Download NSG 526 Exam 1 Questions And Answers 2025 Update. and more Exams Nursing in PDF only on Docsity!
NSG 526 Exam 1 Questions And Answers
2025 Update.
What is not considered a mental disorder? - Correct answer -An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one -Socially deviant behavior (i.e. political, religious, or sexual) and conflicts that are primarily between the individual and society (unless the behaviors are due to a dysfunction) What is considered a mental disorder per the DSM5? - Correct answer -Associated with significant distress or disability in social, occupation, or other important activities -Significant disturbance in cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning Purpose of Scope of Practice? - Correct answer -Define NP roles -Identify competencies assumed to be held by all NPs who function in a particular role -Varies broadly from state to state Purpose of Standard of Practice? - Correct answer -Authoritative statements regarding the quality and type of practice that should be provided -Provide a way to judge the nature of care provided -Reflect the expectation for the care that should be provided to clients with various illnesses -Reflect professional agreement focused on the minimum levels of acceptable performance -Can be used to legally describe the standard of care that must be met by a provider
-May be precise protocols that must be followed or more general guidelines that recommend actions Purpose of Psychiatric Interview? - Correct answer Understand the patient's illness to evaluate the effect on their lives and create a beginning diagnosis and treatment plan What is a Therapeutic Alliance? - Correct answer -Create a relationship with client by being calming, warm, understanding, kind, respectful, concerned and focused -Able to help patient better if a therapeutic alliance was formed Important components of a therapeutic alliance? - Correct answer - Therapist and patient work collaboratively to create therapeutic change through an affectionate bond -Agreement on goals of therapy -The therapist's ability to be empathetic and involved in therapy -The ability of the patient to do the work of therapy What is Psychotherapy? - Correct answer Holistic treatment that relies on the nurse's processing of that the patient is experiencing Peplau's most universal contribution to PMHNPs? - Correct answer -Her application of Sullivan's theory of anxiety to nursing practice -Described the effects of different levels of anxiety (mild, moderate, severe, and panic) on perception and learning -Promoted interventions to lower anxiety, with the aim of improving clients' abilities to think and function at more satisfactory levels Per Peplau, skills of a MH nurse? - Correct answer -Observation, interpretation, and intervention (The PMHNP observes and listens to the client, developing impressions about the client's situation)
-Advising -Probing -Challenging -Defending -Requesting an explanation -Indication the existence of an external source -Belittling feelings -Making stereotypical comments -Giving literal responses -Introducing an unrelated topic Four Phases of the Nursing Model? - Correct answer -Orientation -Identification -Exploitation -Resolution Psychotherapy Process? - Correct answer -The PMHNP addresses individual and family problems with the patient -Assess identified problems during the orientation phase -Determines the underlying healthcare issues with the patient -Collects psychiatric data -Establish a trusting relationship How does the patient recover through adaption? - Correct answer By applying core principles of psychotherapy, as well as, nursing theory What does the PMHNP need to avoid? - Correct answer Avoid taking patients with similar problems or put aside personal pathology Goals for Interpersonal Therapy? - Correct answer -Focus on difficulties patient is experiencing in current relationships and the ways the relationships can be handled -Change pattern of communication
-Alter expectations within relationships -Use social supports to help patients deal with stressors and improve their environment -Relieve symptoms -Build social skills Indications for Interpersonal Therapy? - Correct answer - Complicated bereavement/grief -Marital and interpersonal conflicts, such as role disputes -Life events, such as role transitions -Isolation, lack of support, interpersonal deficits Early Phase of Interpersonal Therapy? - Correct answer Therapist identifies depressive symptoms, evaluates patient, generates a diagnosis, obtain information on how the patient handles relationships Middle Phase of Interpersonal Therapy? - Correct answer Patient and therapist derive more specific strategies to deal with stressors Termination Phase of Interpersonal Therapy? - Correct answer - Consolidate gains -Foster independence in the person -Review risk of relapse and reappearance of depressive symptoms -To contract again for continuation of treatment as needed Purpose of Group Therapy? - Correct answer Facilitate changes by the patient in order to address identified problems Role of leader in group therapy? - Correct answer Assure dominant members are brought to the attention of the group, so they are able to address issues within the process
