NSG 526 Exam 1 |110 questions and answers 2023.

-An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one -Socially deviant behavior (i.e. political, religious, or sexual) and conflicts that are primarily between the individual and society (unless the behaviors are due to a dysfunction) What is not considered a mental disorder? -Associated with significant distress or disability in social, occupation, or other important activities -Significant disturbance in cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning What is considered a mental disorder per the DSM5? -Define NP roles -Identify competencies assumed to be held by all NPs who function in a particular role -Varies broadly from state to state Purpose of Scope of Practice? -Authoritative statements regarding the quality and type of practice that should be provided -Provide a way to judge the nature of care provided -Reflect the expectation for the care that should be provided to clients with various illnesses -Reflect professional agreement focused on the minimum levels of acceptable performance -Can be used to legally describe the standard of care that must be met by a provider -May be precise protocols that must be followed or more general guidelines that recommend actions Purpose of Standard of Practice? Understand the patient's illness to evaluate the effect on their lives and create a beginning diagnosis and treatment plan Purpose of Psychiatric Interview? -Create a relationship with client by being calming, warm, understanding, kind, respectful, concerned and focused -Able to help patient better if a therapeutic alliance was formed What is a Therapeutic Alliance? -Therapist and patient work collaboratively to create therapeutic change through an affectionate bond -Agreement on goals of therapy -The therapist's ability to be empathetic and involved in therapy -The ability of the patient to do the work of therapy Important components of a therapeutic alliance? Holistic treatment that relies on the nurse's processing of that the patient is experiencing What is Psychotherapy? -Her application of Sullivan's theory of anxiety to nursing practice -Described the effects of different levels of anxiety (mild, moderate, severe, and panic) on perception and learning -Promoted interventions to lower anxiety, with the aim of improving clients' abilities to think and function at more satisfactory levels Peplau's most universal contribution to PMHNPs? -Observation, interpretation, and intervention (The PMHNP observes and listens to the client, developing impressions about the client's situation) Per Peplau, skills of a MH nurse? -The processes by which the nurse helps clients make positive changes in their health care status and well-being -Believed that illness offered a unique opportunity for experiential learning, personal growth, and improved coping strategies and that PMH-APRNs play a unique role in facilitating this growth What is the main idea for Peplau's Theory of Interpersonal Relationships? -Silence -Accepting -Giving recognition -Giving information -Offering self -Giving broad openings -Offering general leads -Placing the event in time or sequence -Making observation -Encouraging description of perceptions -Encouraging comparison -Reflection -Exploring -Seeking clarification -Presenting reality -Voicing doubt -Verbalizing the implied -Attempting to translate into feelings -Encouraging formulation of a plan of action -Summarizing Therapeutic Communication Techniques? -Reassuring -Approving -Disapproving -Rejecting -Advising -Probing -Challenging -Defending -Requesting an explanation -Indication the existence of an external source -Belittling feelings -Making stereotypical comments -Giving literal responses -Introducing an unrelated topic Non-Therapeutic Techniques? -Orientation -Identification -Exploitation -Resolution Four Phases of the Nursing Model? -The PMHNP addresses individual and family problems with the patient -Assess identified problems during the orientation phase -Determines the underlying healthcare issues with the patient -Collects psychiatric data -Establish a trusting relationship Psychotherapy Process? By applying core principles of psychotherapy, as well as, nursing theory How does the patient recover through adaption? Avoid taking patients with similar problems or put aside personal pathology What does the PMHNP need to avoid? -Focus on difficulties patient is experiencing in current relationships and the ways the relationships can be handled -Change pattern of communication -Alter expectations within relationships -Use social supports to help patients deal with stressors and improve their environment -Relieve symptoms -Build social skills Goals for Interpersonal Therapy? -Complicated bereavement/grief -Marital and interpersonal conflicts, such as role disputes -Life events, such as role transitions -Isolation, lack of support, interpersonal deficits Indications for Interpersonal Therapy? Therapist identifies depressive symptoms, evaluates patient, generates a diagnosis, obtain information on how the patient handles relationships Early Phase of Interpersonal Therapy? Patient and therapist derive more specific strategies to deal with stressors Middle Phase of Interpersonal Therapy? -Consolidate gains -Foster independence in the person -Review risk of relapse and reappearance of depressive symptoms -To contract again for continuation of treatment as needed Termination Phase of Interpersonal Therapy? Facilitate changes by the patient in order to address identified problems Purpose of Group Therapy? Assure dominant members are brought to the attention of the group, so they are able to address issues within the process Role of leader in group therapy? A person explaining to the group ways that person is able to cope with things Role of information giver in group therapy? A technique where special favors or awards are given to assure patient participation and involvement in group therapy Role of Reinforcement in group therapy? Increase subjectivity about thoughts governing their behavior. This is done by: -homework assignments -dream description -looking at ideas and beliefs the patient has about themselves Goal of Cognitive Behavioral Therapy (CBT)? -Encouraging patient to analyze early parental relationships -Underlying meaning of behavior -Identification of negative thoughts -Effect of thoughts on feelings and behaviors CBT Interventions? -Anxiety -Bipolar Disorder -Eating Disorders -Borderline Personality Disorder Interpersonal Therapy (IPT) is useful for? 1. Infancy (birth to 18 months) 2. Childhood (18 months to 6 yrs.) 3. Juvenile (6 to 9 yrs.) 4. Preadolescence (9-12 yrs.) 5. Early Adolescence (12-14 yrs.) 6. Late Adolescence (14-21 yrs.) Stages of Development? Gratification of needs Characteristic of Infancy? Delayed gratification Characteristic of Childhood? Formation of peer group Characteristic of Juvenile? Developing relationships within same gender Characteristic of Preadolescence? Identity Characteristic of Early Adolescence? Forming lasting and intimate relationships Characteristic of Late Adolescence? -Good me vs Bad me: based on social appraisal and the anxiety that results from negative feedback -Not me: unknown, repressed component of self What are the 3 types of self? Measures that the individual employs to reduce anxiety and enhance security How does Sullivan's theory define security operation? All of the security operations that an individual uses to defend against anxiety and ensure self-esteem How does Sullivan's theory define self system? -Significant time spent in a home-like environment -Interact with similar individuals -Conduct different activities throughout the day -May attend group or individual therapy sessions -Establish treatment goals for themselves and community -Learn new ways to respond from peers and counselors What is Milieu Therapy? Return to larger society when goals have been met Goal of Milieu Therapy? -Broad term referring to psychotherapy, behavior analytics, or a combination of the two -Focus on behaviors or in combination with thoughts and feelings that might be causing them What is Behavioral Therapy? -Treatment method in which the client expresses all thoughts freely and without censoring self -Freud concluded that talking about emotional issues had the potential to heal the wounds causing mental illness What is Psychoanalysis? -General appearance, attitude, behavior -Speech -Mood and Affect -Thought content -Thought process -Impulse Control -Cognition and Sensorium Components of Mental Status Exam (MSE)? -General description of what the patient talked about -I.E. information and description related to symptoms or circumstances of depression, anxiety, compulsions, phobias, delusions, SI/SH/HI/AVH How to describe thought content? Clinical tool to determine suicide risk -Sex -Age -Depression -Previous Attempts -Ethanol Abuse -Relational Loss -Social Supports Lacking -Organized Plan -No Souse -Sickness SAD PERSONs Scale? The way in which a client thinks What is Thought Process?