NURS 6670 FINAL EXAM STUDY GUIDE CHAPTER
1 TO 39Mental Health Case Study
Case Study, Mohr: CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing
1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen
has been divorced for 2 years and is taking Proz...
nurs 6670 final exam study guide chapter 1 to 39 mental health case study case study
mohr chapter 1
introduction to psychiatric–mental health nursing 1 karen is a 25 year old white woman who liv
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NURS 6670 FINAL EXAM STUDY GUIDE CHAPTER
1 TO 39
Mental Health Case Study
Case Study, Mohr: CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing
1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen
has been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for
depression. Karen and her boyfriend had been discussing marriage until he told her that
he wanted to end their relationship. Karen became even more depressed and could not
work for a week. Karen returned to work, refusing to discuss her issues with family,
friends, or coworkers. She did, however, make an appointment to see a psychiatric nurse
practitioner. Karen told the nurse that she was making some changes in her life. Karen
said that she and a girlfriend were joining a gym program for workouts and a social group
for young men and women. Karen stated that she realizes that her former boyfriend had
not been committed to her, and she anticipates meeting and dating other young men from
the adult social group. Karen also said that she thinks that the gym exercise will be
beneficial to her mentally and physically. (Learning Objectives: 1, 4)
A-How will the psychiatric nurse assess if Karen has made progress toward self-
realization?
➢ Karen had suffered from depression which is a form of mental disorder because of
divorce and a broken relationship with her boyfriend. This situation according to
Hypocritical in 15th century BC, upholds the brain as the organ of consciousness;
this occurs when both normal and abnormal behavior arise from the brain.
➢ The psychiatric nurse can assess if Karen has made progress towards self-
realization by committing to diagnosing and treating her responses to the
problems that caused her psychiatric disorder. In-addition, the nurse can make
assessment based on Karen’s psychoanalytical disposition such as: transference,
defense mechanism, countertransference, acting out, denial of the reality befallen
her and projection.
B-Identify strengths that Karen has for progress in personal growth. The strengths Karen
has for progress in personal growth include the followings:
➢ Her cognitive behavioral responses showed optimism towards a better life as well
as fighting against her depressed state. Hence, her willingness to date younger
men.
➢ Karen sought immediate medical attention where she was administered with
Prozac to help mitigate her depression state.
, ➢ Ability to make use of social support, that is, she visited a psychiatric nurse,
social group and registered in a gym.
➢ She was realistic about her situation, therefore made herself ready to face the
reality before her.
C-Karen has been seeking treatment for her depression. Analyze the factors that might
contribute to Karen’s reluctance to discuss her depression with others.
➢ Karen’s reluctance to discuss her depression with others hinges on the fact that
her depression was a kind called social depression. Social depression is a
psychological disorder caused by several factors such as: interpersonal
relationship which involves the relationship between a person and the interactions
of emotions of everyone expressed directly and discreetly to each other.
➢ Another is a Common interpersonal relationship, this includes: Family, social
environment (work place), and interaction among age groups and genders.
Because Karen had divorce and broken relationship, she didn’t feel safe in herself
discussing her depression with family and friends but to seek a professional
whose job is to attend to her depressed case. Hence, her neuroticism was calm and
strong willed.
Case Study, Mohr: CHAPTER 2, Neuroscience: Biology and Behavior
1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s
grades. Michael plans to apply to medical school and thinks that the lower GPA may prevent
his acceptance to medical school. For the last 2 weeks, Michael has skipped most classes
because he has insomnia and fatigue. Michael is now very depressed and has been thinking
of suicide. He took a loaded gun from his father’s gun cabinet and then wrote a suicide note
to his family. At the last moment, he telephoned 911 and told them of his suicide plan. The
police came, took the gun away, and then took Michael to the city hospital to be admitted for
psychiatric treatment. In the admission interview with the psychiatric nurse, Michael said
that his pastor thought that only weak-willed people experienced depression and that it was a
punishment for personal sins and the sins of one’s ancestors. Michael told the nurse that he
must be weak-willed and will never be able to accomplish anything. The psychiatric nurse
explained that multiple factors are the cause of depression. The nurse told Michael that one
theory holds that an imbalance of neurotransmitters, or chemical messengers of the brain,
occurs in depression. Neurotransmitters influence the individual’s emotions, thoughts, and
subsequent behavior. Recent research implies that neurobiology, heredity, as well as
Psychological and environmental factors may be involved in the development and
progression of depression. (Learning Objectives: 5, 6)
A-Will Michael think that the psychiatric nurse’s explanation for the cause of depression
is more correct than that of his pastor?
➢ No. It is indeed difficult for Michael to accept the doctor’s opinion since before
he fell sick, he had information from the pastor on depression on which he solely
believed and now he is a living prove.
