ANCC PMHNP Chapter 3 Questions & Answers 2024, Exams of Nursing

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Answers 2024

DSM IV and DSM V - Correct Answers ✅DSM IV: Multi-axial approach DSM V : Emphasis dimensional assessment and aligns diagnosis with ICD codes Therapeutic communications - Correct Answers ✅Mutual, interactive, interpersonal relationship focused on the patient's need, are goal directed, theory based and open to supervision Transference - Correct Answers ✅Displacement of feelings by the client of someone in his or her past onto the PMHNP in the present relationship. Counter transference - Correct Answers ✅Represents the PMHNPs emotional reaction to the patient based on his or her past experiences Faces of therapeutic nurse-patient relationship - Correct Answers ✅Introduction= Orientation Working= Identification and exploitation. Termination= Resolution Introduction - Correct Answers ✅Initial therapuetic stage. Creating boundaries, making plans for the length of therapy, setting up tx goals and planning.

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Working - Correct Answers ✅2nd stage of theraputuic relationship. Implementing tx plan, measuring outcomes and evaluation of goals. This is where transference may play a role. Termination - Correct Answers ✅This is the 3rd stage of a therapeutic relationship. Reviewing client goals and progress towards objectives. Disengaging from the relationship. May have regression or symptoms may reappear. Trust v Mistrust - Correct Answers ✅0-1 year Ability to form meaningful relationships, hope about the future, trust in others. If not achieved you show poor relationships, lack of future hope, suspicious of others. Autonomy v Shame and doubt - Correct Answers ✅1-3 years Self control, self esteem, willpower. If not achieved you show poor self control, self doubt and lack of independence. Initiative v guilt - Correct Answers ✅3-6 years Self directed behavior, goal formation, sense of purpose. If not achieved lack of self initiated behavior, lack of goal orientation.

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Industry v inferiority - Correct Answers ✅6-12 years ability to work, sense of competency and achievement. If not achieved sense of inferiority, difficulty with working and learning. Identity v role confusion - Correct Answers ✅12-20 years Personal sense of identity. If not achieved poor self identification in group settings and identity confusion. Intimacy v isolation - Correct Answers ✅20-35 years Committed relationships, capacity to love. If not achieved Emotional isolation. generativity v self absorption or stagnation - Correct Answers ✅35- 65 years ability to give time and talent to others, ability to grow and change. If not achieved self absorption and inability to care for others. integrity v despair - Correct Answers ✅> 65 years fulfillment and comfort with life, willingness to face death, insight and balance. If not achieved will feel bitterness, sense of dissatisfaction and despair over impending death. Psychodynamic theory - Correct Answers ✅Freud

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intrapsychic conflict among structures of mind Id (I want), ego (I think, I evaluate), superego (I should or ought) all behavior is purposeful and meaningful oral stage - Correct Answers ✅0-18 months the focus is on sucking and swallowing, gratification of oral needssucking, chewing, feeding, and crying linked to schizophrenia, substance abuse, paranoia anal stage - Correct Answers ✅18 - 3 years focus on spontaneous bowel movements, control over impulses, sphincter control, activities of expulsion and retention. linked to depressive disorders phallic stage - Correct Answers ✅3-6 years focus on genital region, identification with parent of the same gender exhibitionism, masturbation with focus on oedipal conflict and castration anxiety linked to sexual identity issues latency stage - Correct Answers ✅6-puberty focus on coping with the environment;

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sexual impulses dormant, peer relationships, learning, socialization linked to issues forming relationships genital stage - Correct Answers ✅puberty and on focus on erotic and genital behavior, developing mature sexual and emotional relationships, integration and synthesis of behaviors from early stages, genital based sexuality linked to sexual perversion disorders Id - Correct Answers ✅"I want", drives urges, instincts, fantasies (hunger, sex, aggression) Operates on the pleasure principle, largely unconscious; desire for immediate and complete satisfaction; disregard for others. Ego - Correct Answers ✅"I think and evaluate" Rational mind, logical and abstract thinking. The reality principle; rational and conscious; weighing of actions and consequences Superego - Correct Answers ✅"I should or I ought to" Conscience and right vs. wrong Regulated by guilt and shame.the censoring force of the personality; conscious and unconscious; evaluating and judging behavior.

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Defense mechanisms - Correct Answers ✅Are a function of the ego, are unconsciously called into action to reduce anxiety, may become part of the personality, may become fixed as in neurosis. Classified as primitive, immature, neurotic and mature Denial ( primitive) - Correct Answers ✅avoidance of unpleasant realities by unconsciously ignoring their existance projection (primitive) - Correct Answers ✅unconscious rejection of unacceptable personal beliefs or feelings by attributing them to others regression (immature) - Correct Answers ✅return to more comfortable thoughts, behaviors, or feelings in earlier stages of development Somatization (immature) - Correct Answers ✅Transferring emotional distress to bodily symptoms (pains and other ailments) undoing (immature) - Correct Answers ✅attempting to make up for or undo an unacceptable behavior Introjection (immature) - Correct Answers ✅Unconsciously taking on another person's values/traits and becoming like that person.

