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GEORGETTE REVIEW EXAM Questions with Correct Answers Latest Updates 2024.pdf, Exams of Nursing

GEORGETTE REVIEW EXAM Questions with Correct Answers Latest Updates 2024.pdf

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Download GEORGETTE REVIEW EXAM Questions with Correct Answers Latest Updates 2024.pdf and more Exams Nursing in PDF only on Docsity! When many answers are remarkably similar, they are usually โœ”โœ” GEORGETTE REVIEW EXAM Questions with Correct Answers Latest Updates 2024 wrong Interprofessional collaboration is encouraged. โœ”โœ” Collaborate is usually right. Delegate is usually wrong. ADPIER โœ”โœ” Assessment, diagnosis, Plan, intervention, evaluate, refer out last. Lithium โœ”โœ” Normal 0.6-1.2 Lithium toxicity occurs at levels โœ”โœ” > 1.5 Signs of Lithium toxicity โœ”โœ” severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait Lithium is gold standard for โœ”โœ” MANIA Lithium has evidence shown to โœ”โœ” reduce suicidal ideation What does lithium cause in neonate, especially 1st trimester โœ”โœ” Ebstein anomaly (congenital heart defect) dehydration and hyponatremia cause lithium levels to โœ”โœ” rise Baseline labs before initiation of lithium โœ”โœ” TSH creatinine (0.6-1.2) BUN (10-20) HCG (all psychotropics females 12-51) EKG 50+ Urinalysis (check for proteins, 4+ may indicate kidney disease) Side Effects of Lithium โœ”โœ” hypothyroidism coase hand tremors with toxicity maculopapular rash diarrhea, vomiting, cramps--signs of toxicity. Monitor closely. anorexia t wave inversions leukocytosis Pt education for lithimum โœ”โœ” staying hydrated Clozaril only known antipsychotic to โœ”โœ” decrease risk of suicide in patients with schizophrenia. Your patient with bipolar disorder is admitted to a medical hospital. The internist contacts your office and asks whether the lithium you prescribed him is effecting his ECG. How do you respond? A. Lithium can prolong the QT interval B. Lithium has no effect on his ECG C. Lithium can invert the t waves D. Lithium can shorten the PR interval โœ”โœ” Answer: Lithium can invert the t waves. Mary is a 45-year-old African American female who has been treated on Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is strictly contraindicated with Isocarboxazid? A. Morphine B. NSAIDS C. Methylphenidate D. Acetaminophen โœ”โœ” Answer: Methylphenidate You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client needs to discontinue treatment? A. WBC less than 1800 and ANC less than 1200 B. ANC less than 1,000 C. WBC less than 5,000 D. ANC less than 2000 โœ”โœ” Answer: ANC less than 1000 If given during pregnancy, socium valproate can cause which of the following medical problems in the baby? A. SJS B. Ebstein's anomaly C. Spina bifida D. Cleft palate โœ”โœ” A. Spina bifida Which mood stabilizer is associated with potential life-threatening rash in the Asian population? A. Carbamazepine (tegretol) B. Depakote C. Lithium D. Lamictal โœ”โœ” A. Carbamazepine Bulimia, weight is โœ”โœ” within the normal range. Pharm treatment for bulimia โœ”โœ” Fluoxetine SSRIs and TCAs effective in reducing binging and purging Signs of anorexia nervosa โœ”โœ” low BMI Amennorrhea Emaciation Bradycardua Hypotension Pharm treatment for anorexia โœ”โœ” there is none therapy Which of the following physical exam findings would help the PMHNP differentiate anorexia nervosa from bulimia nervosa? A. Russell sign B. Low BMI C. Erosion of dental enamel D. Hypertrophy of salivary glands โœ”โœ” Low BMI If a patient is depression, low energy, fatigued, you would prescribe โœ”โœ” Wellbutrin Wellbutrin is contraindicated in patients with โœ”โœ” seizure disorder or conditions that increase risk of seizures such as eating disorder. Which of the following medications has a unique mechanism that is both a norepinephrine and dopamine reuptake