NSG 526 EXAM 2 LATEST 2024-2025 WITH ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS ALREA, Exams of Nursing

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NSG 526 EXAM 2 LATEST 2024-2025 WITH ACTUAL

QUESTIONS AND CORRECT VERIFIED ANSWERS

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Group Therapy primary purpose - ANSWER-The primary purpose of group therapy is to facilitate changes by the patient to address identified problems. A technique for dealing with an over talkative client and silence from other participants in a group during therapy - ANSWER-make an observation about the group's silence and invite the others to comment the technique of "Information Giver". - ANSWER-During group members sharing methods they personally use for dealing with problems CBT - ANSWER-consists of active questioning, homework assignments, and dream survey. The therapist helps the patient consider personal ideas and beliefs in order to increase the patient's realization about how thoughts influence behaviors. Attachment - ANSWER-Attempts to explain the dynamics of interpersonal relationships between humans. A child needs to form a relationship between at least one primary caregiver. Mileu - ANSWER-Milieu therapy requires consideration of the client's social, economic, and cultural status.

Complementary Alternative Medicine vs Western major difference - ANSWER- Western medicine focuses on what is done to the patient whereas CAM focuses on mind-body interactions. Beck - ANSWER-Beck developed the cognitive model of depression and the concept that cognitive processing distortions underlie psychological disorders ACTIVE, TIME-LIMITED APPROACH depression can be understood via schemas: - ANSWER-Beck; cognitive errors, and the cognitive triad (i.e., negative views of self, tendency toward interpreting experiences in a negative manner, and holding negative views of the future). Beck assumption - ANSWER-Distorted thinking contributes to and maintains bheavior (symptoms) Ellis - ANSWER-RET (Rational Emotive Therapy) a form of cbt ret - ANSWER-unrealistic and irrational beliefs cause many emotional problems. The purpose of RET is to identify an irrational belief and dispute it through active, philosophical, confrontational therapy. RET assumption - ANSWER-People make themselves sick anytime they escalate a desire or preference into a demand or absolute must. (People become who they become based on their beliefs). Skinner - ANSWER-operant conditioning

Imparting information - ANSWER-Yaslom: While this is not strictly speaking a psychotherapeutic process, members often report that it has been very helpful to learn factual information from other members in the group, for example, about their treatment or about access to services. Corrective recapitulation of primary family experience - ANSWER-Yaslom: Members often unconsciously identify the group therapist and other group members with their own parents and siblings in a process that is a form of transference specific to group psychotherapy. The therapist's interpretations can help group members gain understanding of the impact of childhood experiences on their personality, and they may learn to avoid unconsciously repeating unhelpful past interactive patterns in present-day relationships. Development of socializing techniques - ANSWER-Yaslom: The group setting provides a safe and supportive environment for members to take risks by extending their repertoire of interpersonal behavior and improving their social skills. Imitative behavior - ANSWER-Yaslom: One way in which group members can develop social skills is through a modeling process, observing and imitating the therapist and other group members. For example, sharing personal feelings, showing concern, and supporting others. Cohesiveness - ANSWER-Yaslom: Is the primary therapeutic factor from which all others flow. Humans are herd animals with an instinctive need to belong to groups, and personal development can only take place in an interpersonal context. A cohesive group is one in which all members feel a sense of belonging, acceptance, and validation. Existential factors - ANSWER-Yaslom: Learning that one has to take responsibility for one's own life and the consequences of one's decisions

Catharsis - ANSWER-Yaslom: The experience of relief from emotional distress through the free and uninhibited expression of emotion. When members tell their story to a supportive audience, they can obtain relief from chronic feelings of shame and guilt. We refer to catharsis as "getting things off our chest." Interpersonal learning - ANSWER-Yaslom: Group members achieve a greater level of self-awareness through the process of interacting with others in the group, who give feedback on the member's behavior and impact on others Self-understaning - ANSWER-Yaslom: This factor overlaps with interpersonal learning but refers to the achievement of greater levels of insight into the genesis of one's problems and the unconscious motivations that underlie one's behavior. Autocratic leader - ANSWER-exerts control over the group and does not encourage much interaction among members. For example, staff leading a community meeting with a fixed, time-limited agenda may tend to be more autocratic Democratic leader - ANSWER-supports extensive group interaction in the process of problem solving. Psychotherapy groups most often employ this leadership style Laissez-faire leader - ANSWER-allows the group members to behave in any way they choose and does not attempt to control the direction of the group. In a creative group, such as an art group, the leader may choose this style of leadership, giving minimal direction to allow for a variety of responses Primary purpose of group therapy - ANSWER-(1) human beings are social animals, and (2) that we heal in community. This is why group therapy is so

