Social Stigman (1)

1.What was the first textbook written on psychiatric health nursing and
who wrote it? Nursing Mental Disease written by Harriet Bailey in
1920

2.The belief that mental health disorders have biologic origins and
therefore can be treated with physical interventions is referred to as
the ______________. Biologic View

3.The belief that mental health disorders result from environmental and
social deprivation and could therefore be treated with moral
management in an asylum is referred to as the ________________.
Psychosocial theory

4.Venesections is a fancy word for? Bloodletting

5.Gyrations is a fancy word for?. Strapping mental health patients to a

rotating board

6.Who introduced the concept of psychiatric pluralism? Adolf Meyer

7._________ is the term for the integration of human biologic functions with
the environment. Psychiatric pluralism

8.Who is the creator of the psychoanalytic theory? Sigmund Freud

9._________ is the theory that unconscious motivations for behavior, rooted

in early childhood and adolescent experiences, are the cause of
aberrant behaviors. Psychoanalytic theory/Freud

10.Which classification, psychosis or neurosis, is considered more severe?

Psychosis

11.What development revolutionized the treatment of mentally ill

individuals and provided the eventual focus on the brain as the key to
understanding psychiatric disorders? The use of pharmacology to
treat mental illnesses

12.What historical event fostered the view that mental illness could
impact normal people? World War II and the effect it had on soldiers

13.What legislative act provided substantial funding to hospitals to

construct/expand psychiatric units in hospitals? The Hill-Burton Act
of 1946

14.What legislative act provided training grants to prepare specialty

nurses in advance practice, especially psychiatric nursing? The
 Hill-Burton Act of 1946

15.Who wrote Interpersonal Relations in Nursing and why is it an

important work? Hildegarde E. Peplau: it highlighted the importance
of a therapeutic relation

16.ship and the use of self as a therapeutic tool

17.What was formed in 1955 to study the problems of mental health care
delivery? The Joint Commission on Mental Illness (existed for 6
years)

18.What was the major omission of the Community Health Construction

Act signed by President Kennedy? There was no role for mental
hospitals, the push was for the creation of community-based mental
health services with no bridge to care from or to hospitalizations.

19.T/F Mental illness ranks first in terms of causes of disabilities in the US.
TRUE

Classifications (2)

20.A syndrome that has multiple causes and may represent several
difference areas of disease states that have not yet been defined?.
Mental disorder

21.Term used to mean a diagnosable mental disorder? Mental illness

22.What is the negative consequence of a diagnosis of a mental

illness? Labeling

23.The term for a recurrent, locality-specific pattern of aberrant

behavior and trouble experience that is limited to specific societies
or culture areas is? Culture-bound syndrome

24.Which syndromes do not fit the DSM-IV-TR classification of mental

disorders, and why? Culture-bound syndromes, because the
DSM-IV-TR is dominated by Western thought

25.Describe the general categories of disorders included in the five

Axes of the DSM-IV-TR: Axis 1: clinical disorders/mental health
diagnosis, excludes mental retardation & personality disorders. Axis
2: mental retardation & personality disorders. Axis 3: medical
diagnosis (i.e. asthma). Axis 4: psychosocial problems (stressors) or
probl
26.__________ is the study of patterns of disease distribution and
determinants of health within populations. The focuses include
health status of aggregates and their associated factors.
Epidemiology

27.What is Ataque de Nervios? A culture bound syndrome

associated with Latinos from the Caribbean It is characterized by
shouting, crying, trembling, heat in the chest that rises to the head,
and verbal or physical aggression. Typically occurs after a stressful
event involving famil

28.What is Brain Fag? A culture bound syndrome associated with high

school or university students who are responding to the challenges
of schooling. Term was originally used in West Africa.

29.What is Falling-Out/Blacking Out? A culture bound syndrome

that occurs primarily in the southern US and Caribbean. Sudden
collapse that is preceding by dizziness. The eyes are usually open,
but the person is unable to see.

30.What is Mal de Ojo? A culture bound syndrome also referred

to as the evil eye. Often found in Mediterranean cultures.
Characterized by fitful sleep, crying without cause, diarrhea,
vomiting and in children it is accompanied by a fever.

31.What is Shenjuing Shuairo? A culture bound syndrome also

referred to as neurasthenia. It is often found in China and is
characterized by physical/mental fatigue, dizziness, headaches,
pain, difficulty concentrating, sleep disturbances, memory loss, GI
problems, sexual dysfunctio

32.What is Hwa-Byung? A culture bound syndrome found in Korea.

Characterized by insomnia, sensation of heat, pins and needles
sensations, headache, or sensation of epigastric mass.

