NURS 661 PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+<RECENT VERSION>

NURS 661 PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+&lt;RECENT VERSION&gt; 1) Unconscious incompetency: - answer novice no experience, governed by rules and regulations 2) ious incompetency: - answer advanced beginner recognizes aspects of situations and makes 3) ious competency: - answer competency/proficiency 2 to 5 years' experience, coordinates complex care and sees situations as wholes, and long-term solutions 4) cious competency - answer expert flexible, efficient, and uses intuition. 5) Attunement - answer describes how reactive a person is to another's emotional needs and moods. A person who is well attuned will respond with appropriate language and behaviors based on another person's emotional state. Are you able to read social cues? Verbal or non-verbal, whether to engage with it or not 6) Egocentrism: - answer is the inability to differentiate between self and other. More specifically, it is the inability to untangle subjective schemas from objective reality and an inability to accurately assume or understand any perspective other than one's own. All about me, especially in teens and kids. 7) Minimizing: - answer downplaying the significance of an event or emotion—is a common strategy in dealing with feelings of guilt. In teens. Not to minimizing patient's problem. Normalizing their situation is good but not minimizing. 8) Neuroplasticity: - answer also known as brain plasticity, neuroelasticity, or neural plasticity, is the ability of the brain (cortex) to change continuously throughout an individual's life, e.g., brain activity associated with a given function can be transferred to a different location, the proportion of grey matter can change, and synapses may strengthen or weaken over time. Therapy can help to change the brain. 9) Nurturing: - answer the entirety of climate-related aspects which impact the growth and actions of an individual. Psychologists have displayed specific interest in sociosocial and ecological factors, like family characteristics, child-rearing traditions, and economic status. Can be immature or maladaptive 10) Overdeterminism: - answer occurs when a single-observed effect is determined by multiple causes, any one of which alone would be sufficient to account for the effect. That is, there are more causes present than are necessary to cause the effect. Problem may come from different source. 11) Reframing: - answer developing a new conceptual or emotional outlook relating to situations experienced, and putting it into another frame which follows the facts or evidence equally well, changing its whole definition. Reconstruction of a subject's experiential view to impart a more positive view of it. Method for changing self-defeating thought processes by consciously inserting more positive ones. Restarting 12) Resilience - answer the ability to adapt or rebound quickly from change, illness, or bad fortune. Also known as: psychic resilience; psychological resilience. Able to handle stress. May have a genetic component. 13) Know what the adaptive information processing model and what it is used for. - answer the aip model was developed by shapiro through her development and observations of the effects of eye movement desensitization and reprocessing (emdr) therapy (shapiro, 2001). Aip hypothesizes that humans have an inherent information processing system that usually processes experiences to a physiological adaptive state in which information can be taken in and learning can occur. This model posits that there is an innate self-healing quality in the brain that strives to regulate its internal environment to survive and to maintain a stable, constant condition by means of dynamic regulation. Positive and negative experiences affect neurophysiological harmony. Optimally, memory is stored in a way that allows for connection with other adaptive memory networks. How traumatic memories are stored in the brain. 14) Know what the diathesis-stress model is what it is used for: - answer theory stating that mental and physical disorders develop from genetic or biological predisposition combined with stress. This theory is often used to describe the pronunciation of mental disorders, like schizophrenia, that are produced by the interaction of a vulnerable hereditary predisposition, with precipitating events in the environment. Nature (genetic) vs nurture (stress). Schizophrenia and bipolar look at this module. 15) Acetylcholine - answer this neurotransmitter occurs in cholinergic tracts extending from the limbic structures to the cortex, and a decrease in concentration is associated with memory and cognitive impairments. An increase is associated with alzheimer's disease. 