inhibitor? A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Clomipramine (Anafranil) D. Duloxetine (Cymbalta) โœ”โœ” bupropion CLozaril is metabolized by โœ”โœ” cytochrome P450 enzyme CYP1A2 INducers โœ”โœ” induce metabolism and therefore decrease serum levels of other drugs that are substrates Smoking will do what to drug levels โœ”โœ” decrease therapeutic levels of the drug Bull Shit CRAP GPS Induces my rage โœ”โœ” Barbituates St. Johns Wart Carbamazepine Rifampicin Alcohol Phenytoin Griseofulvin Phenobarbital Sulphonylureas higher Inhibitors โœ”โœ” inhibit metabolism and therefore increase levels of the drug. SICKFACES.com for Inhibitors โœ”โœ” Sodium valproate Isoniazid Cimetidine Ketoconazole Alcohol Chloramphenicol Erythromycin Sulfonamine Cipro Omeprazole Metronidazole Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with clozapine a. 2D6 b. 1A2 c. 2C19 d. 2C9 โœ”โœ” 1A2 (want A 2 cigarette break) When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? A. Decreased body fat B. Increased liver capacity C. Decreased protein binding D. Increased muscle concentration โœ”โœ” Decreased protein binding For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium and the thiazide diuretic has induced: A. hypokalemia B. hyponatremia C. Increased renal clearance of lithium D. Decreased renal clearance of lithium โœ”โœ” A. decreased renal clearance of lithium Where is norepinephrine produced โœ”โœ” locus coeruleus and medullary reticular formation Norepinephrine is associated with โœ”โœ” mood disorders If your patient is a smoker you will need doses of their medication. โœ”โœ” the PMHNP should apply his knowledge that these symptoms represent problems with the A. frontal lobe B. Temporal lobe C. Parietal lobe D. Occipital lobe โœ”โœ” frontal lobe Impairments in the clock drawing test can be associated with โœ”โœ” damage to the right parietal lobe What part of the brain is responsible for regulating emotions? A. Wernicke's area B. Occipital lobe C. Hippocampus D. Parietal lobe โœ”โœ” Hippocampus Limbic system responsible for โœ”โœ” emotions and memory Hypothalamus โœ”โœ” appetite, hunger, water balance, circadian rhythms, libido, hormonal regulation thalamus โœ”โœ” sensory relay for smell emotions, memory, and regulated affective behaviors amygdala โœ”โœ” regulated emotion mediates mood emotional memories/meanings, fear, anxiety, stress emotion, aggression substantia nigra โœ”โœ” motor movements amygdala= โœ”โœ” emotional memory Which of these brain structures puts emotional meaning on a stimulus, forms, emotional memories and is involved with rage and fear โœ”โœ” amygdala A client presents with complaints of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. What is the neuroanatomical areas off the brain that is responsible for the regulation of these functions? โœ”โœ” Hypothalamus Which serotonin receptor antagonism makes an antipsychotic "atypical" โœ”โœ” 5HT2A Excess dopamine in this area causes positive schizophrenic symptoms โœ”โœ” meoslimbic pathway decreased dopamine leads to negative symptoms of schizophrenia โœ”โœ” mesocortical pathway Increased blockade of dopamine here leads to EPS โœ”โœ” nigrostriatal pathway Blockade of dopamine in this pathway can lead to increased prolactin levels โœ”โœ” tuberoinfundibular pathway Muscle spasms ninth face, neck, tongue, back/neck muscles โœ”โœ” acute dystonia Oculogyric crisis, which can lead to permanent injury. Patients have prolonged involuntary upwards deviation of the eyes bilaterally. โœ”โœ” Rare presentation of acute dystonia. Pharm treatment for dystonia โœ”โœ” cogentin (IM first then oral) Restlessness, inability to sit still. Pacing. Mistaken for anxiety. โœ”โœ” Akathisia Commonly used rating scale for akathisia is โœ”โœ” Barnes Akathisia rating scale and extrapyramidal symptom rating scale. Treatment for akathisis 1st line 2nd line 3rd line โœ”โœ” 1st: beta blocker 2nd: Cogentin 3rd: