Exam 3: NU 160 / NU160 (2026–2027 Updated Edition) Mental Health Concepts | Comprehensive Q&A | Verified Solutions | 100% Accurate | Grade A – Galen

…..DLDD Exam 3: NU 160 / NU160 (2026–2027 Updated Edition) Mental Health Concepts | Comprehensive Q&A | Verified Solutions | 100% Accurate | Grade A – Galen Q. What are antipsychotics used to treat? ANSWER Schizophrenia, acute mania, resistant bipolar(manic-depressive), paranoid, and movement disorders Q. Some common antipsychotics include ANSWER Haloperidol, apiprazole, risperidone, clozapine Q. Positive symptoms of schizophrenia include ANSWER Delusions, illusions, hallucinations Q. Positive symptoms of schizophrenia, how are they caused? Do they respond well to meds? ANSWER -caused by TOO much dopamine -no brain size change -do respond well to meds Q. Negative symptoms of schizophrenia include: ANSWER Anergia(lack of energy) Anhedonia(inability to be happy) Apathy(no care for anything) Avolition(unable to choose or exert own will) Flat affect(no emotional response) Will not speak unless spoken to Q. Negative symptoms of schizophrenia, how are they caused? Do they respond well to meds? ANSWER -too LITTLE dopamine -brain changes: decreased in brain size and blood flow, increased ventricle size -do not respond to meds Q. 1st Gen(typical)antipsychotics side effects include stronger SE such as Extrapyramidal effects(Parkinson's like)such as ANSWER Neuro malignant syndrome tardive dyskinesia dystonia Akathisia Akinesia Dyskinesia Anticholinergic effects Q. Akinesia ANSWER Absence of movement Q. Akathisia ANSWER Inability to sit still Q. 2nd gen(atypical) antipsychotics side effects include less risk of strong SE but more likely to cause ANSWER Metabolic side effects such as Wt gain Hyperglycemia Dyslipidemia Agranulocytosis Q. 1st gen antipsychotics treat which symptoms of schizophrenia? ANSWER Positive symptoms Q. 2nd gen antipsychotics treat which symptoms of schizophrenia? ANSWER Negative symptoms Q. What are Extrapyramidal Side Effects(EPSE) ANSWER Abnormal involuntary movement that occur bc of imbalance between dopamine and ach. Usually caused by high potency antipsychotics such as haldol Q. Anticholinergic effects ANSWER Dry mouth, blurred vision, urinary retention Caused by less potent antipsychotics such as chlorpromazine Q. Tardive dyskinesia ANSWER Irreversible side effect of long term use, repeated movement of face, trunk, arms, and legs lip smacking, teeth grinding Q. Agranulocytosis ANSWER Associated with clozapine. Deficiency of granulocytes in blood making pt susceptible to infection. Wbc should be performed weekly Q. NMS(neuromalignant syndrome) cause ANSWER Fatal side effect of antipsychotics High risk when 2+ psychotherapeutic drugs are combined Q. S/S of NMS ANSWER High body temp(up to 108F) sudden change in LOC Rapid onset in rigid muscles Respiratory difficulty, tremors, inability to speak. Q. Paranoid schizoprenia ANSWER Organized delusions of auditory hallucinations, high anxiety level, guarded, suspicious, hostile, a dry, violent, late onset good prognosis Q. Catatonic schizophrenia ANSWER Psychomotor problems, immobility or excessive activity with no purpose, odd movements, rigid movement, mute or echolia(echoes others speech) automatic obedience, malnutrition, dehydration, exhaustion Fair prognosis Q. Disorganized schizophrenia ANSWER Disordered thinking speech, and behavior. Flat or inappropriate emotion, distorted facial expression, giggles/cries out, withdrawn, unable to perform adls, onset early prognosis is poor. Q. There are many overlapping characteristics in which two phases of schizophrenia ANSWER Prodromal and residual Q. Prodromal phase of schizophrenia ANSWER Begins with withdrawal, lack of energy, little motivation. May complain about multiple physical problems or show new, excessive interest in religion. Blunt affect. Personal hygiene ignored Q. Presychotic phase of schiozphrenia ANSWER Pt usually quiet, passive, obedient, prefer to be alone. No friends bc of odd, sus, eccentric behavior. Family may report they are "slipping away" Behavior is not completely disorganized but hallucinations/delusions may be present Q. Acute phase of schizophrena ANSWER Disturbances in thought, perception, behavior, and emotion. Pt loses contact with reality and becomes unable to function Q. Residual phase of schizophrenia ANSWER Anergia, no interest in goal directed activity, negative outlook. Q. Remission phase of schizophrenia ANSWER Ability to manage some adls return and the individual experiences some relief from distress of psychosis Q. The goal of inpatient care is to ANSWER Stabilize pt(w/ meds), keep safe, prevent further decline in function, and assist with coping, orient to reality Q. Ideas of reference Idea that people or media are talking about oneself Q. Brief psychotic disorder ANSWER Psychotic disturbance that lasts more than 1 day but less than 1 month Delusions, hallucinations, disorganized behavior then return to normal state Delusional disorder More than 1 month of nonbizarre(reality-based) fixed ideas. Able to do adl but holds to delusion such as being followed, poisoned, or controlled Schizoaffective disorder Schizophrenia and mood disorder(mania/depression) Disorganized behaviors of schizophrenia present and emotions move from depression to elation(happiness) Hallucinations False sensory inputs either no external stimuli Delusions Fixed false ideas not based in reality Illusions False perception of real stimuli Stage 1 Illness experience: Symptoms begins when a person becomes aware that something