16) Cortisol - answer a potent stress hormone that mobilizes energy stores, stimulates the release of glucose, potentiates the release of adrenaline, increases cardiovascular tone, and inhibits growth, immune, and inflammatory responses. An increase leads to cell atrophy and a decrease leads to cell growth. Weight gain, ptsd. 17) Dopamine - answer produced in the substantia nigra and other areas in the brainstem, it is a key neurotransmitter for motor action and the reward system. Too much may change mood, increase motor behavior, and disturb frontal lobe functioning, resulting in depression, memory impairment, and apathy. Parkinson's disease has been linked with decreased levels of dopamine. Mood, reward. Positive symptoms in schizophrenia and psychosis due to increase the da. Antipsychotic can cause eps, because it lowers the dopamine. Nuplazid, does not hit da for parkinson. 18) Gaba: - answer this inhibitory neurotransmitter contributes to a momentary refraction of neuron firing, and the glutamate derivative is found in most neurons in the central nervous system. It is involved in postsynaptic inhibition when benzodiazepines are given for anxiety, which further decreases the firing of the neurons. A decrease is associated with anxiety disorders. Dependency, addiction, seizure if withdraw. Gaba and benzo, brain accommodates to benzo quickly so after two weeks brain needs more. So only as needed. 19) Glutamate - answer it is found in all cells, and its major receptor, n-methyl-d-aspartate (nmda), helps to regulate brain development. Too much glutamate is toxic to neurons. Very exciting. Can cause problem with ach if dysfunctional. Helps with memory. 20) Acting out: - answer avoiding conscious experience of the emotion through impulsive action (e.g., instead of feeling sad, a person gets drunk). Impulsive to undesired feeling. Dysfunctional. 21) Denial: - answer avoiding the reality of painful reality by ignoring or refusing to acknowledge reality (e.g., a man with schizophrenia denies that he is ill and does not take his 99 62 medication). 22) Hypochondria: - answer exaggerating an illness arising from unacceptable feelings (e.g., anger and hostility are transformed into pain and somatic complaints). Response to fear or stressors. 23) Introjection: - answer internalizing the qualities of the other (e.g., identification with the aggressor through which the person becomes aggressive to gain control). 24) Isolation: - answer an unconscious separation of an unacceptable act or idea from its memory. This removes any emotional association from the memory which means it can no longer trigger anxiety. Avoiding, no social engagement, 25) Regression: - answer avoiding emotional pain through returning to an earlier level of development (e.g., a child begins wetting the bed after a sibling is born). Going back to previous behavior, like bed wetting. 26) Repression: - answer thought to be the basis of all other defenses and involves withholding from consciousness an idea or feeling that is unacceptable (e.g., the child cannot remember her anger or hitting her mother). Keeping emotions in. Making the stress unconscious. 27) Close-ended question: - answer how many drinks did you have? Yes or no questions. 28) Empathetic statement - answer you must have been so hurt by that. That is very frustrating. It is hard to lose someone you love. Expressing care and support, rewarding what is said and relating it to own experiences. 29) Gentle command - answer tell me about your family situation. Try to describe how you felt when. Share with me what you think a good outcome would be. Tell me more questions 30) Open-ended question - answer what brings you in today? How can i help you? How would you describe your relationship with...? What, when, how, why, where questions, seeking info 31) Qualitative question - answer how have you been sleeping? How is school going? How have you been getting along with your mom? Measures how much, quality 32) Swing question - answer (client can say "no" or client can elaborate) can you describe the depressive symptoms? Can you tell me anything more about that? Can you tell me what you're thinking right now? Can be answered with yes or no or elaborate. Close or open ended. 33) Domineering: - answer i try to change other people too much. Commanding, authoritative 34) Intrusive: - answer it is hard for me to stay out of other people's business: invading privacy, crossing he line. 35) Overly nurturing: - answer i put other people's needs before my own too much. 36) Vindictive: - answer i fight with other people too much. 37) Know the change agent of classical psychodynamic therapy: - answer insight 38) Relational psychodynamic psychotherapy - answer is all about helping you to better understand how your mind, body, and interpersonal life can work together to relieve your emotional pain and to create opportunities to make lasting changes in your life. We will work to help you discover how your unconscious mind is creating problems for you and how those problems can be altered toward creating opportunities for change, healing, and growth. The motivation is communication, affect and regulation. The change agent is mindfulness. 