Theories and Foundations
Defense Mechanism--Student decides not to think about a parent's illness to study for a test
What is suppression
This type of mood refers to average affect and activity; happy events stimulate joy and enthusiasm
Euthymic mood
During the interview at a crisis center, a newly widowed client reveals the wish “to join my husband in Heaven.” The nurse determines that the client does not plan to hurt herself. Which question is appropriate to use next?
a. "Tell me what feelings you have been experiencing."
b. "Have you considered taking antidepressants?”
c. "What was the cause of your husband's death?"
d. "Do you have children who are willing to help you?"
a. "Tell me what feelings you have been experiencing."
name three types of extrapyramidal side effects of antipsychotic medication--
dystonic reaction--spasms of muscle groups
pseudoparkinsonism--shuffling gait, masklike facies
akathisia--restless movement
Tardive dyskinesia
flight of ideas
excessive amount and rate of speech composed of fragmented or unrelated ideas; racing, often unconnected, thoughts
labile
high switch/variability between moods
The emergency department nurse is caring for a 2-month-old infant who was brought in by a hired caregiver. The infant is underweight and looks uncared for. The caregiver reports that the mother of the infant is unreliable and may be using drugs; the infant is often unclean and hungry when dropped off at the caregiver’s home. The infant has diaper rash and a weak cry. If this situation is not remedied, what will this infant have difficulty achieving, according to Erikson’s developmental theory?
a. Trust
b. Autonomy
c. Initiative
d. Identity
a. Trust
This theory is part of humanistic perspective in psychology
What is Maslow's
What is the difference between mania and hypomania--name at least two differences
hypomania does not impair the person's ability to function; no psychotic features--hypomania usually does not require hospitalization
As the nurse is turning off the television, a client with bipolar disorder, manic phase, says, "I want the television on so I can watch the late show. I am not tired and you cannot tell me what to do. I want it on!" The nurse should tell the client:
a. "I will let you watch television just this once, but you have to turn the sound off.
b. "I will turn the television off when you get sleepy. Do not ask me to do this again."
c. "Television hours are from 1900 hours to 2200 hours. It is 2200 hours, and the television goes off so everyone can sleep."
d. "The television goes off at 2200 hours. I have been telling you this for the past three evenings."
c. "Television hours are from 1900 hours to 2200 hours. It is 2200 hours, and the television goes off so everyone can sleep."
thepoint.lww.com (PREPU)
name at least three unusual speech patterns patients may display if they have schizophrenia
Clang associations, neologisms, echolalia, stilted language (flowery words), word salad
pressured speech
unrelenting, rapid, often loud talking without pauses
Hypervigilence
enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviors whose purpose is to detect threats
The developmental task of the adolescent period, according to Erikson, is to form a sense of:
a. autonomy versus shame or doubt
b. initiative versus guilt
c. identity versus role confusion
d. decisiveness versus indecisiveness
c. identity versus role confusion
This stage of Erikson's the task is set on being creative and productive; establishing the next generation
What is Generativity v Stagnation
Name at least 5 s/s of major depressive disorder
depressed mood most of the day, diminished interest or pleasure in all activities, significant weight loss, insomnia or hypersomnia, psychomotor agitation or retardation; fatigue or loss of energy, feelings of worthlessness or inappropriate guilt; diminished ability to think or concentrate; recurrent thoughts of death, recurrent suicidal ideation
Assessment of suicidal risk in children and adolescents requires the nurse to know what information?
a. Children rarely commit suicide unless one of their parents has already committed suicide, especially in the past year.
b. The risk of suicide increases during adolescence, with those who have recently suffered a loss, abuse, or family discord being most at risk.
c. Children do have a suicidal risk that coincides with some significant event such as a recent gun purchase in the family.
d. Adolescents typically do not choose suicide unless they live in certain geographical regions of the United States or Canada.
b. The risk of suicide increases during adolescence, with those who have recently suffered a loss, abuse, or family discord being most at risk.
