Mark Klimek NCLEX notes; Psych With Questions and

Mark Klimek NCLEX notes; Psych With Questions and Answers

the first thing you should do with a psych question is to: - ANSWER determine if the patient is psychotic or nonpsychotic with a non psychotic patient, pick an answer that focuses on: - ANSWER good therapeutic communication a person is non psychotic if: - ANSWER they have insight into their problem and how if affects their life.If a patient is psychotic, they are: - ANSWER not reality based and have no insight into their problems.Non reality-based thinking means: - ANSWER they think everyone else is the problem.deny being sick.may have hallucinations, allusions, or delusions.Insight with psych patients means that they: - ANSWER know they have a problem and how if affects them.

Psychotic patients will have: - ANSWER hallucinations, allusions, or delusions.

Dellusions are: - ANSWER false, fixed, idea or belief without a sensory components (see, taste, smell).Paranoid delusion means the patient thinks: - ANSWER people are out to get them.

grandiose delusions are: - ANSWER you are superior/god

Somatic dellusion are: - ANSWER false belief about body: worms are in my arm, my body is hollow, false pregnancy, can shoot lasers out eyes

Hallucinations are: - ANSWER false sensory experiences.

most common hallucinations are: - ANSWER auditory

the most common auditory hallucination are: - ANSWER hearing voices telling you to harm yourself.

2nd most common hallucination is: - ANSWER visual

3rd most common hallucination is: - ANSWER tactile.

least common types of hallucinations: - ANSWER gustatory and olfactory.

An Illusion is: - ANSWER a misinterpretation on reality based on a sensory experience.

illusions have a: - ANSWER grain of truth / referent in reality.

patient hears someone in the hallway, but thinks they are demon voices. there were actually voices, so it's not a hallucination, but they misinterpreted, making it an illusion.Functional psychosis is: - ANSWER when you can still function in every day life. jobs, marriage, kids. etc..brain is not damaged. chemicals are out of balance.three types is psychosis - ANSWER 1) functional 2) dementia 3) delirium

• diseases that make up functional psychosis: - ANSWER schizo, schizo, major, manic

schizophrenia schizo affective major depression manic

dementia psychosis is due to: - ANSWER actual brain damage.

stroke, senile, dementia

The functional psychotic: - ANSWER has the potential to learn reality.

The nurses role with a patient who is functionally psychotic is to: - ANSWER teach reality.The 4 steps to dealing with a functional psychotic are: - ANSWER 1) acknowledge feelings 2) present reality 3) set limits/boundries 4) enforce limits/boundries the first thing you say to a functional psychotic should: - ANSWER acknowledge their feelings.might have the word "feel" in it or state "that must be hard" or "you seem to be upset"

Examples of classic forms for presenting reality: - ANSWER I know that ____ is real to you, but I do not _____.

I am a nurse. this is a hospital. this is your breakfast.

Presenting reality with a functional psychotic is: - ANSWER not the first thing you should do!

Enforcing a limit with a functional psychotic is: - ANSWER the only enforcement is ending the conversation, NOT punishing.

cannot take priveledges away.

a schizophrenic is a ______ psychotic. - ANSWER functional

a patient with schizoaffective disorder is a _____ psychotic. - ANSWER functional

a schizophrenic patient states he hates us all and is going to kill everyone. how do you reply? - ANSWER I see you are upset, but everyone will be kept safe while we are here.

then say:

we are not going to talk about this any longer.

keeps going so say:

I see you are too ill to stay reality based so this conversation is over, but we have medications to help you with those symptoms.

if the patient has psychosis of dementia, they: - ANSWER cannot learn reality.

Steps to dealing with the psychosis of dementia: - ANSWER 1) acknowledge feelings 2) redirect them to something else (from something they cannot do to something they can do)

when dementia patients are not experiencing psychosis, but are confused, you should: - ANSWER present reality orientation

presenting reality and reality orientation are: - ANSWER totally different.

reality orientation is for confusion.

when talking about a patients feeling it is better to: - ANSWER acknowledge a feeling than explore a feeling. it's better to say "you look excited" rather than "how do you feel about it" if the question gives you clues to the patient being excited.

what should you do with dementia patients regarding their memories? - ANSWER reinforce intact memories

psychotic delirium is: - ANSWER temp, sudden, dramatic, episodic, secondary loss of reality.

psychotic break. due to a chemical imbalance in the body.

Causes of psychotic deliurm: - ANSWER drug reactions, OD, withdrawal, Delirium tremors, post op psychosis, ICU psychosis, occult UTI in the elderly, thyroid storm, adrenal crisis.

focus of managing psychotic delirium: - ANSWER removing underlying cause of psychosis and keeping them safe.

when a patient has psychotic delirium you should: - ANSWER 1) acknowledge feelings 2) reassure them that the symptoms are temporary and that they are safe.