N201 Exam 1

Mental Health

Chapter 10, Trauma and Stress Related Disorders:

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Chapter 14
14 questions Eating Disorders:

 Know the characteristics and signs and symptoms of the different eating disorders. There are
several questions on this.
o Anorexia
o Bulimia
o Binging
o purging
 Look at nursing diagnoses for clients with eating disorders. Body image has a huge effect on the
ability of a patient to recover. Nurses need to be aware of this and assess the feelings a patient has
about their body image. Review your text for information about this.
 See Box 14-2 and note the medical complications of eating disorders?
 What are the main goals for all eating disorders? For nervosa anorexia? How is this main goal
accomplished?
 Look at nursing interventions. We discussed some of these in class when we discussed the goals.
 How dodoes a nurse asses a client with an eating disorder. What questions should be asked?
 The client with anorexia nervosa will resist treatment, weight gain and will become anxious
and upset about gaining weight. What things might help with this problem?
 It is a priority and important to identify triggers that cause the behaviors associated with eating
disorders. How does a nurse get this information from their client?
 What are considerations for client teaching for a client with bulimia or
anorexia? There is a table that refers to conditions that the patient might develop. Remember we
talked about electrolyte imbalances etc.
 Remember eating disorders are about control.
 The word catastrophizing means making a catastrophe out of something or seeing it as a
catastrophe. Something that possibility could alter in a bad way one’s life or even ruin it. For
example my life will be over if I gain 10 lbs.

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Mental Health

Chapter 20 Crisis
12 questions

 What should you do when talking to someone who is extremely upset? Remember do not give
reassurances such as everything will be fine. Presence and staying with them will allow you to
keep an eye on them and keep them safe, which is important if they have a history of hurting
themselves and may help them feel supported and like someone cares if they are told that
someone recognizes their feelings and wants to help them feel better.
 Know what the different types of crisis are. We covered these in class.
 Remember when first meeting someone in crisis to keep calm and keep your sentences short and
clear and speak in a soft voice, ask them what brought them to seek assistance or help.
 Remember safety, preventing injury or suicide is always the highest priority. Think Maslow.
 Nurses need to assess a patient’s resources and support systems. This is extremely important for
those with ongoing mental health and living in a extremely stressful situation. Family friends,
groups organization, belonging to a church, etc are among the support systems we need to assess.
Please read about this in your book.
 What is debriefing and when is it used?
 Review briefly how you deal with a client who shows signs of escalating anger and aggression
from chapter 24 (anger, Aggression and violence. When someone is in crisis they can be angry,
and aggressive or even violent. Verbal threats are a form of aggression. Bullying is a form of
aggression. When kids bully the parents need to be educated about the long term affects the
bullying can have on the child being bullied. Some use aggression to gain control over a
stressor. A history of violence should put you on the alert. Keep space between you and the upset
client if you see signs of anger/aggression. Speak softly, slowly and be clear and concise.
You may need a show of strength by having several team members and behind you, only one
person should be talking to the client. Do not surround the client when trying to deescalate.
Someone who is shouting an throwing objects is at risk for other directed violence (a nursing
diagnosis).
 What is impulsivity? (Little or no thought before acting and it can happen very quickly because
the action is not thought through.)

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Mental Health

Chapter 22 Sexual Violence

11 questions
 There are many psychological effects of rape. What are these?
Before discharging a victim of rape, remember to try and get their agreement for a follow up
appointment with the rape crisis center.
 What do you need to do before allowing a rape victim to wash themselves after they were
sexually assaulted?
 You need to think about the emotional effects rape can have on the victim. Shame, guilt, anxiety,
fear, and depression can cause one to consider self-harm. How will you asses for the potential of
self-harm/ suicide?
 Recognize the client’s feelings and restate them. It can help them think about their reaction.
Perhaps it will cause them to recognize they may be blaming themselves or feel guilty. Then
these feelings can be addressed. But first recognize and restate their feelings. “It sounds like you
feel guilty… “ They did nothing to deserve sexual violence.
 Do not leave the client alone. Mae sure they have privacy and are not sitting in a waiting room.
 Presence can be very comforting. Remember they are sometime in shock and scared.
 Remember to speak in calmly and softly in short concise sentences with the client when you first
meet them as they are likely to be very upset. Ask them why they are seeking help.
 Safety is always a priority.
 How do you plan for discharge? Part of this is you need to make sure to check on what their
support systems are.
 Someone who was raped years ago can still struggle with it emotionally. It ca haunt them. The
can develop rape-trauma syndrome. See page 355 read the phases of this. Someone has problems
even years afterwards may need to seek help. A good first step I developing a therapeutic
relationship is to recognize feelings or that they are struggling. “It sounds like you are having
difficulty..”

Chapter 26 Children and Adolescents

11 questions

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N201 Exam 1
Mental Health

 Know signs and symptoms (behaviors) of

o ADHD
o CD
o ASH
o ODD
o IDD
o childhood depression disorder
o Tourette’s disorder (tic disorder)
 What type of group should the nurse suggest for a child who had trouble getting along with
others, a social skills group. Think about the things this group would work on.
 What type of medications might a child with ADHD be put on to help with the ADHD? Central
nervous system stimulants may be one type.
 Autism spectrum disorder may be placed on the medication risperidone (Risperdal). See you ATI
book for this. It is also mentioned in your textbook. It is important to teach the parents about
symptoms of diabetes if the client is placed on this medication. Please look at this drug in your
ATI mental health book.
 A child with ADHD may be placed on dextroamphetamine/levoamphetamine (Adderall).
Please look this drug up in your ATI mental health book. It may affect appetite and the
child may lose weight.
o What should the nurse advise the parents?
 Give the drug after meals. Check weight in the morning, before breakfast,
once or twice a week.
 If weight loss continues please call the mental health provider that ordered
the medication and tell them that the weight loss has continued.
 What are the signs and symptoms associated with Autism spectrum disorder?
 Know what separation anxiety disorder is. P.411
 Establishing limits, teaching the rules, and orientation to a unit, program, group etc. are an
important way of fostering a therapeutic milieu as well as keeping clients and staff safe.
 What is play therapy, bibliotherapy, behavior modification therapy therapeutic games, music
therapy, and family therapy? See p. 414 and 415 If there are problems in relationships with
family members family therapy is the treatment of choice.
o play therapy

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Mental Health

o bibliotherapy
o behavior modification therapy
o therapeutic games
o music therapy
o family therapy
 See lithium carbonate on page 235. The therapeutic level is found on page 236. Table 16-5 refers
to side effects and toxicity. It is not stating what the normal level is. It says less than, < 0.4 to 1,
so this is less than the therapeutic level found on page 236. I do not want this to confuse you. You
need to no know therapeutic level.
 You should have a knowledge of normal child development.

There will be 2 math calculation questions. If you put you work on the exam under the
question and you get it wrong, Professor Sharon will write corrections of the work on the
exam, so you can see why you missed it, should you miss it.