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How is health defined?
A changing state that is influenced by genetics, behavior and the environment.
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Who is considered a mentally healthy adult?
A person who can cope with and adjust to the recurrent stresses of daily living in an acceptable way.
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When does a mental illness occur?
When one�s problems are so overwhelming they are unable to carry out ADLs or function independently and develops maladaptive behaviors.
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What are the 7 principles of mental health?
Do no harm; accept client as whole; develop trust; explore behaviors and emotions; encourage responsibility; encourage effective adaptation; provide consistency.
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What is the responsibility of the care provider in a mental health setting?
To protect clients
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What is one of the barriers in recovering from a mental illness?
The social stigma the clients experience
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What is the foundation of therapeutic relationships?
Trust
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What are the three concepts for the development of trust between client and caregiver?
Caring, empathy, and advocacy
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When are many clients willing to share themselves?
When they have trust and the caregiver is willing to listen
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How can we simply understand the meaning of the clients behavior?
Don�t be afraid to ask the pt why they are behaving a certain way
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What is a primary mental health intervention?
Encouraging responsibility
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What happens when the client assumes responsibility for basic needs?
It helps build self-worth, dignity, and confidence
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How can a care provider encourage responsibility?
Give the pt a task
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Who is responsible for cooperating and following a plan of care?
The pt
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What is the principle of acceptance?
Allowing others to be who they are without passing judgement
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What is most important when planning therapeutic interventions?
Master the first item before proceeding to more complex steps
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What do all mental health clients have in common?
Unsuccessful coping behaviors
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What is an example of psychomotor coping behaviors?
Confrontation, fighting; cope directly with the problem
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What is an example of cognitive coping behaviors?
Reading, problem-solving methods; neutralize threat by changing meaning of the problem
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What is an example of affective coping behaviors?
Groups, suppression; reduce emotional distress but does nothing to solve the problem
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What is the main goal of crisis intervention?
Help pts & families by offering immediate emotional support
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Why is control important in a crisis?
Without it, the pt can�t be helped to work with problems that triggered the crisis
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What is introspection?
Analysis of self
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How does one practice professional introspection?
By jotting down questions relating to the care of pts, or anything one would like to know more about
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What is personal introspection?
Process of learning who you are
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What do we accept when we accept a pt?
The pt as a person, but not the behavior
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No matter what the setting or circumstances, what must caregivers be committed to providing?
Competent health care
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What does behaviors consist of?
Perceptions, thoughts, feelings and actions
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What is self-commitment?
A promise to do one�s best in very situation
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What is professional commitment?
Seeking out new knowledge
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What is completed in the assessment phase of the nursing process?
Data relating to the client are collected from every possible source
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What is completed in the 2nd step of the nursing process?
Each problem is examined and nursing diagnoses and interventions are developed
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What takes place during the planning phase of the nursing process?
Short & long term goals and the written care plan is developed
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What is objective data?
Data that can be measured and shared
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What is subjective data?
Data that relates to the clients� perceptions
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Why are physical assessment skills important to the data gathering process?
They are used to gather data, investigate changes in physical conditions, an evaluate the effectiveness of therapeutic interventions
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How is data documented?
Accurately and just as you see t
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When is a physical assessment warranted in a mental health client?
When changes in the client�s condition is noticed
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What is the purpose of a physical assessment in the mental health client?
To discover physical problems that can be treated medically
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A nurse who is caring for a mentally ill client establishes a supportive and honest relationship with the client and maintains client confidentiality. What principle of mental health care is this an example of?
Develop mutual trust
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A mentally ill client begins to argue and hit another client because of a money dispute. What coping behavior is this client using?
Psychomotor
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After a suicidal client has been appropriately discharged from an inpatient mental health unit, the nurse recommends continued tx with the client�s outpatient psychiatrist. What guideline for crisis intervention is this an example of?
Follow-up
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What defines self-awareness?
Consciousness of one�s personality
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A nurse who is caring for a depressed client understands the significance of the client�s depression as well as the overwhelming grief and loss issues felt by the client. What is this an example of?
Empathy
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An anxious client refuses to eat with other clients in the dining room. The nurse recognizes the importance of nutrition and offers to serve the client�s meals in the client�s room. What is this an example of?
Advocacy
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What research-based practices is a valuable source of stress reduction for health care providers?
Meditation
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What is the ability to clearly see and understand the nature of things?