Milieu benefit bipolar - ANSWER-Seclusion room- comfort and relief for those that are out of control. Reduces overwhelming environmental stimuli Protects a client form injuring self, others, or staff Prevents destruction of personal property or property of others Milieu benefit depression - ANSWER-The client with depression needs protection from suicidal acts and a supervised environment for regulating treatments. Often, being removed from a stressful interpersonal situation increases therapeutic value. Milieu benefit anxiety - ANSWER-Structuring the daily routine to offer physical safety and predictability, thus reducing anxiety over the unknown Providing daily activities to promote sharing and cooperation Providing therapeutic interactions, including one-on-one nursing care and behavior contracts Including the client in decisions about his or her own care Organization to help learn more about complementary and alternative medicines - ANSWER-National Institutes of Health (NIH) established the National Center for Complementary and Alternative Medicine (NCCAM) in

Acupuncture. - ANSWER-The term "acupuncture" describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

health is achieved by maintaining the body in a "balanced state"; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Herbal therapies advantages - ANSWER-echinacea (immune stimulant and anti- infection agent); garlic (antihypertensive and antibiotic); ginger (anti-nauseant and antispasmodic); ginseng root (increased stamina and decreased fatigue); kava kava (calming effect); and St. John's wort (anxiolytics and antidepressant). Therapeutic touch - ANSWER-useful in relieving premenstrual syndrome, depression, complications in premature babies, and secondary infections associated with human immunodeficiency virus (HN) infection; lowering blood pressure; decreasing edema; easing abdominal cramps and nausea; resolving fevers; and accelerating the healing of fractures, wounds, and infections. Concurrent use of SSRI and St. John's Wort - ANSWER-No, risk of serotonin syndrome Yoga as a treatment approach - ANSWER-People use yoga for a variety of conditions and to achieve fitness and relaxation. Dolores Krieger and use of therapeutic touch - ANSWER-Dolores Krieger, a nursing professor at New York University healing is promoted by balancing the body's energies. practitioners focus completely on the person receiving the treatment, without any other distraction. Practitioners then assess the energy field, clear and balance it through hand movements, and/or direct energy in a specific region of the body. The therapist does not physically touch the client. After undergoing a session of therapeutic touch, clients report a sense of deep relaxation.

The client's fear is broken down into its components by exploring the particular stimulus cues to which the client reacts. The client is incrementally exposed to the fear. The client is instructed in how to design a hierarchy of fears. The client practices these techniques every day. Approach to patient wanting to use CAM to treat his health conditions - ANSWER-studies in the field are minimal when compared to those of conventional medicine. no standards or regulations that guarantee the safety or efficacy of herbal products. Consumers may waste a great deal of money and risk their health on unproven, fraudulently marketed, useless, or harmful products and treatments. Another concern regarding CAM therapies is that diagnosis and treatment may be delayed while clients try alternative interventions, which is common with mental health symptoms such as major depression and anxiety. Research on herbs such as St. John's wort, valerian, and ginkgo biloba and mind-body interventions such as yoga and meditation is extensive, and results are available on the NCCAM website. Cognitive distortions - ANSWER-schemas can be conceptualized as stored bodies of knowledge that interact with incoming information to influence selective attention and memory search schema is an abstract cognitive plan that serves as a guide for interpreting information and solving problems schema as "the basis for molding data into cognitions, defined as nay verbal or pictoral content schema is dormant until activated by a relevant stimulus DBT - ANSWER-tx designed specifically for individuals with self harm behaviors, self cutting, suicide, etc.

