | General medical conditions |
| What is the Axis IV of the DSM-IV-TR? | Problems that pt are having difficulty with such as family functioning, support groups, etc. |
| What are primary prevention services? | Where the number of ppl who would get/have mental illness are reduced by helping to identify ppl at risk; try to help pts cope constructively |
| What are secondary prevention interventions? | Trying to minimize symptoms of the pts mental illness by utilizing group therapy and medication |
| What are tertiary prevention services? | Pts go to outpatient therapy; almost like a rehab |
| What is congruency of care? | Taking care of pts while keeping in mind their cultural, spiritual and religious needs |
| Who developed the psychoanalytical theory and what did it entail? | Sigmund Freud and he believed that a mental illness could occur when there was a malfunction between the id, ego and superego |
| Who developed the Interpersonal theory and what did it entail? | Sullivan and it dealt with Stages of Personality Development |
| What was Erikson's type of theory called? | Psychosocial theory |
| What type of theory did Piaget have and what did it deal with? | Cognitive Development Theory and it has to do with concrete and abstract thinking |
| Who developed the Moral Development Theory? | Kohlberg |
| What four aspects did Peplou point out in her Nursing Model? | 1. Learning to count on others 2. Learning to delay personal satisfaction 3. Identifying oneself 4. Developing skills in participation |
| Define a therapeutic relationship? | In interaction between two ppl; one is the caregiver and one is the client |
| What are some roles that a nurse takes on in a Nurse-Client relationship? | Stranger, Resource, Teacher, Leader, Surrogate, Manager of care |
| What is the end goal of most therapeutic relationships? | To get pt back to pre-illness state |
| What are the 7 characteristics of a therapeutic relationship? | Caring, Rapport, Trust, Respect, Genuineness, Empathy, & Absolute Professionalism |
| What are the four phases of a therapeutic relationship? | Pre-interaction, Orientation, Working, & Termination |
| What happens in the pre-interaction phase of the therapeutic relationship? | Prepping- getting to know a little about your pt |
| What happens in the orientation phase of the therapeutic relationship? | You work with the pt to establish a trusting relationship |
| What happens in the working phase of the therapeutic relationship? | You work on coping strategies with the pt to help get them to a point where they can solve some problems |
| What is it called when a pt suddenly starts looking at you unconsciously and you remind them of someone and they start to treat you as if you are that person? | Transference |
| What is it called when you believe you are the super nurse and that you can handle everything for a specific pt? | Counter-transference |
| In which phase does transference and counter-transference occur? | The working phase of the therapeutic relationship |
| What occurs in the termination phase of the therapeutic relationship? | Pts become attached & dependent on you and that's why you need to explain that you will only be there for a short while so they know an end will come to the relationship. |
| What are three boundaries in the Nurse/Client relationship? | Social, Personal, & Professional |
| What does SOLER stand for? | Sit squarely, Open posture, Lean forward, Establish eye contact, Relax |
| What is one of the hardest parts of communication? | Listening |
| What are five pre-existing conditions that occur with communication? | Values, Attributes & Beliefs: Culture or Religion; Social Status: Gender: Age or Developmental Level ( I try to remember the beginning of each as VSCAG) |
| What are six forms of non-verbal communication? | Physical Appearance & Dress: Body Movement & Posture: Touch: Facial Expressions: Eye Behavior: Vocal Cues or Paralanguage. ( VEPT BF) |
| What is waxy flexibility? | A movement done by schizophrenic pts in which limbs stay in whatever position they are placed |
| What is paralanguage? | A gestural component of the spoken word that consists of pitch, tone and loudness of spoken messages. |
| When someone is agitated what can you do with your hands to try to calm them down? | Place them in prayer mode |
| What is considered milieu therapy? | It is the therapeutic community |
| What did Skinner believe about basic assumptions? | That in order for us to be able to have a better community for the pts, we should have 7 basic assumptions with three basic goals. |
| What are the three basic goals that Skinner believed in? | 1) Get pts to learn coping skills (either something they have used in the pst or something new) 2) Show pts appropriate role models 3) Develop healthy relationship skills |
| What are the 7 basic assumptions that Skinner believed in? | Identify strengths, Interpersonal interaction is inevitable, Autonomy & needs of the group, Responsibility for own behavior, Peer pressure & feedback, Inappropriate behaviors addressed, Restrictions & punishment are avoided |
| With Skinner's 7 basic assumptions, why is it important to identify strengths? | So pts know there are some good things about them; it's important to give them positive feedback |
| With Skinner's 7 basic assumptions, why is interpersonal interaction inevitable? | It's important to have conversations to build upon relationships |
| With Skinner's 7 basic assumptions, how do you get a pt to be responsible for their own behavior? | Set limits and have them understand what is and isn't appropriate |
| When delivering punishments and reprimands, in what order do you want to go in as far as ending up in restraints? | Talk a pt down, chemical restraints and lastly physical restraints |
| Why do we try to talk a pt down first? | We want them to preserve their dignity |
| Define psychotherapy? | It's a treatment for mental illness in which a mental health professional and a pt discuss problems and their feelings and work together to find solutions |
