ATI Mental Health Final Exam Latest Update With Verified Correct Answers
Mental Health - ANS-State of well-being in which the individual realises
... [Show More] his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
Mental Illness - ANS-medical conditions that affect a person's thinking, feeling, mood, ability to relate to others, and daily functioning
Mental Disorders - ANS-Health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning
Beneficence - ANS-The duty to act so as to benefit or promote the good of others
Autonomy - ANS-respecting the rights of others to make their own decisions
Justice - ANS-the duty to distrubute resources or care equally, regardless of personal attributes
Fidelity - ANS-a.k.a. Nonmaleficence maintaining loyaltiy and comitment to the patient and doing no wrong to the ptient
Veracity - ANS-one's duty to communicate truthfully
Conditioinal Release - ANS-requires outpatient treatment for a specific period to determine the patient's adherence
with medicatin protocols, ability to meet basic needs, and abilit to reintegrate into the community
Patient's Rights - ANS--right to treatment -right to refuse treatment -right to informed consent -rights surrouding involuntary commitment and psychiatric advanced directives -rights regarding restraint and seclusion
HIPAA (Health Insurance Portability and Accountability Act) - ANS-
Consent - ANS-permission to do something
ANA (American Nurses Association) - ANS-Professional organization for all RNs. Concerned with licensure, collective bargaining and education -defines scope of practice
Duty to Warn - ANS-the exception to the client's right to confidentiality; when health-care providers are legally obligated to warn another person who is the target of the threats or plan by the client, even if the threats were discussed during therapy sessions otherwise protected by confidentiality
Tort - ANS-a civil wrong for which mone damages may be collected by the injured party
Defamation of Character - ANS-wrongfully hurting a person's good reputation -slander (spoken) -libel (written0
False Imprisonment - ANS-restraining an individual or restricting an individual's freedom
Assault vs. Battery - ANS-Assault: victim made reasonably afraid that he is about to be battered Battery: harmful or offensive bodily contact
When an attacker pulls fist back as if to punch (assault), follows through with the punch (battery)
Chapter 51 - ANS-admission is without the patient's consent and is related to presenting as a danger to self or others or they are unable to meet their basic needs -usually only for 72 hrs (business hours)
Chapter 51 Patient Rights - ANS-pt. maintain right to: -be free from restraints -informed consent on meds and treatment -refuse meds and treatment
Chapter 51 Example Scenarios - ANS-OD on meds Homicidal Suicidal-high lethality Slashing wrists/self harm
Chapter 55 - ANS-chronic, long-term protective placement
-determined by a judge -must determine that pt is incompetent and unable to care for self -POA/guardian appointed for decisions within protective placement
Chapter 55 Example Scenarios - ANS--traumatic brain injury -Alzheimer's/dementia -nonreversible conditions
Do psychotropic medications require consent to administer? - ANS-YES BISH -considered a chemical restraint -can violate autonomy
Does psychotic thinking inhibit a patient from making informed consent? - ANS-NO BISH -not always, unless they are a danger to themselves or others they are usually still capable of making their own consent for treatment or medications
Restraints Should: - ANS--never interfere with treatment -restrict movement as little as is necessary to ensure safety -fit properly -be easily changed to decrease the chance of injury and to provide for the greatest level of dignity *should be the least restrictive with the shortest duration*
Chapter 51 vs 55 - ANS-51
-acute -high danger -72 hrs -pt maintains rights
55 -long-term cognitive -nonreversible condition -pt can't make their own decisions
5 Elements to prove Negligence - ANS-1. duty to provide care as defined by a standard (care that should be given) 2. Breach of duty by failure to meet standard (failure to give care that should have been given) 3. Forseeability of harm (knowing that failing to give the proper standard of care may cause harm to the client) 4. Breach of duty has potential to cause harm (failing to meet standard had potential to cause harm-relationship must be provable) 5. harm occurs
What should the nurse do if a severely psychotic patient refuses required medication? - ANS-offer the medication with a brief explanation to see if the patient will willingly take it -then follow with written consent to get order for IM injection per MD order
What is the priority assessment for a Chapter 51 patient? - ANS-assessing risk for self-harm, suicide, or harm to others
ANA Code of Ethics - ANS-The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
Psychosocial Assessment - ANS-A comprehensive document which looks at the client as a whole person (not as a set of symptoms) and holistically combines the spiritual, emotional, physical, mental, behavioral, and social dimensions.
