Nur 150 - Psych

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The quantitative study of the distribution of mental disorders in human populations.

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Epidemiology

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Deaths

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Mortality

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Refers to the proportion of a population who has a mental disorder at a given time.

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Prevalence

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Deals with what happens to people with illnesses who are seen by providers of care.

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Clinical epidemiology

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Classification of mental disorders that includes descriptions of diagnostic categories and uses an axis system to provide a broad range of assessment.

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The DSM-IV-TR

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True or False? The biologically influenced illnesses include schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism. Therefore many (but not all) of the most prevalent and disabling mental disorders have been found to have strong biological influences.

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True

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Possesses specialized nursing skills and implements the nursing process to manage and deliver nursing care to the mentally ill.

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A Psychiatric Mental Health Nurse

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Refers to impairment in important areas of functioning or a significantly increased risk of death, pain, or an important loss of freedom.

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Disability

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Called the Global Assessment of Functioning and gives an indication of the client's best level of psychological, social, and occupational functioning during the preceding year.

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Axis V

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True or False? Every society has its own view of health and illness and the types of behavior categorized as mental illness. Culture also influences the symptoms of a particular disorder. For example, individuals of certain cultures are more likely to express depression through somatic symptoms than through affect and feeling tone.

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True

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True or False? Statistics show that the prevalence rate over a 12-month period for major depressive disorder is 6.7%, and the lifetime prevalence rate for generalized anxiety is 3.1%.

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True

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Indicates some mild symptoms are present or some difficulty in social, occupational, or school functioning is present but the individual is functioning well enough to have some meaningful interpersonal relationships.

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A global assessment of functioning in the 70s.

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True or False? Worldwide studies indicate that both schizophrenia and bipolar disorder are recognized cross-culturally.

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True

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On the basis of the current understanding of neurotransmitters, the nurse can view a client's symptoms of profound depression as likely related in part to...

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Decreased serotonin level. A lowered serotonin level is highly supported as being related to depression; however, depression is more probably influenced by a number of neurotransmitter abnormalities.

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The nurse caring for a client taking risperidone (Risperidal) observes the client carefully for:

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Napping during the day, a weight gain, and reports of dizziness.

H1 blockade has the potential to produce sedation, weight gain, and hypotension.

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The behavior of an individual who seems unable to learn right from wrong and who repeatedly violates norms and laws demonstrates problems related to the brain's inability to...

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Regulate social behavior.

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The inability to regulate social behavior usually results in...

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Antisocial behaviors such as lying, cheating, taking advantage of others, and breaking laws.

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When the nurse cares for a client taking an antipsychotic medication that blocks muscarinic receptors, the nurse would assess for:

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Blurred vision, dry mouth, and constipation. Anticholinergic effects are the effects produced by atropine: dry mouth, dry eyes, blurred vision, constipation, and urinary retention.

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The nurse responsible for the care of a client prescribed clonazepam (klonopin) would evaluate treatment as being successful when the client demonstrates:

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Less anxiety. γ-Aminobutyric acid is thought to modulate neuronal excitability and anxiety. A drug that increases the effectiveness of γ-aminobutyric acid would result in anxiety reduction.

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The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine. The nurse evaluates the treatment as successful when observing:

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Laughing at a joke. Depression is thought to be at least in part caused by lowered levels of serotonin and norepinephrine. Increasing the amount of these transmitters in the brain by blocking reuptake may result in mood elevation.

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An important difference between the developmental theories of Freud and Erikson is...

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Erikson viewed individual growth in terms of social setting. Erikson placed greater emphasis on the role of the ego. He also stressed that an individual's development is influenced by more than the restricted mother-child-father triangle and that culture and society exert significant influence on personality.
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Maslow's theory of Humanistic Psychology has provided nursing with a framework for...

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Holistic assessment. Central to Maslow's theory is the assumption that human beings are active rather than passive participants in life, striving for self-actualization. Maslow (1968) focuses on human need fulfillment, which he describes in six incremental stages; beginning with physiological survival needs and ending with self-transcendent needs (Figure 2-5). Although these needs are present in all human beings, the behaviors that emanate from them differ according to a person's individual biological makeup and environmental factors. This picture is broader and more holistic.
Text pages: 38, 39

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The premise underlying behavioral therapy is...

