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Test 1 - NURS 383 - Psychiatric Mental
Health Nursing - Jamie Davis Newest
Edition 2025-2026. Questions &
Correct Answers. Graded A
______ _______ outlined stages of moral development. His stages are not closely tied to specific age groups or the maturational process. He believed that moral stages emerge out of our own thinking and the stimulation of our mental processes. – ANS Lawrence Kohlberg ______ ________ a former New England school- teacher, who lobbied tirelessly on behalf of the men- tally ill population – ANS Dorothea Dix _______ ______ has been called the father of child psychology. He believed that human intelligence progresses through a series of stages that are re- lated to age, demonstrating at each successive stage a higher level of logical organization than at the previous stages. - ANSJean Piaget _______ ________ is defined as conduct that results from serious critical thinking about how individuals ought to treat others. - ANSMoral behavior _______ ________ provided a framework for "psychodynamic nursing," the interpersonal involvement of the nurse with a client in a given nursing situation. - ANSHildegard Peplau
_______ __________ espouses that what is right and good is what is best for the individual making the decision. An individual's actions are determined by what is to his or her own advantage. The action may not be best for anyone else involved, but consideration is only for the individual making the decision. - ANSEthical egoism _______ described four psychological tasks that she associated with the stages of infancy and childhood as identified by ______ and ________ - ANSPeplau Freud Sullivan _______ is a branch of philosophy that addresses methods for determining the rightness or wrong- ness of one's actions. __________ is the term applied to these principles when they refer to concepts within the scope of medicine, nursing, and allied health - ANSEthics Bioethics _______ set limits on unacceptable behaviors - ANSNurses ________ ______ theory is based on the writings of St. Thomas Aquinas. It advances the idea that deci- sions about right versus wrong are self-evident and determined by human nature.
Our actions are bound by a sense of duty. This theory is often called
For example, "I make this choice because it is morally right and my duty to do so" - ANSKantianism deontology _________ _________ is generally defined as a condition in which an individual, as a result of mental illness, is in danger of serious physical harm resulting from inability to provide for basic needs such as food, clothing, shelter, medical care, and personal safety. - ANSGravely disabled _________ laws are derived from decisions made in previous cases. An example of a common law might be how different states deal with a nurse's refusal to provide care for a specific client - ANSCommon law __________ blockage leads to movement abnormalities like PseudoParkinsonism, ________ Reactions, Akathisia, Tardive dyskinesia - ANSDopamine Dystonic ___________ nursing is being able to under- stand one's own behavior, to help others identify felt difficulties, and to apply principles of human relations to the problems that arise at all levels of experience. - ANSPsychodynamic
"I can't control my emotions" "My childhood will always affect me" "I must depend on others" "I can't change what I think" - ANSCommon cognitive distortions "maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and that interfere with the individual's social, occupational, and/or physical functioning." - ANSmental illness "the successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age- appropriate and congruent with local and cultural norms." - ANSmental health #1 reason for relapse is _________ non-compliance - ANSmedication
- A duty to the patient existed, based on the recog- nized standard of care.
- A breach of duty occurred, meaning that the care rendered was not consistent with the recognized standard of care.
- The client was injured.
- The injury was directly caused by the breach of a standard of care. - ANSbasic elements of a nursing malpractice lawsuit
- diagnose and treat disease and illness.
- provide counseling and make recommendations for care.
C. Pleasure principle. Social and cultural acceptability are not considered. - ANS1. C. Pleasure principle
- B. Rational self
- A. Perfection principle
- The individual delays in reaching the point of a communication be- cause of unnecessary and tedious details. The point or goal is usually met but only with numerous interruptions by the interviewer to keep the person on track of the topic being discussed.
- the person never really gets to the point of the communication. Unrelated topics are introduced, and the focus of the original discussion is lost.
- Speaks very little; may respond in mono syllables
- take the form of rhyming. For instance, "It is very cold. I am cold and bold. The gold has been sold."