bnzodiazepine Absence of movement or difficulty initiating movement โœ”โœ” akinesia Treatment: cogentin Presence of symptoms of Parkinson's produced by D2 blockade in the nigrostriatal pathway โœ”โœ” Pseudo-Parkinsonism Signs of Parkinsons โœ”โœ” muscle rigidity shuffling gait mask like facial expression pill rolling tremors cogwheel rigidity Treatment for pseudo parkinsonism โœ”โœ” cogentin Involuntary abnormal muscle movement of the mouth tongue face and jaw that may progress to limbs. Can take 1-2 years to occur. โœ”โœ” Tardive dyskinesia Signs of tar dive dyskinesia โœ”โœ” lip smacking protrusion of the tongue chewing motion facial dyskinesia involuntary movement. Treatment for TD โœ”โœ” Stop offending antipsychotic, reduce the dose, or switch to clozapine. COGENTIN WORSENS IT Ingrezza or Austedo approved Non-psych med that can cause TD โœ”โœ” Reglan A patient has been treated for the past several years with fluphenazine (Prolixin). You tonic that he is drooling and has a slight pill rolling movement of the fingers. These are EPS symptoms known as A. pseudo parkinsonism b. anticholinergic effects C. Tardive dyskinesia D. Acute dystonia โœ”โœ” A. Pseudoparkinsonism A patient is diagnosed with schizophrenia. Which of the following would be the appropriate question for the PMHNP to ask when assessing side effects produced by dopamine antagonism in the nigrostriatal pathway? A. Are you experiencing constipation? B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression? C. Are you experiencing increased thirst? D. Are you experiencing breast discharge? โœ”โœ” Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression Fetal alcohol syndrome โœ”โœ” Everything is low low weight, small features of the face. Which if the following antidepressants is associated with the most cardiovascular side effects? โœ”โœ” Citalopram--causes QT prolongation What the body does to drugs? โœ”โœ” Pharmacokinetics What the drug does to the body โœ”โœ” pharmacodynamics Component of Folstein/mini mental status โœ”โœ” I would like you to could backwards from 100 by 7s or do serial 7s Folstein/mini mental status registration/ability to learn new material โœ”โœ” repeat after me, bed, bat, ball Suiciidal risk factors โœ”โœ” previous attempt Male 45+ Female 55+ Divorced, single, separated white living alone psychiatric disorder physical illness substance abuse family history recent loss male gender Characteristics of therapeutic relationship โœ”โœ” Genuineness Acceptance Nonjudgment Authenticity Empathy Respect Professional boundaries displacement of feelings for significant people int he client's past onto the PMHNP โœ”โœ” transference Nurses's emotional reaction to the client based on past experiences. โœ”โœ” Countertransference Sarah presents for her initial intake appointment with complaints of depression. She is being treated for hypertension and asthma by her primary care provider. Knowing that certain medications can cause or exacerbate depression, you obtain a complete medication history. Which of the following medications is known to exacerbate or cause depression? A. Omeprazole B. Propranolol C. Levothyroxine D. Clarithromycin โœ”โœ” Propranolol A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of manic symptoms and insomnia. Your patient has been stable on lithium for the past six months To determine if a medication change or increase is warranted, it is important to gather more information. You suspect a possible medication-induced manic episode when the patient endorses what? A. She was recently placed on a beta blocker for anxiety. B. She was recently prescribed a benzo C. She recently had a flare up of her rheumatoid arthritis and received treatment for one week (aka a steroid) D. She recently began a new retroviral agent for hepatitis โœ”โœ” recently treated for RA Scale to test for alcohol withdrawal โœ”โœ” CIWA Score on CIWA that warrants PRN