33.The epidemiologic term for the proportion of cases in the population

when compared to the total population? Rate

34.The epidemiologic term for the total number of people who have
the disorder within a specified time, regardless of how long ago the
disorder started? Prevalence

35.The epidemiologic term for the basic measure of the proportion of

individuals in a population that have the disorder at a specified
point in time? Often expressed as a fraction. Point prevalence

36.The epidemiologic term for the rate of new cases that have
 occurred within a clearly defined time period? Incidence

_________ is the term that refers to the proportion of the population that
has a disorder. Rate of occurrence

Psych Theories (6)

37.___________ theories explain the mental or emotional forces or

developing processes, especially in early childhood, and their
effects on behavior and mental states. Psychodynamic
theories

38.__________ is the father of psychodynamic theories. Sigmund

Freud

39.Although Freud's psychodynamic theories regarding the cause of

mental disorders have been disproved, how has Freud's work
influenced today's care of mental illness? His theories were
important to the development of therapeutic relationships,
techniques and interventions

40.__________ is the term for unconscious material that is capable of

entering consciousness, like through a dream. Preconscious

41.What are the three components of personality as described by

Freud? The id: formed by unconscious desires, primitive
instincts, and unstructured drives (including sexual and
aggressive drives). The ego: controls movement, perception,
contact with reality. Sum of mental mechanisms like perception,
memory, motor control

42.________ is a term coined by Freud to describe the psychological

attachment to another person or an object like a blanket. Object
relations

43.________ is a term coined by Freud to describe the therapeutic

process of accessing the unconscious and resolving the conflicts
that originated in childhood with a mature adult mind.
Psychoanalysis: includes free associations and dream
interpretation.

44._________ is a term coined by Freud to describe the displacement

of thoughts, feelings and behaviors originally associated with
significant others from childhood onto a person in a current
therapeutic relationship. Transference
45._________ is a term coined by Freud to describe the direction of
all of a therapist's feelings and attitudes towards a patient. It is
considered a possible interference with a therapist's ability to
understand the patient. Countertransference

46.___________ developed a theory that indicated a sense of

inferiority is the motivating force in human life. Alfred Adler

47.What are the principles that the Alderian theory is based on?
Mutual respect, choice, responsibility, consequences and
belonging

48.Who created the analytical psychology model? Carl Gustav

Jung

49.Extroversion, Introversion and persona are components of what

neo-Freudian model? The analytic psychology model (Jung)

50.Who was the first person to introduce feminine psychology?

Karen Horney

51.________ believed Freud's concept of women feeling

disadvantaged because of their lack of a penis was completely
incorrect. This person argued that women were truly at a
disadvantage bceause of the authoritarian culture in which they
lived. Karen Horney

52.__________ introduced the theory of neurosis which stated that all

neurotic disturbances could be attributed to the trauma of birth.
Otto Rank

53._______ was a theorist that believed in the importance of will, a

positive guiding organization in the integraiton of self. Otto
Rank

54.________ was a theorist who believed that the needs and desires
of individuals are largely formed by society and that the
fundamental problem of psychoanalysis and psychology was to
bring about harmony and understanding of the relationship
between individ Erich Fromm

55._________ devised play therapy techniques to demonstrate how a

child's interaction with toys revealed earlier infantile fantasies
and anxieties. Melanie Klein

56.Who is credited with being the pioneer in presenting the concept

of an object relations to the psychodynamic field and with
 introducing the concept of early identification as a defense
mechanism? Melanie Klein

57.What is the major difference between interpersonal theories and

psychoanalystic theories? Interpersonal theories acknowledge
the importance of individual relationships in personality
development.

58.Who believed interpersonal relationships included characteristic

interaction patterns and therefore personality could be identified
in the ways a person dealt with other people? Harry Stack
Sullivan

59.__________ theories are based on the views of human potential

for goodness and focuses on one's ability to learn about oneself,
acceptance of self and exploration of personal capabilities.
Humanistic theories

60.Alfred Adler, Carl Jung, Karen Horney, Otto Rank, Erich Fromm
and Melanie Klein are all considered what type of theorists?
Neo-Freudian

61.Harry Stack Sullivan is considered a __________ theorist.

Interpersonal

62.Carl Rogers, Abraham Maslow and Frederick Perls are considered

___________ theorists. Humanistic theorists

63.__________ theorists believe a patient should work towards

developing a positive attitude and learning to experience the
world in a different way. Humanistic theorists

64.___________ is a theorist who defined empathy as a clinical tool to

perceive the world in the same way as a client. It is considered a
non-direct but not passive, method. Carl Rogers

65.________ was a theorist who believed that a therapist must be

emotionally invested in a client to ensure a therapeutic process.
Carl Rogers

66.Who developed Gestalt Therapy? Frederick S. Perls

67.What is Gestalt Therapy? Individual and group exercises that

enhance a person's awareness of emotions, physical state, and
repressed needs as well as physical and psychological stimuli in
their environment.

