NUR 330 Exam 1 Study Questions and
Correct Answers
Mental health ✅the successful adaptation to stressors from the internal or external
environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate
and congruent with local and cultural norms
Six indicators of mental health ✅1. Positive attitude toward self
-this refers to an objective view of self, including knowledge and acceptance of
strengths and limitations. The individual feels a strong sense of personal identity and
security within his or her environment.
2. Growth, development (see erikson's theoretical models of personality development),
and the ability to achieve self-actualization (see maslow's hierarchy of needs)
-this indicator correlates with whether the individual successfully achieves the tasks
associated with each level of development. With successful achievement in each level,
the individual gains motivation for advancement to his or her highest potential.
3. Integration
-the focus here is on maintaining equilibrium or balance among various life processes.
Integration includes the ability to adaptively respond to the environment and the
development of a philosophy of life, both of which help the individual maintain a
manageable anxiety level in response to stressful situations.
4. Autonomy
-this refers to the individual's ability to perform in an independent, self-directed manner.
He or she makes choices and accepts responsibility for the outcomes.
5. Perception of reality
-accurate reality perception is a positive indicator of mental health. This includes
perception of the environment without distortion, as well as the capacity for empathy
and social sensitivity—a respect and concern for the wants and needs of others.
6. Environmental mastery
-this indicator suggests that the individual has achieved a satisfactory role within the
group, society, or environment, and is able to love and accept the love of others. When
faced with life situations, the individual is able to strategize, make decisions, change,
adjust, and adapt. Life offers satisfaction to the individual who has achieved
environmental mastery.
Maslow's hierarchy of needs ✅
Erikson's stages of development ✅page 551 pocket guide, chp 41 online
Influence of culture and history on mental health ✅1. Primitive beliefs regarding mental
disturbances
-some cultures thought that evil spirits or supernatural or magical powers had entered
the body
,-still others considered that an individual with mental illness may have sinned against
another individual or god
-during the middle ages, the association of mental illness with witchcraft and the
supernatural continued to prevail in europe
-*this was brought over to new england during the colonial time*
Mental illness ✅maladaptive responses to stressors from the internal or external
environment, evidenced by thoughts, feelings, and behaviors that are incongruent with
the local and cultural norms and that interfere with the individual's social, occupational,
and/or physical functioning
Influence of culture and history on mental illness ✅1. Incomprehensibility
-the inability of the general population to understand the motivation behind the behavior
2. Cultural relativity
-the "normality" of behavior is determined by the culture
3. Cultural norms
- the standards we live by
Social stigma (pg. 472) ✅1. Whatever group someone puts a label on, making them
"less worthy"
-not acceptable to our cultural norm
-may result in social isolation
Deinstitutionalization ✅1. The institutions became overcrowded and understaffed, and
conditions deteriorated
2. Residents in hospitals for years; pushed back out into community
Responses to stress ✅1. Anxiety
-a diffuse, vague apprehension that is associated with feelings of uncertainty and
helplessness
-low levels of anxiety are adaptive and can provide the motivation required for survival.
-anxiety becomes problematic when the individual is unable to prevent their response
from escalating to a level that interferes with the ability to meet basic needs.
2. Grief
Peplau's four levels of anxiety (pg. 18) (handout) ✅1. Mild anxiety
-seldom a problem
-prepares people for action. It sharpens the senses, increases motivation for
productivity, increases the perceptual field, and results in a heightened awareness of
the environment. Learning is enhanced, and the individual is able to function at his or
her optimal level.
2. Moderate anxiety
-perceptual field begins to diminish
- extent of the perceptual field diminishes. Individual becomes less alert to events
occurring within the environment. Attention span and ability to concentrate decrease
, and assistance with problem-solving may be required. Increased muscular tension and
restlessness.
3. Severe anxiety
-perceptual field diminishes greatly
-concentration centers on one particular detail only or on many extraneous details.
Attention span is extremely limited; the individual has much difficulty completing even
the simplest task. Physical symptoms may include headaches, palpitations, and
insomnia. Emotional symptoms may include confusion, dread, and horror. Virtually all
overt behavior is aimed at relieving the anxiety.
4. Panic anxiety
-the most intense state
-individual is unable to focus on even one detail within the environment. Misperceptions
are common, and a loss of contact with reality may occur. Hallucinations or delusions
may be present. Behavior may be characterized by wild and desperate actions or
extreme withdrawal. Human functioning and communication with others are ineffective.
Individuals may be convinced that they have a life-threatening illness or fear that they
are "going crazy," are losing control, or are emotionally weak. Prolonged panic anxiety
can lead to physical and emotional exhaustion and can be life threatening.
Behavioral adaptation responses for each level of anxiety (pg. 19, 22, slides 14-23 wk 1
pt 1) ✅1. Mild anxiety
-individuals employ any of a number of coping behaviors that satisfy their needs for
comfort.
2. Mild-to-moderate anxiety
-sigmund freud identified the ego as the reality component of the personality, governing
problem solving and rational thinking.
-as the level of anxiety increases, the strength of the ego is tested, and energy is
mobilized to confront the threat.
-anna freud identified a number of defense mechanisms employed by the ego in the
face of a perceived threat to biological or psychological integrity
-maladaptive use of defense mechanisms promotes disintegration of the ego.
3. Moderate-to-severe anxiety
-anxiety at this level that remains unresolved over an extended period of time can
contribute to a number of physiological disorders.
-measurable pathophysiology can be demonstrated.
4. Severe anxiety
-extended periods of severe anxiety can result in psychoneurotic behavior patterns.
-psychiatric disturbances characterized by excessive anxiety that is expressed directly
or altered through defense mechanisms. Appears as a symptom, such as an obsession,
compulsion, phobia, or sexual dysfunction.
-aware they are experiencing distress
-aware their behaviors are maladaptive
-feel helpless to change their situation
-experience no loss of contact with reality
-neurosis is no longer considered a separate category of mental disorder. However, the
term is still used in the literature to further describe the symptomatology of certain
