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Hello Class of 2007, Welcome to our blog community. This is our area to share information, resources, ask and answer questions. You will have fellow students, past students, and many other assets available to you through this site. Everyone is encouraged to discuss and problem solve here. Check back frequently as we post sample questions and links to relevant sites. We are on the same journey, let's discover it together.
Hello Class of 2007, Welcome to our blog community. This is our area to share information, resources, ask and answer questions. You will have fellow students, past students, and many other assets available to you through this site. Everyone is encouraged to discuss and problem solve here. Check back frequently as we post sample questions and links to relevant sites. We are on the same journey, let's discover it together.
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Loose associations = a pattern of thinking that is haphazard, illogical, and confused, and in which connections in thought are interrupted; it is seen in primarily in schizophrenic disorders. (positive symptoms)
Eg: Nurse: are you going to the picnic today? Client: I’m not an elephant hunter, no tiger teeth for me. Important to let the client know if you do not understand. Clear messages and complete honesty are an important part of working with clients w/ loose association w/ is commonly seen in schizophrenia.
Neologisms= a word that a person makes up that has meaning only for that person; often part of a delusional system. (positive symptoms)
Eg: “I want all the vetchkisses to leave the room and leave me be.” In people w/ schizophrenia this represents a disruption in thought processes.
Anhedonia= the inability to experience pleasure (negative symptoms)
Concrete thinking= Thinking grounded in immediate experience rather than abstraction. There is an overemphasis on specific detail as opposed to general and abstract concepts.
Eg: during an assessment, nurse might ask what brought the client to hospital. Client will answer a cab. When asked “people in glass houses shouldn’t throw stones” client w/ schizophrenia will say don’t throw stones or the windows will break. Answer is literal w/ no abstract reasoning. (positive symptoms)
Thought withdrawal= the belief that thoughts have been removed from one’s mind by an outside agency
Eg: “the devil takes my thoughts away and leaves me empty” This is a common delusion in schizophrenia. (positive symptoms)
Thought insertion= the belief that one’s thought of others are being inseted into one’s mind.
Eg: they make me think bad thoughts. (positive symptoms)
Aphasia= difficulty in the formulation of works; loss of language ability. In extreme cases, a person may be limited to a few words, may babble, or may become mute.
Eg:
Apraxia= Loss of ability to perform purposeful movements.
Eg: a person may be unable to shave, to dress, or to perform other once-familiar and purposeful tasks.
Agnosia= Loss of the ability to recognize familiar objects.
Eg: a person may be unable to identify familiar sounds, such as the ringing of the doorbell (auditory agnosia) or familiar objects such as a toothbrush or keys (visual agnosia)
Confabulation= the filling in of a memory gap with a detailed fantasy believed by the teller. The purpose is to maintain self-esteem. It is seen in organic condition such as Korsakoff’s psychosis.
Akathisia= regular rhythmic movements, usually of the lower limbs; constant pacing may also be seen; constant back and forth motion; often seen in patients taking antipsychotic meds.
Tardive dyskinesia= A serious and irreversible side effect of the phenothiazines (antipsychotic) and consist of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, trunk, or pelvis.
Eg: most frequently in women and older clients. Early symptoms are fasciculation’s of the tongue or smacking of the lips. Most of the time early symptoms are relieved when medication is discontinued. (aims test) pg.410
Pedophilia= involves sexual activity with a prepubescent child. Predator must be at least 16 yrs old and at least 5 yrs older than the victim.
Exhibitionism= intention display of the genitals in public. Done more for the shock value.
Fetishism= a sexual focus on objects such as shoes, gloves, pantyhose, and stockings that are intimately associated with the human body.
Voyeurism= PEEPING TOM need I say more
Impulsivity= Inclined to act on impulse rather than thought.People who are overly impulsive, seem unable to curb their immediate reactions or think before they act. As a result, they may blurt out answers to questions or inappropriate comments, or run into the street without looking. Their impulsivity may make it hard for a child to wait for things they want or to take their turn in games. They may grab a toy from another child or hit when they are upset.(ADHD) SYMPTOMS:
Often blurts out answers before questions have been completed
Often has difficulty awaiting turn
Often interrupts or intrudes on others (such as butting into conversations or games)
Hyperactivity= A higher than normal level of activity. An organ can be described as hyperactive if it is more active than usual. Behavior can also be hyperactive.