| What are the three phases of psychotherapy? | Assessment (what brought pt here) Resolution (pt feel like their making headway; problem is closed to be resolved or thought of in a different way) Growth [Self-Actualization] (meet all your goals by Maslow) |
| What do you call a group a ppl that come together to share a common interest to learn to practice skills resolve conflict, etc? | A therapeutic group |
| What's the number of ppl that you want in a therapeutic group? | 7-10; anymore and you would have chaos with ppl vying for attention |
| What are three leadership styles? | Autocratic, democratic, and laissez-faire |
| What is autocratic leadership? | It's all about the leader, what he wants and how he wants to get it done, members of the group are unhappy; things get done |
| What is democratic leadership? | Members have input and are the focus of the group; productivity is lower because the members are well-informed with knowledgeable opinions and resolutions to problems |
| What is laissez-faire leadership? | The group doesn't get a lot done because they have a 'who cares' attitude |
| What is considered a crisis intervention? | When a mental illness pt either loses to a battle in their life or with a battle currently going on in their life. |
| Can a crisis be major or minor? | It can be either all dependent on the pts perception |
| With a crisis, what can in result in psychologically? | disequilibrium and at times, so severe that the individual requires assistance to recover |
| How many phases of crisis development are there? | 4 |
| What is phase I of crisis development? | Being exposed to the stressor |
| What is phase II of crisis development? | Start working with coping mechanisms and they may begin to fail. If this happens, anxiety and helplessness starts to set in and the though processes are disorganized |
| What is phase III of crisis development? | Pt tries to use all resources. They get into panic type situation trying everything in their power to get back to homeostasis |
| What is phase IV of crisis development? | This is the possible breaking point. The pt almost disintegrates because tension has reach such a high point. It becomes an emotional roller coaster and behavior and thinking is very disorganized. |
| What is a dispositional crisis? | It's unanticipated, could be chronic where the pt feels like they are out of control |
| What are anticipated life transitions? | They are milestones you know are coming but they are still difficult such as the death of a parent |
| What is traumatic stress? | It's stress that is very unexpected where the pt feels as if they have no control and are extremely vulnerable such as a rape |
| What are maturational/developmental crises? | They are anticipated crises that make you feel helpless, rejected or depressed |
| What is crises reflecting psychopathology? | It is when the pt already has a mental illness diagnosis but then they have a crisis in their life and it may become so distorted that the pt may feel abandoned or like they can't resolve the crisis due to their mental illness |
| What are considered psychiatric emergencies? | The person's ability to function physically & psychologically are impaired and it becomes a question if the pt will be safe. They need someone to intervene on their behalf because they can't take responsibility for themselves |
| What is the essential goal of the Nurse Practice Act and what gives it, it's authority? | To protect the public and it is given authority by the state legislature |
| Who's duties are delineated in the Nurse Practice Act? | LPN's & RN's |
| The Nurse Practice Act is given authority by the state legislature, what type of law is this an example of? | Statutory law |
| What are common laws? | Laws that are based on decisions made in previous cases |
| What is civil law? | Private and property rights of people and business (tort & contracts) |
| What is criminal law? | Laws that offer protection from conduct that could injure the public |
| What are torts? | A violation of civil law in which a person has been wronged |
| What are two examples of unintentional tort? | Malpractice & negligence |
| What are two examples of intentional tort? | Battery & assault |
| What is the BIGGEST issue that ppl get into so much trouble with as far as legal issues? | Confidentiality & the Right to Privacy |
| What is HIPAA? | An act that protects pts privacy and information |
| What is it considered when a pt tells you information? | Privileged Communication |
| When do pts have the right to refuse treatment? | When they are of mental status and awareness and are there by voluntary consent |
| When is it okay to challenge informed consent? | When the pt is judged incompetent |
| When did the Mental Health Bill of Rights come about? | In 1980 the bill came up stating that mental health pts have the right to have physiological needs met |
| What does JCAHO say about restraints? | It has to be an emergent situation to put someone in restraints & seclusion; there are very specific timelines when using restraints & seclusion; different guidelines for different ages; tell you how to evaluate pt to make sure they are safe in restraints |
| What are voluntary admissions? | Pts that sign themselves in |
| With an involuntary admission, how often may a pt must be re-evaluated to see if they stay on this status and be documented? | 72 hours |
| What are three conditions of a pt of an involuntary admission? | 1) Pt has to be dangerous to self or to others 2) They have to be observed as a mentally ill pt 3) They have to be gravely disabled |
| What type of procedure can a family start as well as a mental health official? | Emergency commitment; person has to be obviously unsafe and the board decides if pt can stay or leave |
| What is involuntary outpatient commitment? | The court orders a person to go for outpatient treatment |
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