Psychology Nursing CCBC Exam 2025

Social and intimate relationships - --meet the needs of both individuals -built on shared interests, companionship and friendship Therapeutic relationships - --focused on the clients issues, problems, and concerns -4 predictable goal directed phases which usually consist of an explicit time frame -client often learns new material, develops new coping skills or makes a lifestyle change -nurse provides a high degree of confidentiality -client trusts nurse Phases of the nurse- client relationships - -pre-orientation: before nurse meets client; collects data, determines the best place to meet and provides an adequate amount of time for the first interaction; determine her own bias Orientation: the first contact between nurse & client; builds rapport and client becomes more comfortable and learns to trust the nurse- nurse clarifies her role and forms a contract, discussing termination and a caring manner Working: work together to set and accomplish goals; nurse assists in expressing problems and feelings; helps client work through any resistance and different ways to adapt/cope Termination: nurse reviews the goals the client has accomplished and discuss the clients feelings towards termination; nurse will reliquinsh care back to the client; they should feel empowered Self disclosure - -if the nurse shares personal information, experiences, attitudes and feelings with a client; self disclose only when it benefits the client -brief and focused on the issue -only disclose after trust established -don;t assume your experiences are the same as the clients -redirect it back to the client Transference and countertransference - -transference: when a client unconsciously associates the nurse with someone signification in his/her life Counter transference: nurses emotional response to a specific client Interventions - --open ended questions -closed ended questions -offering yourself -general lead NURSING NURSING -clarifying -paraphrasing -reflecting -confronting -silence -active listening -empathy Factors that hinder communication - -- asking personal questions -giving advice -approval/disapproval -giving reassurance -changing the subject -interrupting -sympathy Right to privacy - --clients rights to keep personal information private -as the right to keep the fact that they are in treatment private Exceptions include -mental health evaluation for a third party such as court evaluation -parents of a minor -in situation of violence where safety is at risk -duty to warn and protect third parties -allegations of sexual misconduct with a therapist -required reporting of certain communicable diseases -required reporting of gunshot wounds, etc Right to keep personal items - --if the item is unsafe, the nurse must find a safe place to store the item -even hygiene products are kept in locked areas -money and important papers can be sent to the hospital safe Right to enter legal contracts - --right to vote, get married, sign for a mortgage, write a will, manage personal finance affairs -competence - court hearing to determine individuals ability to manage their personal affairs (probate proceeding) -if not, they get a conservator -clients competency to stand trial : ncr or ngri (rare) Right of habeas corpus - --ensures all clients to a speedy legal hearing and evaluation with a judge determining if the client with be released or detained for treatment Right to informed consent - -- the right to clear information regarding treatment options, risks, benefits, and alternatives -assumes the client is competent NURSING NURSING Right to refuse treatment - -- except in an emergency or as permitted by state law Psychiatric advance directives - --legal document where an individual documents their preferences regarding mental health care; enhances a clients autonomy and guide significant others when the situation requires Right to retain their civil rights - --getting the mail, making phone calls, visits from clergy and attorney Right to treatment - -- a client is guranteed psychiatric treatment and a facility must have a treatment program -participation in treatment planning -adequate plans for discharge to a less restrictive setting must be included Right to treatment in the least restrictive setting - -- if a patient doesn't need to be in the hospital, they should be treated in an out client setting -unless it is necessary, a client must be restraint free -seclusion: involuntary confinement of a person in a room that is locked. -restraint: application of physical force to a person without their permission to restrict their freedom of movement -can only be used if the client is immenitely aggressive or a danger to self -short term : max of four hours and dr must do a face to face evaluation within hour of seclusion or restraints -monitoring: one to one monitoring on restraints -seclusion required one to one monitoring for the first hour and then can occur by camera Voluntary admission - -- considered competent unless a legal court action has determined them incompetent -have the right to refuse treatment unless dangerous to self or others -do not have the absolute right to discharge at anytime and have to request it -if a client requests discharge when a psychiatrist is unavailable, the nurse should discuss with the client the reasons to leave and have the client complete a 72 hour notice - if the dr says no, there is a hearing where the judge would determine if the client should stay or go - becomes involuntary Emergency petition - --allows a violent or suicidal person with a mental disorder to be brought to an emergency facility for rapid evaluation regarding the need for emergency treatment Three ways for this to occur -the court is petitioned by someone else and police brings them in -a professional gives the ep directly to the police -police observes the individual and brings them in Involuntary admission - --hospitalized against their will because they pose a danger to themselves or others and unable to provide for their basic need