• The patient should be asked about his hobbies so that he can be given the recreational he likes
• The patient should be given a game like carrom board or ludo to play
• To use up energy, a game like badminton can also be given to the patient
• Initially, the patient No competitive games should be given or done
• If someone wins a competition, he should be congratulated

5. Spiritual Needs Nursing Management

• The patient should be encouraged to pray every day and separate arrangements should be made for him and all the upcoming festivals should be celebrated in a proper manner but no one can ever be forced to celebrate other religions or festivals

Q-2

a) Define therapeutic communication and explain about therapeutic communication technique. Define therapeutic communication and explain its techniques.08

Definition of therapeutic communication:

(Definition of Therapeutic Communication)

Therapeutic communication is a process in which a nurse uses step-by-step verbal and nonverbal communication with a client with a purpose in which she understands the patient well and knows his physical and mental status. is.

techniques of therapeutic communication : (Techniques of Therapeutic Communication)

The techniques of therapeutic communication are given as follows :

1) Observing :

2) Listening :

3) Restating :

4) Questioning :

5) Clarifying:

6) Focusing:

Focusing on a single point. By focusing on a single point, the patient will provide more detailed information about that topic, which will help us understand it better. If the topic changes, we should talk about the next topic so that the patient can focus on that topic.

7) Silence :

When the patient is talking, the nurse should remain silent. Do not interrupt the patient. So that the patient can express his/her point well.

8) Sharing : (Sharing)

The nurse should think about the patient in the extra time after providing the patient at home so that the patient feels that the nurse is thinking about him/her. For example, the nurse tells the patient that I reminded you of something yesterday.

9) Broad opening :

The nurse encourages the patient to select a topic so that the patient feels that the nurse is also paying attention to his condition and asking open-ended questions will provide a detailed answer to that question.

10) Linking :

Linking means making connections. Nurses link two events or feelings of the patient. For example, the patient’s wife is angry with him because the patient went out to eat with her friend.

11) Pinpointing :

The nurse should also pay attention to certain statements made by the patient. For example, differentiating between what the patient says and what he does. For example, the patient says that he is sad but a smile is seen on his face.

12)Providing information:

Providing personal, social and therapeutic information to the patient. For example, giving information to the patient about when to take the medicine, what to take it with and its side effects.

13) Suggesting:

Suggesting means presenting your own ideas. While communicating, give suggestions and advice to the patient when needed.

14) Role playing: (Role playing)

Role playing is important along with communication. In which a role is played on a situation, that is, that situation is described by acting. Role playing is helpful in changing the attitude of a person and increases self-awareness in the patient.

15) Summary : (Summary)

At the end of the communication, the nurse should summarize the entire process of communication. In which the main theme, topic should be listed and remembered. So that the next day, communication can be done better on that topic.

b) Describe the characteristics of mentally healthy person. Describe the characteristics of a mentally healthy person.04

The characteristics of a mentally healthy person are as follows.

1. He has his own philosophy of life:A mentally healthy person formulates his own values keeping in mind the demands of society. This philosophy guides him in various activities of his life.

2. A proper sense of self-evaluation:-

A well-adjusted person is aware of his or her abilities, motives, strengths, and limitations. He carefully evaluates his behavior and admits his mistakes.

3. Emotionally mature:-

  He is emotionally mature and stable and expresses his feelings well and uses them with proper control.

4.A balanced self-regarding sentiment. (Balanced self-regarding sentiment):-

He has a proper sense of personal respect. He thinks that he is an important member of the social group and can contribute something to its progress and welfare.

5. . Socially adjustable (. Socially adjustable):-

We are all social beings. This social life refers to the reality of Give & Take. A mentally healthy person knows the art of living a social life and does social give and take

6. A realistic approach:-

:  His approach to various problems in life is realistic. He is not afraid of imaginary dangers or difficulties that may arise.

8. Intellectually sound:He has sufficiently developed intellectual powers. This enables him to think independently and take the right decision at the right time.

9. Emotional maturity. (Emotion Maturity): 

Emotions like fear, anger, love,  etc. are commonly seen in our social life. Such a person has mature emotion behavior. He has control over them and expresses them according to accepted social norms.

10. Bravery facing failures (Courage to face failures):

Life is a see-saw game. If we aim for success, we sometimes face failures. A person with complete mental balance has enough courage and endurance to face the failures in his life.

11. Punctuality:

A person with mental health has desirable social and healthy habits. He does not forget his commitments and is regular and punctual in fulfilling his duties.

12. 13. Self-judgment :

   Self-judgment is one of the important characteristics of such a person. He uses it to solve his problems. He does not rely on the judgment of others.

