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38 Cards in this Set
- Front
- Back
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The pt. ask the nurse about milieu therapy. The nurse responds, knowing that the primary forcus of milieu therapy can best be described as which of the following?
1)A form of behavior modification therapy 2)A cognitive approach to changing behavior 3)A living, learning, or working environment 4)A behavioral approach to changing behavior |
3)A living, learning, or working environment
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The nurse is caring for a pt with a phobia who is being treated for the condition. the pt is introduced to short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of behavior modification can best be described as:
1)Milieu therapy 2)Aversion therapy 3)Self-control therapy 4)Systematic desensitization |
4)Systematic desensitization is a form of therapy used when the pt is introduced to short periods of exposure to the phobic object while in a relaxed state. Gradually exposure is increased until the anxiety about or fear of the object or situation has ceased
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A pt with an eating disorder is planning to atend group meetings with overeaters anonymous, and the nurse describes this group to the pt. The nurse determines that the pt needs more information if the pt states while of the following about this self-help group?
1)The leader is a nurse or psychiatrist 2)The members provide support to each other 3)People who have a similar problem are able to help others 4)It is designed to serve people who have a common problem |
1)The sponsor of a self-help group is an experienced member of the group. A nurse or psychiatrist may be ask by the group to serve as a resource but would not be the leader of the group
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The nurse is conducting a group therapy session, and a pt with a manic disorder is monoplizing the group. The appropriate nursing action is which of the following?
1)Ask the pt to leave 2)Refer the pt to another group 3)Tell the pt to stop monopolizing 4)Thank the pt for the contribution and tell him or her to allow others a chance to contribute. |
4)if a pt is momopolizing the group, the nurse must be direct and decisive. The best action is to thank the pt and suggest that the pt stop talking and try listening to others
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A nurse employed in a mental health unit of a hospital is the leader of a group psychotherapy session. The nurse's role in the termination stage of group developmentis to:
1)Encourage problem-solving 2)Encourage accomplishment of the group work 3)Acknowledge the contribution of each group member 4)Encourage members to become acquainted with one another |
3)In the termination stage, the group leader's task is to acknowledge the contributions of each member and the experience of the group as a whole. In ehis stage, the group members prepare for separation and assist each other to prepare for the future
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All tx team members are seen as equally important in helping pt meet their tx goals. This type of therapy approach is:
1)Milieu Therapy 2)Interpersonal therapy 3)Behavior modification 4)Rational emotive therapy |
1)All tx team members are viewed as significant & valuable to the pts successful tx outcomes in miliew therapy. Behavior modification is based on rewards and punishment. Rational emotive therapy deals with the correction of distorted thinking. Interpersonal therapy on the other hand is based on a one-to-one or group therapy approach in which the therapist-pt relationship is often used as a way for the pt to examine other relationships in their life
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An 18-yr-old woman is admitted to an inpatient mental health unit with the dx of anorexia nervosa. A cognitive behavioral approach is used as part of her tx plan. The nurse understands that the purpose of this approach is to:
1)Provide a supportive environment 2)Examine intrapsychic conflicts and past issues 3)Emphasize social interaction with pts who withdraw 4)Help the pt identify & examine dysfxal thoughts and beliefs |
4)Cognitive behavioral therapy is used to help the pt identify and examine dysfxal thoughts and to identify and examine values and beliefs that maintain these thoughts
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A pt with major depression is considering cognitive therapy. The pt asks the nurse, How does this tx work? The nurse responds & tells the pt that:
1)This type of tx will help you relax & develop new coping skills 2)This type of tx helps you confront your fears by gradually exposing you to them 3)This type of tx helps you examine how your past life has contributed to your problems 4)This type of tx helps you examine how your thoughts and feelings contribute to your difficulties |
4)Cognitive therapy frequently is used for pts with depression. This type of therapy is based on exploring the pts subjective experience. Cognitive thearpy includes examining the pts thoughts and feelings about situations and how these thoughts and feelings contribute to and perpetuate the pts difficulties and mood.
