1
what health problems can chronic stress lead to
high blood pressure
sleep disturbances
weakened immunity
NAME THAT DISORDER
excessive, persistent concern on physical symptoms (pain, fatigue, dizziness, headache, swelling, back pain) --> need reassurance from medical personnel
they see their symptoms as life threatening and harmful
Somatoform/Somatic Symptom Disorder
NAME THAT PERSONALITY DISORDER
long-standing distrust and suspicion of others
believes that others want to harm, exploit, or deceive
Symptoms are apparent in childhood
difficulty with relationships
often reject treatment
Paranoid (Cluster A) Personality Disorder
NAME THAT PERSONALITY DISORDER
exaggerated belief in one's own importance
feelings of entitlement
arrogant - lack of empathy for others
weak self-esteem, fear of abandonment, does not tolerate rejection well
hypersensitive to criticism and rejection - needs constant admiration
Narcissitic (Cluster B) Personality Disorder
A client prescribed lorazepam (Ativan) for acute anxiety becomes unsteady when walking. What is the nurse’s priority action?
A. Encourage ambulation to build tolerance
B. Hold the medication and notify the provider
C. Restrict fluid intake
D. Administer propranolol
✅ Correct Answer: B. Hold the medication and notify the provider
🧠 Rationale:
Benzodiazepines cause:
Sedation
Ataxia (loss of coordination)
Decreased cognitive function
NUR211 Notes - Psych (6)
Ataxia significantly increases fall risk, making this a safety priority.
❌ Why others are wrong:
A: Dangerous — increases fall risk
C: No relevance
D: Beta blockers treat physical symptoms, not benzodiazepine toxicity
if a patient is pacing, shouting, screaming, running, impulsive, unable to communicate
unable to problem solve and lose touch with reality
which level of anxiety is this
panic anxiety
NAME THAT DISORDER
emotional conflicts transferred to physical symptoms
neurological symptoms without a neurological diagnosis
They become paralyzed, blind, deaf, have a gait disorder
it happens from a trauma response
Conversion Disorder
NAME THAT DISORDER
lifelong pattern of social withdrawal
restricted range of emotion (introspective)
uncomfortable with social interaction
prevalent in families with schizophrenia
friendships are rare - often have imaginary friends
AVOID BEING TOO NICE OR FRIENDLY WITH THESE PATIENTS
Schizoid (Cluster A) Personality Disorder
NAME THAT PERSONALITY DISORDER
excitable, dramatic, colorful personality
high functioning - full of drama, extrovert, flamboyant
limited ability to develop meaningful relationships
emotional attention-seeking behaviors
self-centered, easily frustrated, insensitive, no personal insight
flirtatious
Histrionic (Cluster B) Personality Disorder
A nurse is caring for a client experiencing panic-level anxiety. Which intervention is most appropriate?
A. Teach coping skills and deep breathing techniques
B. Encourage the client to discuss the source of anxiety
C. Stay with the client and provide simple, calm communication
D. Ask the client to complete a written anxiety log
✅ Correct Answer: C. Stay with the client and provide simple, calm communication
🧠 Rationale:
During panic-level anxiety, the client:
Cannot process information
Cannot problem solve
May lose touch with reality
NUR211 Notes - Psych (6)
The priority is:
Reduce stimulation
Provide safety
Use simple communication
❌ Why others are wrong:
A: Client cannot learn during panic
B: Client cannot analyze causes
D: Client cannot focus or write
NAME THAT DISORDER
a sudden onset of extreme apprehension or fear
- feelings of impending doom
- limited perception of reality
- extremely intense, lasting a few minutes, then subsides
panic disorder
NAME THAT MEDICATION
fast onset, sleep-inducing, lowers BP
Side Effects: sedation, ataxia, decrease in cognitive function
benzodiazepines
ativan, xanax, Klonopin
NAME THAT PERSONALITY DISORDER
severe social and interpersonal deficits
aware of magical thinking and odd beliefs
strange speech patterns
inappropriate affect (paranoia)
extreme anxiety in social interactions
risk for violence
conversations are rambling, over detailed
usually avoids treatment
Schizotypal (Cluster A) Personality Disorder
What can Naltrexone be used for?
Decrease cravings of alcohol or opioids
ALSO can be used to decrease self harming behaviors
A client is prescribed propranolol for anxiety. Which symptom indicates the medication is effective?