Insight
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The nursing (therapeutic) process is designed to support goal-directed care for clients. Which of the following steps is included in the five-step process?
Diagnosis
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A nurse reviews the pt�s medical record to obtain health info. Which step of the nursing process is this?
Assessment
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What assessment methods assists with the formulation of a nursing diagnosis based on the identification of factors that potentially may threaten a client?
Risk factor assessment
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A nurse gathers info about a Spanish pt�s education, culture, and belief system. What assessment method is used?
Sociocultural assessment
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What components of the health history would be most important to obtain for a client with alcohol dependence?
Family history
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A male client with Alzheimer�s is asked to remember what he ate for breakfast this morning. What type of memory is being assessed?
Recent
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To assess a client�s ability to think abstractly, which of the following would be appropriate to ask of the client?
�What does it mean when someone says, �when it rains, it pours.�?�
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What is the client�s emotional display of the mood that he or she is experiencing?
Affect
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What is immediate memory referred to as?
Recall
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Which memory includes events within the past two weeks?
Recent
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A nurse is working with three depressed pts in group therapy. She yawns and keeps looking at her watch during the therapy time. Which nontherapeutic communication technique is used?
Failure to listen
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A female client wants to discuss her history of sexual abuse as a child. The nurse tells her not to talk about it. Which nontherapeutic communication technique is used?
Rejecting
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A suicidal client is talking to a nurse. The client states that he has a plan to kill himself. The nurse asks why he has not already put the plan into action. Which nontherapeutic communication technique is used?
Challenging
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What is disturbed communication?
Unsuccessful interactions that result from an interference in the sending or receiving of messages, inadequate master of the language being used, insufficient information, or no opportunity for feedback
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What is transactional analysis?
The process of investigating hat people say and do to each other
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What is structural analysis?
The study of the personality
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What is the main goal of transactional analysis?
To establish the most open and authentic communication possible between the affective and intellectual components of the personality
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What 5 factors influence communication?
Social class, relationships, perceptions, values, and parts of the message
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What is verbal communication?
Speaking, writing, the use of language & symbols, and the arrangement of words or phrases
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What is nonverbal communication?
Communication expressed as appearance, body motions, use of space, and nonlanguage sounds
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What can effective listening do?
Identify hidden messages and agendas, minimize misunderstandings, and clarify messages
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Why should the care provider not use the word why in a question?
It requires a response that justifies one�s actions or opinions
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What is nontherapeutic communication?
Messages that hinder effective communication
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What is listening?
Active process of receiving info and examining reactions to messages received
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What is a broad opening?
Encouraging the client to select topics for discussion
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What is restating?
Repeating the main thought expressed by the client
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What is clarification?
Attempting to put into words vague ideas or unclear thoughts of client; asking client to explain what he means
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What is reflection?
Directing back pts ideas, feelings, questions and content
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What is humor?
Discharge of energy through comic enjoyment
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What is informing?
Skill of information giving
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What is focusing?
Questions or statements that help pt expand topic
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What is theme identification?
Underlying pt issues or problems that emerge repeatedly during caregiver-client reationships
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What is sharing perceptions?
Asking pt to verify caregiver�s understanding of client�s message
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What is silence?
Lack of verbal communication for therapeutic reason
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What is suggesting?
Presenting alternative ideas for client�s consideration relative to problem solving
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What is failure to listen?
Placing own thoughts above client; not being involved in communication
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What is failure to explore pts point of view?
Does not ask client to describe abstract words such as pain, angry, sick
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What is failure to probe?
Does not seek clarification or validation from client
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What is eliciting vague descriptions?
Does not encourage client to explain or expand message
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What is giving inadequate answers?
Does not collect enough data to answer pts questions accurately
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What is parroting?
Continuous repeating of client�s words
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What is following standard forms too closely?
Using a question-and-answer format to elicit specific info
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What is being judgmental: giving approval or disapproval, agreeing or disagreeing?
Many responses that tell clients that they must think as you do
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What is giving advice?
Telling clients what to do
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What is being defensive?
An attempt to protect something or someone
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What is challenging?
Inviting or daring client to explain, act or complete
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What is giving reassurance?
Messages that negate feelings or areas of concern
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What is rejecting?
Refusal to discuss feelings or areas f concern
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What is using stereotyped responses?
Using clich�s, popular sayings, or trite expressions
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What is speech cluttering?
Rapid, confused delivery of unrhythmic speech patterns
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What is aphasia?
