NURS 3132- Mental Health Midterm/
Final
Levels Of Consciousness - correct answer 1) Alert- Open there eyes and can respond
appropriately to stimuli.
2) Lethargic- Drowsy, eyes remain open, fall asleep easily
3) Obtunded- decreased interest in their surroundings, slowed responses, and sleepiness, slow
to respond
4) Stupor- aroused after painful stimuli, verbal responses slow or nothing, barely awake to
painful stimulus
5) Comatose- NO response/ unresponsive/ abnormal posturing (Decorticate/Decerebrate)
Nursing Ethical Principles - correct answer 1. Right of Autonomy: right to make their own
decision even if not in best interest ex. forgo chemo
2. Beneficence: Doing what is best for patient
3. Fidelity: keep promises, Loyal, faithful
4. Justice: fairness, allocation of resources ex. care for easy and hard patients regardless of
opinion of opinion
5. Non maleficence: doing no harm to patient
6. Veracity: telling the truth / being honest
Patient Rights - correct answer 1. The right to refuse treatment:
,NURS 3132- Mental Health Midterm/
Final
2. Confidentiality: patient's medical information can not be released without patient's
permission
3. Report suspicion of abuse/ warn third parties who may be at risk of harm: Don't play
detective, report them not prove them.
4. Informed Consent: Provider= communicate purpose of procedure, risks/ benefits, other
options in primary language Nurse= Make sure provider gave all info and ensure patient is
competent to give informed consent - adult, unimpaired (drugs/schizophrenia), get them to
sign document
* if pt asks q's about procedure you need to get the doctor back in
OR?
1. The right to Safety:
2. The right to be Informed:
3. The right Choose:
4. The right to be Heard:
Restraints - correct answer Physical (vest/belt) or Chemical (sedative)
* try alternatives (reorientation, supervision, diversion, quiet calm environment) first!
- Only in emergency with prescription from provider quickly (usually 1 hour) after application
- Provider needs to re write every 24 hours NO PRN
,NURS 3132- Mental Health Midterm/
Final
Best Practice:
- 2 fingers can fit
- quick release knot (slip knot)
- place on movable part of bed frame
- place belt over pt gown to protect skin breakdown
- document 15-30 mins (precipitating event, alternative interventions attempted, time
treatment began, meds admin, assessment of behaviour, vitals, pain, chart patient care such as
food and toileting)
Discontinue:
- when pt follows directions as nurse
Torts - correct answer Unintentional Torts: (Negligence, Malpractice) no bed alarm for fall risk
Malpractice: med error that harms patient by accident but rights weren't followed
Quasi-intentional Torts (Breach of confidentiality, defamation of character)
Intentional Torts: Assault (threat), Battery (hit or med admin against will), False Imprisonment
(inappropriate restraint physical or chemical)
Communication Techniques - correct answer Intrapersonal communication: thinking thoughts/
self talk without verbalizing them ex. evaluating pros and cons
Interpersonal communication: one on one with another person
Open Ended Questions: used to promote interactive discussion with patient
Close Ended Questions: find exact / specific data
, NURS 3132- Mental Health Midterm/
Final
Communication Techniques - correct answer Restating: repeat exact words
Reflecting: return focus back to patient
Paraphrasing: restate patient feelings to confirm understanding "what I think I hear you saying"
Exploring: gather more info about something they've mentioned "earlier you mentioned... can
you tell me more"
General leads: let patient guide the discussion
Presenting reality: communicate what is actually happening (dispel hallucination, delusions or
false beliefs)
Offering of self: provide limited self-disclosure (share about yourself) but return back to patient
as soon as possible
Wrong/ Right Techniques of Communication - correct answer Wrong:
- asking "why"
- offering opinion
- giving false reassurance "everything is going to be ok"
- advice
- just changing subject
- minimize feelings
Right: "therapeutic"
- asking open ended Q's "you seem angry about this"
- maintain eye contact
- sit/stand at eye level
- use therapeutic touch when appropriate
Older Adults:
- minimize distractions
- discuss in private setting
Final
Levels Of Consciousness - correct answer 1) Alert- Open there eyes and can respond
appropriately to stimuli.
