Psych_NURS417_Quiz 1 Flashcards

Developed better nursing care in psychiatric hospitals & organized nursing services & educated programs in state mental hospitals in Illinois

Called the first American psychiatric nurse

One of Linda Richards most important contributions was her emphasis on what?

The role of psychiatric nursing began to emerge in the early 1950's, but the following three problems affected psychiatric nurses:

Dr. Hildegard Peplau, who published the book, Interpersonal Relations in Nursing (1952), defined nursing as:

6 interpersonal nursing roles identified by Dr. Peplau

The role assumed by both nurse & patient when they first meet

Provides health information to a patient who has assumed the counselor role

Helps the patient grow & learn from experience with the health care system

Helps the patient participate in a democratically implemented nursing process

Assumes roles that have been assigned by the patient, based on significant past relationships

Helps the patient integrate the facts & feelings associated with an episode of illness into the patient's total life experience

Jones' idea of the therapeutic community (1953) includes these ideas:

Along with Jones' publication of The Therapeutic Community, another significant development in psychiatry in the early 1950's was the use of:

Peplau's Interpersonal Techniques: The Crux of Psychiatric Nursing (1962) identified the heart of psychiatric nursing as the role of:

For this individual's contributions to psychiatric nursing, they are often referred to as the mother of psychiatric nursing

Made federal money available to states to plan, construct, & staff community mental health centers & resulted in a growing awareness of the value of treating people in the community & preventing hospitalization whenever possible.

An interpersonal process that promotes & maintains patient behavior that contributes to integrated functioning

The five core mental health disciplines, per The Center for Mental Health Services

This type of collaboration/relationship includes the elements of clinical competence, consumer-family advocacy, fiscal responsibility, interprofessional collaboration, social accountability, & legal-ethical parameters

3 domains of contemporary psychiatric-mental health nursing practice

One strategy psychiatric nurses can use to enhance their growth is to participate in:

4 factors that help determine the level of a psychiatric nurses performance

In 1952, Hildegard Peplau defined the psychiatric nurse’s role as a:

The contribution of Linda Richards that remains a part of contemporary psychiatric nursing practice is the idea that:

A nurse states, “I plan ways for patients assigned to me to participate in their own care and to be actively involved in all of the activities on the unit.” This approach demonstrates the concept of:

Hildegard Peplau’s classic article “Interpersonal Techniques: The Crux of Psychiatric Nursing” directed psychiatric nursing’s future growth by stating that the primary role of the psychiatric nurse was that of:

When teaching the orientation portion of a psychiatric nursing course, which statement would the instructor be most likely to make to the students?

For psychiatric nurses in the 1980s and 1990s, the scope of practice began to change to include:

During orientation to the inpatient psychiatric unit, new staff members are told, “Address all patients by their title and surname unless you are directed by the patient to do otherwise.” The belief that underlies this directive is that:

A psychiatric aide says, “I don't know why that patient does all that silly giggling and posturing. It’s senseless!” The best reply to this comment would address the psychiatric nursing principle that states:

The role of the psychiatric nurse in today’s contemporary practice settings is:

The primary opportunity provided by psychiatric clinical rotations for nursing students is an opportunity to:

Case supervision is a psychiatric nursing activity that falls within the nursing practice domain of:

When one considers the roles and functions of psychiatric nursing, the overlap of communication and management roles is seen in the function of:

The major determinants of the roles in which a psychiatric nurse engages are:

Nursing should increase its role in the advocating of funding for outcome studies because these studies:

New opportunities for psychiatric nursing practice have emerged as psychiatric hospitals have changed from large institutions providing custodial care to:

A psychiatric nurse uses leadership skills to strengthen the profession by:

In the 1960s, the psychiatric nurse began to shift to primary prevention and psychiatric nursing practice began to focus more on community care. This focus was initiated by which act?

A nurse is contemplating a change from a medical-surgical nursing psychiatric nursing unit in a community hospital. Which intervention would help the nurse identify the supportiveness of the new unit?

It is essential that psychiatric nurses become aware of their ability in the area of positive political action. The nurse can best achieve this goal by:

When considering psychiatric nursing roles and functions, in order to delegate effectively the nurse must have knowledge of the domains of: (Select all that apply.)

A. management

B. communication

C. direct care

D. teaching

E. collaboration

In the nurse-patient relationship, _____ _____ are respected

The key therapeutic tool of the psychiatric nurse

A holistic nursing model of self-awareness includes these 4 interconnected components:

Concepts that are formed as a result of life experiences with family, friends, culture, education, work, and relaxation

Concern for the welfare of others

The 4 phases of the nurse-patient relationship

Actual or concrete meaning of a word

Implied or suggested meaning of a word

Plays a major factor in the meaning of nonverbal behavior

Personal space generally consists of this distance range

What eye level encourages greater communication?

The structural model of communication has these 5 components

If the sender is communicating the same message both verbally & nonverbally, it's called

The first rule of a therapeutic relationship

Encourages the patient to select topics to discuss

"What are you thinking about?"

"Can you tell me more about that?"

"What shall we discuss today?"