Inability to speak
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What is dyslexia?
Mixing of letters or syllables in a word
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What is trust?
Risk-taking process whereby an individual�s situation depends on the future behavior of another person
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What is autonomy?
The ability to direct and control one�s activities and destiny
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What is caring?
The energy that allows caregivers to unconditionally accept all people
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What is a vital part of the therapeutic relationship?
Caring
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What does the concept of hope involve?
The future
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What is needed for hope to be achievable?
It must be realistic, possible and personally significant
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What is empathy?
The ability to understand the emotions, viewpoints and situations of another
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What is the affective dimension of hope?
The emotional aspect of hope
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What is the affiliative dimension of hope?
Focuses on how hope is related or interwoven; seeking or receiving help
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What is the behavioral dimension of hope?
Actions or behaviors that may make the hoped-for situation come true
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What is the cognitive dimension of hope?
The process of thinking through and analyzing hope
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What is the temporal dimension of hope?
Experience of time as it relates to hope; past, present, future
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What is the contextual dimension of hope?
One�s personal life situation as it relates to hope
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How does a caregiver develop acceptance?
Accept the person, not the behavior or attitude
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What takes place during the preparation phase of the therapeutic relationship?
Goals are to establish a client database and assess your own feelings regarding the client
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What is the goal of the orientation phase of the therapeutic relationship?
To build trust and establish the caregiver as significant in the life of the client; caregiver and client agree to work with each other
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What is the focus of the working phase of the therapeutic relationship?
To achieve goals in the client-caregiver agreement
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What takes place during the termination phase of the therapeutic relationship?
Goals are met
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When do steps toward termination begin?
Before the last meeting
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How does a caregiver act as a change agent?
By providing an accepting atmosphere that values the contributions of each individual
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When are teaching opportunities available in the mental health environment?
From instructing about ADLs to major lifestyle changes
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What does the technician focus on in the mental health environment?
Holistic care
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How are all care providers like therapists?
They use every opportunity to assist their clients
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What environmental problems do mental health pts face?
Lack of privacy, inappropriate meeting place, uncomfortable furniture, lighting or temp
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What is countertransferrence?
Inappropriate emotional responses to the client
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What is transference?
Client�s emotional response to the caregiver
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What is crisis stabilization?
Interventions provided by placing client in 1- or 2-day tx settings where balance is reestablished
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What is the goal of crisis therapy?
To help clients successfully cope with crisis
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When is the inpatient environment necessary?
When people cannot function sufficiently to satisfy their basic needs
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What can flickering lights trigger?
Delusions or hallucinations
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What relationship refers to a consciously-directed exchange that is focused on moving the client toward more constructive ways of thinking?
Therapeutic relationship
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What can light that is too bright cause?
Overstimulation and aggressive behaviors
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The ability to share in a client�s life is defined by what term?
Empathy
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What qualities must be communicated to a pt in order to establish a therapeutic relationship?
Genuineness
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A female client asks how any children the nurse has, and the nurse answers. The nurse then focuses on the client by asking her how many children she has. What concept is this consistent with?
Therapeutic use of self
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What is a regressive client response to the termination of a therapeutic relationship?
Returns to previous maladaptive behavior
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Establishing a working caregiver-client relationship is a step in what phase of the therapeutic relationship?
Orientation
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A nurse becomes hostile and angry with a pt who has sexually abused a child. What is this an example of?
Countertransference
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A nurse responds empathetically when a depressed client discusses the recent death of his wife. Which dimension of a therapeutic intervention is this an example of?
Affective
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A certain setting, or environment, designed to help clients replace inappropriate behaviors with more effective personal and psychosocial skills defines which of the following?
Therapeutic environment
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A depressed client threatens to kill himself and tells a friend his plan. The client should be admitted to which of the following?
Inpatient unit
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A client is emotionally distraught over an impending divorce and is unable to cope effectively. Which of the following interventions would be most appropriate for this client?
Crisis stabilization
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Which of the following is a goal of a therapeutic environment?
Educate
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A hospitalized client who is paranoid believes that all food served in the hospital is poisoned. An appropriate intervention by the nurse is which of the following?
Allow client to observe other clients eating the same food.
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Which of the following is a lower-order need that must be fulfilled before self-esteem needs can be met?
Sleep
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Which of the following is included in a mental health admission assessment?
Orientation
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What is the process of actively interacting with the environment and those persons within it?
Involvement
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