Characteristic of Infancy? - Correct answer Gratification of needs Characteristic of Childhood? - Correct answer Delayed gratification Characteristic of Juvenile? - Correct answer Formation of peer group Characteristic of Preadolescence? - Correct answer Developing relationships within same gender Characteristic of Early Adolescence? - Correct answer Identity Characteristic of Late Adolescence? - Correct answer Forming lasting and intimate relationships What are the 3 types of self? - Correct answer -Good me vs Bad me: based on social appraisal and the anxiety that results from negative feedback -Not me: unknown, repressed component of self How does Sullivan's theory define security operation? - Correct answer Measures that the individual employs to reduce anxiety and enhance security How does Sullivan's theory define self system? - Correct answer All of the security operations that an individual uses to defend against anxiety and ensure self-esteem What is Milieu Therapy? - Correct answer -Significant time spent in a home-like environment -Interact with similar individuals -Conduct different activities throughout the day -May attend group or individual therapy sessions -Establish treatment goals for themselves and community
-Learn new ways to respond from peers and counselors Goal of Milieu Therapy? - Correct answer Return to larger society when goals have been met What is Behavioral Therapy? - Correct answer -Broad term referring to psychotherapy, behavior analytics, or a combination of the two -Focus on behaviors or in combination with thoughts and feelings that might be causing them What is Psychoanalysis? - Correct answer -Treatment method in which the client expresses all thoughts freely and without censoring self -Freud concluded that talking about emotional issues had the potential to heal the wounds causing mental illness Components of Mental Status Exam (MSE)? - Correct answer - General appearance, attitude, behavior -Speech -Mood and Affect -Thought content -Thought process -Impulse Control -Cognition and Sensorium How to describe thought content? - Correct answer -General description of what the patient talked about -I.E. information and description related to symptoms or circumstances of depression, anxiety, compulsions, phobias, delusions, SI/SH/HI/AVH SAD PERSONs Scale? - Correct answer Clinical tool to determine suicide risk
-Rapid topic changes -Topics may relate but in strange ways What is Confabulation? - Correct answer -Often indicates dementia -Fabrication of information to fill in missing gaps What is Concrete Thought Process? - Correct answer -Only understands things literally -Common in schizophrenic patients What is Abstract Thought Processes? - Correct answer -Able to think abstractly -Can be determined by asking patient how a chair and table are similar or "why should people in glass houses not throw stones?" What are Perceptual Disturbances? - Correct answer Describes whether the patient is in good contact of their environment or is there is a distortion of reality (Typically presents as hallucinations) What are Illusions? - Correct answer -Misinterpretation of true stimuli -I.E. a curtain in a dark room is mistaken for a person What are Hallucinations? - Correct answer -Sensations experienced by the client without real external stimuli -Patient may not have intact reality testing, which is the ability to accept evidence that these perceptions re not real These hallucinations may indicate a medical illness , substance intoxication or withdrawal? - Correct answer -Visual -Gustatory (taste) -Olfactory (smell) -Tactile
What are Hypnagogic and Hypnopompic Hallucinations? - Correct answer False sensory perceptions that occur while falling asleep and while awakening from sleep Ways to test Cognition and Abstraction? - Correct answer - Sensorium can be obtained while observing patient during the evaluation -Memory can be tested by having the patient remember and repeat 3 objects -Concentration can be tested by counting backwards from 100 by 7s DSM-5 Axis 1? - Correct answer Clinical disorders -does not include personality disorders or mental retardation DSM-5 Axis 2? - Correct answer Personality Disorders and Mental Retardation DSM-5 Axis 3? - Correct answer General Medical Conditions (medical issues that causes the mental disorder) DSM-5 Axis 4 - Correct answer Psychosocial and environmental problems DSM-5 Axis 5 - Correct answer Global Assessment of Functioning (GAF) What is GAF? - Correct answer -Scoring system that is used to assess how well an individual is functioning in their daily lives -Scores range from 0 to 100 GAF Scoring System? - Correct answer 100 - no symptoms 90 - minimal symptoms with good functioning 80 - transient symptoms that are expected reactions to psychosocial stressors
-Focused on oral pleasures (sucking) -Too much or too little can result in oral fixation or oral personality, which is evidence by preoccupation with oral activities -May have stronger tendency to smoke, drink alcohol, over eat, or bite nails
- Potential personality: overly dependent, gullible, perpetual followers, pessimism, aggression Psychosexual stage: Anal? - Correct answer -18 months to 3 yrs -Focused on eliminating and retaining feces -Learn to control anal stimulation through pressure from society -Potential personality: obsession with cleanliness, perfection, controlling (anal retentive), messy, disorganized (anal expulsive) Psychosocial stage: Phallic - Correct answer -3 yrs to 6 yrs -Pleasure zone switches to genitals -Boys may develop unconscious sexual desires for their mother, which can result in seeing father as competition. Will fight for mothers affection -Oedipus complex: fear of castration as punishment for having these feelings (can be opposite with girls) -When the boy identifies with father, they become masculine, identifies as males, repress sexual feelings towards mother -A fixation in this stage can cause sexual deviancies, weak/confused sexual identity Psychosocial stage: Latency? - Correct answer -6 to 12 yrs -sexual urges remain represses -children interact and play mostly with same sex peers Psychsexual stage: Genital? - Correct answer -12yrs+ -begins at the start of puberty -sexual urges are awakened -through past lessons, adolescents direct their sexual urges onto opposite sex peers with the primary focus of pleasure in genitals