2) Lethargic- Drowsy, eyes remain open, fall asleep easily
3) Obtunded- decreased interest in their surroundings, slowed responses, and sleepiness, slow
to respond
4) Stupor- aroused after painful stimuli, verbal responses slow or nothing, barely awake to
painful stimulus
5) Comatose- NO response/ unresponsive/ abnormal posturing (Decorticate/Decerebrate)
Nursing Ethical Principles - correct answer 1. Right of Autonomy: right to make their own
decision even if not in best interest ex. forgo chemo
2. Beneficence: Doing what is best for patient
3. Fidelity: keep promises, Loyal, faithful
4. Justice: fairness, allocation of resources ex. care for easy and hard patients regardless of
opinion of opinion
5. Non maleficence: doing no harm to patient
6. Veracity: telling the truth / being honest
Patient Rights - correct answer 1. The right to refuse treatment:
,NURS 3132- Mental Health Midterm/
Final
2. Confidentiality: patient's medical information can not be released without patient's
permission
3. Report suspicion of abuse/ warn third parties who may be at risk of harm: Don't play
detective, report them not prove them.
4. Informed Consent: Provider= communicate purpose of procedure, risks/ benefits, other
options in primary language Nurse= Make sure provider gave all info and ensure patient is
competent to give informed consent - adult, unimpaired (drugs/schizophrenia), get them to
sign document
* if pt asks q's about procedure you need to get the doctor back in
OR?
1. The right to Safety:
2. The right to be Informed:
3. The right Choose:
4. The right to be Heard:
Restraints - correct answer Physical (vest/belt) or Chemical (sedative)
* try alternatives (reorientation, supervision, diversion, quiet calm environment) first!
- Only in emergency with prescription from provider quickly (usually 1 hour) after application
- Provider needs to re write every 24 hours NO PRN
,NURS 3132- Mental Health Midterm/
Final
Best Practice:
- 2 fingers can fit
- quick release knot (slip knot)
- place on movable part of bed frame
- place belt over pt gown to protect skin breakdown
- document 15-30 mins (precipitating event, alternative interventions attempted, time
treatment began, meds admin, assessment of behaviour, vitals, pain, chart patient care such as
food and toileting)
Discontinue:
- when pt follows directions as nurse
Torts - correct answer Unintentional Torts: (Negligence, Malpractice) no bed alarm for fall risk
Malpractice: med error that harms patient by accident but rights weren't followed
Quasi-intentional Torts (Breach of confidentiality, defamation of character)
Intentional Torts: Assault (threat), Battery (hit or med admin against will), False Imprisonment
(inappropriate restraint physical or chemical)
Communication Techniques - correct answer Intrapersonal communication: thinking thoughts/
self talk without verbalizing them ex. evaluating pros and cons
Interpersonal communication: one on one with another person
Open Ended Questions: used to promote interactive discussion with patient
Close Ended Questions: find exact / specific data
, NURS 3132- Mental Health Midterm/
Final
Communication Techniques - correct answer Restating: repeat exact words
Reflecting: return focus back to patient
Paraphrasing: restate patient feelings to confirm understanding "what I think I hear you saying"
Exploring: gather more info about something they've mentioned "earlier you mentioned... can
you tell me more"
General leads: let patient guide the discussion
Presenting reality: communicate what is actually happening (dispel hallucination, delusions or
false beliefs)
Offering of self: provide limited self-disclosure (share about yourself) but return back to patient
as soon as possible
Wrong/ Right Techniques of Communication - correct answer Wrong:
- asking "why"
- offering opinion
- giving false reassurance "everything is going to be ok"
- advice
- just changing subject
- minimize feelings
Right: "therapeutic"
- asking open ended Q's "you seem angry about this"
- maintain eye contact
- sit/stand at eye level
- use therapeutic touch when appropriate
Older Adults:
- minimize distractions
- discuss in private setting