A. Reduced hallucinations
B. Reduced racing heart and sweating
C. Improved sleep cycle regulation
D. Reduced obsessive thoughts
✅ Correct Answer: B. Reduced racing heart and sweating
🧠 Rationale:
Beta blockers treat physical symptoms of anxiety, including:
Tachycardia
Sweating
Tremors
NUR211 Notes - Psych (6)
They do NOT treat psychological symptoms directly.
❌ Why others are wrong:
A: Antipsychotics treat hallucinations
C: Antidepressants improve sleep cycle regulation
D: SSRIs and CBT treat obsessive thoughts
explain the difference between obsessions and compulsions
obsessions - persistent thoughts, impulses, or images that cannot be dismissed from the mind
compulsions - ritualistic behaviors performed in an attempt to reduce anxiety
what does rumination mean?
consistent negative thoughts
The most dramatic of personality disorders
unstable mood
unstable interpersonal relationships
self-soothing habits - cutting, substance use, sexual behavior
splitting - inability to view both positive and negative aspects as a whole
Borderline (Cluster B) Personality Disorder
How should we react when someone gives themself a self inflicted wound
dress wound in a matter of fact manner
DO NOT DRAW ATTENTION TO THEM
Which client statement indicates a need for further teaching about benzodiazepines?
A. “This medication can cause sedation.”
B. “This medication works quickly.”
C. “This medication increases serotonin levels.”
D. “This medication can decrease my blood pressure.”
✅ Correct Answer: C. “This medication increases serotonin levels.”
🧠 Rationale:
Benzodiazepines work by suppressing CNS activity, not increasing serotonin.
NUR211 Notes - Psych (6)
SSRIs increase serotonin levels.
Correct benzodiazepine effects include:
Sedation
Rapid onset
Lower blood pressure
CNS depression
❌ Why others are wrong:
A: Correct benzodiazepine effect
B: Correct — fast onset
D: Correct — lowers BP
NAME THAT DISORDER
An unconscious defense mechanism to protect against overwhelming anxiety through emotional separation
Memories are fragmented
Multiple Personality Disorder - two personality states take control of behavior (original personality is moralistic and secondary is non-conforming)
Dissociative Disorders
what are some predisposing factors that can affect personality disorder
genetic/biological vulnerability
Hypersensitivity
Impulsiveness
Emotion dysregulation
Temperament
Neurobiological
Serotonin and dopamine imbalance
Abnormalities in the prefrontal cortex and limbic regions
Essential for emotional processing
Environmental
Childhood trauma
Dysfunctional families
Child separation (Mahler) - this was a part of the notes before so maybe take note on this?
Substance abuse
Can trigger symptoms
Chronic stress
Negatively influence personality development
NAME THAT PERSONALITY DISORDER
disregard and violation of the rights of others
decietful, manipulative for personal gain, hostile, poor impulse control
risk taking, disregard for responsibility, criminal conduct
they do not think rules apply to them
Antisocial (Cluster B) Personality Disorder
A client with generalized anxiety disorder is prescribed venlafaxine (Effexor). The client states, “This medication isn’t working after 5 days. I want to stop taking it.” What is the nurse’s best response?
A. “You should feel the effects immediately; notify the provider.”
B. “This medication requires several weeks to achieve full therapeutic effect.”
C. “This medication is only effective for panic disorder.”
D. “You should stop the medication to prevent dependence.”
✅ Correct Answer: B. “This medication requires several weeks to achieve full therapeutic effect.”
🧠 Rationale:
Antidepressants such as SSRIs and SNRIs have a delayed onset of 4–8 weeks before full therapeutic effects are achieved.
NUR211 Notes - Psych (6)
Stopping early is inappropriate and can worsen symptoms.
These medications are first-line treatment for anxiety disorders.
They are not addictive, unlike benzodiazepines.
❌ Why others are wrong:
A: Incorrect — effects are delayed.
C: Incorrect — SNRIs treat multiple anxiety disorders.
D: Incorrect — antidepressants do not cause dependence.
A nurse is caring for a client with severe anxiety. Which finding indicates progression to panic level?
A. Muscle tension and irritability
B. Difficulty concentrating
C. Inability to communicate effectively
D. Increased awareness of surroundings
✅ Correct Answer: C. Inability to communicate effectively
🧠 Rationale:
Panic-level anxiety causes:
Loss of communication ability
Loss of contact with reality
Inability to function
NUR211 Notes - Psych (6)
This is the most severe level of anxiety.
❌ Why others are wrong:
A: Mild–moderate anxiety
B: Moderate anxiety
D: Panic causes decreased awareness, not increased