- group of words that are put together randomly, without any logical connection (e.g., "Most forward action grows life double plays circle uniform."). A. Word Salad B. Tangentiality C. Circumstantiality D. Clang Associations E. Poverty of speech - ANS1. C. Circumstantiality
- B. Tangentiality
- E. Poverty of speech
- D. Clang Associations
- A. Word Salad
- They value punctuality, work responsibility, and a healthy lifestyle.
- Have large support systems and a strong religious orientation. Many have assimilated into and have many of the same characteristics as the dominant culture.
- They often appear silent and reserved and many are uncomfortable with touch and expressing emotions. Health care may be delivered by a healer called a shaman.
- languages are very diverse. Touching during communication has historically been considered unacceptable. May have difficulty expressing emotions and appear cold and aloof. Family loyalty is emphasized. Psychiatric illness is viewed as behavior that is out of control and brings shame on the family.
- Large family groups are important, and touch is a common form of communication. The predominant religion is Roman Catholicism and the church is often a source of strength in times of crisis. Health care may be delivered by a folk - ANS1. C. Northern European Americans
- A. African Americans
- E. Native Americans
- B. Asian American
- D. Latino Americans
- F. Western European Americans
- G. Arab Americans
- H. Jewish Americans
- Verbalizations shift from one unrelated topic to another.
Communicate their choices 4 important Patient rights laws - ANSUniversal Bill of Rights for Mental Health Patients APA of 1990 HIPPA Tarasoff vs Regents 4 of the pt bill of rights - ANSRight to communicate with people outside the hospital - with restrictions Right to religious freedom Right to treatment Right to refuse treatment A _________ law is a law that has been enacted by a legislative body, such as a county or city council, state legislature, or the U.S. Congress. An example of statutory law is the nurse practice acts. - ANSstatutory A client's refusal to accept treatment may be challenged under the following circumstances: - ANS1. When a client is mentally incompetent to make a decision and treatment is necessary to preserve life or avoid serious harm
- When refusing treatment endangers the life or health of another
- During an emergency, in which a client is in no condition to exercise judgment
- When the client is a child (consent is obtained from parent or surrogate)
- In the case of therapeutic privilege: Information about a treatment may be withheld if the physician can show that full disclosure would a. hinder or complicate necessary treatment b. cause severe psychological harm, or c. be so upsetting as to render a rational decision by the client impossible A complex right The right to control one's life and actions as long as they don't interfere with others - ANSRight to refuse treatment A major focus of nursing in the therapeutic _______ is the one-to-one relationship that grows out of a developing trust between client and nurse. Many clients with psychiatric disorders have never achieved the ability to _______ - ANSmilieu trust ABC's of Treatment - ANSAffective - feelings Behavioral - actions Cognitive - thoughts Action is taken based on the end results that produced the most good (happiness) for the most people. - ANSutilitarianism
This syndrome is diagnosed when at least three of the following five risk factors are present: abdominal obesity, high triglyceride level, low HDL cholesterol level, hypertension, and an elevated fasting blood glucose level. For these reasons, it is not uncommon for patients prescribed antipsychotics to have lipid and fasting blood glucose level monitoring. Lifestyle changes aimed at reducing cardiovascular risk may be indicated. - ANSmetabolic syndrome Behavioral examples. Id/Ego/Superego? "I already have money. This money doesn't belong to me. Maybe the person who owns this wallet doesn't have any money." "Mom and Dad said no friends over while they are away. Too risky." "Promiscuity can be very dangerous." - ANSEgo Behavioral examples. Id/Ego/Superego? "I found this wallet; I will keep the money." "Mom and Dad are gone. Let's party!!!!!" "I'll have sex with whomever I please, whenever I please." - ANSId Behavioral examples. Id/Ego/Superego? "It is never right to take some- thing that doesn't belong to you." "Never disobey your parents." "Sex outside of marriage is always wrong." - ANSSuperego
body language, affect (facial) and gestures - ANSKinesics CBT is highly __________ psychotherapeutic method to alter distorted ________ and problems. Cognitive therapy focuses in the ______ and ______ - ANSstructured beliefs here now changing default thinking with relevant, positive thought - ANSReframing communication of the spoken word - ANSParaverbal/paralanguage communication Define Psychosis - ANSExperiencing reality differently from others Diagnostic Criteria: Uninterrupted period of illness when there is a major depressive, manic, or mixed episode. Along with two of the following symptoms of schizophrenia: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, or negative symptoms.
