Mental Health Final

Front 1

When nurses assess clients for stress, what factors should they be aware of that affect our reactions to stress?

Back 1

not everyone responds the same way to stress, its individualistic, responses vary, its relative, not absolute, varies with environment and varies with temperament.

Front 2

How does culture affect our understanding of mental health and our receptiveness to psychiatric care?

Back 2

its variable, multi dimensional, diverse and culturally defined.

Front 3

Using Kubler-Ross’s stages of grief, what would a grieving client be able to focus on or say during counseling with a nurse to indicate they are in the acceptance phase?

Back 3

Focus is on the reality of the loss and its meaning for the individuals and the person should be able to verbalize those feelings.

Front 4

When you look at Erikson’s developmental theory, what tasks are appropriate for various age groups, specifically Adulthood/middle age?

Back 4

The major task of this stage is to achieve the life goals established for oneself while also considering the welfare of the future generations.

Front 5

When dealing with client who attempted suicide and states that she is a loser and no one loves her, what stage of personality development according to Erikson, should a nurse recognize as not being adequately completed?

Back 5

Intimacy vs. isolation (young adulthood age 20-30). Major developmental task is to form an intense, lasting relationship or a commitment to another person, cause, institution, or creative effort.

Front 6

Look @ the theories that describe a person’s personality and stages of development. What kind of situations would describe weak or strong Id, Ego, or Super Ego?

Back 6

Superego is the strongest. A superego would never do something morally wrong. ex. "Its never right to take something that doesn't belong to you.", "never disobey your parents.", "Sex outside the marriage is always wrong".

Front 7

When looking at a child who is willing to share their toys, determine what stages of psychological development a child has completed, according to Peplau.

Back 7

Toddlerhood. Learning to delay satisfaction. Major developmental task is learning the satisfaction of pleasing others by delaying self-gratification in small ways.

Front 8

A nurse praises a child for his accomplishments and provides parental guidance. What therapeutic role is the nurse providing, according to Peplau?

Back 8

Surrogate - one who serves as a substitute figure for another. In this case a parent.

Front 9

According to Peplau, when a nurse provides direction and helps a client plan and achieve their goals, what role is the nurse assuming?

Back 9

The leader role.

Front 10

10. When assessing a patient, what underlying concept associated with Interpersonal theory should a nurse consider.

Back 10

According to Sullivan, individual behavior and personality development are the direct result of interpersonal relationships. His theoretical framework focused on the interpersonal flavor in which human behavior could be observed in social interactions with others.

Front 11

If a newborn infant is left alone and without nourishment for extended periods, according to Mahler, what developmental phase won’t they reach?

Back 11

The Autistic phase. Major dev. task : fulfillment of basic needs for survival and comfort.

Front 12

When a first grade child explores another child’s genitalia, according to Freud, what normal stage of psychosocial development is he in?

Back 12

The Phallic stage. Id's with parent of same gender; dev of sexual identity; focus on genitalia.

Front 13

A young married couple just had their first baby. According to Erikson’s developmental theory, what is this couple as in the process of successfully accomplishing?

Back 13

Intimacy vs. Isolation. 20-30 years. Objective is to form an intense lasting relationship or a commitment to another person, a cause, an institution, or a creative effort.

Front 14

What part of Sullivan’s concept of self-esteem connects with childhood situations that produce intense anxiety?

Back 14

The "Not me" .

Front 15

What kind of statements should a nurse associate with the Superego?

Back 15

"Never disobey you parents."
"You should not steal"

Front 16

According to Peplau, a nurse , hearing an upset child, who was demeaned by his father, swearing in the clinic, should identify that his behavior indicates unsuccessful completion of which stage of child development.

Back 16

Identifying oneself. Learning appropriate roles and behaviors by acquiring the ability to perceive the expectations of others.

Front 17

17. A hungry , homeless woman with bipolar disease, refuses to participate in her admission interview. The nurse provides the woman with a sandwich and comfortable chair in an effort to promote what?

Back 17

Trust. The Orientation/Introductory phase.

Front 18

During the introductory phase of a client-nurse relationship, what are the first things a nurse should do?

Back 18

Establish rapport.

Front 19

19. During the working phase of a nurse-client relationship, what task should the nurse emphasize?

Back 19

Therapeutic work is done. Help promote client change.

Front 20

20. A nurse is assessing a patient, who is experiencing hallucinations. What therapeutic communication technique can the nurse use in “making observations”?

Back 20

Verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and compare perceptions with the nurse.

Front 21

21. Why do nurses give patients appropriate feedback?

Back 21

Feedback is a method of communication that helps the client consider a modification of behavior. Feedback gives information to clients about how they are being perceived by others. Can be useful if presented with objectivity by a trusted individual.

Front 22

22. A client with a dependant personality disorder, has recently lost his job. He asks the nurse, “Do you think there would be any jobs for me at this hospital?” The most appropriate nursing response would be?

