NSG 526 Exam 3 Wilkes University Updated 2023-2024 Latest Version/ NSG 526 Exam 3 Study, Exams of Nursing

Download NSG 526 Exam 3 Wilkes University Updated 2023-2024 Latest Version/ NSG 526 Exam 3 Study and more Exams Nursing in PDF only on Docsity! NSG 526 Exam 3 Wilkes University Updated 2023-2024 Latest Version/ NSG 526 Exam 3 Study Guide Primary prevention --------- Correct Answer --------- Actually preventing the thing Secondary Prevention --------- Correct Answer --------- early identification and treatment Tertiary prevention --------- Correct Answer --------- Avoiding complications Norms are considered --------- Correct Answer --------- The right patterns of behavior for a society Crisis is --------- Correct Answer --------- a time limited response lasting 4 to 6 weeks What initiates a crisis --------- Correct Answer --------- A crisis is initiated by internal or external demands that are perceived as a threat to a persons physical or emotional functioning. Precipitating event is stressful and unusual or rare. maturational crisis --------- Correct Answer --------- Describes unfavorable person- environmental relationships that relate to maturational events such as leaving home for the first time, completing school or accepting the responsibility of adulthood. Situational Crisis --------- Correct Answer --------- Occurs whenever a specific stressful event threatens a person's biopsychosocial integrity and results in some degree of psychological disequilibrium Aventitious Cirsis --------- Correct Answer --------- Initiated by an unexpected unusual events that can affect an individual or a multitude of people. National and natural disasters. During an adventitious crisis (e.g., flood, hurricane, forest fire) that affects the well-being of many people, the interventions of the PMH-APRN will be a part of the community's efforts to respond to the event. Goal for people experiencing crisis --------- Correct Answer --------- To return to pre-crisis level of functioning. Role of APRN in Crisis --------- Correct Answer --------- he role of the PMH-APRN is to provide a framework of support systems that guide the client through the crisis and facilitate the development and use of positive coping skills. Assess risk of homicide/suicide/self-injury Assess coping skills Assess perception of problem and support mechanisms Assess biologic items - sleep, eating, hygiene, etc Assess psychological - emotions and coping Asses social - individual, family, community. Social support Disaster --------- Correct Answer --------- A disaster is a sudden ecological or man-made phenomenon that is of sufficient magnitude to require external help to address the psychosocial needs as well as the physical needs of the victims MCI triage category: Expectant --------- Correct Answer --------- Injuries are extensive and chances of survival are unlikely even with definitive care. Separate and provide comfort 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 24hr after radiation exposure, profound shock with multiple injuries, agonal respirations; no pulse, no BP, pupils fixed and dilated MCI Category: Immediate --------- Correct Answer --------- Injuries are life-threatening but survivable with minimal intervention. Individuals in this group can progress rapidly to expectant if treatment is delayed. Sucking chest wound, airway obstruction secondary to mechanical cause, shock, hemothorax, tension pneumothorax, asphyxia, unstable chest and abdominal wounds, incomplete amputations, open fractures of long bones, and 2nd/3rd degree burns of 15%-40% total body surface area MCI Category: Delayed --------- Correct Answer --------- Injuries are significant and require medical care but can wait hours without threat to life or limb. Individuals in this group receive treatment only after immediate casualties are treated. factors and interventions to prevent the development of PTSD focus on --------- Correct Answer --------- preventing or treating new stressors, reducing distress, modulating arousal, managing pain, and treating depression. Propranolol, opioid, psychotherapy Primary Feature of PTSD: --------- Correct Answer --------- disturbance of memory, in which memories of the traumatic event are not processed and integrated with other information, so they are reexperienced Overall treatment goal for PTSD --------- Correct Answer --------- is to enable patients to regain control of their emotional responses and to place the trauma in the larger perspective of their lives as an event that happened at a certain time and that is unlikely to recur. One of the first steps in PTSD treatment --------- Correct Answer --------- is to help the patient to develop a sense of trust, safety, and separation from the traumatic event Psychotherapy for PTSD --------- Correct Answer --------- psychotherapy: Exposure, CBT, EMDR, Trauma management therapy, structured writing, VRE/tech based, interpersonal therapy, psychodynamic Pharmacological choice for PTSD --------- Correct Answer --------- SSRI Cluster A --------- Correct Answer --------- Odd or eccentric PD Paranoid PD --------- Correct Answer --------- 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. Traits of a person with Paranoid Personality Disorder. o They do not trust others easily and it's best to use a respectful neutral approach. o They are critical of others because they project blame for their own shortcomings onto others Schizoid PD --------- Correct Answer --------- Avoids close relationships, is socially isolated, has poor occupational functioning, and appears cold, aloof, and detached. Social awareness is lacking and relationships generate fear and confusion in the client. Nurses should strive for simplification and clarity to help decrease client anxiety. Therapy: Individual psychotherapy is the appropriate modality to use with Schizoid personality disorder Schizotypical PD --------- Correct Answer --------- ideas of reference; magical thinking or odd beliefs; perceptual distortions; vague, stereotyped speech; frightened, suspicious, blunted affect; distant and strained social relationships. These clients tend to be frightened and suspicious in social situations. o Explanations can ease their anxiety. Cluster B --------- Correct Answer --------- Dramatic, Emotional, Erratic Borderline Personality symptoms --------- Correct Answer --------- Unstable, intense relationships; identity