Mental Health Exam #1

A client is angry at his doctor, does not express it, but becomes verbally abusive with the nurse.

A woman says her former friend which she previously described as perfect and wonderful is now an evil, hateful person.

A child integrates their parent’s values by saying to a friend, “Don’t cheat. It’s wrong.”

A 12-year-old boy starts wetting the bed after the death of his father.

A young man is late for class. He tells the professor, “Sorry, I’m late for class, but my stupid wife forgot to set the alarm last night.”

Nancy was emotionally abused as a child and hates her mother. However, when she talks to others about her mother she tells them how wonderful she is and how much she loves her.

Pete grew up in a rough neighborhood where fighting was a way of coping. He is tough and aggressive and is noticed by the football coach, who makes him a member of the team. Within a year, he becomes a star player.

Fred stops at the bar every night after work and has several drinks. During the past 6 months, he has been charged twice with driving under the influence, both times while driving recklessly after leaving the bar. Last week he was stopped again. The judge ordered rehab services. Fred responded, “I don’t need rehab. I can stop anytime I want to!”

An adult describes severe sexual abuse experienced as a child but does it without feeling. She says that the experience was as if she were outside her body watching the abuse.

John tells the nurse, “I drink because it’s the only way I can deal with my bad marriage and terrible job.”

Janice is extremely upset when her boyfriend of 2 years breaks up with her. Her best friend tries to encourage her to talk about the breakup, but Janice says, “No need to talk about him anymore.       He’s history.”

A physically handicapped boy is unable to participate in football, so he compensates by becoming a great scholar.

Joe is nervous about his new job and yells at his wife. On his way home, he stops and buys her flowers.

Susan’s husband is being transferred with his job to a city far away from her parents. She hides her anxiety by explaining to her parents the advantages associated with the move.

Jennifer, age 18, can recall nothing related to an automobile accident in which she was involved 8 years ago in which both of her parents were killed.

A teenager who required lengthy rehabilitation after an accident decides to become a physical therapist as a result of his experiences.

A woman is unable to swallow food after surviving a brutal, sexual attack.

This form of exposure therapy, exposes the patient to a hierarchy of feared situations that the patient has rated from least to most feared. The patient is taught to use relaxation techniques at each step when anxiety becomes overwhelming.

With ?, exercises for breathing or muscle groups are taught. This elicits the opposite of the stress response and results in reduced heart rate, respiratory rate and less tense muscles.

is a method that exposes the patient to a large amount of an undesirable stimulus in an effort to extinguish the anxiety response. The client learns through prolonged exposure that survival is possible and the anxiety diminishes spontaneously.

is a type of therapy in which the individual is taught to control thought distortions that are considered to be a factor in the development and maintenance of emotional disorders

With the use of ?, the therapist or significant other acts as a role model to demonstrate appropriate behaviors in a feared situation, and then the patient imitates it.

The technique of ?, involves interrupting a negative thought or obsession. The patient may be instructed to say “Stop” out loud when the idea comes to mind or to snap a rubber band worn on the wrist. This distraction briefly blocks the automatic undesirable thought and cues the patient to select an alternative, more positive idea.

An emotional response to anticipation of danger, the source of which is largely unknown or unrecognized

Name the levels of anxiety

This level of anxiety is normal in everyday living

This level of anxiety is when mild anxiety escalates

This level of anxiety is when the perceptual field is greatly reduced

This level of anxiety is when the individual is unable to process what is happening and can lose touch with reality

What is crucial for patients with Severe/Panic level anxiety?

Is anxiety objective or subjective?

How are anxiety and fear distinguished from one another?

When is anxiety considered abnormal or pathological?

Name the epidemiological statistics of Anxiety:

This disorder is characterized by:
»recurrent panic attacks-onset of which is unpredictable
»manifested by intense apprehension
fear or terror
»often associated with feelings of impending doom
»accompanied by intense physical discomfort.

Name symptoms of panic attack

The DSM-5 states you must have how many symptoms to identify a panic attack?

This disorder is characterized by chronic, unrealistic, and excessive anxiety and worry for at least 6 months

Name a comorbidity of Generalized Anxiety Disorder (GAD)?

Name factors that predispose a person to Panic and GAD:

This is a theory in which a person has faulty, distorted, or counterproductive thinking patterns

In anxiety disorders what happens to the neurotransmitters serotonin and GABA?

Fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of panic-like symptoms or other incapacitating symptoms.

A persistent, intensely felt, and irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the feared stimulus.

Excessive fear of situations in which the affected person might do something embarrassing or be evaluated negatively by others

Name the theories on predisposing factors of phobias

Name some medical conditions that may produce anxiety symptoms

What are phobias NOT related to?

Benzodiazepines are used for anxiety. What do they do to GABA?

More GABA does what?

The locus of control goes hand in hand with what?

When you believe that you have a part in the outcome of events in your life what locus of control is this?

When you believe that you have no control over anything in your life what locus of control is this?

The locus of control theory may be an important variable in the development of what?

Intrusive thoughts that are recurrent and stressful in OCD are the ?

Repetitive ritualistic behaviors or mental acts that the individual feels driven to perform, which are intended to reduce the anxiety are the ?

Name comorbid mental disorders that accompany Body Dysmorphic Disorder

What are the theories predisposing factors to OCD and related disorders?

Name patient/family education techniques

Name treatment modalities for anxiety, OCD, and related disorders

Name two types of behavioral therapy

What is the first line drug of choice for anxiety (temporary)?

Name some benzodiazepines

Name an anxiolytic that is best for long-term use

Why is buspirone (BuSpar) better for long-term use?

Name medication classes used for panic and GAD

Name medication classes used to treat Phobias

Name medication classes used for OCD and body dysmorphic disorders

Name medications used for hair-pulling disorder

Nursing interventions to educate patients regarding medication

Name some SSRI's (Selective Serotonin reuptake inhibitors)

What is substance-induced anxiety disorder?

Early experiences may set the stage for phobic reactions later in life:

Characteristics with which one is born that influence how he or she responds throughout life to specific situations (e.g., innate fears)