39) Classic: psychodynamic psychotherapy. - answer is derived from psychoanalysis and is based on a number of key analytical concepts. These include freud's ideas about psychosexual development, defense mechanisms, free association as the method of recall, and the therapeutic techniques of interpretation, including that of transference, defenses and dreams psychodynamic psychotherapy is classically indicated in the treatment of unresolved conflicts in early life. The motivation is sex and aggression. The change agent is insight 40) Supportive psychotherapy - answer is psychodynamic in that it is based on a knowledge of the patient's psychodynamics, which shapes the approach, but the goals of treatment differ considerably. Whereas psychoanalytic psychotherapy aims to restructure defenses and change personality organization through interpreting feelings, fantasies, and beliefs, supportive psychotherapy aims to strengthen defenses, promote problem solving, restore adaptive functioning, and provide symptom relief. Supportive is for stabilization. Psychoanalytic can be hard and they do need to have insight and mature coping skills and defenses. Is utilizing immature coping the y will feel defeated and wont continue. 41) Expressive psychotherapy: - answer the psychodynamic treatment of choice for those with borderline character structure is expressive psychotherapy. Processing emotions, 42) Group therapy - answer group work is considered a useful adjunct to individual cbt or emdr, and current findings do not support one type of group over another. Group therapy is thought to help the person cope with feelings of isolation, alienation, and anhedonia that are common for patients who have suffered significant trauma. Addiction, substance abuse, grief. The focus is on getting support, validating feeling and thoughts, learning coping experiences. 43) Psychoanalytic therapy: - answer patients who are considered ideal candidates for psychoanalytic psychotherapy are those with neurotic-to-healthy personality organization, who primarily rely on mature defenses. Some primitive defenses may be present, but along with these, mature defenses are also evident. These individuals have a sense of who they are, generally are in touch with reality, and have achieved object constancy. Object constancy refers to the capacity to be alone. These persons may come to treatment because of obstacles in love or work that they are uncomfortable about. Usually, they are the people who seek help without being forced. Good for mature persons and it focuses on overcoming any obstacles in life. 44) Supportive therapy: - answer is indicated to assist the person in stabilization, as illustrated by the treatment hierarchy in figure 1.6 in chapter 1. This involves increasing external and internal resources. The supportive model is the preferred model for most patients and that it is only when the goals of treatment cannot be met through this model that more expressive therapies should be employed. (primitive defenses/psychotic/ trust vs mistrust patients). For stabilization. Alternating with processing and stability. 45) Trauma-focused cognitive behavioral therapy: - answer when the client is no longer engaging in life-threatening or therapy interfering behaviors and has a strong trusting relationship with her therapist, the client and therapist can begin to focus on the traumatic experience that brought the client into therapy. Without the dbt skills and reinforcement of skills in everyday life it would likely be destabilizing to address trauma exposure, and may even contribute to worsening of the client's condition. For ptsd. The different with emdr is prolong exposure, there is more challenging of the believes and not eye movement and has homework. 46) Mindfulness: - answer research has shown that the regular practice of mindfulness improves, empathy, insight, immune function, attention, and emotional regulation. Awareness. 47) Projective identification: - answer is considered a defense mechanism and a countertransference constellation. It essentially involves behaving in such a way that subtle interpersonal pressure is placed on the therapist to take on dimensions of an experience or unconsciously identify with aspects of the patient. It can be positive if they are aware of their biases and struggles. Transferring emotions to another person. 48) Reframing: - answer the therapist recasts the problem in a new light in order to modify interactions and provide a different perspective. For example, a 12-year-old daughter is described by her parents as difficult. After listening to them squabble, the therapist said, "is this what happens when the three of you try to communicate with each other?" the problem is reframed as a systems problem rather than as an individual problem within the daughter. Taking the negative outs and adding positives. 