West Coast University- Mental Health Final Exam With complete solutions

Beneficence - Answer- The quality of doing good, can be described as charity Ex: A nurse helps a newly admitted client who has a psychotic disorder to feel safe in the environment of the mental health facility Justice - Answer- Fair and equal for all Ex: nurse will discuss with other nurses if two patients who broke the same facility rule were treated equally Autonomy - Answer- The client has the right to make their own decisions. However, the client must accept the consequences of those decisions. The client must also respect the decisions of others. Ex: not giving the client advise, but helping the client explore alternatives and arive at a choice Fidelity - Answer- Loyalty and faithfulness to the client and to one's duty A client asks a nurse to be present when they talk to their guardian for the first time in a year. The nurse remains with the client during this interaction Veracity - Answer- Honesty when dealing with a client A client states, you and other staff member were talking about me, werent you. The nurse truthfully says, we were discussing ways to help you relate to other clients in a more positive way. Tort - Answer- a wrongful act or an infringement of a right (other than under contract) leading to civil legal liability. Negligence - Answer- Failing to provide adequate care in a professional situation when one has the obligation to do so. Malpractice - Answer- Failure by a health professional to meet accepted standards Vocabulary - Answer- Words used to communicate, written or spoken. Limited vocabulary or speaking a language other than english can make it difficult for the nurse to communicate with the client. Using medical jargon can decrease the client understanding Denotation vs. Connotation - Answer- Denotation = dictionary definition; connotation = context (the way we use a word). For example, the denotation of ignorant is not knowing something, but the connotation is that someone is generally stupid. clarity and brevity - Answer- the shortest, simplest communication is usually most effective. Client can have difficulty understanding communication that is long and complex Timing and Relevance (Verbal Communication) - Answer- Knowing when to communicate allows the receiver to be more attentive to the message. Communicating with a client who is in pain or distracted will make it difficult for the nurse to convey the message Pacing - Answer- the rate of speech can communicate a meaning to the receiver. Speaking rapidly can give the impression that you are in a hurry intonation - Answer- the tone of voice can communicate a variety of feelings (acceptance, judgement and dislike) through tone of voice nonverbal communication - Answer- Can have more impact on a message than verbal communication. Culture impacts interpretation Pay attention to: Appearance Posture Gait Facial expression Eye contact Gestures Sounds Territoriality Personal space Silence Social relationship - Answer- Primary purpose is for socialization or friendship with focus on the mutual needs of the individual involved in the relationship Therapeutic relationship - Answer- Primary purpose is to identify the client's problems or needs and then focus on assisting the client in meeting or resolving those issues Involuntary hold - Answer- Taking their right to freedom. It revokes the right to freedom. Still maintain all other rights. Patient Rights - Answer- 1. Right to refuse 2. Right to privacy 3. Right to nutrition 4. Right to shelter 5. Right to writing utensils 6. Right to speech We can break patient confidentiality if? - Answer- They're a danger to others *legal right to let police know (tera soft warning) *Abuse cps/aps let them know of possible abuse *In front of a judge under oath In mental health court - Answer- Client fights for rights back Or treatment team wants to revoke the right to refuse treatment (writ of habeas corpus) right to freedom Or can file for medication adherence hearing aka rese treatment If you dont do to sleep I will put you to sleep is call what? - Answer- Tort If you call me ugly, I wont feed you - Answer- Tort Psychosocial integrity and behavioral interventions - Answer- 1. Saftey 2. Milieu 3. Medication 4. Seclusion (15-30 mins. Need an order) 5. Mechanical restraints (15-30 minutes, need an order) Acute - Answer- Stabilize continuous reinforcement - Answer- Return to baseline Maintenance - Answer- Prevent replase PHP - Answer- Partial hospitalization IOP - Answer- Intensive outpatient programing 3-5 days per week ACT - Answer- Assertive community treatment Always replasing, case manager can help mental status exam - Answer- A- appearance/behavior S- speech E- emotion (how are they feeling, what you can see. ex: I'm happy and they are smiling P- perception delusions, illusions T- Thought process I- Insite C- Cognition positive symptoms of schizophrenia - Answer- hallucinations, delusions, paranoia, bizarre behavior (walking backwards) speech, bizarre behavior Delusions: Ideas of reference Persecution Grandeur Somatic delusions Jealousy Being controlled Thought broadcasting Thought insertion Thought withdrawal Religiosity Magical thinking Schizophrenia - Answer- Psychotic thinking of behavior present for a least 6 months. Areas of functioning including school, work, self care and interpersonal relationships are significantly impaired Schizotypal personality disorder - Answer- The clients has impairments in personality (self and interpersonal) functioning. Impairment not as severe as schizophrenia Delusional disorder - Answer- The client experiencing delusional thinking for at least 1 month. Self and interpersonal functioning is not markedly impaired Brief psychotic disorder - Answer- The client has psychotic symptoms that last between 1 day and 1 month in duration. schizophreniform disorder - Answer- The client has manifestations similar to schizophrenia, but the duration is 1-6 months social and/occupational dysfunction might not be apparent schizoaffective disorder - Answer- The clients disorder meets the criteria for both schizophrenia and depressive or bipolar disorder substance-induced psychotic disorder - Answer- The client experiences psychosis due to a substance intoxication or withdrawal. However the paychotic manifestations are more severe than typically expected Psychotic or catatonic disorder not otherwise specified - Answer- Exhibits psychotic features (impaired reality testing) or bizarre behavior (paychotic) or a significant change in motor activity behavior (catatonic) but does not meet the criteria for diagnosis with another specified dosorder negative symptoms of schizophrenia - Answer- the absence of appropriate behaviors (expressionless faces, rigid bodies) Negative symptom of schizophrenia- Affect - Answer- flat, face expression never changes Negative symptom of schizophrenia- Alogia - Answer- Poverity of thought or speech. The client might sit with a visitor but k ly mumble or respond vaguely to questions Negative symptom of schizophrenia- Angeria - Answer- Lack of energy Negative symptom of schizophrenia- Anhedonia - Answer- Lack of pleasure or joy. The client is indifferent to things that make others happy. Like looking at a beautiful scenery Negative symptom of schizophrenia- Avolition - Answer- Lack of motivation in activities like hygiene Ex: the client completes a task, such as making their bed, but is unable to start the next common chore without being asked ideas of reference - delusion - Answer- Misconstrues trival events and attaches personal significance to them, such as believing that others who are diacussing the next meal are talking about them Persecution- delusions - Answer- Feels singled out for harm by others, such as being hunted down by the FBI grandeur delusion - Answer- Believes that they are all powerful and important like God somatic delusions - Answer- Believes that their body is changing in an unusal way, such as grwoing a new arm