People who are hyperactive always seem to be in motion. They can't sit still; they may dash around or talk incessantly. Sitting still through a lesson can be an impossible task. They may roam around the room, squirm in their seats, wiggle their feet, touch everything, or noisily tap a pencil. They may also feel intensely restless.(ADHD) SYMPTOMS:
a. Often fidgets with hands or feet or squirms in seat
b. Often leaves seat in classroom or in other situations in which remaining seated is expected
c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d. Often has difficulty playing or engaging in leisure activities quietly
e. Is often "on the go" or often acts as if "driven by a motor"
f. Often talks excessively
Inattention= symptoms of (ADHD)
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b. Often has difficulty sustaining attention in tasks or play activities
c. Often does not seem to listen when spoken to directly
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
e. Often has difficulty organizing tasks and activities
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as homework)
g. Often loses things necessary for tasks or activities (toys, school assignments, pencils, books, or tools)
h. Is often easily distracted by extraneous stimuli
i. Is often forgetful in daily activities
QUESTIONS THAT MIGHT BE GOOD TO REVIEW
(I took them off of the Evolve website as they pertained to our study questions)
1.A client with paranoid schizophrenia refuses food. He states the voices are telling him the food is contaminated and will change him from a male to a female. A therapeutic response for the nurse would be? "I understand that the voices are very real to you, but I do not hear them."
2.A client with disorganized schizophrenia would have greatest difficulty with the nurse? giving multistep directions. The thought processes of the client with disorganized schizophrenia are severely disordered and severe perceptual problems are present, making it extremely difficult for the client to understand what others are saying. All communication should be simple and concrete and may need to be repeated several times. Text page: 415
3.A client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me." The term "volmers" can be assessed as? a neologism
4. When a client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me," an appropriate response for the nurse would be? "It must be frightening to think something is going to harm you."
5. A client has been receiving antipsychotic medication for 6 weeks. At her clinic appointment she tells the nurse that her hallucinations are nearly gone and that she can concentrate fairly well. She states her only problem is "the flu" that she's had for 2 days. She mentions having a fever and a very sore throat. The nurse should? arrange for the client to have blood drawn for a white blood cell count. Antipsychotic medications may cause agranulocytosis, the first manifestation of which may be a sore throat and flulike symptoms. Text page: 409
6. The purpose for a nurse periodically performing the Abnormal Involuntary Movement Scale (AIMS) assessment on a persistently mentally ill client who has schizophrenia is early detection of? tardive dyskinesia An AIMS assessment should be performed periodically on clients who are being treated with antipsychotic medication known to cause tardive dyskinesia.
Text page: 410
7. Which of the following would be assessed as a negative symptom of schizophrenia? Anhedonia. Negative symptoms include the crippling symptoms of affective blunting, anergia, anhedonia avolition, poverty of content of speech, poverty of speech, and thought blocking.
8. The type of altered perception most commonly experienced by clients with schizophrenia is? auditory hallucinations. Hallucinations, especially auditory hallucinations, are the major example of alterations of perception in schizophrenia. They are experienced by as many as 90% of schizophrenic individuals. Text page: 393
9. Which symptom would be assessed as a positive symptom of schizophrenia? Idea of reference. Positive symptoms are the attention-getting symptoms such as hallucinations, delusions, bizarre behavior, and paranoia. They are referred to as florid symptoms. Affective flattening is one of the negative symptoms that contribute to rendering the person inert and unmotivated.
Text page: 390
10. When a client with schizophrenia hears hallucinated voices saying he is a vile human being, the nurse can correctly assume that the hallucination? is a projection of the client's own feelings. One theory about derogatory hallucinations is that the content is a projection of the individual's feelings about self. The derogatory hallucinations are an extension of the strong feelings of rejection and lack of self-respect experienced by the individual during the prodromal period.
Text page: 394
11. Which event would a client with early (stage 1) Alzheimer's disease has greatest difficulty remembering? What the client ate for breakfast. Initially, recent memory is impaired while remote memory remains intact.
Text page: 435
12. A client has been diagnosed with delirium caused by a metabolic disorder. He begs the nurse to get someone to take away the huge snake in the hallway before it comes into his room. The nurse looks to where he is pointing and sees the hose of the vacuum cleaner being used by the housekeeping staff to clean the hall. The nurse can assess this symptom as? a visual illusion
13. What is the usual course of Alzheimer's disease? Progressive deterioration
14. A client with Alzheimer's disease looks confused when the phone rings and seems not to recognize what the stimulus is. He also cannot recall many common household objects by name, such as a pencil or glass. The nurse can document this as? Agnosia
15. A nursing diagnosis appropriate for a client with Alzheimer's disease, regardless of the stage, would be? risk for injury. Memory loss, agnosia, poor judgment, and the other symptoms of Alzheimer's disease contribute to placing the client at risk for injuries such as burns and falling down stairs.
