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What is mental health defined as?
Mental health is a static concept that does not change.
False
What are some factors that affect mental health?
Inherited characteristics, childhood nurturing, and life's circumstances
Mental health can be defined as a person's ability to _______________ with and adjust to the recurrent stresses of everyday living.
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Which of the following is NOT a possible positive influence on mental health?
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Match the following factors with their influence on mental health:
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All individuals respond similarly to changes in daily activities.
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What is behavior in the context of mental health?
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What was the goal of the community treatment in the 1960s and 1970s?
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President Jimmy Carter established the President's Commission on Mental Health in 1975.
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What was the significance of Martha Mitchell's appointment to the President's Commission on Mental Health?
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Match the following concepts with their descriptions:
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The Omnibus Budget Reconciliation Act (OBRA) of 1981 led to a drastic reduction in funding for the ______________ system.
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What is the holistic health movement focused on?
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Nursing is a person-oriented profession.
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What is the role of a nurse in supporting a patient's emotional needs?
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The Mental Health Care Systems Act was passed in ______________.
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What was the result of the severe fiscal cuts in the 1980s?
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What was the primary goal of mental health care in the 1950s?
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Dr. Philippe Pinel was a Quaker who built an asylum in England.
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Who is known as the father of American psychiatry?
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Dorothea Dix surveyed jails, almshouses, and asylums throughout the United States, Canada, and ______________.
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Match the following individuals with their contributions to mental health care:
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The 20th century saw a decline in mental health care.
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What was the purpose of the Committee for Mental Hygiene formed in 1909?
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Who introduced elaborate theories and treatment for mental illnesses?
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The National Institute of Mental Health was established in the ______________.
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What was the result of Dorothea Dix's efforts?
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What is frustration in the context of goal-directed activity?
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What is conflict in the context of mental health?
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Adaptation always leads to positive growth.
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Defense mechanisms are used to block conscious awareness of ____________________ feelings.
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How does illness affect an individual's mental state and level of functioning?
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What is a common coping response to stress?
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Nurses only address the mental health needs of their patients in a mental health care facility.
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Match the following concepts with their descriptions:
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Illness can alter dramatically a person's ____________________, body image, lifestyle, and role performance in family life, recreation, and work.
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Why is it important for nurses to consider a patient's emotional state?
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What percentage of adults in the United States received treatment for a mental health problem in 2018, according to the National Institute of Mental Health (2021)?
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In ancient times, people believed that mental illness was a result of evil spirits.
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What is the term used to describe the idea that mental illness can be explained by an imbalance of humors based on the fundamental elements of the world?
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The first English institution for the mentally ill was _______________________, founded in the 16th century under Henry VI.
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Match the following ancient civilizations with their approach to mental illness:
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What is the estimated percentage of people in the United States who will develop a mental health disorder in their lifetime?
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During the Renaissance and the Reformation, there was a significant improvement in the treatment of mental illness.
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What is the term used to describe the practice of displaying mentally ill residents in a hospital for a price to people who were curious to see them?
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The English word _______________________ originated from the nickname of Bethlehem Royal Hospital.
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What was the main reason for the treatment of mental illness during medieval times?
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Which part of the self is the organizing principle of the self?
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Stress is an objective phenomenon that affects everyone in the same way.
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What is the primary function of the ego?
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The superego is the ______________________ force that develops from the ego in response to reward or punishment from others.
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Match the following levels of awareness with their descriptions:
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What is the primary determinant of whether an individual feels distress in response to a stressor?
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The id functions to integrate and mediate between the self and the environment.
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What is the outcome when all three substructures (id, ego, and superego) function in harmony?
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Self-concept is more than the total of the four parts of self, including ______________________, body image, role, and self-esteem.
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Role performance is always an ascribed role.
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What is the primary focus of mental health nursing?
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Stress is always a negative experience.
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What is anxiety in the context of mental health?
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Anxiety is relieved through various coping and mental _______________.
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Match the following events with their potential to precipitate feelings of anxiety:
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What is the primary goal of motivation in treating emotional problems?
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Anxiety is a rare emotional experience.
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What is the role of the nurse in helping a patient develop adaptive patterns of behavior?