QSEN Competencies - ANS-Patient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics
Affect - ANS-behavioral expression of emotion
Charting Affect - ANS-*DO NOT chart NORMAL* labile euphoric manic sad, tearful appropriate/inappropriate constricted or blunted flat
Charting Attitude - ANS-cooperative/uncooperative friendly/hostile
polite indifferent oversensitive negative respectful attentive guarded suspicious defensive
Charting Attention - ANS-Normal- focused Abnormal- interupting, unfocused, poor listening, distracted, fidgety
Charting Consciousness - ANS-clear, oriented degree of confusion obtunded sedated/lethargic
Obtunded - ANS-Less than full alertness (altered level of consciousness), typically as a result of a medical condition or trauma. -depression
Charting Rapport - ANS-normal-engaged, good, fair abnormal- poor, indifferent, too engaging
Apathy - ANS-a lack of feeling, emotion, or interest, concerns
Anhedonia - ANS-inability to experience pleasure
-depression
Avolition - ANS-lack of energy or dirve
Catatonic - ANS-stupor- extreme state of psychomotor retardation, mutism, negativism, and posturing
Compulsion - ANS-compelling; strong desire that is difficult to control; irresistible impulse
Confabulation - ANS-the unintended false recollection of episodic memories -dementia
Congruent - ANS-verbal and nonverbal messages that express the same meaning
Delirium - ANS-reversible state of mental confusion with disoriented often with hallucinations incoherent speech and aimless physical activity
Delusions - ANS-fixed beliefs that are not amenable to change in light of conflicting evidence
Dementia - ANS-progressive impairment of intellectual function that interferes with performing activities of daily living
Depersonalization - ANS-Altering of perception that causes people to temporarily lose a sense of their own reality; most prevalent in people with the dissociative
disorders. There is often a feeling of being outside observers of their own behavior. -mania
Derailment - ANS-person's ideas slip off one track and onto another -completely or minimally unrelated
Displacement - ANS-shifting of an emotion from a person or objection from which is was originally intended
EPS (extrapyramidal symptoms) - ANS-A variety of signs and symptoms that are often side effects of the use of certain psychotropic drugs, particularly phenothiazines. Three reversible extrapyramidal side effects are acute dystonia, akathisia, and pseudoparkinsonism. A fourth, tardive dyskinesia, is the most serious and is not reversible. -SE of antipsychotic drugs
Flight of Ideas - ANS-rapidly changing or disjointed thoughts
Hypomania - ANS-A mild manic state in which the individual seems infectiously merry, extremely talkative, charming, and tireless.
Ideas of Reference - ANS-incorrect interpretation of casual incidents and external events as having direct personal references
Introjection - ANS-The beliefs and values of another individual are internalized and symbolically become a part of the self, to the extent that the feeling of separateness or distinctness is lost.
Mania - ANS-a mood disorder marked by a hyperactive, wildly optimistic state
Melancholia - ANS-symptoms are exaggerated and has loss of interest or pleasure in virtually all activities
Narcissism - ANS-excessive love of one's body or oneself
Perseveration - ANS-persistent repetition of the same word or idea in response to different questions
Projection - ANS-psychoanalytic defense mechanism by which people disguise their own threatening impulses by attributing them to others
Psychomotor Retardation - ANS-overall slowed movements; a general slowing of all movements; slow cognitive processing and slow verbal interaction -demetia, melancholic depression
Psychosis - ANS-gross departure from reality, which may include hallucinations and delusions
Reaction Formation - ANS-a conscious attitude or behavior that is opposite of what one would really like to have
Rationalization - ANS-giving a socially acceptable or logical response to justify an unacceptable or logical one
Repression - ANS-involuntarily blocking unpleasant feelings and experiences from one's awareness
Ritualistic - ANS-action performed repetitively due to belief system, possibly in connection with a ceremony -OCD
Splitting - ANS-unable to integrate and accept both positive and negative feelings
Tangential - ANS-inability to get to the point of the conversation -mania
Thought Blocking - ANS-sudden halt in the train of thought or in the middle of a sentence -mania
Warning Signs of Blurring Nurse-Patient Relationship - ANS-overhelping controlling narcissism nontherapeutic disclosure about personal life poor professional boundaries
Transference - ANS-the process where the patient unconsciously displaces to another individual some of
their own experiences and emotional reactions that relate to significant figures from childhood ex. you remind me of my mother because...