68.Maslow advocated viewing human behavior from the perspective

 of a person's ________. Needs

69.Edwin Guthrie, Ivan Pavlov, and John Watson are all _________
theorists. Behavioral

70._________ theories attempt to explain how people learn and act.

They focus on normal human behavior. Behavioral

71.__________ made a clear connection between thought processes

and physiologic responses through his experimentation with
dogs and their stomach secretions. Ivan Pavlov

72.Classical conditioning is associated with what behaviorist? Ivan

Pavlov

73._________'s work was important in understanding the learning of

automatic responses such as habitual behaviors. Ivan Pavlov

74._________'s work was important in analyzing habitual behaviors.

He found that the recurrence of responses tends to follow a
specific stimulus. Edwin Guthrie

75.__________ introduced the principles of frequency and recency in

his focus on the relationship between mind and body. John
Watson

76.Skinner and Thorndike are behavioral theorists that focused on

_________ theories. Reinforcement

77._________ developed an understanding of the importance of

reinforcement and differentiated types and schedules of
reinforcement. Skinner

78.These two researchers work were important in understanding

behavior modification? Skinner and Thorndike

79.What is classical conditioning? Eliciting an unconditioned

response (a response that occurs without training) using a
conditioned stimulus (an association)

80.Who initiated the behaviorism revolution? John Watson

81._________ is a principle of behaviorism that states that the more

often a given response is made to a given stimulus, the more
likely the response to that stimulus will be repeated.
Frequency

82._________ is a principle of behaviorism that states that the more

 recently a given response to a particular stimulus is made, the
more likely it will be repeated. Recency

83.________ is a reinforcement theorist that studied the behavior of

cats to determine whether animals solved problems by
reasoning or instinct. Edward Thorndike

84.What was the major difference between Watson's behaviorist

theory and Thordike's reinforcement theory? Thorndike believed
that the effects following the reinforcement or response towards
a behavior was also important

85.Which behaviorist recognized two different types of learning,

each involving different types of behaviors? B.F. Skinner

86.________ behavior is a concept of Skinner's that describes

learning elicited by specific stimuli. Respondent

87.________ behavior is a concept of Skinner's that describes

learning elicited by a specific consequence to a behavior.
Operant

88.The learning of operant behavior is also referred to as __________.

Conditioning

89._________ theories attempt to link internal thought processes

with human behavior. Cognitive theories

90.Aaron Beck and Albert Bandura are considered _______ theorists.

Cognitive theorists

91.____________ believed that behaviors are learned from other

people, the basis of social cognitive theory. Albert Bandura

92.Bandura identified the process of modeling, what is it? The

process of imitating a person to be more like them?.a vehicle to
internalization of behaviors.

93.___________ is a concept of Bandura's that refers to a situation in

which someone has learned not to engage in a specific
behavior/response (although they desire to), but in a given
situation where another person is engaging in that behavior the
person do Disinhibition

94.___________ is a concept of Bandura's that refers to a situation in

which someone observes an individual engaging in a
behavior/activity and therefore wants to engage in the same
activity although no desire was present before the observation.
 Elicitation

95.Gerrit is playing with a truck and sees his sister playing with a
baby doll. He decides he wants to play with the baby doll. What
priniciple described by Bandura is being displayed? Elicitation

96.Ellery has been told by her mother not to shout while inside and
to use her indoor voice. Ellery is playing at her friend's house
and observes her friend shouting the lyrics to a song. Ellery
happily begins shouting the song as well. What principle d
Disinhibition

97.Who developed the concept of self-efficacy? Bandura

98.________ is a term used to describe a person's sense of their

ability to deal effectively with their environment. Self-efficacy

99.________ was a cognitive theorist that believed that people had

faulty information processing systems that led to biased and
incorrect cognitions. The incorrect cognitions caused errors in
judgment which led to habitual errors in thinking. Aaron Beck

100.__________ conceptualized distorted cognitions as a basis for

depression. Aaron Beck

101._________ developed field theory, a system for understanding

learning, motivation, personality and social behavior. Kurt
Lewin

102._______'s work was important in understanding motivation for

changing behavior. Kurt Lewin

103._________ introduced the concept of cognitions and believed

that people act on beliefs and attitudes and strive towards
goals. Edward Chace Tolman

104.________'s work highlighted the importance of identifying an

individual's beliefs. Edward Chace Tolman

105.What theories is the nursing intervention of patient education

based on? Behavioral (the learning theories derived from
behavioral theories)

106.__________ theories explain normal human growth and

development and focus of change over time. Developmental
theories

107.__________ is a developmental theorist that believed people go

 through 8 developmental stages with specific tasks that can be
successfully or unsuccessfully achieved. Erik Erikson

108.What developmental stage of Erikson's theory is an infant in?