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The degree of anxiety experienced is influenced by the individual's _______________ of the stressor.
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What is the result of ineffective coping with stress?
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What is the final phase of reconciliation?
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A crisis often tends to resolve over a 6-to 8-week period.
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What is the role of the LPN/LVN in the nursing process?
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The nurse provides ____________________ support to the individual or family in crisis by focusing on problem-solving.
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Match the following with their roles in the nursing process:
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Why is it important for nurses to provide empathic gestures to individuals or families in crisis?
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Identifying family supports and adequate coping mechanisms helps the nurse recognize family ____________________ patterns.
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Nurses only address the mental health needs of their patients in a mental health care facility.
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What are the characteristics of a mentally healthy individual?
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Mental illness results from an ability to cope with a situation that an individual finds overwhelming.
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What is personality development influenced by?
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Erik Erikson provided a framework for understanding personality development in terms of _______________.
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Match the following psychological concepts with their definitions:
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According to Erikson’s framework, if a person masters a given task, then it is possible to predict a certain set of behaviors.
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What is the midpoint on the continuum of mental health characterized by?
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What is the superego characterized by?
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Sigmund Freud described personality development as having three parts: _______________, ego, and superego.
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Mental health is determined by a single component.
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What is one way to build trust with patients and encourage them to have faith in the care given?
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Older adults experiencing significant sensory changes in hearing or vision sometimes display behavioral changes that are easy to mistake for disorientation.
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What are some common feelings experienced by older adults?
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Illness is a state of ______________ imbalance.
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What is the primary goal of the sick role in the illness experience?
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A crisis can be defined as a stable period in a person's life.
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What is the purpose of reminiscence and life review in older adults?
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The experience of being ill involves stages that are subjective and very ______________.
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Match the following stages of the illness experience with their descriptions:
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Alcoholism is frequently recognized among older adults.
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What is a common manifestation of an inability to navigate a crisis situation?
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The sick role can never become a way of life.
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What is the result of an identity crisis?
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The United States is teeming with ______________ diversity, which affects the patient's and family's behavior during illness.
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Match the following behaviors with their descriptions:
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Cultural and ethnic backgrounds do not affect the patient's and family's behavior during illness.
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What is the nurse's responsibility in dealing with a patient's behavior?
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What is a possible outcome of an identity crisis?
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The sick role can produce secondary gains as well as ______________ attention.
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Behavior is learned through innate abilities.
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What is the primary goal of crisis intervention?
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How can a nurse help an individual or family in crisis?
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What is the importance of identifying family supports and adequate coping mechanisms?
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What is the result of a crisis, if managed effectively?
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What is the role of the LPN/LVN in the nursing process?
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Why is it essential to include other psychosocial professionals in the care of the individual or family in crisis?
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What is the importance of offering flexibility in visiting hours?
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What is the typical duration of a crisis?
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What is the primary focus of the nurse's active support in crisis intervention?
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What is the ultimate goal of crisis intervention?
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How do individuals respond to changes in daily activities?
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What is the primary characteristic of mentally healthy individuals?
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What influences an individual's response to daily stressors in life?
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What is the dynamic nature of mental health?
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What is the primary role of a licensed practical/vocational nurse (LPN/LVN) in relation to mental health?
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What is the significance of an individual's personality and resources in relation to mental health?
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What is the relationship between an individual's mental health and their ability to cope with stress?
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What is the primary goal of understanding a patient's behavioral responses to disease and dysfunction?
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What was the main purpose of Dorothea Dix's efforts?
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What was the significance of Clifford Beers' work?
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What was the focus of the Committee for Mental Hygiene formed in 1909?
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What was the purpose of William Tukes' asylum in England?
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What was Dr. Philippe Pinel known for?
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What was the significance of the National Institute of Mental Health established in the 1940s?
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What was the main reason for the harsh treatment of the mentally ill during the 17th and 18th centuries?
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What was the significance of the McLean Hospital in Waverly, Massachusetts?
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What was the main goal of Dr. Benjamin Rush's practice?
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What was the significance of Sigmund Freud's work?
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What is the primary characteristic of an individual at the midpoint of the mental health continuum?