This communication tool shows that the nurse is listening

This communication technique can give the patient time to think & gain insights

This type of questioning has limited usefulness in the therapeutic relationship

An attempt by the nurse to make the patient aware of inconsistencies in feelings, attitudes, beliefs, and behaviors

This occurs when the patient is encouraged to talk about things that are most bothersome

This technique can increase the patient's insight into human relations & deepen the ability to see the situation from another point of view

A patient's reluctance or avoidance of talking about or experiencing troubling aspects of oneself

A related benefit that a patient may experience as a result of their illness

Can be a cause of resistance (patient's avoidance of talking about troubling aspects of oneself)

Unconscious response in which patients experience feelings & attitudes toward the nurse that were originally associated with other significant figures in their lives

Transference is characterized by the inappropriate intensity of the patient's response...

The two types that are problematic in the nurse-patient relationship include:

A novice nurse states, “Psychiatric nursing can’t be very difficult. After all, I believe in showing care and in mutual exchange with my friends.” The experienced nurse’s understanding of the difference between a social and a therapeutic relationship is primarily based on the:

Which strategy can the nursing student use to foster authenticity in therapeutic relationships with patients?

A person who has always wished to care for “special children” adopts a biracial child and another child who has spina bifida. What is the highest step of the value clarification process that this person has achieved?

3 steps in the value clarification process

A nurse makes observations that a depressed patient is more energetic and is smiling much more. Still, the nurse shares with the unit manager that when thinking about the patient a sense of hopelessness surfaces. The nurse manager replies:

A new nurse has the following thoughts: “How will I handle things if my patient walks away from me? How will I react if the patient is sexually provocative? How will I cope with a patient who cries?” These thoughts indicate that the nurse is engaged in:

A nurse’s most appropriate initial action during the preinteraction phase of a relationship with a homosexual patient should be to:

A nurse engaged in the preinteraction phase of the nurse-patient relationship will:

When asked to contrast social superficiality with therapeutic intimacy, an experienced nurse mentor explains to a new nurse that the termination component in therapeutic intimacy is:

Which task would be most appropriate to focus on during the introductory phase of work with a teenage patient with low self-esteem?

A patient admitted with a diagnosis of schizophrenia, paranoid type, coldly tells a nurse during the admission interview, “I am here because my family brought me here and locked me up.” The nurse’s best response would be:

A patient is admitted to the unit and complains of being depressed. The patient says, “I want to feel like my old self again.” Which nursing response will be most therapeutic?

In the initial sessions a patient frequently asks the nurse for money and expresses doubt about the nurse’s ability to help. Which principle provides guidance for the nurse in this situation?

A young adult has been receiving treatment for an anxiety disorder. Which statement by the patient confirms that the nurse and patient are most likely entering the terminal phase of the therapeutic relationship?

A psychiatric nurse will recognize which action as demonstration of resistance behavior?

A. Regularly referring to himself as a “loser”

B. Becoming tearful during every therapy session about abuse

C. Asking to postpone a therapy session until after visiting hours

D. Consistently describing his drug use as starting “a little while ago”

During the working phase of the relationship, the nurse assesses that the patient may be demonstrating resistance. The most appropriate way to deal with this would be to:

A patient reports seeing a “frightening” face on the wall of the dayroom. A nurse attempts to calm her by providing an explanation for the flawed perception of what she saw. The nurse would implement this strategy by stating:

A patient says to a nurse, “My spouse and I get along just fine. We usually agree on everything.” The nurse observes nonverbal communication that disagrees with what the patient has verbally communicated. Which of the patient’s actions is incongruent with her statement?

A nurse tells a patient who is feeling guilty about an infidelity to call the spouse and beg for forgiveness. According to the transactional model of communication, the nurse’s response originated from which state?

According to transactional analysis theory, when a patient finally recognizes the importance of being medication-compliant, which type of transaction has occurred?

When the nurse suggests the patient communicate to her employer how overwhelmed she is by the workload, the patient responds, “Yes but I’ll get fired if I do that.” According to transactional analysis theory, this is an example of a(n) _____ transaction.

A patient who is currently in an abusive marriage shares, “Some days I think it’s just not worth it. I’d be better off if we separated.” The nurse uses restating as a therapeutic communication technique when responding:

When a patient is late for three consecutive therapy sessions, the nurse implements perception sharing as a communication technique when stating:

The therapeutic communication technique of suggesting is appropriate to use when it:

A teenager being treated for oppositional defiance behavior states: “I wish my parents would stop treating me like an irresponsible child.” The nurse implements confrontation as a therapeutic technique when responding:

Which statement is true of planning the timing for the use of confrontation?

A. Confrontation should never be used during the orientation phase of the relationship.

B. Confrontation is useful during the working phase to focus on specific patient discrepancies.

C. Confront patients with their limitations early in the relationship and with their assets later in therapy.

D. Confront patients when other therapeutic action dimensions have proven ineffective.

The nurse suspects that a client has a problem with the action dimension of immediacy when she states, “You can’t tell people very much about yourself; it gives them too much power over you.” The nurse responds:

A chronically depressed patient has been diagnosed with having a dependent personality. The nurse suspects that the situation has resulted in dependence transference when the patient shares that:

A nurse tells the unit supervisor, “I’m having a difficult time empathizing with my patient especially since he is so unwilling to change. Talking with him makes me feel both frustrated and depressed.” The supervisor may suspect that the cause of the barrier in this nurse-client relation is the:

If the potential for suicide is suspected, what should the nurse do?