Trust vs. Mistrust

109.In the Trust vs. Mistrust stage of Erikson's theory, what

happens if the person is successful? Drive and hope are
achieved, the person develops trust

110.What developmental stage of Erikson's theory is a toddler in?

Autonomy vs. Shame and Doubt

111.What developmental stage of Erikson's theory is a Preschool-

aged child in? Initiative vs. Guilt

112.What developmental stage of Erikson's theory is a school-aged

child in? Industry vs. Inferiority

113.What developmental stage of Erikson's theory is an adolescent

in? Identity vs. role diffusion

114.What developmental stage of Erikson's theory is a young adult

in? Intimacy vs. Isolation

115.What developmental stage of Erikson's theory is an adult in?

Generativity vs. Stagnation

116.What developmental stage of Erikson's theory is a mature adult

in? Ego integrity vs. despair

117.In the Autonomy vs. Shame & Doubt stage of Erikson's theory,
what happens if the person is successful? Self-control and
will power is possible

118.In the Initiative vs. Guilt stage of Erikson's theory, what

happens if the person is successful? Direction and purpose is
achieved

119.In the Industry vs. Inferiority stage of Erikson's theory, what

happens if the person is successful? Method and competence
are possible

120.In the Identity vs. role diffusion stage of Erikson's theory, what
happens if the person is successful? Devotion and fidelity are
possible

121.In the Generativity vs. Stagnation stage of Erikson's theory,

 what happens if the person is successful? Productivity and
caring are possible

122.In the Ego integrity vs. despair stage of Erikson's theory, what
happens if the person is successful? Renunciation and wisdom
are possible

123.In the Intimacy vs. Isolation stage of Erikson's theory, what

happens if the person is successful? Affiliation and love with
another is possible

124.Who is considered one of the most influential people in child

psychology? Jean Piaget

125._______ believed that cognitive growth was like embryologic

growth, it became more and more differentiated over time.
Jean Piaget

126.What period of intellectual development (Piaget) is a child from

birth to age two in?The sensorimotor period

127.What period of intellectual development (Piaget) is a child from

age 2-7 in? The preoperational period

128.What period of intellectual development (Piaget) is a child from

7-11 in? Concrete operations

129.What period of intellectual development (Piaget) is a child from

11 through the end of adolescence in? Formal Operations

130._________ is a period of intellectual development described by

Piaget as an understanding of the world via the overt, physical
action on that world. Concepts like space, time, causality and
object permanence are learned. Sensorimotor Period

131._________ is a period of intellectual development described by

Piaget as an understanding of symbols to represent objects, and
use of the symbols in an increasingly organized and logical
fashion. Preoperational period

132._________ is a period of intellectual development characterized

by deferred imitation, symbolic play, graphic imagery, mental
imagery and language. The person is egocentric, rigid in thought
and has limited social cognition. Preoperational period

133._________ is a period of intellectual development described by

Piaget as an understanding of conservation. Concrete
operations
134._________ is a period of intellectual development characterized
by hypothetical, deductive thinking. Formal Operations

135.___________ was a theorist that believed most development

models were male-centered and not appropriate for girls and
women. Carol Gilligan

136.What did Carol Gilligan believe that female development was

dependent on? Relationships

137.__________ is a theorist that believed that a woman's

development was organized by a sense of connection to others
and therefore a goal of development should be to increase a
woman's ability to build and enlarge mutually enhancing
relationships. Jean Baker Miller

138.__________ is a term describe by Jean Baker Miller to describe

the lack of response from others when a person expresses a
feeling or explains an experience. Disconnection

139.What is considered the most damaging type of disconnection

(Jean Baker Miller)?The lack of response after abuse or attacks

140._________ theory is a useful theory for understanding caregiving

activities within a community. It explains the importance of
informal and formal support systems in the delivery of health
care. The balance theory

141.Who developed the balance theory? Eugene Litwak

142.What is social distance? The degree to which the values of the

formal organization and primary group members differ.

143._________ is a practical theoretical model for conceptualizing

delivery if mental health care services to a community,
particularly rural ones. Balance theory

144.________ theories emphasize the importance of social

interactionin either the individual's choice of role or the society's
reaction to it. Role theory

145._________ devoted much of her studies to the patterns of child

rearing and the cultural influences that determine male and
female behavior. Margaret Mead

146._________'s work highlighted the importance of culture in

determining human behavior. Margaret Mead
147.___________ developed transcultural nursing which is focused on
holistic, congruent, beneficent care. Madeleine Leininger

148.Transcultural health care is an example of a ___________ theory.

Sociocultural

149.What type of theory are many group interventions based on?