Common Characteristics of a Mentally Healthy Person:-

They feel good about themselves.

They are not overwhelmed by emotions like fear, anger, love, jealousy, guilt, or anxiety.

They have stable and satisfying personal relationships.

They feel comfortable with other people.

They can laugh at themselves and with others.

They have respect for themselves and others even if there are differences.

They are able to accept life’s disappointments.

They can meet the demands of life and manage their problems when they arise.

They make their own decisions.

They shape their environment whenever possible and Adjusts it when necessary.

OR

a) Write down about behavioral psychotherapy. Write about behavioral psychotherapy.08

introduction :
Behavioral Psychotherapy is a psychiatric method that uses medically proven techniques to identify and correct a patient’s unhealthy and unwanted behaviors. This therapy is based on the belief that most behaviors are learned and that those behaviors can also be unlearned. Behavioral Therapy focuses primarily on the patient’s immediate responses to the behavior and situation, not on the patient’s thoughts or inner feelings.

main Element :
Behavioral Psychotherapy is based on the following elements:

1. The behavior that the patient exhibits develops under the influence of the environment.
2. Behavior can be modified through reward and punishment.
3. The patient’s anxious or unwanted actions can be reduced step-by-step.
4. The patient can also learn by watching the behavior of another person (Modeling).

Main Techniques

1. Systematic Desensitization
   This method is used especially for phobias. The patient is gradually introduced to the imagined or actual situations that frighten him, and the patient is taught to remain calm. This is based on the theory of Classical Conditioning.
2. Aversion Therapy
   To eliminate unwanted behavior such as substance abuse, smoking, etc., it is associated with a negative experience, such as disgusting pictures or an unbearable-tasting drug.
3. Token Economy
   Under this method, when the patient behaves positively, he is given a Token as a Reward. This Token can then be redeemed for the desired item. This method is especially useful for children or institutionalized patients.
4. Modeling
   How another person behaves appropriately is presented to the patient and the patient follows it. This is based on the Social Learning Theory presented by Albert Bandura.
5. Flooding
   In this method, the patient is directly placed in a frightening situation. For example, a patient with claustrophobia is kept in a closed room until his fear subsides.
6. Behavioral Contracting
   A contract is made between both the patient and the therapist in which the patient’s goals and rules for behavior are clearly written. Reward and Consequences are also determined.

Usefulness (Indications)
Behavioral Psychotherapy is particularly useful in the following mental disorders:

• Phobias (such as Acrophobia, Agoraphobia)
• Obsessive Compulsive Disorder
• Conduct Disorder
• Attention Deficit Hyperactivity Disorder
• Substance Use Disorders
• Sexual Dysfunction
• Anxiety Disorders
• Autism Spectrum Disorder

Advantages

• Rapid and visible improvement in patient behavior
• Less medication and fewer side effects
• Short-term therapy reduces costs
• Makes patients responsible for their behavior
• A suitable option for institutionalized patients

Limitations

• This therapy does not pay much attention to the patient’s inner thoughts and feelings
• May not be effective for every patient
• Some techniques may be difficult to implement in civilian life
• Therapy requires the patient’s preparation and cooperation

Behavioral Psychotherapy is a Identifying the learned unhealthy behavior, it tries to correct it through scientific therapeutic methods. The main objective of this therapy is to improve the behavior of the patient so that he gains the ability to live a socially acceptable and practical life. This therapy is highly effective and widely adopted for mental illnesses like Anxiety, Phobia, Conduct Disorders, ADHD, Autism. Behavioral Psychotherapy has emerged as an effective, drug-free and excellent method of making the patient active in today’s times.

b) Write down about qualities of psychiatric nurse. Tell about the qualities of a psychiatric nurse.04

Self confident :
(Self confident) A nurse must have self confidence so that she can take decisions on her own and provide holistic care in any serious situation.

Empathy :
(Empathy) A nurse should have empathy for the pain and suffering of others. She should be able to understand the pain and situation of others.

Excellent communication :
(Excellent communication) A nurse should have effective communication skills so that she can Through communication, one can understand the patient’s situation and provide psychological support to him.

Non judgmental attitude:
(Non judgmental attitude) Accept the patient as he is and do not form any kind of prejudice by looking at the patient. To provide care without any preconceived notions.

Compassion :
Compassion means being sensitive to the patient’s condition so that the patient trusts us and shares all their problems.

Intelligence
A nurse should be intelligent so that she can detect problems early and provide care for them.

Emotional stability :
A nurse should be emotionally stable while working.
She should have empathy but There is no need to be saddened by the suffering of others.

Devotion to duty:
(Devotion to duty) A nurse should perform her duty with honesty and complete devotion. Allocate enough time to him during his duty and provide good care to the patient.