Text page: 437
16. The nurse caring for a client with Alzheimer's disease can anticipate that the family will need information about therapy with? acetylcholinesterase inhibitors. Memory deficit is thought to be related to a lack of acetylcholine at the synaptic level. Acetylcholinesterase inhibitor drugs prevent the chemical that destroys acetylcholine from acting, thus leaving more available acetylcholine.Text page: 444
17. A client is brought to the hospital by her daughter, who visited this morning and found her mother to be confused and disoriented. The client has difficulty answering the questions asked by the nurse. The daughter reports that her mother had been oriented and able to carry on a logical conversation the evening before. The nurse can suspect that the client is displaying symptoms associated with? delirium. Delirium is characterized by a disturbance of consciousness, a change in cognition (such as impaired attention span), and a fluctuating level of consciousness that develop over a short period of time.
Text page: 423
18. The nurse is expected to perform an assessment of a client suspected to be in the earliest stage of Alzheimer's disease. What finding would the nurse see if the client truly has stage 1 Alzheimer's disease? Confabulation to compensate for forgotten information.During stage 1 Alzheimer's disease the client is aware of memory impairment and may attempt to disguise it or cover it by being evasive or using confabulation.Text page: 432-433
19. Client with Alzheimer's disease can no longer perform hygiene and grooming. She often objects to being led to the shower and does not participate in washing herself. She puts her arms into the legs of her slacks, and so forth. She tests doors and walks through any door that will open. Sometimes she seems unable to find the bathroom and is incontinent. Communication with her is difficult because of the loss of language skills. The nurse would assess the client as being in the stage of Alzheimer's disease labeled? stage 3, moderate-severe. Moderate-severe Alzheimer's disease requires a high level of supervision because of the severe memory loss the client is experiencing. Wandering and inability to meet self-care needs become problematic.
Text page: 435
20. A client with severe and persistent mental illness tells his case manager "I think people are laughing at me behind my back. I get real upset and anxious when I have to be around the others in the group home. It's better when I just stay by myself." The nurse should consider the nursing diagnosis of? social isolation. Social isolation is aloneness experienced by the individual and perceived as imposed by others.
Text page: 577
21. The nurse, working with a client in the partial hospitalization program, seeks advice from the psychiatric clinical nurse specialist to help a client who has auditory hallucinations that make him escalate to a point where he is disruptive to all around him. The clinical nurse specialist would most likely suggest which of the following cognitive interventions for this client? Distracting technique. Strategies have been successfully applied to treat hallucinations, delusions, and negative symptoms, making cognitive interventions an evidence-based practice. For example, distraction techniques can be taught when auditory hallucinations occur, such as listening to music or humming.Text page: 584
22. The mother of a client with severe and persistent schizophrenia tells the nurse "My son has slipped so far away from me over the last few years. We really don't have a relationship anymore. He just sits and stares or walks around and around the perimeter of the yard. He hardly answers when I ask him simple questions. I miss him." The nursing diagnosis the nurse might consider is? grieving. The mother is mourning the loss of her son as she formerly knew him. Grief is a common experience for families with mentally ill members.
Text page: 577
23. Dual diagnosis refers to having a severe mental illness and? substance abuse problem Dual diagnosis is the term used to identify a client with severe mental illness and a substance abuse problem. Both problems must be treated if the client is to be successfully rehabilitated.Text page: 579 and 580
24. An important reason for nurses to identify coexisting or resulting anxiety and anxiety disorders among their clients is? anxiety disorder is a risk factor for development of cerebrovascular disease.
25. A client tells the nurse that her relationship with her terminally ill mother has always been one in which petty animosities got in the way of a harmonious, loving relationship. She states she wishes things could have been different. The nurse could explain to the client the use of? the four gifts. The four gifts refer to simple tools for identifying distress and expressing it in a healthy way by making use of forgiveness, expression of love, gratitude, and saying farewell.Text page: 608
26. Nursing interventions that facilitate the grieving process include? making eye contact and listening attentively Eye contact lets the bereaved know you are there and share their sadness. Patient listening helps the bereaved express feelings, both positive and negative.
Text page: 616 and 617
27. A client tells the nurse "I am worried about my 70-year-old mother. My father died almost 9 months ago, and she is still not her old self. She says she is lonely, but she doesn't do anything about getting out and being with others." The most helpful remark for the nurse would be? At about this time in the grieving process people experience disorganization and aimlessness." Teaching the family about the normal phenomena experienced during bereavement is helpful. This statement is the only option that reflects a fact about the bereavement process. Disorganization, depression, restlessness, and aimlessness precede reorganization of behavior and are generally most pronounced at 6 to 9 months.