Sociocultural

150.___________ introduced the first systematic framework for

psychiatric nursing and focused on the nurse-patient
relationship. Hildegarde Paplau

151._________ is a term defined by Paplau as the ability to feel in

oneself the feelings experienced by another person or people.
Empathic linkage

152.__________ is a term defined by Paplau as the product of

socialization that proceeds through personal development and is
always open to revision. Approval, disapproval and indifference
can cause a child to define themselves positively or negatively.
Self-system

153.________ is an important tenet of Paplau's and is defined as an

energy that arises when expectations are present and unmet.
Anxiety

154.Who wrote The Dynamic Nurse-Patient Relationship and what

was its purpose? Ida Jean Orlando-it was a book to offer the
nursing student theory of effective nursing practice

155._________ is a theorist that believes that humans seek meaning

in their life and experiences. She postulated that the nurse's
spiritual values and philosophical beliefs impacted the extent
that a patient found meaning in their sickness experience. Joyce
Travelbee

156.The theory of transpersonal caring was developed by

__________. Jean Watson

157.The ________theory emphasizes the importance of sensitivity to

self and others, the development of helping and trusting
relations, the promotion of interpersonal teaching and learning
and provision for supportive, protective and corrective mental,
physica theory of transpersonal caring

158._________ is the term used to describe Jean Watson's

 foundational concept of a relational process related to
philosophic, moral and spirital foundations of a nurse.
Transpersonal Caring-Healing Relations

159._________ is the term used to describe Jean Watson's

foundational concept of the assumptions and processes involved
in caring. Clinical Caritas Process

160._________ is the term used to describe Jean Watson's

foundational concept of a field of consciousness created when
the nurse focuses on love and caring as her way of being and
consciously manifests a healing presence with others.
Caritas Field

161._________ developed a theory of goal attainment that defined

nursing as a process of human interactions between nurse and
patient whereby each perceives the other and the situation, and
through communication they set goals, explore means, and
agree on the Imogene M King

162._________ is defined by Imogene M King as the transfer of value

between two or more people. Transaction

163.__________ developed a theoretical nursing model to guide the

actions of the professional caregiver through the assessment
and intervention processes by focusing on two major
components: the nature of the relationship between the nurse
and patient, and t Betty Neuman

__________ is the focus of the general theory of nursing initiated by

Dorothea Owen. It's purpose is to promote independence of the
individual. Self-care

Therapeutic Relation (9)

164.What is components make up the biopsychosocial self?

Age, gender, body weight, height, ethnicity, and any
other physical characteristics. Any chronic illnesses,
psychological states, emotional states, social biases and
sociocultural values.

165.What should a nurse do if he/she realizes that their own

personal beliefs are too ingrained and in conflict with a
patient's to such an extent that a therapeutic relationship
isn't achievable? Refer the patient to someone who can be
 therapeutic.

166.___________ includes the underlying emotions, context and

connotation of speech. Verbal communication

167.__________ includes gestures, expressions, and body

language. Non-verbal communication

168._________ is the term for the direct communication of

feelings. Empathic Linkages

169.In analyzing patient-nurse communication, a patient's

verbal and non-verbal communications are contradictory.
Which should you give priority to? Nonverbal behaviors
and gestions are communicated first and should be given
priority.

170.________ is the primary focus of therapeutic communication

and interaction. The patient

171.What are the caveats to using self-disclosure? It should

be used cautiously and only when the disclosure has a
therapeutic purpose.

172.__________ is an essential tool to ensure that a nurse has

received a patient's message accurately during verbal
communication. Validation

173.What should a nurse do if a patient begins asking personal

questions? Try to determine the underlying reason for the
question

174.What is the difference between silence and listening?

Silence is a deliberate pause to encourage the patient
to reflect and eventually respond. Listening is an active
process and by which the nurse attends to the patients
verbal and non-verbal communication.

175.What is passive listening? Sitting quietly and letting a

person talk, This allows a person to ramble and does not
focus or guide the thought the process. It doesn't foster
therapeutic communication.

176.T/F When working with a patient, you should avoid giving

advice. TRUE

177.In prioritizing therapeutic communication interventions,

which one should take priority? Active listening
178.___________ is a communication technique that is used in
establishing trust and developing empathy. It involves
encouraging and receiving information in a non-judgmental
and interested manner. Acceptance

179.________ is a communication technique that involves

presenting a patient with a different reality of a situation
than the patient interprets. It should be used cautiously and
a nonjudgmental attitude is critical. Confrontation

180.__________ is a communication technique that involves

expressing uncertainty when a patient relates a situation. It
is used carefully and only when the nurse feels confident
about the details of an event. Used to guide a patient to
other explanations. Doubt

181._________ is the process of putting into words what the

patient is implying or feeling. It is used to help patient
identify underlying thoughts or feelings. Interpretation

182._________ is a communication technique where the nurse

states what he/she is seeing. It is used when a patient's
behaviors are obvious and unusual for that patient.
Observation, ex: You are trembling and perspiring,
when did this start?