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The pt is preparing to attend a Gamblers Anonymous meeting for the first time. The prototype used by this group is the 12-step program develped by AA. The nurse tells the client that the first step in the 12-step program is which of the following?
1)Admitting to having a problem 2)Substituting other activities for gambling 3)Stating that the gambling will be stopped 4)Discontinuing relationships with friends who are gamblers |
1)The first step in the 12-step program is to admit that a problem exsists.
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Select the characteristics of the termination stage group development. Select all that apply
1)The group evaluates the experience 2)the real work of the group is accomplished 3)Group interaction involves superficail converstation 4)Group members become acquainted with each other 5)Some structuring of group norms, roles, and responsiblities take place 6)The group explores members' feelings about the group and the impending separation |
1,6)The stages of group development include the initial stage, the working stage, and the termination stage. During the initial stage, the group members become acquainted with each other and some structuring of group norms, roles, and responsiblities take place. During the initial stage, group interaction involves superficial conversation during the working stage, the reals work of the group is accomplished. During the termination stage, the group evaluates the experience and explores members' feelings about the group and the implending separation.
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use of the environment to promote optimal functioning in a group or individual
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milieu therapy
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tx environment managed in such a way that the environment itself is therapeutic
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therapeutic milieu
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organization that requires institutions routinely evaluate the environment for its ongoing effectiveness for providing care
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JCAHO
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Psy nurses manage the tx environment by modification of what 5 elements
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-safety
-structure -norms -limit setting -balance |
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it is important that a seclusion room be seen as a tx intervention when someone is unresponsive to other nursing interventions and environmental modifications, and not as a place of ______
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-punishment
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_____ has very clear standards regarding the effects of the environment of care on inpat. psy settings. Safety and a functional environment conducive to pt. care are major priorities of the environment of care
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JCAHO
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what are some manifestations of burnout?
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-low morale
-passivity -avoidance -disinterest -chronic complaning -(-),hostile rx to others |
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What is the precipitating factor leading to a pt being restrained
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-stuggle over rules
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One of the most frequently reported distressing events on a psy unit is dealing with ____ ____
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-suicidal behavior
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Lacking time to plan care, nurses find themselves responding only to emerging crises and pts quickly learn that getting the nurses attention requires a ____
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-crisis
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the possible negative effects for staff when dealing with the daily traumas in pt care areas
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-vicarious or 2nd traumatization
-compassion fatique |
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how pts are educated about psychiatric illness management
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-psychoeducational
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What is the purpose of group therapy?
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-to facilitate awareness & insight about behavior and develop plans for change/coping
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Who do the therapeutic community meeting consist of?
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-patients
-staff -students |
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Activities on the open psy unit focus on problems r/t admission and on ____ ____ to avoid re-admisssion
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-problem-solving
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____ _____ help dementia pts navigate the hospital
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-environmental cue
--ex. pics, names, lg calender board |
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____ is considered on of the most stressful events associated with dementia.
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-bathing
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____ psy units are the least restrictive inpatient tx environment
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-open
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a pt judged to have committed a crime in connection with a mental illness might be found ____
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-NGRI (not guilty by reason of insanity)
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judgemental attitude whereby the nurse perceives the pt as different, thereby justifying distancing with in the nurse-pt relationship
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-othering
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to avoid becoming manipulated by character diordered pts the staff must______
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-work together
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unlicensed personnel must be included in the tx plan and offered ______ _____ and mentoring relationships with professional staff
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-inservice education
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The pt in the _______ psy setting is guilty of committing a crime believed to be caused by a mental illness
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-forensic
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Training in ______ prevention is essential for forensic psy staff
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-violence
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Pt in a forensic psy unit have a mental illness & ____
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-committed a crime
(usually horrendous) |
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______interfers with developing a relationship with pts in forensic settings
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-countertransference
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_____ _____ with an advanced practice nurse is an absolute necessity to assist staff in remaining clear about the dangers of boundary violations
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-clinical supervision
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What are the 2 primary interventions used by forensic psy nurses
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-verbal interactions with focus on limit setting
-discussion about problems in daily life |
