Nursing 114 Practice actual exam questions and answers pass at first attempt

Viewed as the ability to carry out personal roles in society, along with demonstration of appropriate and adaptive behaviors - correct answers Mental Health Includes disorders that affect mood, behavior, and thinking and cause significant distress, and impaired functioning. May also cause dissatisfaction with self, interpersonal relationships and ineffective coping. - correct answers Mental Illness Part of a treatment team- everyone has goal on treatment instead of just care plan - correct answers Role of Psychiatric Nurse Therapeutic relationship is patient focus- only patient needs are being meet- verbal and nonverbal communication are important. Ways to achieve therapeutic outcome: Use their name Provide privacy Actively listen Maintain eye contact and smile Maintain professional boundaries - - correct answers Therapeutic nurse- pt relationship- Rapport Trust Respect Genuineness Empathy - correct answers Remember essential components to development therapeutic relationship .... Test Question needs of both or all are meet and addressed, example- friendship - correct answers Social relationship- You are the instrument of tool - requires self-awareness and self-understanding - leaving baggage at the door and being present with the patient. Work with pt before looking over the chart. - correct answers Therapeutic Use of self 1.Reoriented them 2.Keep them hydrated - correct answers Test Question- If you are taking care of delirious pt. and they are disoriented what is the priority care? Coping technique that reduces anxiety usually arises from unacceptable or potentially harmful stimuli - correct answers Ego Defense Mechanisms Failure to acknowledge an unbearable condition, failure to admit the reality of a situation or how one enables the problem to continue - correct answers Denial- Test question Diabetic person eating chocolate candy Spending money freely when broke Waiting 3 days to seek help for severe abdominal pain - correct answers Examples of Denial transfer our feeling onto the person or object Argument with my friend and then take it out on my husband - correct answers Displacement Test Question projecting your feeling onto someone else Man, who has thoughts about same gender sexual relationship but never had one beats a man who is gay - correct answers Projection excusing own behavior to avoid guilt, responsibility conflict anxiety or loss of self-respect Going on a shopping spree to because someone did you wrong - correct answers Rationalization occurs when the client displaces onto the nurse or therapist/doctor attitudes and feelings that the client originally experienced in another relationship. - correct answers Transference When people met a new person, who reminds them of someone else they unconsciously infer that the new person has traits similar to the person previously known. Pt to nurse- - correct answers Example of transference occurs when the nurse displaces onto the client attitudes or feeling from the past. Nurse to pt. - correct answers Countertransference Never use the why, never the right answer - correct answers Communication allows the client to take initiative in introducing the topic. - correct answers Broad opening- Is there something you would like to talk about? Where would you like to begin Rational- make explicit that the client has the lead in the interaction. For the client who is hesitant about talking it may stimulate him or her to take the initiative. - correct answers Examples of broad opening searching for mutual understanding, for accord in the meaning of the words. - correct answers Consensual validation- Tell me whether my understanding of it agrees with yours. Are you using this word to convey that? Rational- for verbal communication to be meaningful, it is essential that the words being used have the same meaning for both, all participants. Sometimes, words, phrases, or slang erm save different meaning and can be easily misunderstood. This is a way to come to a mutual understanding with your pt. when you both reach an understanding. - correct answers Examples of consensual validation Alarm Reaction Stage (protect state) everything is heightened Stage of Resistance- Adapt to the stressor Stage of Exhaustion- due to prolong stress due to state of resistance failing and the adaptive energy is depleted. Disease of Adatation - correct answers General Adaptation Syndrome- Headaches Mental disorders CAD Ulcers/colitis Without intervention- exhaustion/death occur - correct answers Diseases of adaptation: 3 stage of General Adaptations teaching is taking place day to day seldom a problem (able to problem solve)- learning is most effective. Enlarge perceptual field coping behaviors- sleeping, problem- solving, eating, laughing, exercise, stress management technique. - correct answers Peplau's Four Degrees of Anxiety- Mild teaching is taking place Taking an exam/performing a procedure. perceptual field is reduced. Sees and hears less. Person is still in control and capable of learning. Focus on immediate concerns. Coping behavior- the ego defenses mechanisms - correct answers Peplau's Four Degrees of Anxiety- Moderate teaching is not taking place Witnessing an accident, perceptual field reduced. Scattered details, inability to follow directions, attention span reduce Physiological disorders, anxiety disorders - correct answers Peplau's Four Degrees of Anxiety- Servere teaching is not taking place Being caught in a flood, being in the accident, Terror. The detail previously focused on is blown up. Perceptions greatly distorted. Nothing or little is heard, panic attack, hallucinations, GAS Loss of ego boundaries , a gross impairment in reality testing - correct answers Peplau's Four Degrees of Anxiety- Panic get a dx when the anxiety interferes with social, occupational, or important areas of functioning. - correct answers Anxiety disorder- tress related - Fight or Flight syndrome: - The Sympathetic Nervous system is stimulated causing: - Norepinephrine & epinephrine are released by the adrenal medulla - Pupils dilate - Bronchioles dilate & RR increases - HR & BP increase - Anus & diaphragm lock - Bladder muscles contracts, sphincter relaxes - Increase in sweating - Insulin is released - Shifts in temperature, hands become cold, blood is being shifted to large muscles - correct answers Symptoms of Anxiety 1. Start with behaviors presented by patient. Some patients find it difficult to name what they are feeling as anxiety 2. Ask patient is he/she is anxious 3. Have the patient to name the cause/trigger of anxiety 4. The patient needs to learn to identify anxiety producing situations 5. Have patient to name what release behavior is useful 6. VERY IMPORTANT to encourage the patient to talk about feelings - correct answers Nursing Interventions for Anxiety a discrete episode of intense anxiety or discomfort; sudden onset and usually builds to a peak within 10 mins or less, but the individual usually believes the episode lasts much longer; often accompanied by a sense of imminent danger or impending doom and urge to escape. These can occur in a variety of anxiety disorders (Panic Disorders, Phobias, and PTSD) - correct answers Panic Attacks: When a person who suffers from panic attacks begins to live in fear that the attacks will reoccur, worry intensively about future attacks and modify behaviors of life in an effort to mini mize recurrence, the dx of panic disorder is made. (Ex: Someone driving 20 miles out of the way to avoid driving over a bridge if bridges cause the panic attacks) - correct answers • Panic Disorder : Panic attacks and panic disorders are characterized by at least 4 of the following 13 symptoms: • Palpitations, pounding heart or increased HR • Sweating, chills or hot flashes (monitor vitals) • Trembling or shaking • SOB • Feeling of choking • Chest pain or discomfort • Nausea or abdominal distress • Dizzy, unsteady, Parathesias (numbness or tingling) • Derealization (feelings of unreality) or Depersonalization (being detached from oneself) • Fear of losing control or going crazy