49) Sublimation - answer person is able to pursue socially acceptable goals through channeling unacceptable impulses (e.g., a young man who is aggressive and impulsive pursues a career as a boxing coach). 50) Phq-9 score 0 to 4 - answer no depression 51) Phq-9 score 5 to 9 - answer mild depression 52) Phq-9 score 10 to 14 - answer moderate depression 53) Phq-9 score 15 to 19 - answer moderately severe depression 54) Phq-9 score 20 to 27 - answer severe depression 55) Type of therapy used with major depressive disorder - answer psychodynamic therapy or When combining theory with antidepressant, apa recommends cbt or interpersonal psychotherapy 56) Interpersonal therapy is good for - answer grief and loss Role transitioning (ex. New mom/new parents) Interpersonal conflict Mild to moderate depression Individuals without personality disorders 57) Know therapy modifications specifically for older adults - answer longer visits Repeat new material over several sessions Adjust physical barriers (hearing aids, glasses) Allow extra time 58) Age that reasoning starts to happen - answer usually ages 4 to 7 years old (intuitive thought or thinking process and reasoning- piaget) They use immature reasoning 59) Piaget birth to 2 years - answer sensorimotor (experiences world through senses and actions) 60) Piaget ages 2 to 6-7 years - answer preoperational Using intuitive rather than logical reasoning 61) Piaget ages 7 to 11 years - answer concrete operational Logical thinking 62) Piaget ages 12 through adulthood - answer formal operational Abstract reasoning 63) Erikson ages birth to 18 months - answer trust vs mistrust 64) Erikson 18 month to 2 years - answer autonomy vs doubt 65) Erikson 3 to 6 years - answer initiative vs guilt 66) Erikson 6 to 12 years - answer industry vs inferiority 67) Erikson 12 to 20 years - answer identity vs role confusion 68) Erikson 20 to 30 years - answer intimacy vs isolation 69) Erikson 30 to 65 years - answer generativity vs stagnation 70) Erikson 65 years to death - answer ego integrity vs. Despair 71) Teaching self-regulation techniques to children - answer manage your own stress Keep the end goal in mind Develop realistic expectations Stay calm Model self-regulation Be supportive and encouraging Reduce unnecessary demands Use motivational interviewing 72) How motivational interviewing helps children and teens - answer resistance is managed better Helps reduce hostility 73) If unable to self regulate, child may become - answer aggressive Have trouble integrating with peers (social withdrawal) Conduct issues Conflict (labeled trouble makers) 74) Taking strengths based approach in pediatrics - answer done during 1st meeting Praise them for what they did well Start with what is present, not what is absent Question strategies to identify what works and how it works Improving their strengths and work with them 75) Trauma focused cbt (tf-cbt) in pediatrics - answer wait to address trauma Usually 4-6 weeks after so child can process it Apa does not support immediately talking about events 76) Tf-cbt is best for child with - answer extensive trauma history Physical abuse Emotional abuse Neglect Having symptoms of poor sleep, nightmares, irritability, minor aggression, and restlessness 77) 3 main characteristics of adhd in children - answer inattention Hyperactivity Impulsivity 78) Brain structure involved in adhd - answer prefrontal cortex 79) Pfc affects - answer distractibility and forgetfulness 80) Gad-7 score 0 to 4 - answer no to low risk 81) Gad-7 score 5 to 9 - answer mild anxiety 82) Gad-7 score 10 to 14 - answer moderate anxiety 83) Gad-7 score 15+ - answer severe anxiety 84) Adhd dsm 5-tr criteria - answer persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Includes 6 or more symptoms of inattention or hyperactivity/impulsivity for at least 6 months Inconsistent with development level and directly impacts social and academic/occupational activities Several symptoms present before age 12 Several symptoms present in 2 or more settings Clear evidence that symptoms interfere with or reduce quality of work or social functioning Symptoms do not occur exclusively during the course of schizophrenia or other psychotic disorder and are not better explained by other mental disorder 85) Inattention symptoms (need 6 or more for adhd) - answer fails to give close attention to details or makes careless mistakes Difficulty sustaining attention in tasks or play activities Does not seem to listen when spoken to directly Does not follow through on instructions and fails to finish duties/work Has difficulty organizing tasks and activities Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort Often loses things needed for tasks or activities Easily distracted by extraneous stimuli Often forgetful in daily activities