The patient's apparent emotional tone

Absence of emotional expression

False sensory impressions or experiences

False perceptions or false responses to a sensory stimulus

A patient admitted for treatment of uncontrolled diabetes mellitus is withdrawn and tearful. The patient says, “I just want to be normal again.” The nurse determines there is a need for a psychiatric evaluation primarily to assist:

A. the patient in verbalizing distress about the disease.

B. in assessing the emotional factors affecting the patient’s present condition

C. in assessing priorities to be set for the patient’s overall nursing plan of care.

D. the patient in emotionally accepting the chronic nature of the disease.

Recall of events, information, and people from the distant past

Recall of events, information, and people from the past week or so

Recall of information or data to which a person was just exposed

Recall of _____ events involves reviewing information from the patient's history

How can we test immediate recall (memory)?

The patient's understanding of the nature of one's problem or illness

This type of interviewing technique can assess a patient's readiness to change

-Interactive & problem-solving

-Systematic & individualized way to achieve outcomes of nursing care

-Respects individual's autonomy & freedom to make decisions & be involved in nursing care

1) Describe what the psychiatric nurse does

2) Describe the context in which the psychiatric nurse performs these activities

The 6 phases of the nursing process (as described by the Standards of Practice)

In the _____ phase of the nursing process, information is obtained from the patient in a direct & structured manner through observations, interviews, & examinations

+ Goal-directed method of communication

+ Should be focused, but open ended

+ Should progress from generic to specific, allowing spontaneous patient self-expression

The nurse develop _____ in the diagnosis phase, which is a clinical judgement about individual, family, or community responses to actual or potential health problems/life processes

What is the subject of the nursing diagnosis?

The _____ phase of the nursing process may include relieving symptoms or improving functional ability

Mutually identifying _____ & expected _____ is an essential step in the therapeutic process

In writing the goals of a nursing care plan, one should remember to classify them into the "ABCs," or 3 domains, of knowledge, which are:

Patients aren't likely to commit to a goal or work toward attaining a goal in this situation

In the planning phase of the nursing process, a plan of care is developed. The goals within are prioritized. What type of goals always receive top priority?

If a goal/s answers the question of "what", then the _____ answers the questions of "how" & "why"?

The _____ phase of the nursing process is the actual delivery of nursing care to the patient & the patient's response to that care

The psychiatric nurse helps the psychiatric patient do these 2 things:

What's the idea behind motivational interviewing?

This type of supervision equates to one-on-one supervision, in which the supervisor meets individually with the nurse being supervised

This term encompasses the idea that nurses view themselves as members of an organized professional group or unit and that nurses trust, support, & demonstrate commitment to other nurses

Collaboration is the shared planning, decision making, problem solving, goal setting, & assumption of responsibilities by individuals who work together cooperatively & w/open communication. These 3 key ingredients are needed for effective collaboration:

A continuous, active process that begins early in the nurse-patient relationship & continues throughout

What should happen when a psych patient who's prescribed drug therapy develops side effects that emerge after treatment?

These drugs speed up the CYP-450 metabolizing system, thus decreasing the blood levels of drugs & potentially causing a lack of effectiveness of those drugs

These drugs slow down the CYP-450 metabolizing system, thus increasing blood levels of drugs & potentially causing increased S/E or even toxicity from those drugs

The study of how the body affects a drug

4 properties of pharmacokinetics (how body affects drugs)

How much of a drug reaches systemic circulation unchanged

The point at which the plasma drug concentration remains relatively constant between doses because the amount of drug excreted equals the amount ingested

Most antidepressants, some antipsychotics, mood stabilizers, and __1__ can inhibit the CYP-450 system, potentially causing toxicity of drugs

In contrast, St. John's wort and __2__ can markedly reduce psychotropic drug levels, rendering them ineffective

The study of the effects of a drug on the body and, in particular, the interaction of a drug on the receptor that it's targeting

A relative measure of the safety & toxicity of a drug

If a drug has a low therapeutic index, does it have a wide or narrow range between achieving the desired effect & toxicity?

The addition of another class of medication to supplement the effectiveness of the primary medication, usually done when the primary medicine (that which is prescribed to treat the target S/S of the patient's primary DX) falls short of expectation & needs a lil' sumpin' sumpin' added ;)

The use of multiple psychopharmacological meds in the treatment of psychiatric disorders

With the elderly, how should medication regimens begin?

Has the FDA approved any psychotropic medications for safe use during pregnancy?

These 3 biological threads can affect biological response to medications

For most psychotropic meds, women require _____ doses than men

A lack of _____ often results in lack of compliance to the medication treatment

Know the 3 domains of contemporary psychiatric-mental health nursing practice, & the 4 functions which oftentimes overlap in the above domains (see figure on opposite side)

Suggesting is appropriate to use in the __1__ phase when you're attempting to present __2__