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Behavior is learned and can be modified.

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The nurse planning care for a 14-year-old needs to take into account that the developmental task of adolescence is to...

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Achieve identity. According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood.
Text page: 29, Table 2-2

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Sullivan viewed anxiety as...

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Any painful feeling or emotion arising from social insecurity.

According to Sullivan, the purpose of all behavior is to get needs met through interpersonal interactions and decrease or avoid anxiety. He viewed anxiety as a key concept and defined it as any painful feeling or emotion arising from social insecurity or blocks to getting biological needs satisfied.
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Which statement best clarifies the difference between the art and science of nursing?

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The art is the care, compassion, and advocacy component, and the science is the applied knowledge base.

This statement reflects the larger thinking of the profession.
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Client problem that would be most suited to the use of interpersonal therapy.

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Dysfunctional grieving.

Interpersonal therapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit.
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A cognitive therapist would help a client restructure the thought "I am stupid!" to...

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"What I did was stupid."

Cognitive therapists help clients identify, reality test, and correct distorted conceptualizations and dysfunctional beliefs, such as realizing that doing a stupid thing does not mean the person is stupid.
Text page: 36

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The nurse providing anticipatory guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by...

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Ignoring the tantrum and giving attention when the child acts appropriately.

Ignoring the tantrum provides no reinforcement of the undesirable behavior. Instead, approval and reinforcement are given when the child is behaving in the desired way. This is an example of absence of reinforcement or extinction.
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Freud believed that individuals cope with anxiety by using...

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Defense mechanisms.

The ego develops defenses or defense mechanisms to ward off anxiety by preventing conscious awareness of threatening feelings.
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The nurse explains to a depressed client who was abused physical as a child that his id is...

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The source of his instincts to save himself from hurting himself.

At birth we are all id. The id is the source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond as well as all the wishes that motivate us.
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As a result of Harry Stack Sullivan, the nurse in virtually all residential and day hospital settings is involved in providing clients with...

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A psychotherapeutic environment.

Sullivan demonstrated that a psychotherapeutic environment, revolving around an accepting atmosphere that provides numerous opportunities for practicing interpersonal skills and developing relationships, is an invaluable treatment tool. This method is used today in virtually all residential and day hospital settings.
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The nurse is working with a severely depressed client who has very low self-esteem and is distrustful of unit staff. The client is facing role transition from wife to wife and mother. The nurse's priority is to...

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Establish trust with the client.

Maslow describes safety as a basic need as meaning that it is so basic to existence that it must be resolved to reduce the tension associated with them. These needs have the greatest strength and must be satisfied before a person turns his attention to higher-level needs.
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The nurse uses Maslow's model of needs to direct the identification of an anxious client' priority intervention to be...

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Assessing the client for her strengths upon which a nurse-client relationship can be based.

The value of Maslow's model in nursing practice is twofold. First, the emphasis on human potential and the client's strengths is key to successful nurse-client relationships. The second value lies in establishing what is most important in sequencing of nursing actions in the nurse-client relationship.
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A suspicious client smokes several packs of cigarettes daily and drinks as much coffee or soda as he is able to afford. The nurse finds that every nursing intervention is met with sarcasm. When she asks for advice from a peer, the most helpful response would be...

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"It might help if you remember that sarcasm represents oral-stage fixation."

According to Freud's psychosexual stages of development, this client is exhibiting the oral (0-1 year) personality traits: fixation at the oral stage is associated with passivity, gullibility, and dependence; the use of sarcasm; and the development of orally focused habits (e.g., smoking, nail biting).
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A client comes to the clinic asking for help because his third fiancée has broken their engagement. He states "I don't know what is wrong with me, but my friends tell me I am too possessive." The type of therapy that might address his interpersonal deficit is...

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Interpersonal psychotherapy.

Interpersonal psychotherapy is considered to be effective in resolving problems of grief, role disputes, role transition, and interpersonal deficit.
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Front 37

Role playing is associated with which type of therapy?

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Modeling

In modeling, the therapist provides a role model for specific identified behaviors, and the client learns through imitation. The therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose. Some behavior therapists use role playing in the consulting room for modeling therapy.
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