NURS 222 – Final exam with answers 2024

NURS 222 – Final exam with answers 2024

Resilience - ANSWER: ➡ - ability to cope/deal/behave effectively w/ life challenges &
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stressors
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- ability & capacity to secure resources needed to support well-being
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- ability to w/stand & recover quickly from difficult situations
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- essential for recovery from illness
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- closely connected to/characterized by: optimism, sense of mastery, competence
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- attribute of a good psych nurse
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Diathesis-stress model - ANSWER: ➡ - diathesis: biological predisposition/sensibility
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- stress: environmental stress/trauma
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*nature vs nurture m m




Erikson's ego theory - ANSWER: ➡ - (1) trust vs mistrust, ages 0-1.5
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- (2) autonomy vs shame/doubt, ages 1.5-3
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- (3) initiative vs guilt, ages 3-6
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- (4) industry vs inferiority, ages 6-12
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- (5) identity vs role confusion, ages 12-20
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- (6) intimacy vs isolation, ages 20-35
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- (7) generatively vs self-absorption, ages 35-65
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- (8) integrity vs despair, ages 65+
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Peplau's model of nurse-patient relationship - ANSWER: ➡ pre-orientation: prepare to meet
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w/ pt
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m - obtain info about pt from chart, significant others, other healthcare team members
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m - examine own feelings, fears, anxieties about working w/ pt
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,m - gather assessment data
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orientation: DISCUSS CONFIDENTIALITY, establish boundaries & trust
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m - create an environment for trust & rapport
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m - pt's problem is discussed & mutually agreed upon
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m - start planning pt's discharge the moment they are admitted
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m - goals are established
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working: PRACTICE PROBLEM-SOLVING & COPING SKILLS
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m - maintain trust & rapport
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m - promote pt's insight & perception of reality
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m - practice solving problems & coping skills
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m - continuously evaluate progress toward goal attainment
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termination: summarize goals achieved during relationship m m m m m m




m - progress has been made toward attainment of goals
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m - a plan of action for more adaptive coping w/ future situations established
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m - discuss w/ pt changes that happened during relationship & evaluate outcomes
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Rational-emotive behavior therapy (Ellis) - ANSWER: ➡ - aims to eradicate irrational beliefs
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- recognize thoughts that are not accurate
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*targets irrational beliefs & patterns
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Cognitive-behavioral therapy (Beck) - ANSWER: ➡ - tests distorted beliefs & change way of m m m m mm m m m m m m m m




thinking; reduce symptoms
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*identifies distorted thinking & develops better coping mechanisms
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Maslow's hierarchy of needs - ANSWER: ➡ *safety is #1 in psych
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- psych pts stuck in safety, they lack love & belonging
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,5 Principles of bioethics - ANSWER: ➡ - beneficence: duty to promote good (i.e. advocating
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for pt by putting them on a 1 to 1 when having suicidal thoughts)
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- autonomy: respecting rights of others to make their own decisions (i.e. refuse meds, pt has
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the right to say no always)
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- justice: distribute resources/care equally
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- fidelity (nonmaleficence): maintaining loyalty & commitment; doing no wrong to a pt (i.e.
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can't restrain pt just bc they're annoying you, etc)
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- veracity: one's duty to always communicate truthfully
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Restraints - ANSWER: ➡ - physical: hand mitts, limb restraints, belts, vests
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- chemical: benzodiazepines, antipsychotics (chemical less restrictive than physical)
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- indications: when pt poses imminent danger to themselves or others; only when least
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restrictive methods haven't worked (verbal interventions, therapeutic communication,
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redirection, calm environment)
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- only use as last resort, SELF-DESTRUCTIVE BEHAVIOR DESPITE ALTERNATIVE
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INTERVENTIONS
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- can place pt in restraints first then call MD for order: in an emergency situation, must obtain
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written order w/in 15-30 mins
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- TIME LIMITS:
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m - >/= 18yrs = 4hrs
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m - 9-17ys = 2hrs
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m - </= 8yrs = 1hr
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- assess circulation at least every 15 mins; ensure-the receives fluids/food, VS, ROM, toileting
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q2hrs
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- document every 15-30 mins
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- pt on restraints = 1 to 1 observation
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Nurse/pt relationship - ANSWER: ➡ - to establish that nurse is: safe, confidential, reliable,
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consistent, establish trust & rapport
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- relationship w/ clear boundaries
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- needs of pt identified & explored
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, - new coping skills developed
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Therapeutic communication - ANSWER: ➡ - use active listening: SOLER (sit, open/observe,
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lean forward, eye contact, relax)
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- always establish trust, security, & rapport (priority)
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- no why questions
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- open-ended (how, what, tell me, could)
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- restating (so are you saying that...?)
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- don't feed into delusions/challenges
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- always supportive, never give advice
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- typically beginning on nurse's part (it sounds like, it appears, it looks like...)
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Schizophrenia - ANSWER: ➡ - symptoms present for at least 6 months m m mm m m m m m m m m m




- >2 symptoms present for at least 6 months, behavior disrupts social &/or occupational
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environment
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- ALWAYS RULE OUT PHYSIOLOGICAL CAUSES (electrolyte imbalance, hypoglycemia,
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substance)
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- positive & negative symptoms must be present in order to diagnose
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SCHIZOPHRENIA - Phases - ANSWER: ➡ Prodromal: initial decline from normal functioning m m m m mm m m m m m m




m - may arise months or yrs before first hospitalization
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m - clear change from previous level of functioning
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m - bizarre, paranoid behavior
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m - withdraws from friends, hobbies, interests
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m - neglects personal hygiene & grooming
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Acute phase aka active: must be hospitalized during this stage
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- commonly triggered by stressful events, & begins to have psychotic symptoms
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(hallucinations, delusions, incoherence, catatonic behavior)
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m - overall goal is pt safety & stabilization
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