183.Redirecting an idea back to a patient for classification of

important emotional overtones, feelings, and experiences is
called _________. It is used when a patient is asking for the
nurse's approval or judgment and allows the nurse to remain
nonjudgmenta Reflection.

184.___________ is the process of repeating the main idea

expressed by a patient. It shows the patient that they were
heard. It is used for clarification. Restating

185.________ is a communication technique used when the nurse

is trying to understand a situation a patient is trying to
describe. It allows the nurse to ensure understanding of a
situation. Validation

186.Advice, Agreement, Challenges, Reassurance and

Disapproval are all communication techniques that __________
communication. inhibit

187._______ is defined as interpersonal harmony characterized

by understanding and respect. Rapport
188.How is rapport developed? By showing interpersonal
warmth, a nonjudgmental attitiude and demonstrating
understanding.

189._________ is explicitly checking out one's own thoughts and

feelings with another person. Validation. Characterized by
I statements.

190.________ is the ability to experience in the present a

situation as another did at some time in the past. Empathy

191.What is considered the intimate zone? Being within 6-

18 inches of a patient

192.What is considered the personal zone? Being within 18-

47 inches of a patient

193.What are some common indicators that a nurse's

professional boundaries are possibly breached? Gift-
giving on either party's part, spending more time than usual
with the patient, defending or explaining a patient's behavior
to others, keeping secrets, thinking about the patient outside
of work, or feeling as though you are the only one who
understa

194.The _________ phase of the nurse-patient relationship begins

when the nurse and patient meet and ends when the patient
begins to identify problems to examine. Orientation

195.What are the major goals of the orientation phase of a

nurse-patient relationship? To develop trust and and
security within the relationship

196.When does the working phase of a nurse-patient

relationship begin? When the patient begins identifying
problems to work on

197.What are the major threats to the success of the working

phase of a nurse-patient relationship? Transference and
countertransference

198.During the ________ phase of the nurse-patient relationship,

the patient connects with community resources, solidifies
understandings, and practices new behaviors.
Resolution phase

199.When does termination of the nurse-patient relationship

 begin? The first day of the relationship

200.What are the three phases of a non-therapeutic

relationship? Orientation, grappling/struggling, and mutual
withdrawal

201.A teenager expressing anger at his parents by staying out

late at nights is an example of what defense mechanism?
Acting out: using actions rather than reflections or
feelings during periods of emotional conflict.

202.Turning to others for help or support, sharing problems with

others without implying that they are responsible for them, is
an example of what defense mechanism? Affiliation

203.Dedicating one's life to meeting the needs of others, for

example, joining the Peace Corps after breaking up with a
boyfriend, is an example of what type of defense
mechanism? Altruism

204.Experiencing emotional reactions in advance or anticipating

consequences of possible future evens and considering
realistic, alternative responses or solutions is an example of
what defense mechanism? Anticipation.

205.Excessive daydreaming as a substitute for human

relationships, more effective action or problem solving is a
defense mechanism called? Autistic fantasy

206.___________ is a defense mechanism where a person

attributes exaggerated negative qualities to self or others.
Devaluation

207.__________ is a term used to describe the transferring of a

feeling or response from one object to another (usually less
threatening) object. Displacement

208.Experiencing a breakdown in the usually integrated

functions of consciousness, memory, perception of self or the
environment or sensory or motor behavior is called?.
Dissociation

209.While a woman is relating her experiences of sexual abuse

as a child, she does it without feeling and expresses that she
felt like she was above her body watching it happen. This is
an example of what defense mechanism? Dissociation
 210.Excessive use of abstract thinking or the making of
generalizations to control or minimize disturbed feelings is a
type of defense mechanism called? Intellectualization

211.Separation of ideas from the feelings originally associated

with them. Example: Knowing that a violent crime happened
to them without being in touch with the feelings related to
the event. Isolation of Affect

212.What is projective identification? Falsely attributing

one's own negatively feelings onto another, while
acknowledging them as well. Example: A child is mad at her
mom who in turn becomes mad at the child, who then feels
justified for the initial anger.

213.Substituting behavior, thoughts, or feelings that are

opposed to one's own unacceptable thoughts or feelings,
usually in conjunction with repression is called? Reaction
formation: ex: telling friends that a husband's affairs are
acceptable and not feeling any anger or hurt on a conscious
level

214.Channeling potentially maladaptive feelings or impulses into

societally acceptable behavior is called? Sublimation

215.What is the difference between suppression and repression?