, B-Michael asks the nurse why he has to have psychotherapy. He states that he only needs
to take a couple of pills to get better. How should the nurse respond to Michael’s question
and comment?
➢ The nurse has to explain to Michael why he should consider psychotherapy.
Because of the many misconceptions about psychotherapy, you may be reluctant
to try it out. Even if you know the realities instead of the myths, you may feel
nervous about trying it yourself.
➢ Overcoming that nervousness is worth it. That’s because any time your quality of
life isn’t what you want it to be, psychotherapy can help. Taking only pills will
not help but increase the effects because most of these medications have side
effects which would have been avoided by psychotherapy.
C-Develop an assessment question for each of the following possible causes of
Michael’s development of depression: Genetic, Environment and Stress.
➢ From the Geriatric Depression Scale: “Do you prefer to stay at home rather than
going out and doing new things?” This question asks for a yes or no answer and
recognizes that isolation and withdrawal are common signs of depression —
especially in the elderly.
➢ From the MADRS: “How is your sleep?” Answers include: Sleeping as usual,
slight difficulty, sleep reduced by at least two hours, or getting less than three
hours of sleep at night. Greater sleep disturbance signals a greater risk for
depression.
➢ From the Beck Depression Inventory: “How is your energy?” Declines in energy
level are a common sign of depression the more significant your lack of energy,
the higher your depression risk rating. Possible answers to this question include:
As much energy as ever, less energy than before, not enough to do much, or not
enough to do anything
Case Study, Mohr: CHAPTER 3, Conceptual Frameworks and Theories:
1. The student nurse has been assigned a 37-year-old woman admitted to the psychiatric
hospital with an anxiety disorder. This morning, the student notices that the client has a
tense facial expression and is walking constantly around the group room. The student
walked over to the client and used reflective communication by stating, “I see that you
have a tense expression and are walking around almost all of the time. Is there something
that we could discuss?” The client replied that she has talked on the telephone to her
mother who was keeping her children while she was in the hospital. The client said that
her mother had told her that she was not a good mother, and then said, “I guess I am a
bad mother, but I could never measure up to my mother’s expectations.” The student has
learned that negative self-talk can greatly aggravate anxiety and lead to depression. The
student decided to use a behavioral intervention with the client and asked the client who
is a good artist and why the client liked the artist’s works. The student and the client then
made a list of activities that the client liked. The student taught the client to engage in one
of these activities when an unpleasant experience evoked negative thoughts. The
following day, the student decided that the client needed some cognitive restructuring for
, her relationship with her mother. The student taught the client that during discussions
with her mother, feelings of incompetence might be experienced when the mother made
negative comments. The client was instructed that if her mother made negative
comments about parenting, she was to immediately tell her mother that she was a good
parent to her children and terminate the conversation at the first opportunity. (Learning
Objective: 3)
A-Will the client be able to learn cognitive restructuring in her relationship with her
mother?
➢ Yes, she will learn because by keeping positive thought, her cognitive restructure
will develop to the positive. Based on the above facts and behavioral intervention
made between client and the student nurse it is possible to establish a good and
collaborative relationship with her mother. Besides, client can also be able to gain
of cognition to maintain a fruitful relationship with her mother.
➢ Anxiety is a normal reaction to certain situations. A small level of anxiety is
normal, but severe anxiety can be a serious problem. Academic anxiety can
become more detrimental over time than community-based anxiety. Much
evidence supports the notion that social anxiety causes impairment in many
domains of life, such as romantic relationships, friendships, work, and physical
health.
B-How will engaging in activities help the client with her anxiety?
➢ Based on the everyday behavior of client the patient nurse decided a plan that how
to solve this problem. Then the student nurse asks client what happened? From
this nurse learn that some phone call received from home relative to negative
thought. The student has learned that negative self-talk can greatly aggravate
anxiety and lead to depression. That is why nurse decided some plan and asked to
each client who great artist their favorite items or activities are.
➢ Then, according to that nurse can able to engage the client into her favorite
hobbies, when an unpleasant experience evoked negative thought. The next day,
the student decided that the client has been gaining some cognitive restructuring
for her relationship with her mother.
➢ Finally, the student nurse had advice to the client that in future when her mother
made some negative thought or narration regarding parenting she should
immediately and confidently tell her mother that she was a good parent to her
children and closed this conversation immediately and if possible divert the topic
to some extent. So, that mental thought can be diversified to some extent could be
able to help to prevent anxiety.
Case Study, Mohr: CHAPTER 4, Evidence-Based Practice
1. Jessica, a 17-year-old girl who came with her family from Romania to the United States
10 years ago, is brought to the mental health clinic by her mother. At the admission
psychiatric interview, the mother stated that Jessica has been saying for 6 months that
aliens have been conducting experiments on her and will soon take her in a spaceship to
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