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repression (neurotic) - Correct Answers ✅Considered to be the basis for all defense mechanisms unconscious exclusion of ideas, feelings, and situations that are unacceptable to the self. reaction formation (neurotic) - Correct Answers ✅Substitution of behavior, thoughts, and feelings with ones that are diametrically opposed to unacceptable ones. Often called overcompensation. rationalization (neurotic) - Correct Answers ✅justification of illogical ideas, feelings or actions by developing an acceptable explanation that satifies the person Displacement (neurotic) - Correct Answers ✅Shifting of feelings from an emotionally charged person or object to a substitute, less threatening, person or object. intellectualization (neurotic) - Correct Answers ✅attempts to master current stressor or conflict by expansion of knowledge, explanation or understanding Compensation (mature) - Correct Answers ✅An individual consciously making up for a perceived lack in one area by emphasizing strengths in another

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suppression (mature) - Correct Answers ✅Conscious analog of repression. Conscious exclusion of thoughts, feelings, and situations that produce discomfort and some anxiety (active forgetting) sublimation (mature) - Correct Answers ✅unconscious process of substitution of socially acceptable constructive activity for strong unacceptable impulse. Conscious/unconscious channeling of unacceptable impulses to a primary goal that is socially acceptable altruism (mature) - Correct Answers ✅Conscious use of service to others; doing good for others to reduce or avoid negative feelings about self.Meeting the needs of others in order to discharge drives. Humor (mature) - Correct Answers ✅Using comedy to assuage emotions without producing discomfort for self or others—wit is a form of displacement that deflects emotion onto others Piaget cognitive theory - Correct Answers ✅Human development evolves through cognition, learning, and comprehending thru 4 stages of development

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Sensorimotor (birth - 2 years) - Correct Answers ✅Object permanence - objects have existence regardless of child's involvement with them Preoperational (2-7 year) - Correct Answers ✅Extensive use of language, symbolism, magical thinking Concrete Operations (7-12 years) - Correct Answers ✅Begin to use logic and understand concepts like Reversibility- (water to ice) and Conservation- (clay) Formal operational (12 to adulthood) - Correct Answers ✅Ability to think abstractly, thinking operates in a formal and logical manner. Interpersonal theory (Harry Stack Sullivan) - Correct Answers ✅Behavior occurs because of interpersonal dynamics; the self system is a total of components of personality when individuals need for satisfaction and security is interfered with by the self-system, mental illness occurs. Sullivan's stages of interpersonal development - Correct Answers ✅Infancy 0-18mo: oral gratification. first time anxiety Childhood 18 mo-6 yr: Delayed gratification Juvenile 6-9yr: Forming of peer relationships

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preadolescence 9-12 yr: Same-sex relationships Early adolescence 12-14 yr: Opposite sex relationships Late adolescence 14-21 yr: Self identity developed Hierarchy of needs (Abraham Maslow) - Correct Answers ✅Basic Needs for Self Actualization. Hierarchial organization of needs. Health model rather than illness mode.Survival, Safety and Security, Love and Belonging, Self Actualization. Health belief model (Marshall Becker) - Correct Answers ✅Healthy people do not always take advantage of screeningsor preventive programs due to perception of susceptibility, benefits of tx, barriers to change etc Transtheorectical model of change (Prochaska) - Correct Answers ✅Behavioral change occurs in stages: precontemplation: no intention to change contemplation: thinking of change but no commitment preparation: made the decision and is ready for action action: engaging in actions to change maintenance: preventing relapse

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Self efficacy/social learning theory (Bandura) - Correct Answers ✅Behavior is the result of cognitive and environmental factors learn by observing others and relying on role models. Self-efficacy is the perception of one's ability to perform a certain task at a certain level Theory of cultural care (Leininger) - Correct Answers ✅Regardless of culture, care is the unifying focus and essence of nursing, health and wellbeingcan be predicted through cultural care Theory of self care (Orem) - Correct Answers ✅self care: activities that maintain life, health, and well being Therapeutic Nurse-Client Relationship Theory/Interpersonal Theory (Peplau) - Correct Answers ✅Sees nursing as an interpersonal process in which all interventions occur within the context of nurse- client relationship. Theory of Adaptation (Roy) - Correct Answers ✅Promotion of adaptive responses is the goal of nursing Caring Theory (Watson) - Correct Answers ✅Caring is essential component of nursing