Back 22

Exploration. Delving further into a subject, idea, experience, or relationship.

Front 23

23. Describe a correctly formulated, measurable client outcome?

Back 23

They measurable, they have expectations and are patient focused.

Front 24

24. Describe the various categories of focused charting and give examples.

Back 24

DAR=Data Action Response
D=data
A=action
R=response

Front 25

25. When assessing a patient’s mental acuity and cognitive abilities, what tool should a nurse use?

Back 25

MMSE-Mini Mental Status Exam

Front 26

26. Why does a nurse gather client information during an assessment?

Back 26

enable the nurse to make sound clinical judgements, plan appropriate interventions with the client, collect and analyze data about the client.

Front 27

27. Review NANDA nursing diagnostic stem and what assessment data most likely would lead to the problem statement “Risk for injury” for an inpatient.

Back 27

Neurological disorders such as MS or Parkinsons, or someone undergoing a certain treatment such as ECT.

Front 28

28. An upset client on an inpatient unit told the nurse that someone took his favorite book and that she needed to help him out. What assumptions of Milieu Therapy should guide the nurse’s response?

Back 28

Every interaction is an opportunity for therapeutic intervention.

Front 29

29. A patient with Bi-polar Disorder did well in the hospital setting but falls apart following discharge. What does Milieu Therapy provide that is missing in a home environment?

Back 29

Milieu therapy is structured.

Front 30

30. In the role of Milieu Manager, what activities should a nurse prioritize?

Back 30

Provide a safe environment.

Front 31

31. A new mother, who is being discharged from the Maternity Unit, is anxious and concerned about being able to perform her role. What information should the nurse be familiar with in order to give effective care.

Back 31

Crises of Anticipated Life Transitions - normal life-cycle transitions that may be anticipated over which the individual may feel a lack of control. Ventilation of feelings encouraged; reassurance and support should be provided as needed.

Front 32

32. A college student recently learned that she has failed her course and will not be graduating. She was admitted to a psychiatric unit of the hospital for overdosing on sleeping pills. The nurse should make what priority diagnosis for this patient?

Back 32

Hopelessness r/t absence of support systems and perception of worthlessness aeb verbal cues, decreased affect; lack of initiative; suicidal ideas or attempts.

Front 33

33. An inpatient tells the nurse that she no longer wants to live and feels useless to society. She also tells the nurse not to share this information with anyone because it is confidential. What would be the most appropriate response of the nurse?

Back 33

Even though the client says not to share the info, you must tell the patient that you must share it with the treatment team.

Front 34

34. What statement from a student would indicate that they understand what case management is?

Back 34

Meet the client needs by organizing care with other resources.

Front 35

35. When intervening with a family experiencing stress due to care giving, describe an approach that reflects nursing intervention at the secondary level of prevention.

Back 35

therapy sessions for family members, home health services, focus on counseling and communication and support groups.

Front 36

36. When giving health-care services to the homeless, what is a realistic concern for the nurse?

Back 36

Transient care. They move around thus harder to follow up with care.

Front 37

37. A newly admitted homeless patient, diagnosed with Tuberculosis, says I have been living under the bridge in the cold. Why did the Government let me down? What would the most appropriate nursing response be?

Back 37

There are not enough resources available anymore after the closing all the inpatient mental facilities across the country.

Front 38

38. A nurse discharges a client to home following delivery of a stillborn baby. Upon returning home, the woman finds the nursery has been cleared of all furniture by friends and neighbors. According to Worden, how can this action affect the woman’s grieving process?

Back 38

removing all reminder effects her ability to face the reality of the loss.

Front 39

39. Looking at both culture and grieving process, match four terms and cultures that a nurse should be familiar with when assessing a grieving response.

Back 39

African Americans-"falling out"
Asian americans - they do not express their emotions openly.
Japanese-prepare body by family, mourning is 49 days. buddhist. cremation common.
filipino - wake, catholic, 9 days of special prayers (novenas), can mourn for 1 year.
Jews-cremation prohibited, wrapped in shroud, unadorned casket, no wake or viewing; after burial is a 7 day shiva where mourners concentrate on deceased.
Mexican americans-natural part of life, catholic, velorio (festive watch); luto (dress in black and/or white and mourn for one year)
native americans- buried 4 days after death, cleansing ceremony,

Front 40

40. A nurse gives a client the diagnosis of Complicated Grieving. Refer to Bowlby and decide what long-term outcomes would be most appropriate for this nursing diagnosis?

Back 40

Reorganization of neglect.

Front 41

41. From a cultural view, what types of clients are most receptive to psychiatric treatment?

Back 41

Jews and women.

Front 42

42. When caring for a patient with neurosis (severe anxiety), what should a nurse know?

Back 42

They feel helpless to change their situation.
They are aware that they are experiencing distress.
They are aware that tier behaviors are maladaptive.
They experience no loss of contact with reality.
they are unaware of any possible psychological causes of the distress.