Text page: 615
28. Which phase of grief is the acute stage of mourning, when a person begins to feel intense feelings of anguish and despair and may exhibit anger, guilt, and tearfulness? Developing awareness. As awareness develops, the denial prominent in the stage of shock and disbelief fades and painful feelings surface. Text page: 614
29. The family of a deceased individual receives friends for two days at a funeral home and attends a funeral service at the deceased's church. The phase of grief represented in these actions is? restitution. Restitution is the formal, ritualistic phase of mourning that occurs during the acute stage. This phase helps the bereaved shed residual denial in an atmosphere of support.
Text page: 614
30. psychiatric forensic nurse must? demonstrate a broad view of issues facing jail inmates
31. Which skill is central to the role of all forensic nurses? Evidence collection is central to the role of all forensic nurses
32. Correctional nurses frequently work with inmates without knowledge of the? nature of the inmate’s alleged offense.
33. While planning nursing care for an adult with ADHD, the nurse must? include the client as an active participant in his or her care
34. Medication used for the treatment of ADHD in children is the same as is used for adults, but some significant differences exist, including the fact that? adults may require less of a particular medication per pound of body weight. Even though adults are generally larger than children, their kidney and liver function may not be as robust. Furthermore, a given dose of a medication may linger in the adult's system.
35. A client has been diagnosed with gender identity disorder. The nurse can expect that the client will evidence? discomfort with biological gender
36. Medications prescribed to treat insomnia are usually for no more than? 2 weeks b/c of tolerance and withdrawal
37. T reveals to the nurse that his sex life with his wife is unsatisfactory. He mentions "I'm turned on by little girls, not adult women." The nurse can assess this condition as? pedophilia. Fantasies of girls under age 13
38. Disorders that involve variations in sexual behaviors are called? paraphilias.
39. A nurse planning continuing education programs for nursing staff at a multipurpose senior center will plan programs based on the knowledge that one of the most common mental health problems among the elderly is? suicidal ideation
40. The intervention strategy least useful when addressing suicidal ideation in an elderly client is? psychoanalytic psychotherapy. Psychotherapeutic approaches need to be simplified and modified for older clients. Of particular usefulness are crisis intervention techniques, empathetic understanding, encouraging ventilation of feelings, reestablishing emotional equilibrium, explaining alternative solutions, and assisting in the use of problem-solving approaches.Text page: 696-968
41. A nurse is asked to explain the difference between alternative and complementary therapy. The best answer is? Complementary therapy is used in conjunction with conventional Western remedies, whereas alternative therapies replace conventional Western remedies
42. When a nurse is asked to give an example of an alternative medical system, the best example would be? homeopathy.
43. A client tells the nurse he has been taking St. John's wort. On the basis of this information the nurse should gather additional assessment data about? feelings of depression St. John's wort is primarily used by individuals to elevate a depressed mood.Text page: 762
44. Using a minute amount of a substance that produces the same symptom as that of the client's chief symptom to stimulate the body's immune system is the rationale for use of the remedies prescribed in? homeopathy. Homeopathy attempts to stimulate the body's immune system to relieve the client's distress and uses tiny amounts of substances known to produce the symptoms from which the client is experiencing.
Text page: 763
45. The client at the alcohol treatment center tells his outpatient group "I went to an oriental medicine place to see if they could do something to help me stay away from alcohol. I ended up with tiny silver rods placed in various spots in my body. They twirled the rods, then removed them. So far I haven't had any cravings since I went there several days ago." The client is describing? acupuncture. Acupuncture is a Chinese remedy that involves insertion of tiny needles through the skin. The rationale for use of acupuncture is to restore the balance of the body's energy (chi).
46. A client has a prescription for lorazepam for acute anxiety attacks. Which herbal remedy should the nurse caution the client to avoid while taking lorazepam? Kava has significant analgesic and anesthetic properties. Kava may potentate the effects of benzodiazepines and other central nervous system depressants such as alcohol.
Text page: 762
47. A client asks the nurse "Why hasn't any research been done to substantiate the curative effect of homeopathic remedies?" The nurse should reply "Research on homeopathic remedies is difficult because? treatment is individualized, and several clients with the same symptom might receive different treatments
48. The nurse cautions a client about the fact that, when using herbal preparations, the client does not know the actual dose being ingested. What is the basis for this caution? No manufacturing standardization exist
I HOPE THIS HELPS EVERYONE INCLUDING MYSELF!
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