Freud's ID? - Correct answer -only personality present at birth -unconscious and includes instinctive and primitive behaviors -driven by pleasure principle, which is the immediate gratification of all desires (anxiety if no instant gratification) Freud's Ego? - Correct answer -develops from the ID -functions in the conscious, preconscious, and unconscious mind -personality component responsible for dealing with reality -ego represents one component of your full personality -ego provides direction and guidance Freud's Superego? - Correct answer -emerges around age 5 -holds the moral standards and ideals -provides guidelines for making judgements -has 2 parts (conscience and ego ideal) Erikson's Stage of Development: Infancy? - Correct answer -birth to 18 months conflict: trust vs mistrust -important events: feeding -outcome: hope Erikson's Stage of Development: Early childhood? - Correct answer -2 to 3 years -conflict: autonomy vs shame and doubt -important events: toilet training -outcome: will Erikson's Stage of Development: Preschool - Correct answer -3 to 5 years -conflict: initiative vs guilt -important events: exploration -outcome: purpose
-associated with schizophrenia, attention disorders, OCD, mood disorders Function of Parietal lobe? - Correct answer -coordination of sensation and motor behavior (coordination of language functions) -spatial orientation (knowing where your body is, physical sensation) -recognition of people and objects Function of temporal lobe? - Correct answer -memory formation: language (Wernicke's area) and learning -associated with euphoria, auditory hallucinations, and delusions (impaired left lobe) -right lobe impairment: dysphoria, depression, irritability, inappropriate affect Function of Occipital lobe? - Correct answer -vision and visual memory -impairment can cause visual defects, blindness and visual hallucinations What is case formulation? - Correct answer -used in treatment planning to justify a level of care, specify treatment needs, provide rationale for legal adjudication, immediate safety measures and ensure reasonable cost containment -hypothesis about the causes, precipitants and maintaining influence of a person's psychological, interpersonal, and behavioral problems -description of chief features 5 Broad Categories of Case Formulation? - Correct answer 1. Symptoms and problems
- Precipitating events or stressors
- Predisposing life events or stressors
- Mechanisms or causes of the problem
- Other contributing factors What are the Biopsychosocial Assessment Domains? - Correct answer Biological -genes -physical health -disabilities Psychological/behavioral factors -lifestyle -stress -health beliefs -self esteem -coping skills Social Conditions -cultural influences -family relationships/circumstances -social support -peers -school What psychosocial factors influence depression? - Correct answer -Family history of psychiatric illness -Early loss of a nurturing relationship -Stressful life events -Low social support Important things to communicate to the patient during an initial psychiatric assessment? - Correct answer -interviewer should know the reason the patient was brought in for an evaluation -area should be secured for safety -patient needs to know that the clinician cannot withhold any information from the team that will affect treatment or safety
What is therapeutic use of touch? - Correct answer -healing with hands -energy is believed to be transferred by laying the hands over specific parts of the body to aid in the process of healing -should only be used if the patient's culture, social, and moral views allow it Descriptors of lack of eye contact during the interview? - Correct answer -Poor -Fair -Good -Intense It is important that the provider takes in account the patient's current condition, and past history to understand why the eye contact is the way it is. How is a SOAPIER note different from a SOAP? - Correct answer It adds 2 additional elements I: Implementation consideration of the services provided E: the evaluation of service provision R: client's response to the diagnostic process, treatment planning, and intervention efforts Phases of the therapeutic patient/nurse relationship? - Correct answer Orientation -establish rapport -set parameters -purpose of meeting -formal/informal contracts of responsibilities -termination begins Working -maintain relationship
-gather further data -promote clients problem solving skills, self esteem, use of language -facilitate changes -overcome resistance behaviors -evaluate problems and goals Termination -deal with intense feelings regarding the experience -summarize goals and objectives -evaluate outcome attainment -review patient's plan for future -finalize termination The PMHNPs role in relationship building, maintaining and terminating? - Correct answer Building -define the structure, size, composition, purpose and time of group -task and maintenance functions may be discussed and demonstrated Working -facilitates communicate and ensures that meetings begin and end on time Termination -ensure each member summarized individual accomplishments -gives positive and negative feedback regarding the group experience What are the psychiatric symptoms measurement scales? - Correct answer -questionnaires, interviews, checklists, outcome assessments -standardized assessments ensure consistent, comprehensive evaluations