Countertransference - ANS-Tendency of the nurse to displace feelings related to people in his or her past onto a patient
Phases of Nurse-Patient Relationship - ANS-Orientation phase Working phase Termination phase
Conversion Reaction - ANS-anxiety is transformed into physical symptoms such as heart palpitations, paralysis, or blindness
Therapeutic Communication DON'Ts - ANS-ask why give advice give opinions ignore pretend you know use complex medical jargon don't probe speak soft, mumble
Denial - ANS-Defense mechanism by which people refuse to accept reality.
Suppression - ANS-Conscious, intentional pushing of unpleasantness from one's mind
Sublimation - ANS-the unconscious channeling of strong socially unacceptable impulses into socially acceptable impulses
Yalom's Curative Factors - ANS-- Altruism - Catharsis - Universality - Interpersonal learning
Interpersonal Learning - ANS-occurs when receiving feedback from grp members re: one's bx (input), learning successful ways of relating to group members (output)
Catharsis - ANS-relieving of emotions by expressing one's feelings
Altruism - ANS-unselfish regard for the welfare of others
Cohesiveness - ANS-feeling connected to other members and belonging to the group
Universality - ANS-the feeling that one is not alone and that others have similar issues or have been in similar situations
Major Depressive Disorder (MDD) - ANS-Psychological disorder involving a significant depressive episode and depressed characteristics, such as lethargy and hopelessness, for at least two weeks.
Dysthymic Disorder - ANS-A chronic depression that is insufficient in severity to merit diagnosis of a major depressive episode.
Postpartum Depression - ANS-the sadness and inadequacy felt by some new mothers in the days and weeks after giving birth -ranges from 'blues' to full blown psychosis
Psychotic Depression - ANS-delusions or hallucinations + depression
Melancholic Depression - ANS-is a type of major depressive disorder that is characterized by a loss of pleasure in most or all activities, psychomotor retardation, weight loss, guilt, and insomnia -may be misdiagnosed as dementia -common in older adults
Seasonal Affective Disorder (SAD) - ANS-depression that involves recurrent depressive episodes in a seasonal pattern -winter and summer -more common in women -light therapy
Euthymic - ANS-normal mood
What is the hallmark sign of depression? - ANSworthlessness
What mood is suicide considered an only option? - ANShopelessness
Medical Conditions that may mimic Depression - ANShypoglycemia hypothyroidism drug induced psychosis
Vegetative Signs of Depression - ANS-eating, sleeping patterns bowel habits decreased libido inability to concentrate decreased energy levels
Beck Depression Inventory (BDI) - ANS-a questionnaire useful for determining the level of depressive symptoms that a person is reporting Q 1-13 assess psychological Q14-21 assess physical
Depression Risk Factors - ANS-Serious losses Difficult relationships Financial problems Unwelcomed stressors Changes in social roles Women 2x as likely
Is a decrease in vegatative signs and symptoms a bad thing? - ANS-NO BISH; it's a good thing, means depression is improving
Passive Suicide Ideation - ANS-a wish to be dead but does not include active planning about how to commit suicide
Active Suicide Ideation - ANS-thoughts about how to commit the act
Suicide Assessment (PALS) - ANS-- Suicidality - Plan - Accessibility - Lethality - Hopelessness
Prototypical Suicide Victim - ANS-male 50+ retired, lonely multiple chronic mental health issues experiencing life changes with multiple losses s/s may have present as other illness
Suicide RED FLAGS - ANS--specific plan -means to carry out -history -lethality -giving away -early stages of antidepressant treatment -increased energy
Should you use logic to reinforce a patient's worth? - ANSNO BISH;
could come accross as judgemental
Why are *tricyclic* antidepressants not commonly used? - ANS-because they are far more lifethreatening to OD on
What is the safest classification of antidepressants? - ANS-SNRI (novel or multimodal)
Tyramine Foods - ANS-aged cheese (cheddar, blue cheese, swiss cured meats (salami, sausages, pepperoni) sauerkraut, soy sauce, shrimp sauce yeast, fava beans,
When are MAOIs prescribed? - ANS-in cases when other antidepressants or ECT have not been successul, they have more serious side effects than other antidepressants