โœ”โœ” greater than 8 Medication that will make patient physically ill if combined with alcohol โœ”โœ” disulfiram (Antabuse) Antabuse shouldn't be taken for at leas after drinking โœ”โœ” 12 hours. Signs and symptoms of alcohol withdrawal โœ”โœ” N/V/D tremors sweats anxiety agitation tactile disturbances auditory disturbances visual disturbances headache altered sensorium agitation Rating scale of opiate withdrawal โœ”โœ” COWS Signs and symptoms of opioid withdrawal โœ”โœ” yawning, irritability, pupillary dilation piloerection muscle aches lacrimation rhinorrhea Treat COWS when score is greater than โœ”โœ” 7 Moderate withdrawal on COWS โœ”โœ” 13-24 Moderate withdrawal on CIWA โœ”โœ” scoring 15 Treatment for COWS โœ”โœ” Buprenorphine (Suboxone) Treatment for CIWA โœ”โœ” scheduled meds plus diazepam SBIRT stands for โœ”โœ” Screening, Brief Intervention, and Referral to Treatment SBIRT FRAMES โœ”โœ” Feedback--tell them about their risk of their current alcohol use Responsibility--reinforce their responsibility for change Advice--based on facts about their drinking, offer simple and direct advice Menu--provide a menu of options for behavior change Empathetic interviewing--consider their perspective. Be non-judgemental Self-efficacy--encourage person to believe they can change. CAGE screening tool โœ”โœ” cut down, annoyed, guilty, eye opener Acute onset altered level of consciousness inattenion poor prognosis--1 year mortality rate of is up to 40% โœ”โœ” delirium Treatment of choice for delirium โœ”โœ” haloperidol Avoid which class in delirium as it tends to prolong it โœ”โœ” benzos impaired executive functioning, impaired problem solving, impaired organizational skills, altered memory. slow onset โœ”โœ” dementia John is a 58 year old male patient with Bipolar 1 disorder and has been stable for 5 years on valproate and Seroquel. He was recently started on Flonase by his primary care. As the PMHNP, you are concerned that the addition of the Flonase may cause A. A hypertensive crisis B. SJS C. NMS D. a manic episode โœ”โœ” a manic episode A 16-year off boy presents with a long head, large ears, and hyper extensible joints, is very shy, and starts rocking and flapping his hands when he is upset. Which of the following is your most likely diagnosis? A. Tourette disorder B. Autism C. Fragile X D. Rett disorder โœ”โœ” Fragile X What muscle relaxant is recommended to be used in treatment of NMS? A. Bromocriptine Moderate level on the MMSE โœ”โœ” 10-20 Moderate level on the HAM-D โœ”โœ” 14-18 Moderate level on the PHQ-9 โœ”โœ” 10-14 Moderate level on the Beck โœ”โœ” 10-29 Moderate on GAD 7 โœ”โœ” 10-14 Moderate on COWS โœ”โœ” 13-24 Moderate on CIWA โœ”โœ” 15 Dementia is characterized by onset. โœ”โœ” gradual Alzheimers is cortical or subcortical dementia โœ”โœ” cortical Cortical dementia causes โœ”โœ” language and memory problems. Examples of subcortical dementia โœ”โœ” Huntington's disease Parkinson's disease AIDS dementia complex Which type of dementia can cause depression, motor symptoms, and apathy โœ”โœ” subcortical Cognitive decline (concentration, attention), motor abnormalities(lack of coordination, ataxia, tremors, dystonia, muscle rigidity) and behavioral abnormalities (HIGH YIELD) โœ”โœ” dementia r/t HIV Recurrent visual hallucinations Parkinson features Adversely reacts to antipsychotics โœ”โœ” Lewy body dementia---recurrent visual hallucinations. caused by cardiovascular disease. Common in hypertension and CVD โœ”โœ” vascular dementia Hallmark signs of vascular dementia โœ”โœ” carotid bruits, fundoscopic abnormalities, and enlarged cardiac chambers Personality, language (slurred) and behavioral changes โœ”โœ” Picks disease --frontal lobe changes Huntington's disease โœ”โœ” subcortical, think motor symptoms High incidence of depression nd psychosis First line agent for psychotic symptoms of dementia โœ”โœ” antipsychotics avoid benzos A 