three modes of dbt - ANSWER-individual, skills group (mindfullness, interpersonal effectiveness (ie), emotional regulation (er), distress tolerance (dt), telephone crises management, contract to call therapist for suicide or self harm behaviors piaget - ANSWER-theory of cognitive development children move through 4 difference stages of mental development. sensorimotor- birth to 2 yearspreoperational- 2 - 7 yearsconcrete operational- 7 - 11 yearsformal operational- 12 plus piaget assumption - ANSWER-Assumption: children construct their own knowledge in response to their experiences. Learn many things on own without intervention, children are intrinsically motivated to learn Ainsworth - ANSWER-theorist that studied types of attachment by use of the strange situation test strange situation test - ANSWER-Gradually subjecting a child to a stressful situation and observing his or her behavior toward the parent or caregiver. This test is used to classify children according to type of attachment—secure, resistant, avoidant, or disorganized/disoriented. Yalom - ANSWER-existential psychotherapy is an attitude toward human suffering and has no manual. Asks deep questions about the nature of the human being and nature of anxiety/despair/grief/loneliness/isolation. Questions meaning of love, creativity. Primary purpose of group therapy. - ANSWER-group therapy helps promotes and enhances understanding of one's self, overcome fears, undesirable thoughts, and feelings and adopt new behaviors.

person can lift the member's self esteem and help develop more adaptive coping styles an interpersonal skills Interpersonal learning. - ANSWER-it occurs when group members learn from one another. it involves exchange of feedback on relational styles through the rational experiences that occur in the here and now of the group. Overgeneralization - ANSWER-affects people with depression or anxiety disorders. way of thinking where you apply one experience to all experiences, including those in the future. Ex. i once gave a poor speech, therefore I always screw up speeches. secure attachment- ainsworth - ANSWER-a relationship in which an infant obtains both comfort and confidence from the presence of his or her caregiver caregiver: reacts quickly and positively to the childs needs. Child- distressed when caregiver leaves, happy when return, seek comfort when scared or sad. insecure-avoidant attachment - ANSWER-a pattern of attachment in which an infant avoids connection with the caregiver, as when the infant seems not to care, no distress, no acknowledgement about the caregiver's presence, departure, or return. Child- dismissive, doesn't seek or make contact with caregiver insecure-ambivalent- anxious attachment - ANSWER-responds to child inconsistently. distress when caregiver leaves, not comforted by return of caregiver. a smaller portion of infants experienced greater levels of distress and upon reuniting with the parents, seemed both to seek comfort and to attempt to "punish" the parents for leaving

insecure-disorganized attachment - ANSWER-a pattern of attachment in which an infant seems confused or apprehensive and shows contradictory behavior, such as moving toward the mother while looking away from her. Abusive, neglectful, responds in frighening ways. No attaching behaviors, often appear dazed, confused or apprehensive in presence of caregiver. Children- no particular pattern of attachment. Effective group leader - ANSWER-Leaders must have skills in communicating effectively, listening actively, working with people, and helping others work together in groups. Leaders must have integrity and honesty. ... True leaders focus on helping their group achieve its goals rather than on their own personal recognition. Paradoxical directive - ANSWER-an instruction by a therapy professional toward the client to do exactly the opposite of what common sense would guide one to do in effort to show the irrationality or self-defeating nature of the patient 's initial intent. Paradoxical directive or instruction (Strategic Family Therapy) - ANSWER- Prescribe the symptomatic behavior so a client realizes he or she can control it; uses the strength of resistance to change in order to move client toward goals Strategic Therapy - ANSWER-is any type of therapy where the therapist initiates what happens during therapy and designs a particular approach for each problem."

• The strategic therapist becomes actively involved and responsible in helping clients turn their lives around, in helping them strategically plan, execute, and measure "game winning" outcomes. Identify solvable problems Set goals Design interventions to achieve those goals

Can form attachments to more than one person, develops gradually It results in the infant wanting to be with the person who is perceived as stronger, wiser, able to reduce stress and anxiety. Gives the infant a feeling of security The amount of time spent together is less important than the amount of activity between the two. Harry Harlow - ANSWER-was able to show with monkeys: Isolating monkeys from birth led to behaviors that were withdrawn, unable to relate to peers, unable to mate, and incapable of caring for their offspring Pre-attachment stage - ANSWER-(birth to 8-12 wks)- babies orient to their mothers, follow them with their eyes over a 180 degree range, and turn towards mothers voice. Attachment in the making - ANSWER- 8 - 12 wks - 6 months. Infants become more attached to one or more persons in the environment. Clear-cut attachment - ANSWER- 6 - 24 months. Infants show signs of distress when separated from caretaker or mother. Can occur as early as 3 months. Insecure-avoidant - ANSWER-Tends to avoid close contact with people andlingers near caregivers rather than approaching them directly. Insecure-ambivalent- - ANSWER-child finds exploratory play difficult, even in the absence of danger, clings to his or her inconsistent parents. Insecure-disorganized - - ANSWER-Children in this case have parents who are emotionally absent with a parental history of abuse in their childhood,