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Which of the following is a characteristic of an individual with a poor self-concept?
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What is the term used to describe an individual's relatively consistent set of attitudes and behaviors?
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According to Erikson, what is the focus of personality development?
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What is the result of an individual's inability to cope with a situation that they find overwhelming?
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Which of the following is a component of mental health?
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What is the term used to describe the inability to recognize one's own talents and limitations?
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What is the result of continued stressor exposure on an individual's mental health?
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What is the primary reason why people with mental illness were abandoned by their community in ancient times?
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Which of the following is a characteristic of an individual at the healthy end of the mental health continuum?
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What is the term used to describe the opposite ends of a mental health continuum?
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What is the significance of the term 'bedlam' in the context of mental health?
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What is the estimated percentage of people in the United States who will develop a mental health disorder in their lifetime?
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What was the primary goal of the treatment of mental illness during medieval times?
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What is the term used to describe the idea that mental illness can be explained by an imbalance of humors based on the fundamental elements of the world?
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What is the primary reason why nurses encounter patients who have mental health concerns?
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What is the significance of the National Institute of Mental Health (2021) statistic that 18.1% of adults in the United States received treatment for a mental health problem in 2018?
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What is the primary focus of Roman physicians in their treatment of mental illness?
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What is the significance of the concept of mental health care in the Greco-Roman era?
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Which part of the psyche is responsible for reasoning and good sense?
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What is the primary function of the superego?
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What is the primary reason why nurses need to consider a patient's emotional state?
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Which level of awareness holds memories, feelings, and thoughts that are not available to the conscious mind?
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What is the term used to describe the assessment one makes about personal worth?
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What is the frame of reference used for all that a person knows and experiences?
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According to Erikson's framework, what happens if a person does not master a given task?
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What is the primary function of the ego?
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What is the term used to describe the thoughts, feelings, drives, and ideas that are outside of awareness but can be recalled easily to consciousness?
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What is the organizing principle of the self?
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What is the result of disturbances in self-concept?
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What was the primary goal of deinstitutionalization during the 1960s and 1970s?
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What was the significance of the Mental Health Care Systems Act of 1980?
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What was the result of the Omnibus Budget Reconciliation Act (OBRA) of 1981?
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What is the focus of the holistic health movement?
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What is the role of a nurse in supporting a patient's emotional needs?
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What is the significance of Martha Mitchell's appointment to the President's Commission on Mental Health?
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What was the result of the severe fiscal cuts in the 1980s?
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What is the goal of community treatment in mental health care?
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What is the significance of the President's Commission on Mental Health established in 1978?
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What is the primary goal of mental health care?
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What is the primary function of coping mechanisms in the context of stress and anxiety?
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Which level of anxiety is characterized by a feeling of impending danger and a significant narrowing of perceptual field?
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What is the primary purpose of motivation in treating emotional problems?
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Which of the following is an example of a conflict in the context of mental health?
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What is the outcome of an individual's inability to meet basic needs or role expectations?
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Which of the following is a negative consequence of severe frustration?
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What is the primary goal of adaptation in the context of mental health?
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Which of the following is an example of a defense mechanism?
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What is the outcome of a person's inability to adapt to changing life situations?
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Which of the following is a common coping response to stress?
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What is the primary reason that illness can alter a person's self-concept, body image, lifestyle, and role performance in various aspects of life?
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What is the main reason that older adults experience social isolation?
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What is the purpose of reminiscence and life review in older adults?
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What is the primary goal of patient education in a healthcare setting?
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What is the significance of considering a patient's emotional state in a healthcare setting?
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What is the primary determinant of whether an individual experiences distress in response to a stressor?
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What is the term used to describe the state of being ill or sick?
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What is the primary reason that behavioral changes occur in older adults?
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Which of the following is NOT a factor that influences the degree of anxiety experienced by an individual?
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What is the result of an individual's response to a stressful situation or event?
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What is the significance of patient support groups in a healthcare setting?
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What is the primary role of the healthcare team in a healthcare setting?
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What is the primary difference between stress and anxiety?
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Which of the following is a characteristic of anxiety?
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What is the primary reason that illness can affect a person's mental state and level of functioning?
