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NURS 6670 Final Exam Study Guide Chapter 1 to 39;Graded A NURS 6670 Final Exam Study Guide Chapter 1 to 39 NURS 6670 Final Exam - PMH Nurse Practitioner Role 11 Case Study, Mohr: CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing 1. Karen is a 25- year-old white woman who lives alone in an apartment with her dog. Karen has been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for depression. Karen and her boyfriend had been discussing marriage until he told her that he wanted to end their relationship. Karen became even more depressed and could not work for a week. Karen returned to work, refusing to discuss her issues with family, friends, or coworkers. She did, however, make an appointment to see a psychiatric nurse practitioner. Karen told the nurse that she was making some changes in her life. Karen said that she and a girlfriend were joining a gym program for workouts and a social group for young men and women. Karen stated that she realizes that her former boyfriend had not been committed to her, and she anticipates meeting and dating other young men from the adult social group. Karen also said that she thinks that the gym exercise will be beneficial to her mentally and physically. (Learning Objectives: 1, 4) Case Study, Mohr: CHAPTER 2, Neuroscience: Biology and Behavior 1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s grades. Michael plans to apply to medical school and thinks that the lower GPA may prevent his acceptance to medical school. For the last 2 weeks, Michael has skipped most classes because he has insomnia and fatigue. Michael is now very depressed and has been thinking of suicide. He took a loaded gun from his father’s gun cabinet and then wrote a suicide note to his family. At the last moment, he telephoned 911 and told them of his suicide plan. The police came, took the gun away, and then took Michael to the city hospital to be admitted for psychiatric treatment. In the admission interview with the psychiatric nurse, Michael said that his pastor thought that only weak-willed people experienced depression and that it was a punishment for personal sins and the sins of one’s ancestors. Michael told the nurse that he must be weak-willed and will never be able to accomplish anything. The psychiatric nurse explained that multiple factors are the cause of depression. The nurse told Michael that one theory holds that an imbalance of neurotransmitters, or chemical messengers of the brain, occurs in depression. Neurotransmitters influence the individual’s emotions, thoughts, and subsequent behavior. Recent research implies that neurobiology, heredity, as well as Psychological and environmental factors may be involved in the development and progression of depression. (Learning Objectives: 5, 6) Case Study, Mohr: CHAPTER 3, Conceptual Frameworks and Theories: 1. The student nurse has been assigned a 37-year-old woman admitted to the psychiatric hospital with an anxiety disorder. This morning, the student notices that the client has a tense facial expression and is walking constantly around the group room. The student walked over to the client and used reflective communication by stating, “I see that you have a tense expression and are walking around almost all of the time. Is there something that we could discuss?” The client replied that she has talked on the telephone to her mother who was keeping her children while she was in the hospital. The client said that her mother had told her that she was not a good mother, and then said, “I guess I am a bad mother, but I could never measure up to my mother’s expectations.” The student has learned that negative self-talk can greatly aggravate anxiety and lead to depression. The student decided to use a behavioral intervention with the client and asked the client who is a good artist and why the client liked the artist’s works. The student and the client then made a list of activities that the client liked. The student taught the client to engage in one of these activities when an unpleasant experience evoked negative thoughts. The following day, the student decided that the client needed some cognitive restructuring for her relationship with her mother. The student taught the client that during discussions with her mother, feelings of incompetence might be experienced when the mother made negative comments. The client was instructed that if her mother made negative comments about parenting, she was to immediately tell her mother that she was a good parent to her children and terminate the conversation at the first opportunity.(Learning Objective: 3) Case Study, Mohr: CHAPTER 4, Evidence-Based Practice Case Study, Mohr: CHAPTER 5, Legal and Ethical Aspects 1. Gerald, a 22-year-old black man, has a diagnosis of schizoaffective disorder. Gerald has been living at home, but this afternoon he had a physical fight with the neighbors and set a fire in their garage to burn their house. His father took him to the local psychiatric hospital and said that he wants an involuntary commitment for Gerald since he will not agree to the hospitalization. The father expressed concern over Gerald’s legal rights. The psychiatric nurse practitioner recommends to the father that he commit Gerald on involuntarily for emergency care for a period of 72 hours since he is clearly a danger to others. The nurse explains that Gerald will be evaluated to determine if he needs involuntary detention for observation and treatment for a longer period of time. The nurse explains that Gerald will be periodically evaluated, and that when it is determined that he is no longer a danger to others or himself, Gerald will be released from the hospital.(Learning Objectives: 4, 5) Case Study, Mohr: CHAPTER 6, Culture 1. Mrs. Maria Gonzalez is a Mexican National, age 58, who was brought to a health clinic by her adult son. She is complaining that she has had aches and pains all over her body for 2 days. Mrs. Gonzalez states that her neighbor is a witch who gave her the mal do ojo (evil eye) and cast a spell on her to cause her death. The clinic nurse takes an oral