disturbances; impulsivity; self-mutilation; rapid mood shifts; chronic emptiness; intense fear of abandonment; splitting; and anger Inability to tolerate perceived rejection BPD Major defense --------- Correct Answer --------- A major defense is splitting (alternating between idealizing and devaluing). Self Mutilation in BPD --------- Correct Answer --------- Self-mutilation and suicide-prone behavior are often-used impulsive self-destructive behaviors. Self mutilation occurs: --------- Correct Answer --------- 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. Self mutilation is mainly due to: --------- Correct Answer --------- fear of abandonment or the increase of independence Note: --------- Correct Answer --------- 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 Best response from PMH-APRN in BPD --------- Correct Answer --------- 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 Anger in BPD --------- Correct Answer --------- Anger is intense and pervasive and help with anger management is an important intervention Other focuses of BPD Management --------- Correct Answer --------- Relationship building, safety, and limit setting are other foci. Clients with BPD have not successfully --------- Correct Answer --------- achieved the developmental stage of separation- individuation during which a child normally develops a sense of self, a permanent sense of significant others (object constancy), and integration of seeing both bad and good components of self Projective Identification: --------- Correct Answer --------- falsely attribute to others their own unacceptable feelings, impulses, or thoughts Boundries and BPD --------- Correct Answer --------- Respecting a client's boundaries is important in establishing a therapeutic relationship with a patient with BPD. Risk Factors for BPD --------- Correct Answer --------- sexual abuse, parental separation, biological component (A decrease in serotonin activity and an increase in α2-noradrenergic receptor sites may be related to the irritability and impulsiveness; an increase in dopamine may be responsible for transient psychotic states) DBT/ Mindfulness --------- Correct Answer --------- DBT is a psychosocial treatment developed by Marsha M. Linehan specifically to treat individuals with borderline personality disorder. DBT includes: o Demands of workplace often overwhelming. Project that caregivers will harm them through disapproval and perceive rejection where none exists. Nurses can teach socialization skills, provide positive feedback, and build self-esteem. OCD --------- Correct Answer --------- Preoccupied with rules, perfectionist, too busy to have friends, rigid control, and superficial relationships. Complains about others' inefficiencies and gives others directions. Assessment of a Child (8 Questions) --------- Correct Answer --------- Behaviors that are possible indicators of a mental illness in a 3-year-old child: o Most psychiatric disorders in children are multifactorial. Understand that children from different cultures develop at different rates. 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. 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). Therapeutic drawing is a helpful technique if a child feels self-blame regarding their parent's divorce. Establishing a therapeutic alliance is important because acceptance and trust convey a feeling of security in an adolescent. Objective observations help the most in evaluating outcomes of child therapy. Play Therapy --------- Correct Answer --------- Play therapy is important because it allows the child to play out their fears and frustrations. Play therapy is child-centered and typically builds on the foundation of the psychodynamic, object-relations, and attachment theories. Used for children 3 years or older 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. Useful for catharsis, abreaction (assimilate previous experiences that have been traumatic or painful), role-play Interventions include reflection (commenting) and interpretation (after rapport developed) Cognitive Therapy --------- Correct Answer --------- Understand schemas o Individuals with BPD develop dysfunctional beliefs and maladaptive schemas leading them to misinterpret environmental stimuli continuously, which in turn leads to rigid and inflexible behavior patterns in response to new situations and people Cognitive therapy is the modality that prioritizes a client's schema. 7 and older Bibliotherapy --------- Correct Answer --------- Bibliotherapy uses books and a librarian as resources. When children listen to or read a story, they unconsciously identify with the characters and experience a catharsis of feelings. Family Therapy --------- Correct Answer --------- Family therapy can promote the greatest change in an adolescent's behavior. Know different family styles such as "closed Family". The Developmental Theoretical approach describes a family's progression through the lifecycle. Flooding --------- Correct Answer --------- Know an example of flooding in a child. When conducting a counseling session for a group of at-risk adolescents on drug use --- ------ Correct Answer --------- it is important to have their peers involved in teaching some of the problem-solving skills ODD --------- Correct Answer --------- Play Therapy (1 question) Play therapy is important because it allows the child to play out their fears and frustrations. Play therapy is child-centered and typically builds on the foundation of the psychodynamic, object-relations, and attachment theories. Used for children 3 years or older 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. Useful for catharsis, abreaction (assimilate previous experiences that have been traumatic or painful), role-play Interventions include reflection (commenting) and interpretation (after rapport developed) Cognitive Therapy (1 question) Understand schemas o Individuals with BPD develop dysfunctional beliefs and maladaptive schemas leading them to misinterpret environmental stimuli continuously, which in turn leads to rigid and inflexible behavior patterns in response to new situations and people Cognitive therapy is the modality that prioritizes a client's schema. 7 and older Bibliotherapy (2 questions) Bibliotherapy uses books and a librarian as resources. When children listen to or read a story, they unconsciously identify with the characters and