69 year old man with diagnosis of delirium has symptoms of psychosis which include frightening auditory and visual hallucinations and paranoid delusions. Which of the following medications should be chosen first for this man's symptoms? A. Haloperidol B. Quetiapine C. Valium D. Olanzapine โœ”โœ” haloperidol. An 81 year old female with a history of vascular dementia is brought to the hospital for increased agitation and UTI. Which of the following features most distinguishes the effects of delirium from dementia? A. Altered level of consciousness B. Behavioral disturbances C. Cognitive deficits D. Language difficulties โœ”โœ” altered level of consciousness What is the best treatment for AIDS dementia complex A. Acetylcholinesterase inhibitors B. Symptom targeted pharmacologic treatments C. Nonpharmacologic supportive care D. Antiretroviral therapy โœ”โœ” Antiretroviral therapy. Aimed at deceasing the number of new cases โœ”โœ” primary prevention Any form of screening is what Level of prevention โœ”โœ” secondary Aimed at decaying disability and severity โœ”โœ” tertiary decreased effects of the same dose over time โœ”โœ” tolerance tendency of some regions of the brine to react to repeated low-level bioelectrical stimulation, by progressively boosting synaptic discharges, thereby lowering seizure threshold (alcohol and benzos) โœ”โœ” kindling Where in the brain are abnormalities found causing ADHD โœ”โœ” frontal cortex --high yield basal ganglia abnormalities in the reticular activating system Neurotransmitters involved in ADHD โœ”โœ” DNS dopamine norepineph serotonin ADHD causes DNS โœ”โœ” dopamine noreip serotonin Hallmarks of ADHD โœ”โœ” persistent pattern of inattention or hyperactivity, impulsivity, or both. What to check prior to prescribing a stimulant? โœ”โœ” cardiac history, family history of CVD and get an EKG prior to starting Amphetamines are approved in children as young as โœ”โœ” 3 Signs of stimulant abuse โœ”โœ” insomnia tremors heart palpiations increased BP and HR Rating scale for ADHD โœ”โœ” Connors and Vanderbilt Must monitor in two settings Hallmarks of borderline personality disorder โœ”โœ” impulsivity with self-damaging behavior Recurrent suicidal behavior Treatment for Borderline โœ”โœ” DBT Hallmarks of antisocial personality โœ”โœ” reckless disregard for welfare of others lack of remorse indifference to the feelings of others INCREASED HOMICIDAL IDEATION --HIGH YIELD Primarily in girls normal development then decline loss of purposeful hand movements stereotypic hand movements --flapping of hands deceleration of head growth โœ”โœ” Rett syndrome Chronically moody, sad irritable for no reason โœ”โœ” Disruptive mood dysregulation disorder When T4 and T3 are low, and TSH is high โœ”โœ” hypothyroidism Hypothyroidism mimics โœ”โœ” depression hyperthyroidism mimics โœ”โœ” mania sensitive to cold, cold intolerant โœ”โœ” hypothyroid heat intolerant โœ”โœ” hyperthyroid Normal AST and ALT โœ”โœ” AST 5-40 ALT 5-35 with liver damage ALT โœ”โœ” rises to 50x normal Argues with authority โœ”โœ” oppositional defiant disorder defiant but not aggressive โœ”โœ” oppositional defiant disorder treatment for ODD โœ”โœ” therapy Person is aggressive, lack of remorse, destruction of property, deceit or theft โœ”โœ” conduct disorder treatment for conduct disorder โœ”โœ” target mood and aggression. person has sudden: blindness, mutism, paralysis, paresthesia, neurological symptoms โœ”โœ” conversion disorder emotional or behavioral reaction to a stressful event or change in person's life within 3 months of it happening. โœ”โœ” adjustment disorder A male patient informs as adult PMHNP that he has not slept in three days, has poor concentration, and denies fatigue. The patient's diagnosis is: A. ADHD B. Bipolar disorder C. Panic disorder D. Primary insomnia โœ”โœ” bipolar disorder The neuroprotective treatment of choice for bipolar disorder is