Acute dystonia—a brief or prolonged contraction of muscles. The patient may present with occulogyric crisis, tongue protrusion, or torticollis. Neuroleptic-induced Parkinsonism—an observable slowing of movement (bradykinesia), muscular rigidity, and resting hand tremor. Tardive dyskinesia—a hyperkinetic movement disorder associated with chronic blockade of dopamine. Patients with tardive dyskinesia display abnormal buccal-lingual movements, often referred to as worm-like movements of the tongue with lip smacking. There may be finger movements, hand clenching, trunk twisting, and pelvis thrusting. Freud's Stages of Psychosexual Development
- Learning independence and control, with focus on the excretory function
- Identification with parent of same gender; development of sexual identity; focus on genital organs
- Sexuality repressed; focus on relationships with same-gender peers
- Libido reawakened as genital organs mature; focus on relationships with members of the opposite gender
- Relief from anxiety through oral gratification of needs A. Oral B. Anal C. Phallic D. Latency E. Genital - ANS1. B. Anal
- C. Phallic
- D. Latency
- E. Genital
- A. Oral guidelines for therapists to follow in determining their obligation to take protective measures: - ANS1. Assessment of a threat of violence by a client to- ward another individual
- Identification of the intended victim
- Ability to intervene in a feasible, meaningful way to protect the intended victim how close you stand while talking. Inside personal space - ANSProxemics If concerns about the validity of a PEC are not resolved with their initial interaction with the person executing the PEC then the concern should be reported to a _____________ for resolution - ANSsupervisor If pt is on typicals/atypical antipsychotics, they most likely will be on ___________ too - ANSBenztropine (Cogentin) If verbal and nonverbal messages conflict, the listener will believe the _________ message - ANSnonverbal inflection of syllables, it's not what you said but how you said it - ANSTone
Interventions: hallucinations o Assess: ask "are you having a hallucination?" o Help pt increase ________ of reality o It may not occur to pt to verify _______ of hallucinations o Regulate environmental < stimulation o Assess for drug or ______ use - could be the cause instead of antipsychotic o Decrease _______ o You may state that you do not _______ the event o Give patients ideas to ______ from hallucination (coloring is calming) - ANSawareness reality ETOH stimuli experience distract Involuntary admit Which one is a second opinion? - ANSPhysician's Emergency Certificate (PEC) -
- Completed by any MD
- 72 hours in the hospital
- Guarantees evaluation by a psychiatrist within 24 hours Coroner's Emergency Certificate (CEC) (Think - second opinion)
- 15 days from signed date/time of PEC
Judicial or Court Committed
- After 15 days of CEC is up they can then file this.
- Court can commit for longer periods of time
- Psychiatrist goes to court and files a petition to commit pt
- Lasts about 3 months Order of Protective Custody (OPC)
- Family member can file a petition with the sheriff's office that that pt is a danger to him/herself or to others Involuntary commitments are made for 3 reasons - ANS■ In an emergency situation (for the client who is dangerous to self) ■ In an emergency situation (for the client who is dangerous to others ■ When an individual is unable to take care of basic personal needs (the "gravely disabled") It advances the importance of virtues such as love, forgiveness, and honesty. One basic principle often associated with ________ ________ is known as the golden rule: "Do unto others as you would have them do unto you." - ANSChristian ethics Jahoda (1958) identified a list of six indicators that she suggested are a reflection of mental health: - ANS1. A Positive Attitude Toward Self.
- Growth, Development, and the Ability to Achieve Self-actualization