is not right (may self-medicate, pray or meditate, ignore mild symptoms) Stage 2 illness experience: The sick role Sickness is confirmed through others (social group helps support presents of illness, individual either assumes sick role or deny illness Stage 3 illness experience: Medical care Seeks medical care when symptoms persist, and home remedies fail. Provider confirms illness and provides tx Stage 4 illness experience: Dependency Must rely on others, need to be informed and emotionally supported Stage 5 illness experience: Recovery and rehabilitation Gives up sick role, returns to normal obligations and duties. can be fast or slow What is a situational crisis? a sudden event that a person cannot handle with their usual coping skills Situational Crisis pt is removed from familiar environment, cared for by strangers, and in a not personal setting---- leads to feelings of loss control, dependence and vulnerability Nursing implications for a situational crisis promote autonomy, explain procedures, allow decision making Stages of hospitalization (hint: FSA) Feeling overwhelmed (anxiety, fear, confusion) Stabilization (anxiety decreases, starts to build trust in staff and understands routines) Adaptation (develops coping strats, adjust to environment, helps in care) therapeutic interventions: psychosocial care Assess coping status ("how are you handling this?" "How do you usually cope?") Crisis assessment (is pt panicking, withdrawn, angry or unsafe?) Active listening (let pt talk without interrupting) Accepting environment (Non-judgmental, calm respective tone) Real-world example: A newly admitted psych patient is pacing and agitated → nurse listens, validates feelings, keeps environment calm. Therapeutic interventions: supporting S/O Family has a big impact on outcome/success of pt, provide education and emotional support. Assess their coping ability as well. Example: A spouse is overwhelmed about caring for a patient at home → nurse teaches care skills and offers reassurance. Therapeutic interventions: Pain management Use non pharm techniques (Heat/cold, positioning, relaxation/music) Example: Patient refuses pain meds → nurse offers repositioning + deep breathing. Therapeutic Interventions: Discharge planning -Identify needs early -Teach in clear simple terms -Address new anxieties before discharge What is compensation? Attempt to overcome feeling of inferiority or make up for e deficiency. (Making up for a weakness by being strong in another area) Example: A client who failed nursing school becomes an excellent volunteer tutor. What is conversion? Channeling of unbearable into body s/s (Emotional stress turns into physical symptoms) Example: A client experiences sudden blindness after witnessing a traumatic event, but tests are normal. What is denial? Refusal to acknowledge conflict and thus escapes the situation (refusing to accept reality) Example: A client with lung cancer continues to say, "The doctors are wrong." What is displacement? Redirecting energies to another person or object (taking anger out on the wrong target) Example: A client yells at the nurse after receiving bad news from the provider. What is dissociation? Separation of emotions from situation; isolation of painful anxieties (Mentally checking out from trauma) Example: A trauma victim says, "It feels like it happened to someone else." What is fantasy? Distortion of unacceptable wishes, behaviors (Escaping reality through imagination) Example: A hospitalized child pretends to be a superhero to cope with fear. What is identification? Taking on characteristics of admired person to conceal feeling of inadequacy (acting like someone you admire to feel stronger) Example: A child imitates a favorite nurse during treatment. What is intellectualization? Focusing of attention on technical or logical aspects of a threatening situation (Focusing on facts instead of feelings) Example: A newly diagnosed cancer patient talks only about lab values, not emotions. What is isolation? separation of feelings from content to cope unemotionally with topics that would normally be overwhelming. (Separate feelings with events) Example: A client calmly describes a traumatic accident with no emotion. What is projection? putting one's own unacceptable thoughts, wishes, emotions onto others. (blaming others for your own feelings) Example: A client who is angry says, "The nurse hates me." What is rationalization? Use of a "good" (but not real) reason to explain behavior to make unacceptable motivation more acceptable. (making excuses to justify behavior) Example: A client says, "I drink because my job is stressful." What is reaction formation? Prevention of expression of threatening material by engaging in behaviors that are directly opposite to Repressed material (Acting the opposite of true feelings) Example: A client who dislikes someone is overly nice to them What is regression? Coping with present conflict stress, by returning to earlier more secure stage of life (Reverting to childlike behavior under stress) Example: An adult client begins crying and refuses to make decisions What is restitution? Giving back to resolve guilty feelings (Trying to make up for guilt) Example: Client brings gift after being rude to staff What is sublimination? Unconscious channeling of an unacceptable behaviors into constructive, more social approved areas (channeling bad feelings into good actions) Example: A client with anger issues takes up boxing or running What is substitution? Disguising of motivations by replacing an inappropriate behavior with