lww.thepoint.com (PREPU)
Name three nursing diagnoses a patient with acute phase of schizophrenia may have
risk for other directed violence, disturbed thought process, risk for suicide, disturbed sensory perception, disturbed personal identity, impaired verbal communication, self-care deficit, social isolation, ineffective health maintenance, etc
rumination
repeatedly going over the same thoughts
Anhedonia
having no pleasure or joy in life; losing any sense of pleasure from activities formerly enjoyed
The parents of a 4 month old cannot visit at the hospital except on weekends. Which of the following actions by the nurse indicates an understanding of the emotional needs of a young infant?
a. Place infant in room away from other clients
b. Tell parents infrequent visiting is not necessary
c. Have different nurses provide care for varied contact
d. Assign the same nurse as much as possible
d. Assign the same nurse as much as possible
A nursing student who fails an examination believes that because the student earned a low grade, the student now must develop a better understanding of the material. This student is exhibiting a belief system that is what?
a. Grandiose
b. Self-defeating
c. Rational
d. Irrational
Name at least 5 s/s of mania
inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual, flight of ideas or racing thoughts, distractibility, increase in goal directed activity, excessive involvement in activities that have a high potential for painful consequences
After telling a nurse to “pray for me,” a client gives away personal possessions and shows a sudden calmness. The nurse recognizes that this behavior may signal which condition?
a. Major depression
b. Panic attack
c. Suicidal ideation
d. Severe anxiety
c. Suicidal ideation
What are at least two nursing interventions relating to communicating with a patient who is actively delusional or actively hallucinating?
Be sincere and honest, initially do not try to argue with patient, interact with the patient on the basis of real things, show empathy, do not be judgmental, never convey to the patient you see the delusions as reality, interject doubt when appropriate, etc
psychomotor retardation
overall slowed movements; a general slowing of all movements; slow cognitive processing and slow verbal interaction
grandiose
inflated sense of self worth
The nurse has just completed an assessment on a child who voices an interest in how things are made and who needs support when they are not successful. The child further reports he is involved in clubs and sports outside the home. The nurse is aware that this child is in which of Erikson’s states of development?
a. Initiative versus guilt
b. Autonomy versus shame and doubt
c. Trust versus mistrust
d. Industry versus inferiority
Erikson's stages in order
Trust v Mistrust; Autonomy v shame and doubt; initiative v guilt; industry v inferiority; identity v role confusion; intimacy v isolation; generativity v stagnation; ego integrity v despair
Name two medication classes used to treat depression
name two medication classes used to treat mania
Name two other treatment modalities for either
SSRI, SNRI, MAOI, Tricyclic, etc
Lithium (mood stabilizer), anticonvulsant, antipsychotics
The nurse is caring for a client who is unconscious following an attempted suicide by drug overdose. When speaking with the client’s distraught wife, what should the nurse do first?
a. Explain that because the client was found on hospital property, he was probably asking for help and did not intentionally overdose.
b. Ask the wife if she would like to speak to a member of the clergy.
c. Encourage the wife to express her feelings and concerns, and listen carefully.
d. Allow the wife to help care for the client by rubbing his back when he is turned.
c. Encourage the wife to express her feelings and concerns, and listen carefully.
Name at least five early signs of relapse in a schizophrenic patient
Poor nutrition, lack of sleep, fatigue, poor social skills, mood swings, lack of control, disinhibition, neglecting appearance, increased negativity
hypomania
period of abnormally and persistently elevated, expansive, or irritable mood lasting 4 days; does not impair the ability to function and does not involve psychotic features
echopraxia
waxy flexibility
repeating of movements
holding same position for long periods of time
An resident of a long-term care facility, age 82 years, often tells stories of the role that he played in the Korean War. According to Erikson, which of the following needs may underlie the resident's storytelling?
a. The need to demonstrate that his life was meaningful and purposeful
b. The need to show that his life was characterized by moral integrity
c. The need to demonstrate that he was capable of physical aggression in earlier adulthood
d. The need to show that others were dependent on him in earlier stages of life
a. The need to demonstrate that his life was meaningful and purposeful