Albert Ellis' Rational Emotive Therapy - ANSWER-People control their own destinies and interpret events according to their own values and beliefs. A-B-C theory - ANSWER-Activating event, belief, consequences (emotional and/or behavioral) Ellis- RET Forms of irrational beliefs - ANSWER-Something should be different/Something is awful or terrible/One cannot tolerate something/Something or someone is damned or cursed. Ellis-RET "Masturbatory" ideologies have 3 forms: - ANSWER-I must do well and win approval or I am a rotten person/You must act kindly toward me or you are a rotten person/My life must remain comfortable or life hardly seems worth living. Ellis-RET Therapy consists of... for RET - ANSWER-Therapy consists of detecting and eradication irrational beliefs, Disputing: Detecting irrationalities, debating them, discriminating between logical and illogical thinking, and defining what helps create new beliefs. Debating: Questioning and disputing the irrational beliefs. Discriminating: Distinguishing between wants and needs, desires and demands, and rational and irrational ideas. Defining: Defining words and redefining beliefs. Assumption of RET - ANSWER-People make themselves sick anytime they escalate a desire or preference into a demand or absolute must. (People become who they become based on their beliefs).

Sensorimotor stage - ANSWER-birth to 2 years Preoperational stage: - ANSWER-ages 2- 7 Concrete operational stage: - ANSWER-ages 7 to 11 Formal operational stage: - ANSWER-ages 12 and up Possible outcomes for patients with Schizophrenia when conducting a symptom management group - ANSWER-found that skills training programs produce moderate but significant improvement in social functioning (ES = 0.52) and negative symptoms (ES = 0.40) and reduce hospitalization rates over a 1- to 2 - year follow-up period Reinforcement while conducting group therapy - ANSWER-Positive behavior is rewarded and motivated. Rules are established by the therapist that specifies behaviors to be rewarded. This technique is based largely on behaviorism. Tokens for example are used to note a reward; accumulated tokens are then rewarded with an established reward Silent Sam - ANSWER-With such clients the goal is to find a way to get all members, especially those who are less verbal, to participate in all group sessions. "Mary, we haven't heard from you tonight." "Mary, I noticed that you haven't said much tonight. How has your week gone?" "Bill has just shared his frustrations with the group. Mary, I know you've said you felt frustrated insimilar situations. What advice can you give Bill?" [This example directly targets a silent client by asking him or her to offer advice or suggestions to another client.]

Late laura - ANSWER-Although most clients who come late to groups are aware of their behavior, some fail to understand the effect their behavior has on the group. Having the group respond to such clients is more likely to result in changes (e.g., coming to subsequent groups on time) than is being told they are late by group leaders. The following responses would be used only with clients who are repeatedly late or who miss several group meetings. "This is the third time Mary has been late. What suggestions can the group provide to help her get here on time?" "I'm wondering how others feel about Mary being late for group several times." [Although this response is more direct than the first example, open discussion of some issues can increase members' sensitivity to their own behavior, as well as help them understand how their behavior affects the entire group.] Tommie THerapist - ANSWER-Such clients may have been attending a group for several sessions, or they may have considerable prior therapy experience. At times, such clients' interactions in groups will parallel those of a therapist. Although such advice can sometimes be helpful to group members, on other occasions the advice can be disruptive or too direct. "Bill, your comments have been helpful. Let's see how others view Mary's concerns." "Bill, that is one way of looking at how Mary can handle the situation. What additional options canothers offer Mary?" Chatty Cathy and Monopolizing Mike - ANSWER-Such clients dominate group discussions. Group leaders need to find effective ways to interrupt such clients, as they are often unaware of the impact that their behavior has on the group. A strategy that group leaders can use when a Chatty Cathy client is talking is to direct questions to the group as a whole. For example: "Bill, it sounds like a lot has happened with you this week. I am wondering what has happened with other group members." (The group leader then calls on another member.) "Mary, how did your week go?"