Suppression is intentional avoidance of something
disturbing with the conscious intent of not thinking about it,
whereas repression is the expelling of something disturbing
from conscious awareness.

Nursing Processes (10)

216.T/F Demonstrating acceptance is the same thing as

agreeing with what a patient is stating. False,
acceptance is considered a neutral stance that allows a
patient to continue sharing.

217.Why should biologic information always be considered when

assessing psychiatric conditions? Many physical
conditions can impact a person's mental health.

218.During a physical examination of a patient with a

psychiatric condition, what abnormal labs a cause for
concern, and why? Any abnormalities of the renal, hepatic, or
 urinary system are concerning because these systems
metabolize or excrete many psychiatric medications.

219.Changes in _________ patterns often reflect changes in a

patient's emotions and are symptoms of disorders. Sleep

220.How can lithium impact CBC results? A patient may develop

leukocytosis (mild to moderate increase in leukocyte)

221.An elevated red cell distribution width (RBC width) in a CBC

can be indicative of what condition? Anemia from chronic
alcoholism resulting from vitamin B12, folate acid and iron
deficiencies.

222.How can birth control medications impact a mental health

exam? Birth control medications can alter mood,
manifesting as a psychiatric problem

223.What should a nurse record/document at the beginning of

an interview with a psychiatric patient? Their initial
impressions of the patient

224.Several terms are used to describe mood. Euthymic means?

Normal mood

225.Several terms are used to describe mood. Euphoric means?

Elated mood

226.Several terms are used to describe mood. Labile means?

Rapid, changeable mood

227.Several terms are used to describe mood. Dysphoric

means? Depressed, disquieted, restless

228.How does a nurse ascertain whether a patient is oriented?

Ask the date, time, and current location of the
interview setting.

229.______ refers to the prominent, sustained, overall emotions

that a person expresses and exhibits. Mood

230.______ refers to a person's outward expression of emotions.

Affect

231.What terms are used to describe the range of affect?

Full range or restricted

232.What terms are used to describe the intensity of affect?

 Increased, flat or blunted

233.What terms are used to describe the stability of affect?

Mobile (normal) or labile

234.What are the four components to describe a patient's

affect? Range, intensity, stability and appropriateness

235.A person who expresses emotions consistent with their

stated feelings and content being expressed is described as
having what range of affect?

236.Why is assessment of a patient's speech important?

Speech provides clues about a patient's thoughts,
emotional patterns and cognitive organization.

237.What terms are used to describe a patient's speech?

Pressured, fast, slow or fragmented

238.How does a nurse assess a patient's comprehension?

Ask the patient to name objects

239.How does a nurse assess a patient's cognition? By using

memory, calculation and reasoning tests to identify specific
areas of impairment.

240.What are the components of cognition that are assessed by

the nurse? Attention & Concentration, Abstract Reasoning
& Comprehension, Memory and Insight

241.What test is used to assess for a patient's

concentration/attention? Ask the patient to subtract 7 from
100 until they reach 65, or subtract 3 from 20 until they
reach 0.

242.What test is used to assess for a patient's abstract

reasoning and comprehension? Ask them to interpret a
proverb like A penny saved is a penny earned.

243.What test is used to assess a patient's immediate and short

term memory? Give the patient three unrelated words
and ask them to repeat them immediately, in 5 minutes, and
again in 15 minutes.

244._________ is a person's awareness of his/her own thoughts

and feelings and ability to compare them with the thoughts
and feelings of others. Insight
245._________ is the ability to reach a logical decision about a
situation and to choose a course of action after examining
and analyzing various possibilities. Judgment

246.What should a nurse attempt to identify when assessing a

patient's behavior? Patterned behaviors in relation to specific
events

247._______ develops over a lifetime and is comprised of a

person's total beliefs about their body image, self-esteem
and personal identity. Self-concept

248.How is self-concept assessed? By eliciting a patient's

thoughts about themselves and their ability to navigate the
world or asking them to draw a self-portrait and then
analyzing the details of the drawing

249.What is a clear indication of a poor self-concept? A

disheveled, sloppy appearance outside of cultural norms
and/or negative self-statements (I'm so stupid),.

250.What are indicators of a low self-esteem when analyzing a

self-portrait? Small size, lack of color variation and sparse
details.

251.What are indicators of powerlessness and feelings of

inadequacy when analyzing a self-portrait? Lack of a head,
mouth, arms, feet or eyes

252.What indicates feelings of insecurity and inadequacy when

analyzing a patient's self-portrait? A lack of symmetry

253.________ is a person's beliefs and attitudes about his or her

body and includes such dimensions as size and
attractiveness. Body image

254.What are nonverbal behaviors that indicate problems with

body image? Avoiding looking at or touching a body part,
hiding the body in oversized clothing or bandaging an area of
dislike like a mole on the face.

