NURS 550 Final Exam with Complete Solutions

NURS 550 Final Exam with Complete Solutions Attention definitions: Alert, lethargic, obtunded, Stuporous, coma Alert - pt is awake and aware Lethargic - you have to speak to pt in a loud and forceful manner to get a response Obtunded - you must shake pt to get a response Stuporous - arousable except by painful stimuli (sternal rub) Coma - pt is completely unarousabe Memory Short term memory - covers events or memories that occurred minutes to days before Long term memory - covers event or memories that occurred months to years before Orientation Aware of person, place, and time Perceptions Awareness of the objects in the environment to the five senses and their interrelationships Thought processes The logic, coherence, and relevance of the patient's thoughts and goals; how ppl think Insight Awareness that thought, symptoms, or behaviors are normal or abnormal; e.g. distinguishing that a daydream or hallucination is not real Judgment process of comparing and evaluating different possible courses of action Affect The observable mood of a person expressed through facial expression, body movements, and voice Mood The sustained emotion of the patient (euthymic, dysthymic, manic) Language The complex symbolic system for expressing written and verbal thoughts, emotion, attention, and memory Higher cognitive functions level of intelligence assessed by vocabulary, knowledge base, calculations, and abstract thinking Speech and Language: Quantity, Rate, Loud, Articulation of words Quantity: is patient talkative or silent Rate: is the speech fast or slow Loud: Is speech loud or soft Articulation of words: does the patient speak clearly and distinctly Fluency: involves the rate, flow, melody of speech Define: hesitancies in speech Monotone infections Circumlocutions Paraphasias Hesitancies in speech - as seen in patients with aphasia from strokes Monotone inflections - schizophrenia or severe depression Circumlocutions - words or phrases are substituted for the word a person cannot remember; e.g. "the thing you block out your writing with" for an eraser Paraphasias: words are malformed ("I write with a den"), wrong ("I write write with a branch"), or invented ("I write with a dar") Abnormal thought processes: Circumstantiality Derailment Flight of Ideas Neologisms Incoherence Blocking Confabulation Perseveration Echolalia Clanging Circumstantiality - speech characterized by indirection and delay due to the patients excessive use of details that have no connection to the point Derailment - speech in which a person shifts topics with no apparent relations between the tropics Flight of ideas - accelerated change of topics in a very fast but generally coherent manner Neologisms - invented or distorted words Incoherence - speech that is incomprehensible because it is illogical Blocking - Sudden interruption of speech, before the completion of an idea, occurs in normal ppl Confabulation - fabrication of facts to hide memory impairment Perseveration - persistent repetition of words or ideas Echolalia - repetition of the words or phrases of others Clanging - choosing a word on the basis of sound rather than meaning Abnormal Thought content Compulsions Obsessions Phobias