NSG 526 EXAM 3 WITH QUESTIONS AND ANSWERS

Norms - are considered the "right" patterns of behavior for a society Event interpretation - should be included for problem-solving therapy for a child with conduct disorder. Family therapy - can promote the greatest change in an adolescent's behavior. The Developmental Theoretical approach - describes a family's progression through the lifecycle. Establishing a therapeutic alliance - is important because acceptance and trust convey a feeling of security in an adolescent. Most children will adopt the same world view - as their parents (ex. If a child was brought up by parents who thought the world was hostile they would most likely adopt this view as they grow older. Bibliotherapy - uses books and a librarian as resources. When conducting a counseling session for a group of at risk adolescents on drug use - it is important to have their peers involved in teaching some problem-solving skills. Play therapy is important - because it allows the child to play out their fears and frustrations. Therapeutic drawing is a helpful technique - is a child feels self-blame regarding their parent's divorce. Objective observations - help the most in evaluating outcomes of child therapy. Schizoid personality disorder - Individual psychotherapy is the appropriate modality to use with this disorder. The best response by the PMHNP when speaking with a client with BPD who has been in counseling for management of self-harm behaviors who now wants to cut themselves is - to assist the client to identify an appropriate coping strategy. Understand that if a client with BPD who was making progress but recently had an anxiety producing situation arise and now cut herself is that even though this behavior is dysfunctional, - it is mostly the patient's best effort to cope. Self-mutilation is mainly due to - fear of abandonment or the increase of independence BPD is often characterized by - an inability to tolerate perceived rejection. Patients will respond better to limit setting if - the PMHNP can reflect back to the client an understanding and validation of their emotional distress. Clients with BPD have not successfully achieved - the developmental stage of separation-individuation. Paranoid Personality Disorder - do not trust others easily, and it's best to use a respectful neutral approach. Paranoid Personality Disorder are - critical of others because they project blame for their own shortcomings onto others. Self-mutilation occurs because - a client may feel that pain is better than not feeling anything, it also results from feelings of abandonment, it can be a manipulative gesture, and it is also happens when a safety plan has been put in place. DBT helps to - replace irrational thoughts. Respecting a client's boundaries - important in establishing a therapeutic relationship with a patient with BPD providing a safe environment - is the priority for any client who is a victim of a serious crime/assault MCI Expectant category - Injuries are extensive and chances of survival are unlikely even with definitive care. Persons in this group should be separated from other casualties, but not abandoned. Comfort measures should be provided when possible Black MCI CATEGORY - Unresponsive patients with penetrating head wounds, high spinal cord injuries, wounds involving multiple anatomical sites and organs, 2nd/3rd degree burns in excess of 60% of body surface area, seizures or vomiting within 24 hr after radiation exposure, profound shock with multiple injuries, agonal respirations; no pulse, no BP, pupils fixed and dilated. Mindfulness - The essential part of all skills taught in skills group are the core mindfulness skills. Mindfulness is the capacity to pay attention, non-judgmentally to the present moment. It is derived from teachings of the Buddha, the Zen tradition being perhaps one of its most well-known proponents. Mindfulness is all about living in the moment, experiencing your emotions and all your senses and being aware of them. The psych NP needs to - foster a child's healthy characteristics and existing environmental supports no matter how negative (ex a child lives in a homeless shelter). children from different cultures - develop at different rates Most psychiatric disorders in children are - multifactorial. Paranoid Personality Disorder characteristics - Characteristics: suspicious of others; fear others will exploit, harm, or deceive them; fear of confiding in others (fear personal information will be used against them); misread compliments as manipulation; hypervigilant; prone to counterattack; hostile; and aloof. Psychotic episodes may occur in times of stress. Nurses should give straightforward explanations of tests, history taking, and procedures, side effects of drugs, changes in treatment plan, and possible further procedures, to counteract client fear Narcissistic Personality Disorder - Characteristics: grandiosity, fantasies of power or brilliance, need to be admired, sense of entitlement, arrogant, patronizing, rude, overestimates self and underestimates others. This behavior covers a fragile ego. In health care setting demand the best of everything. When client is corrected, when boundaries are defined, or when limits are set on client's behavior, client feels humiliated, degraded, and empty. To lower anxiety the client may launch a counterattack. The nurse should gently help the client identify attempts to seek and become perfect, exhibit grandiose behavior, and sense of entitlement splitting - BPD A major defense is splitting (alternating between idealizing and devaluing). client schemas - cognitive therapy is the modality that prioritizes a client's schema. Schemas - stored bodies of knowledge that interact with incoming information to influence selective attention and memory search Bibliotherapy def - is an expressive therapy which involves using child and adolescent literature to help the child express feelings in a supportive environment, gain insight into feelings and behavior, and learn new ways to cope with difficult situations. as the process of using books to teach those receiving medical care about their conditions is believed to be one cost-effective and versatile option for the treatment of several mental health issues. When children listen to or read a story - they unconsciously identify with the characters and experience a catharsis of feelings. The books selected by the PMH-APRN should reflect the situations or feelings the child is experiencing. theoretical model based on the premise that people are greatly influenced by the characters they identify with in stories. Most professionals agree reading is - productive activity that can promote good mental health, as reading has been shown to increase empathy, sharpen the mind, and impact behavior. play therapy - is child-centered and typically builds on the foundation of the psychodynamic, object-relations, and attachment theories. Start age 3 plus give us the same type of information that we gather through verbal communication with adults play therapy helpful for - posttraumatic stress disorder, disruptive behavior disorders, mood disorders, and reactive attachment disorder. Nondirective play - is normally viewed as the best way to begin play therapy. Structured play is rarely used until nondirective play has enabled a full assessment of relevant themes and issues, and the child's trust around anxiety-laden issues has been developed. Symbols in play therapy - such as aggressive behavior toward a father doll) can have several meanings and should never be interpreted in a standardized fashion toys with ambiguous meaning - diverse uses foster symbolic play more effectively because they allow the child to project his or her own identity and function onto the toys Purpose of play therapy - 1. catharsis, the release of strong emotions in order to provide relief from the inner tension they may be causing the child. 2. abreaction, the reliving through play of past events and their related feelings. A child can assimilate 3. to help the child try out other ways of relating to the world or responding to situations. Age 3 child has capacity for role play Cognitive Behavioral Therapy in kids - 1. focus on the child's conscious rather than unconscious issues. 2. emphasis is placed on more effective coping in the present rather than on mastery over unresolved feelings associated with the child's past experiences CBT in kids over 7 years old treat - depression, conduct disorder, ADHD, and anxiety Behavioral techniques, without the cognitive component, are also widely used to address therapeutic goals - for 3- to 6-year-old children and those with mental retardation, learning and communication disorders, pervasive developmental disorders, tic disorders, and elimination disorders. Cognitive behavioral treatment for kid - is a reeducation and relearning process involving the development of new ways of thinking about life and new behaviors that are more adaptive and more functional for the child.