โœ”โœ” lithium According to the current clinical guidelines for treating a patient with bipolar I disorder mania with psychotic features, an adult psychiatric and mental health nurse practitioner prescribes: A.) Lithium B. Citalopram C. Lamotrigine D. Quetiapine โœ”โœ” quetiapine intrusive reexperiencing of a traumatic event โœ”โœ” PTSD symptoms of PTSD โœ”โœ” hyperarousal, avoidance of stimuli associated with trauma, intrusive symptoms Pharm treatment for pTSD โœ”โœ” SSRI (Zoloft) TCA Prazosin AVOID BENZOS Risk factors for OCD โœ”โœ” first degree relative and PANDAS--associated with strep infection, Tourette's โœ”โœ” At least 2 motor tics and at least one vocal tic have been present. Cause of tourettes โœ”โœ” dopamine --hyperactivity of the dopamine system. use of external agents that mimic disease (patient ingests foreign body) โœ”โœ” factitious disease excessive worry more than 6 months โœ”โœ” GAD Age of onset of schizophrenia in males โœ”โœ” 18-25 Age of onset of schizophrenia in females โœ”โœ” 25-35 Cause of schizophrenia โœ”โœ” intrauterine insults prenatal exposure to toxins, including viral agents Problem in the brain in schizophrenia โœ”โœ” enlarged ventricles, everything else decreases Things to monitor and labs while on antispychotic โœ”โœ” serum glucose, serum lipid panel, weight, BMI, waist to hip ratio. liver and kidney function CBC non-harm treatment for schizophrenia โœ”โœ” ACT (assertive community treatment) Person has psychotic symptoms similar to schizophrenia as well as mood symptoms seen in depression and bipolar โœ”โœ” schizoaffective trust vs mistrust โœ”โœ” birth to one year virtue in trust vs mistrust โœ”โœ” hope autonomy vs shame and doubt โœ”โœ” early childhood 1-3 years virtue for autonomy vs shame and doubt โœ”โœ” will (they seek will power, independence) Inititiative vs. guilt โœ”โœ” late childhood 3-6 years virtue of initiative vs guilt โœ”โœ” purpose Ability to be a self-starter, to initiate one's own activities. Industry vs inferiority (VERY HIGH YIELD) โœ”โœ” school age 6-12 years Industry vs inferiority virtue โœ”โœ” competence Identity vs role confusion โœ”โœ” Adolescence 12-20 identity vs role confusion virtue โœ”โœ” fidelity personal identity unfavorable: they're confused over who they are. Initimacy vs isolation โœ”โœ” Early adulthood 20-35 Intimacy vs isolation virtue โœ”โœ” love Generativity vs stagnation โœ”โœ” middle adultgood 35-65 years generatively vs stagnation virtue โœ”โœ” care key event: parenting integrity vs despair (VERY HIGH YIELD) โœ”โœ” late adulthood greater than 65 years integrity vs despair virtue โœ”โœ” wisdom fulfillment and comfort with life method that uses journaling, cognitive restructuring โœ”โœ” cognitive therapy. Who invented DBT โœ”โœ” Marsha Linehan used for borderline personality disorder Goal of DBT โœ”โœ” reduce suicidal behaviors Emphasizes accepting freedom and making responsible choices โœ”โœ” existential therapy well suited to those facing issues of existence, for example those with terminal illness, those contemplating suicide, or going through transition in life Goal: focus on present and personal responsibility focus on a. patient's subjective world โœ”โœ” Existential therapy therapy that is person centered self-directed growth self-actualization โœ”โœ” Humanistic therapy therapy that focuses on interpersonal issues causing distress to understand manage relationship problems โœ”โœ” interpersonal therapy therapy used for PTSD Goal: achieve adaptive resolution relate trauma from a negative thought to a positive thought โœ”โœ” EMDR process providing a personal with visual or auditory information about the autonomic physiologic functions of his or her body. โœ”โœ” biofeedback Family systems therapy (VERY HIGH YIELD) โœ”โœ” triangles, triangulation, self- differentiation triangles are not good for the family Structural family therapy โœ”โœ” boundaries, hierarchies