one that is more acceptable (replacing an unacceptable action with a safer one) Example: a client chews on gum instead of smoking What is suppression? Removal of conflict by removing anxiety from consciousness (choosing to ignore stress for now) Example: A client says, "I'll think about my diagnosis later" What is symbolization? Use of unrelated object to represent a hidden idea (Using objects to represent emotions) Example: client dreams of storms to represent anger What is undoing? Inappropriate behavior that is followed by acts to take away or reverse action and decrease guilt and anxiety (trying to erase bad behavior) Example: a client apologizes excessively after yelling What is Separation Anxiety Disorders? inappropriately fearful and anxious when separated form an important person or object. It is long lasting, and they have extreme reactions. What is Generalized Anxiety Disorder Anxiety is broad, long- lasting, and excessive. worried and anxious more often than not What is panic disorder? Recurrent, unexpected panic attacks plus a fear of having another one --- the fear is what drives the behavior. Pt will not avoid public places; fear is just the panic attack itself not the location. S/S: Palpations, SOB, chest pain, dizziness, fear of dying What is panic disorder with agoraphobia? Fear of having a panic attack in public, where escape might be difficult or embarrassing. Pt will fear public locations. “I’m afraid I’ll have a panic attack and won’t be able to get out.” That = agoraphobia Treatment of Panic Disorders w/ or w/o agoraphobia 1. Educate the pt -- panic attacks are not life threatening 2. Block panic attacks with meds -- SSRIs, SNRIs, benzos (short term) 3. Develop coping skills -- relaxation, breathing, grounding, CBT (helps change catastrophic thinking, works long term) What makes Phobia different from normal fears? -out of proportion -persistent -interferes with life -client knows its irrational but can't control it anxiety happens when thinking about it, constant focus on fear object, avoidance instead of coping, varies by culture What is selective mutism? PEDS FAV Child can speak, chooses when not to. Child will speak at home but silent to strangers. Do NOT force speech, encourage non-verbal communication, build trust gradually What is OCD? Obsessions cause anxiety, Compulsions reduce it. Obsessions of germs, dirt, harm or safety concerns, order, symmetry, aggressive or sexual intrusive thoughts. Compulsions of hand washing, checking, counting, arranging items. What is Body Dysmorphia? Flaw is perceived, not real (or very minor) -Obsessed with perceived flaw in body -Distress interferes with daily life and relationships -preoccupied with physical appearance What is hoarding disorder? difficulty throwing things away Home becomes dirty, cluttered, unsafe, unusable What is trichotillomania? compulsive hair pulling despite efforts to stop -relieves tension -pulls from scalp, eyelashes, eyebrows -attempt to stop fails -relieves tension for pt What is a Traumatic stress reduction? A normal, immediate emotional and behavioral response following a traumatic event What are the stages of a Traumatic stress reaction? Fear and anguish--Recovery and repair --Adaptation What is acute stress disorder? A short-term trauma response involving anxiety and reliving the event lasting 3-days to less than 1 month How is acute stress disorder different from PTSD? Acute stress disorder last less than 1 month; PTSD last longer than 1 month What is adjustment disorder? Emotional or behavioral symptoms that are out of proportion to a life stressor What type of event causes adjustment disorders Non-life- threatening stressors such as divorce, job loss, or relocation What defines post-traumatic stress disorder? Persistent re-living of trauma with anxiety, nightmares, and avoidance lasting longer than 1 month Nursing focus for PTSD? Safety, grounding techniques, trauma-informed care Which disorder involves flashbacks and nightmares years after trauma? PTSD Which disorder is considered a normal response to trauma? Traumatic stress reaction What is the most important distinguishing factor among trauma disorders? duration of symptoms What meds are used to treat anxiety? Benzos, SSRIs, SNRI, Buspirone, beta- blockers, Antihistamine, Anxiolytics which meds are used short term for anxiety benzos Examples of Benzodiazepines Lorazepam alprazolam what is the major risk when taking benzos? dependence and CNS depression first line of meds for chronic anxiety disorders SSRIs, SNRIs How long do SSRI take to work? 2-4 weeks Which anti-anxiety med is non-sedating and non-addictive Buspirone Assessment Subjective: -Feelings of uneasiness, fear, helplessness Objective: -Restlessness, muscle tension, tachycardia Determine level of anxiety: Mild, Moderate, Severe, Panic Nursing diagnosis Anxiety, ineffective coping, Fear, disturbed thought process, impaired social interaction Planning Reduce anxiety to a manageable level, improve coping skills, increase sense of control Interventions -Use simple, clear communication -Stay with patient during severe or panic anxiety -Encourage verbalization of feelings -Teach relaxation techniques (deep breathing, grounding) -Administer medications as ordered Evaluation -Anxiety level decreased -Patient demonstrates coping strategies -Improved functioning What is social phobia? -Fear of embarrassment or scrutiny -Avoid social situations -Anxiety only occurs in social situations Nursing Focus for Social Phobia? Gradual exposure, Cognitive restructuring, social skills training