NUR-253 MENTAL HEALTH EXAM 1 STUDY
GUIDE|COMPLETE SOLUTION| GRADED A+
NUR-253 CONCEPT OF MENTAL HEALTH COURSE
GALEN COLLEGE OF NURSING
KEY CONCEPTS WORKSHEET UNIT 1
CHAPTER 1, 7, 8 ,9
EXAM 1 ( part 1 of 3)
Yellow on Exam
There are factors that can impact an individual’s mental Health and wellbeing. Identify some examples in the following categories.
Personal Individual attributes and behaviors, how we manage thoughts and feelings, how we navigate everyday pressures,
ability to respond to social cues, how we participate in social activities, how we view ourselves, biological and
genetic factors, RESILIENCE
Social & Economic Immediate social surroundings, FAMILY – sets the stage in promoting confidence and coping skills or for instilling
anxiety and feelings of inadequacy, social and peer groups, socioeconomic status = resources available to support
mental health
Environmental Access to basic needs, are mental health services available? Cultural beliefs, attitudes and practices
What is resilience and what contributes to an individual developing it?
Resilience is the ability and capacity for people to secure the resources they need to support their well-being.
Promote well-being by regulating emotions, maintaining positivity and overcoming crises.
Does not mean being unaffected by stressors, rather you are effective at regulating emotions and not focusing on negative, self-defeating
thoughts.
Define protective factors.
Characteristics that are associated with a lower likelihood of negative outcomes or reduce a risk factor’s impact on a situation
-Positive attitudes, values or beliefs. Family or social support. Access to resources
Define risk factors.
Characteristics (biological, psychological, family, community or cultural level) that are associated with a higher likelihood of negative outcomes
-Negative family or cultural support, stigma, no access to resources
What is the DSM 5 and how is it utilized?
Diagnostic and Statistical Manual – describes criteria for 157 disorders
This manual identifies disorders based on specific criteria
Also serves as a tool for collecting epidemiological statistics about the diagnosis of psychiatric disorders. Only item that can diagnose
-Differs from ICD-10 which is the "coding” associated with a specific diagnosis
• Screening is not a Diagnosis.
Provide examples of patient rights:
The right to be free from excessive or unnecessary medication, the right to privacy and dignity, the right to the least restrictive environment,
the right to an attorney-clergy-private care providers, the right to not be subjected to invasive treatments without fully informed consent, right
to refuse treatment, right to informed consent, right to advance directives, right to confidentiality
**Patient can refuse treatment even if they are involuntarily committed**
There are two exceptions when HIPPA can be violated to protect a patient or others. Explain the circumstances when this can happen.
-Duty to warn: an obligation to warn others when they may be in danger from a patient OR
-Duty to protect: when a therapist determines that a patient presents a serious danger of violence to another
(In these situations, you HAVE to warn the person that is at risk)
, -MUST report child and older adult abuse (state laws vary)
Describe a scenario when a patient may be voluntarily admitted and another when a patient may be involuntarily admitted to a locked
psychiatric unit.
-Voluntary Admission: patient signs themselves in, they understand that they need some extra assistance, have the right to request release
whenever they choose (may have to undergo evaluation before being released)
-Involuntary Admission: occurs when a patient is unsafe to themselves or others – can be court mandated
-the Writ of Habeas Corpus: allows a patient to file a petition for release if they believe they are being held against their will
What are some examples of the purpose of the Psychiatric Assessment?
Establish rapport
Obtain an understanding of the current problem or chief complaint
Review the patient’s physical status and obtain baseline
Assess for risk factors affecting the safety of the patient or others
Perform a mental status exam
Asses psychosocial status
Identify mutual goals for treatment
Formulate a plan of care
Document data in a retrievable format
What assessment data is obtained when completing the mental status exam portion of a psychiatric assessment?
Appearance, attitude, behavior: grooming, eye contact, motor behavior, speech
Mood and affect: (mood = subjective, affect = objective)
Perceptual disturbances: hallucinations and illusions
Thought form: HOW are they thinking (organized, tangential, etc)
Thought content: WHAT are they thinking about
Cognition and sensorium: orientation, concentration, memory
Insight and judgment: insight into current circumstances, is their mental state impairing their judgment?
Identify things that a nurse needs to consider when completing a pediatric psychiatric assessment. How would you approach an interview with a
child to make them feel more comfortable?
-main caregiver can provide insight into a child’s behavior, performance or conduct (remember that a separate interview with child may be
necessary when a child is hesitant or reluctant to share information when a caregiver is around = possible abuse)
-always consider developmental levels
-assess through a combination of interview and observation
-verbal expression may be difficult for some children – ask them to tell story, draw a picture or engage in specific therapeutic games
Identify things that a nurse needs to consider that maybe unique when completing a psychiatric assessment with an adolescent.
-adolescents are concerned with confidentiality (they’re scared you will turn around and repeat everything back to their parents)
-privacy DOES exist for adolescents, use your best judgment or consult with supervisor if a situation is questionable
-provide explanation and information to adolescents, they want and need to be involved in their own treatment
-threats of suicide, homicide, abuse or behaviors that put patient or others at risk MUST be reported
-don’t create a fake sense of confidentiality, make sure patient is aware of what can and cannot be shared to others
Identify things that a nurse needs to consider that maybe unique when completing a psychiatric assessment with an older adult.
-do not stereotype – do not EXPECT them to be physically or mentally deficient
-rule out medical causes before assuming it is “just their age”
-evaluate preexisting physical, sensory, motor or medical issues
-make proper accommodations to limitations
What are some mental health issues that are common among older adults?