Strategic therapy โœ”โœ” paradoxical intervention--tell the family member that they can worry for one hour of the day. Solution focused therapy โœ”โœ” miracle question patient attributes their own unacceptable thoughts feelings, and motives onto another person โœ”โœ” projection redirection of an impulse (usually aggression) onto a powerless substitute target โœ”โœ” displacement displace our unacceptable emotions onto behaviors which are constructive and socially acceptable, rather than destructive healthy defense mechanism โœ”โœ” sublimation concentrating on intellectual aspects to avoid emotional aspects of a difficult situation. Ex, cancer patient reading up on their disease โœ”โœ” Intellectualization Justification for an uncceptable behavior โœ”โœ” rationalization Yalom's Curative Factors โœ”โœ” - Altruism: giving of oneself to help others - Catharsis: relieving of emotions by expressing one's feelings - Universality: recognizing shared feelings and that one's problems are not unique - Existential factors: address accepting the fact that respons. for change comes from w/in oneself - Self-understanding: discovering and accepting unknown parts of oneself - Family reenactment: understanding what is was like growing up in one's family through group exp. - Guidance: accepting advice from other members - Identification: benefiting from imitation of the positive behaviors of other group members - Instillation of hope: experiencing optimism through observing improvement of other members - Interpersonal learning: occurs when receiving feedback from grp members re: one's bx (input), learning successful ways of relating to group members (output) study of long term sequel of adverse childhood events found โœ”โœ” positive relationship between heart disease, obesity, DM, unintended pregnancy, depression, anxiety, cancer, COPD, sleep disorders, dissociative disorders, and substance use disorder. Dialectical behavioral therapy (DBT) draws on cognitive theory and behavioral theory, along with other theories. Elements of behavioral therapy in DBT include which of the following? A. Skills training and exposure B. Examination of feelings and relating feelings to visceral sensations C. Working through the transference with the therapist D. Cognitive interpretation of past traumatic events. โœ”โœ” A skills training and exposure treatment approach that does not focus on full symptom resolution but emphasizes resilience and control over problems and life. Recovery isn't about getting rid of the problem, but recognizing and fostering their abilities, interests, and dreams. โœ”โœ” Recovery Model Goals of Assertive COMMUNITY Treatment โœ”โœ” help people become more independent and integrate into the community reduce reliance on hospitals providing around the clock care. NP Core Competencies โœ”โœ” Scientific Foundations Leadership Quality Practice Inquiry Technology and Information Literacy Policy Health Delivery System Ethics Independent Practice who identifies our scope of practice โœ”โœ” state board of nursing if board of nursing is an answer, to verify information ........... โœ”โœ” it is usually the correct answer. Reporting your coworker to the board of nursing ......... โœ”โœ” is usually the incorrect answer. standard or quality of practice is determined by โœ”โœ” American Nurses Association How many releases of information are required to release information on patients chemical and psychiatric care to a third party โœ”โœ” 2 Exceptions to confidentiality โœ”โœ” patient revels an intent to harm self or others. answering court orders, subpoenas, or summonses Tarasoff principal โœ”โœ” duty to warn competency โœ”โœ” legal term, we can not determine competency. we can determine their capacity care is provided on a fair and equal basis โœ”โœ” justice do no harm imminent danger โœ”โœ” nonmaleficience promoting well being and doing good โœ”โœ” beneficence