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What is the result of an individual's inability to cope with stress?
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What is the role of the nurse in supporting a patient's emotional needs?
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What is the primary focus of mental health nursing?
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What is the relationship between stress and anxiety?
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What is the primary goal of mental health care?
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What is the primary role of a nurse during the recovery and rehabilitation stages of an illness event?
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What is a common response to feeling mistreated, injured, or insulted?
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What is the term used to describe a condition of instability that arises from an emotional or situational upheaval?
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What is the result of successful management of a crisis period?
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What is the focus of professional care during an illness event?
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What can trigger a crisis response in an individual or family?
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What is the result of long-term denial in an individual?
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What is the term used to describe the removal of self from interaction with others and the environment?
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What is the primary goal of a nurse when dealing with a patient in crisis?
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What is the term used to describe an overwhelming emotion that paralyzes the individual's ability to process information?
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What is the primary goal of crisis intervention?
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Which of the following is a characteristic of the final phase of grief?
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What is the role of the LPN/LVN in the nursing process?
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What is the purpose of the assessment of emotional status?
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What is the goal of active listening in crisis intervention?
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What is the outcome of crisis intervention?
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What is the purpose of offering flexibility in visiting hours during crisis intervention?
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What is the role of the nurse in supporting a patient's emotional needs?
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What is the purpose of the steps in crisis intervention?
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What is the result of the nursing process in crisis intervention?
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Which of the following defense mechanisms is characterized by the expression of emotions towards someone or something other than the actual source of the emotion?
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What is the term used to describe the process of constructing plausible reasons to explain and justify one's behavior?
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Which of the following defense mechanisms involves the separation and detachment of emotional significance and affect from an idea or situation?
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What is the term used to describe the attribution of problems to other characteristics that the person does not want to admit possessing?
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Which of the following defense mechanisms involves the exhibition of behavior, thoughts, or feelings used at an earlier stage of development?
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What is the term used to describe the incorporation of a characteristic of another individual or group into one's own behavior?
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Which of the following defense mechanisms involves the unconscious process of barring from conscious thought of painful, disagreeable thoughts, experiences, and/or impulses?
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What is the term used to describe the discharge of sexual or aggressive energy and impulses in a socially acceptable way?
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Which of the following defense mechanisms involves the intentional exclusion of painful thoughts, experiences, or impulses from conscious awareness?
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What is the term used to describe the conscious behavior that reflects an emotion opposite to the emotion actually felt?
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Study Notes
Mental Health Concepts
- Behavior is the manner in which a person performs daily life activities, influenced by unique personality and resources.
- Mental health is the ability to cope with and adjust to daily life's stresses, and is dynamic and fluctuating.
- Factors affecting mental health include:
- Inherited characteristics
- Childhood nurturing
- Life's circumstances
- Positive influences: inherent coping ability, mother-child bonding, success in school, good physical health, financial security
- Negative influences: cognitive impairment, schizophrenia, extreme sibling rivalry, parental rejection, deprivation of maternal love, poor physical health, poverty, dysfunctional relationships
History of Mental Health Care
- Ancient times: people believed mentally ill individuals were possessed by evil spirits, and treatments included magical and physical rituals.
- Greco-Roman era: introduction of the idea that mental illness can be explained by observing behavior, and the concept of the humoral theory.
- Medieval times: mental illness was seen as punishment for sins, and treatments included exorcisms, physical punishment, and imprisonment.
- 16th century: establishment of the first English institution for the mentally ill, Bethlehem Royal Hospital.
- 17th and 18th centuries: little change in treatment, with common practices including bleeding, starving, beating, and confinement.
- Late 18th century: establishment of psychiatry as a separate branch of medicine, and introduction of humane care and case history records.
- 19th century: establishment of asylums and mental hospitals, with harsh treatments and overcrowding.
- Late 19th and early 20th centuries: introduction of newer, more humane therapies, and establishment of psychiatric training schools for nurses.
- 20th century: reform of mental health care, with a focus on prevention and removal of stigma, and introduction of psychotherapeutic drugs and deinstitutionalization.
