Rasmussen Mental Health Final Exam WITH 100% VERIFIED ANSWERS(REVISED)

Rasmussen Mental Health Final Exam WITH 100% VERIFIED ANSWERS(REVISED) Active listening - • Observing the patient's nonverbal behaviors • Listening to and understanding the patient's verbal message • Listening to and understanding the person in the context of the social setting of his or her life • Listening for "false notes" (i.e., inconsistencies or things the patient says that need more clarification) • Providing the patient with feedback about himself or herself of which the patient might be unaware Acute dystonia - Severe spasms of the muscles of the tongue, head, and neck; fixed upward deviation of the eyes; and severe back spasms that arch the trunk forward and thrust the head and lower limbs backward. Nursing interventions: Diphenhydramine hydrochloride (Benadryl) IM/IV or benztropine IM/IV. Relief occurs in minutes. Prevent further dystonias with any anticholinergic agent. Experience is very frightening. Take patient to quiet area and stay with him or her until medicated. Advanced signs of lithium toxicity - 1.5 to 2 mEq/L Coarse hand tremor, persistent gastrointestinal upset, mental confusion, muscle hyperirritability, electroencephalographic (EEG) changes, incoordination Adventitious crisis - AKA crisis of disaster Unplanned and tend to be catastrophic or violent in nature. Adventitious crises may result from natural disasters such as tsunamis, fires, hurricanes, flooding, or earthquakes; national disasters such as war, terrorist attacks, airplane or train crashes; or crimes of violence such as shootings in a public venue. Adverse effects of MAOI's - • Hypotension*** • Sedation, weakness, fatigue • Insomnia • Changes in cardiac rhythm • Muscle cramps • Anorgasmia or sexual impotence • Urinary hesitancy or constipation • Weight gain Agranulocytosis - Severe neutropenia, with less than 200 cells/mm3. Symptoms include: -Sores in the mouth, throat, or gastrointestinal tract -Chronic infections of the gums, throat, or skin -Malaise -Chills -Fever -Weakness -Severe fatigue -Hypotension Akathisia - Internal restlessness and external restless pacing or fidgeting. Nursing interventions: Reduced dosage or switched to a low-potency antipsychotic. Treat with anticholinergic, benzodiazepine, or beta blockers. Antisocial personality disorder - Characterized by persistent disregard for and violation of the rights of others with an absence of remorse for hurting others. Lack regard for the law and the rights of others and have a history of persistent lying, use of aliases, conning others for personal profit or pleasure, and stealing (deceitfulness). Have a sense of entitlement and are very callous Manipulative Asking "why" questions - Implies criticism; often has the effect of making the patient feel defensive. "Why did you stop taking your medication?" Autonomy - Respecting the rights of others to make their own decisions. Ex: Acknowledging the patient's right to refuse medication. Beneficence - The duty to act so as to BENEfit or promote the good of patients or others. Ex: Spending extra time to help calm an extremely anxious patient is a beneficent act. Benzodiazepines - Alprazolam (Xanax) Lorazepam (Ativan) Diazepam (Valium) Prescribed for SHORT-TERM treatment ONLY; not recommended for use by patients with substance use problems. Benzodiazepines can be HIGHLY addictive and are prescribed for short periods of time, especially when used to self-medicate for anxiety or depression. Borderline personality disorder - Unstable and intense relationships, and, instability of affect. Emotional liability Poor impulse control Primitive defense mechanism of projected identification and splitting Always seeking relationships to avoid feelings of abandonment and chronic feelings of emptiness Boundaries - A well-defined therapeutic relationship allows for the establishment of clear patient boundaries that provide a safe space through which the patient can explore feelings and treatment issues. In reality, boundaries are at risk of blurring, and a shift in the nurse-patient partnership may lead to nontherapeutic dynamics. Examples of circumstances that can produce blurring of boundaries include the following: • When the relationship slips into a social context • When the nurse's needs are met at the expense of the patient's needs Buspirone (BuSpar) - Alleviates anxiety, but works best before benzodiazepines have been tried. Less sedating than benzodiazepines. **Does not appear to produce physical or psychological dependence. Requires 3 or more weeks to be effective. Caring for the dying - One of the most important skills necessary in caring for the dying and their family members is to be "in the moment." Demonstrate presence and caring behaviors. Allow for a review of successes in the patients' lives and their lasting legacy; discuss any suicidal thoughts using a nonjudgmental approach and make appropriate referrals for care; allow time for patients to express their feelings and give them as much control over their care as possible; assist in supporting the family in repairing conflicts; help to make the most of things they enjoy (visits with friends, foods and music, storytelling, living in the moment); and assist with spiritual comfort—finding solace in spiritual beliefs and achieving a peaceful death. Convey caring, sensitivity, and compassion. Listen. Be patient; be present