255.________ is a person's attitude and satisfaction about one's

self. Self-esteem

256._________ is knowing who I am and allows people to

establish boundaries and understand personal strengths and
limitations. Personal identity
257.What should a nurse do if a patient gives indication that
he/she is being told to harm someone? Ensure self-safety and
institute assaultive precautions

258.Why is a cultural assessment an important part of a mental

health evaluation? Culture helps a person frame beliefs
about life, death, health and illness, roles and relationships.

259.What are outcome indicators? A measurement of patient

progress towards mututally agreed upon goals.

260._________ interventions are specific, time limited interactions

between a nurse and a patient, family or group experiencing
immediate or ongoing difficulties related to their health or
well-being. Counseling

261.How is counseling different from psychotherapy?

Counseling is a short term intervention that focuses on
improving coping abilities, reinforcing healthy behaviors,
fostering positive interactions or preventing illness/disability.
Psychotherapy is a long term approach aimed at regaining or
improving hea

262._________ is a specific type of intervention that is used to

help resolve disagreements or disputes with family, friends,
or between patients. Conflict resolution

263.What are the general steps in the conflict resolution

process? Identify the problem, develop expectations,
identify intersts, creative brainstorming and combining
options to achieve a win-win situation.

264._________ is the act of bridging, linking, or mediating

messages, instructions, and belief systems between patients
who are politcally and economically powerless and people in
the health care system. Cultural brokering

265.What is required in order for a nurse to be an effective

cultural broker? Establish and maintain a sense of
connectedness with the patient and cultural competence.

266._________ is the reading of selected materials to express

feelings or gain insight under the guidance of a health care
provider. Bibliotherapy

267.Why would a health care provider assign reading material to

a patient (bibliotherapy)? They believe that the patient would
 receive therapeutic benefit from reading the material

268.What are four ways a patient can be enriched by

bibliotherapy? Catharsis, problem soliving ideas, develop
insight or reduce anxiety

269._______ is an expression of feelings stimulated by parallel

experiences. Catharsis

270._________ is a therapeutic technique that encourages

discussion about a person's past to identify past coping
strategies and to maintain self-esteem, stimulate thinking,
support the natural healing process of life review and can
include a written account Reminiscence

271.________ therapy focuses on reinforcing or promoting

desirable behaviors or altering undesirable ones.
Behavioral

272.________ is a specific, systematized behavior therapy

techniques to reinforce desired behaviors and extinguish
undesired ones by rewarding desired behavior. Behavior
modification

273.What types of conditions has behavior modification been

successful in treating? Dysfunctional eating, addictions,
anger management, impulse control and in treating children
and adolescents.

274.What is a token economy? A behavior modification

technique used in inpatient and group home settings to
encourage selected behaviors. Patients are awarded tokens
that can later be exchanged for a desired item.

275.What populations are especially receptive to token

economies? People who are developmentally disabled or
have severe or persistent mental illness. It also works with
aggressive patients.

276.____________ is an educational strategy to teach skills with

the goal of changing knowledge and behavior by adapting
teaching strategies to a patient's capabilities.
Psychoeducation

277.What is the key to providing a spiritual intervention?

Being with and not doing for a patient.
278.________ support is the process of assisting patients to feel
balanced and connected within their relationships, involves
listening to expressions of lonliness, using empathy and
providing patients with desired spiritual articles. Spiritual
support

279.In ________ therapy, the design of the physical surroundings,

structure of patient activities, and promotion of a stable
social structure and cultural setting enhances the setting's
therapeutic potential. Milieu therapy

280.What are the general key concepts of milieu therapy?

Containment, validation, structured interaction, and
open communication.

281.The process of providing safety and security, including

access to food and shelter is referred to as? Containment

282._______ is a process that affirms patient individuality,

reaffirms a patient's humanity and human rights. It is a
component of milieu therapy. Validation (patients must
believe that staff members truly like and respect them)

283.Purposeful interaction that allows patients to interact with

others in a useful way is a tenant of milieu therapy. This is
referred to as? Structured interaction

284._________ is the ongoing assessment of the patient's mental

statys to identify and subvert any potential problems. It
involves continual monitoring. Observation

285._________ is an interactive process of calming and

redirecting a person and involves calmly calling to a
patient/individual and asking them to leave a negative
situation while avoiding rushing or giving orders. De-
escalation

286.Involuntary confinement for the purpose of maintaining a

patient's safety or to obtain behavioral management is
called? Seclusion (this is considered an extremely
negative event by the patient and most places are seeking
alternatives)

What governs the use of seclusion and restraints? Medicare

regulations contained in the Patient's Rights Condition of
Participation (CoP)