Mental Health Care in the 20th and 21st Centuries
- 1940s: establishment of the National Institute of Mental Health, with a focus on research and treatment of mental illnesses.
- 1950s: introduction of psychotherapeutic drugs, and deinstitutionalization movement.
- 1960s and 1970s: legislation and community-based mental health care, with a focus on returning individuals to their home environment.
- 1980s: establishment of the Mental Health Care Systems Act, with a focus on comprehensive mental health care.
- 21st century: increased funding for mental health care, with a focus on research, services, and community-based care.
Mental Health Continuum
- Mental health and mental illness are opposite ends of a continuum, with normal functioning at the healthy end.
- Influences of daily stressors can result in a deterioration of mental health, with continued exposure leading to dysfunctional behaviors.
- Midpoint of the continuum represents normal mental health, with adequate coping skills and problem-solving ability.
Characteristics of Mental Illness
- Poor self-concept and feelings of inadequacy
- Dependent behavior resulting from feelings of inadequacy
- Constant pessimism and poor judgment
- Inability to cope with daily events and irresponsibility
- Avoidance of problems and inability to recognize own talents and limitations
- Maladaptive behavior and demanding or seeking immediate gratification
- Inability to establish a meaningful relationship### Self-Concept and Self-Esteem
- Self-concept is the frame of reference used for all that a person knows and experiences, including perceptions, values, behaviors, and interactions.
- Self-esteem is the thoughts and feelings an individual holds about themselves, influencing their behavior and interactions with others.
- Disturbances in self-concept commonly arise in people with mental illness or emotional problems.
Stress
- Stress is the nonspecific response of the body to any demand made on it, and is highly subjective and uniquely perceived by the individual.
- Stressors can be physical, social, economic, chemical, spiritual, or developmental, or a combination of these.
- The meaning of the stress to an individual determines whether they feel distress.
- Stress can have positive effects, facilitating individual growth and development, or negative effects, leading to ineffective coping.
Anxiety
- Anxiety is a vague feeling of apprehension that results from a perceived threat to the self, often unknown.
- Anxiety is a response to a stressful event, and is a major component of all mental health disturbances.
- Anxiety is described in terms of levels, with higher levels immobilizing coping skills and resulting in emotional chaos.
- Signs of higher levels of anxiety include vocal changes, rapid speech, increased pulse, respirations, and blood pressure, as well as other physical symptoms.
Motivation
- Motivation is the gathering of personal resources or inner drive to complete a task or reach a goal.
- Motivation is generated by anticipation of reward or punishment, and is an important aspect in treating emotional problems.
Frustration
- Frustration is the emotional response to anything that interferes with goal-directed activity.
- Frustration can increase anxiety when adaptive behavior fails.
Conflict
- Conflict is a struggle, usually mental, resulting from opposing or incompatible thoughts, ideas, goals, or emotional forces.
- Conflict can be resolved easily or lead to serious levels of anxiety.
Adaptation and Coping
- Adaptation refers to the ability to adjust to changing life situations by using various strategies.
- Coping responses are used to reduce anxiety brought on by stress, and can be conscious or unconscious.
- Defense mechanisms are unconscious, intrapsychic reactions that offer protection to the self from a stressful situation.
Illness and Mental Health
- The stress of being ill greatly influences an individual's mental state and level of functioning.
- Illness can alter an individual's self-concept, body image, lifestyle, and role performance in family life, recreation, and work.
- The nurse is able to provide effective nursing interventions only if the patient's emotional state is considered.
Crisis
- A crisis is an unstable period in a person's life, characterized by the inability to adapt to a change from a precipitating event.
- Crisis can result from accumulating stressors, illness, or a turning point in life.
- Successful management of a crisis period is needed to prevent disorganization within the individual or the family unit.
Illness Behaviors
- Illness behaviors are responses to feeling unwell, including denial, anxiety, shock, anger, withdrawal, and depression.
- The nurse's responsibility is to note and respond therapeutically to all behavior.
Application of the Nursing Process
- The nursing process is used to meet the many needs of patients in every setting.
- The LPN/LVN participates in the nursing process by observing patient behavior and assisting in establishing patient problem statements, and working with the RN on outlining appropriate nursing interventions.