Depression, anxiety, cognitive deficits, neurocognitive disorders
-older adults are less likely to be accurately diagnosed and treated for mental health disorders than younger adults
GUIDE|COMPLETE SOLUTION| GRADED A+
NUR-253 CONCEPT OF MENTAL HEALTH COURSE
GALEN COLLEGE OF NURSING
KEY CONCEPTS WORKSHEET UNIT 1
CHAPTER 1, 7, 8 ,9
EXAM 1 ( part 1 of 3)
Yellow on Exam
There are factors that can impact an individual’s mental Health and wellbeing. Identify some examples in the following categories.
Personal Individual attributes and behaviors, how we manage thoughts and feelings, how we navigate everyday pressures,
ability to respond to social cues, how we participate in social activities, how we view ourselves, biological and
genetic factors, RESILIENCE
Social & Economic Immediate social surroundings, FAMILY – sets the stage in promoting confidence and coping skills or for instilling
anxiety and feelings of inadequacy, social and peer groups, socioeconomic status = resources available to support
mental health
Environmental Access to basic needs, are mental health services available? Cultural beliefs, attitudes and practices
What is resilience and what contributes to an individual developing it?
Resilience is the ability and capacity for people to secure the resources they need to support their well-being.
Promote well-being by regulating emotions, maintaining positivity and overcoming crises.
Does not mean being unaffected by stressors, rather you are effective at regulating emotions and not focusing on negative, self-defeating
thoughts.
Define protective factors.
Characteristics that are associated with a lower likelihood of negative outcomes or reduce a risk factor’s impact on a situation
-Positive attitudes, values or beliefs. Family or social support. Access to resources
Define risk factors.
Characteristics (biological, psychological, family, community or cultural level) that are associated with a higher likelihood of negative outcomes
-Negative family or cultural support, stigma, no access to resources
What is the DSM 5 and how is it utilized?
Diagnostic and Statistical Manual – describes criteria for 157 disorders
This manual identifies disorders based on specific criteria
Also serves as a tool for collecting epidemiological statistics about the diagnosis of psychiatric disorders. Only item that can diagnose
-Differs from ICD-10 which is the "coding” associated with a specific diagnosis
• Screening is not a Diagnosis.
Provide examples of patient rights:
The right to be free from excessive or unnecessary medication, the right to privacy and dignity, the right to the least restrictive environment,
the right to an attorney-clergy-private care providers, the right to not be subjected to invasive treatments without fully informed consent, right
to refuse treatment, right to informed consent, right to advance directives, right to confidentiality
**Patient can refuse treatment even if they are involuntarily committed**
There are two exceptions when HIPPA can be violated to protect a patient or others. Explain the circumstances when this can happen.
-Duty to warn: an obligation to warn others when they may be in danger from a patient OR
-Duty to protect: when a therapist determines that a patient presents a serious danger of violence to another
(In these situations, you HAVE to warn the person that is at risk)
, -MUST report child and older adult abuse (state laws vary)
Describe a scenario when a patient may be voluntarily admitted and another when a patient may be involuntarily admitted to a locked
psychiatric unit.
-Voluntary Admission: patient signs themselves in, they understand that they need some extra assistance, have the right to request release
whenever they choose (may have to undergo evaluation before being released)
-Involuntary Admission: occurs when a patient is unsafe to themselves or others – can be court mandated
-the Writ of Habeas Corpus: allows a patient to file a petition for release if they believe they are being held against their will
What are some examples of the purpose of the Psychiatric Assessment?
Establish rapport
Obtain an understanding of the current problem or chief complaint
Review the patient’s physical status and obtain baseline
Assess for risk factors affecting the safety of the patient or others
Perform a mental status exam
Asses psychosocial status
Identify mutual goals for treatment
Formulate a plan of care
Document data in a retrievable format
What assessment data is obtained when completing the mental status exam portion of a psychiatric assessment?
Appearance, attitude, behavior: grooming, eye contact, motor behavior, speech
Mood and affect: (mood = subjective, affect = objective)
Perceptual disturbances: hallucinations and illusions
Thought form: HOW are they thinking (organized, tangential, etc)
Thought content: WHAT are they thinking about
Cognition and sensorium: orientation, concentration, memory
Insight and judgment: insight into current circumstances, is their mental state impairing their judgment?
Identify things that a nurse needs to consider when completing a pediatric psychiatric assessment. How would you approach an interview with a
child to make them feel more comfortable?
-main caregiver can provide insight into a child’s behavior, performance or conduct (remember that a separate interview with child may be
necessary when a child is hesitant or reluctant to share information when a caregiver is around = possible abuse)
-always consider developmental levels
-assess through a combination of interview and observation
-verbal expression may be difficult for some children – ask them to tell story, draw a picture or engage in specific therapeutic games
Identify things that a nurse needs to consider that maybe unique when completing a psychiatric assessment with an adolescent.
-adolescents are concerned with confidentiality (they’re scared you will turn around and repeat everything back to their parents)
-privacy DOES exist for adolescents, use your best judgment or consult with supervisor if a situation is questionable
-provide explanation and information to adolescents, they want and need to be involved in their own treatment
-threats of suicide, homicide, abuse or behaviors that put patient or others at risk MUST be reported
-don’t create a fake sense of confidentiality, make sure patient is aware of what can and cannot be shared to others
Identify things that a nurse needs to consider that maybe unique when completing a psychiatric assessment with an older adult.
-do not stereotype – do not EXPECT them to be physically or mentally deficient
-rule out medical causes before assuming it is “just their age”
-evaluate preexisting physical, sensory, motor or medical issues
-make proper accommodations to limitations
What are some mental health issues that are common among older adults?
Depression, anxiety, cognitive deficits, neurocognitive disorders
-older adults are less likely to be accurately diagnosed and treated for mental health disorders than younger adults