Electroconvulsive Therapy - ANS-a treatment that involves inducing a mild seizure by delivering an electrical shock to the brain
Adverse Effects of ECT - ANS--Possible cardiovascular effects (arrythmias, tachycardia- monitor EKG and K+) -systemic effects (headaches, anorexia, muscle aches, drowsiness) -cognitive effects such as confusion and memory difficulties
Post Procedure ECT Care - ANS-VS with O2
gag reflex cognitive function assess
Vagal Nerve Stimulation (VNS) - ANS-a treatment for depression in which an electrical stimulator is surgically implanted next to the vagus and then connected to a pulse generator in the person's chest; like a pacemaker in the heart, the pulse generator can be programmed to deliver electrical pulses at desirable frequencies and currents -alterative to ECT
How long does it take for MAOIs to become therapeutic? - ANS-2-4 weeks
How long does it take SSRIs to become therapeutic? - ANS-8-12 weeks
Postpartum Depression Risk Factors - ANS-Inadequate social support Poor relationship with partner Life and childcare stress Low self-esteem Unplanned pregnancy
Anergia - ANS-lack of energy
PHQ - ANS-Patient Health Questionnaire -fast assessment for depression
What is a good question to ask patients who have gone from passively suicidal to active? - ANS-Why now?
(exception to why restriction)
High Lethality (Suicide) - ANS-hanging jumping gunshot CO poisoning
Low Lethality (Suicide) - ANS-OCT drugs (except Tylenol and AS due to liver distruction) cutting
Does asking a patient about suicide increase their risk? - ANS-NO BISH
Reverse Room Restriction - ANS-patient is not allowed in room for extended periods during the day and has to be out amoungst people
What is the oldest form of antidepressants? - ANStricyclics
When is ECT indicated? - ANS-If patient is unresponsive to medications, if the patient is pregnant, or if you need rapid reduction of symptoms (immediate suicide risk, refusal to eat/drink, catatonia). Very good in elderly. It is also used for treatment of manic episodes.
What is a good treatment time for ECT? - ANS-20-40 seconds of seizure activity -3 treatments per week with 6-12 total depending on seizure activity
ECT Nursing Considerations - ANS--education -misconception address -contraindicated in MI, CVA, increased ICP, low INR -give insulin before if DM
Depression Interventions - ANS-ask about feelings and plans to harm self; implement suicide precautions; monitor sleep/nutrition/elimination; assist with ADLs; initiate interaction with client; insist on participation in activities; observe for sudden elevation in mood; assist in identifying support system; encourage discussion of feelings; sit in silence if client isn't talkative
Bipolar Etiology - ANS-several genes contribute to the expression
strong significance of higher inheritability
increase in excitatory neurotransmitters: serotonin, dopamine, norepinephrine
Bipolar I Disorder - ANS-a type of bipolar disorder marked by full manic and major depressive episodes -switching process
Bipolar II Disorder - ANS-a type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes
Cyclothymic Disorder (Cyclothymia) - ANS-Milder, chronic form of bipolar disorder Lasts at least 2 years in adults, 1 year in children/adolescents Numerous periods with hypomanic and depressive symptoms Does not meet criteria for mania or major depressive episode Symptoms do not clear for more than 2 months at a time
Rapid Cycling Bipolar Disorder - ANS-diagnosis given when a person has four or more cycles of mania and depression within 1 year -more severe symptoms than bipolar I or II -greater resistance to treatment
Hypomania vs Mania - ANS-hypomania: a milder form of elevated mood that are less severe and cause less impairment than full mania and (usually) don't require hospitalization
Labile - ANS-Changing rapidly and often in moods -mania
Mania Symptoms - ANS-DIG FAST. Distractable. Insomina Grandiose.
Flight of ideas. Active.
Speech pressured. Taking risks.
Mania Nursing Interventions - ANS-Develop trusting relationship Self-awareness Administer anti-mania medication Set and enforce limits on inappropriate behavior Redirect patient where appropriate Protect from self-embarrassment Provide for physical safety Provide Balance for activity and rest Facilitate sleep Ensure nutrition Provide Self-care [Show Less]