Calmness :
(Calmness) The nurse should remain calm while communicating with the patient and his relative. Sometimes the patient becomes aggressive while communicating, so the nurse should remain calm and communicate.

Patience :
(Patience) The nurse should remain patient while communicating and providing care. The patient will not communicate properly because he is sad, so the nurse should keep the patient calm during that time.

Team work :
(Team work) The nurse should work as a team with her mental health team members. So that better care can be provided.

Conflict resolution :
(Conflict Solution) If any conflict or problem arises, the nurse should have the capacity to solve it.

Good listener :
(Good Listener) While communicating with the patient, the patient’s feelings, problems and statements should be listened to with concentration.

Keen observation :
(Keen Observation) The nurse should make sharp observations of any person or situation so as to identify the actual problem. Can be.

Punctuality :
(Punctuality) A nurse should be punctual. When a task has to be done at a certain time, the nurse should work at that specific time.

Q-3

Write short answer (any two) Write a short answer. (any two) 6+6-12

a) List out defense mechanisms and explain any four in details. Make a list of defense mechanisms and write about any four of them in detail.

Defense mechanisms are classified into two parts:
1) positive defense mechanism
2) negative defense mechanism

Positive defense mechanism

~ Compensation
~ Substitution
~ Sublimation
~ Rationalization
~ Repression
~ Undoing
~ Identification (Identification)
~ Transference
~ Intellectualisation
~ Introjection

Negative defense mechanism:

~ Suppression
~ Displacement
~ Projection
~ Regression
~ Fixation
~ Fantasy
~ Reaction formation
~ Conversion
~ Dissociation
~ Denial (Denial)

Denial (Denial) :

• Denial means to deny.
• In this defense mechanism, the person refuses to face reality. He is not ready to accept reality.
• The person unconsciously uses this mechanism for some time.
• Example: A person has a very close and dear person who passes away, but that person is not ready to accept that his dear one has passed away. The person thinks that the person is still alive.

Displacement (Displacement) :

• Displacement means displacement
• In this defense mechanism, the person unconsciously transfers his emotional feelings to another person or object that is less dangerous.
• Example: A worker works in an office and his boss gets angry with him. This worker cannot tell the boss anything so he goes home and gets angry with his family member which is called displacement.
• A student nurse gets scolded by her senior. The student nurse cannot get angry with her senior but she goes home and punishes her younger sibling and gets angry too.

Rationalization:

• Rationalization means rationalization.
• In this defense mechanism, the person gives his own logical reasons against his failures, socially unacceptable things and behavior.
• Example: A girl who is not admitted to nursing school, she criticizes the nursing professor.

Identification (Identification):

Example: When a girl is admitted to the hospital for surgery, she gets inspired by seeing a girl nurse and thinks of becoming a nurse and compares herself with a nurse. When she is diagnosed with an illness, she will not believe it and will not accept her diagnosis.

Identification means identification

Identification mechanism is used more in children.

In the identification mechanism, the person compares himself to someone he likes or someone in a superior position and shows similarities between himself and the person in front of him.

b) Describe Nursing management of dementia client- Describe nursing management of dementia patient.

Nursing Diagnoses for Dementia :

1. Impaired Memory related to progressive cognitive decline.
2. Risk for Injury related to wandering or confusion.
3. Self-Care Deficit related to impaired cognitive function.
4. Disturbed Thought Processes related to neuronal degeneration.
5. Caregiver Role Strain related to the burden of providing constant care.

Cognitive Function -To maintain cognitive function

-Environmental confusion should be removed, hazardous items should not be kept in the ward.

-Orientation to time, place and person.

-Maintain the patient’s physical safety.

-Treat the patient calmly and give a proper introduction.

-Provide the patient with opportunities to do things like walking, exercise, music, etc.

-Openly discuss the issue of anxiety with the patient.

Promote patient interaction.

-Necessary steps should be taken to maximize the exchange of ideas and feelings between the patient and others.

-Assess the level of social interaction to form a baseline data.

-Encourage them to participate in group therapy to promote their social interaction.

-Spend time with the client.

-Communicate with the client in a language that is simple and understandable to them.

Promote the patient’s daily activities.

-Assess the patient’s daily life activities.

-Make a plan for various activities of daily life according to the patient’s condition and encourage him to actively participate in daily activities.

-Help should be provided whenever needed.

-Teach him/her the techniques to change his/her behavior and motivate him/her to follow them.

-Create a daily activity schedule for the patient and ensure bathroom safety.

Maintain the patient’s nutrition level.

-Observe food intake and food habits.

-Provide a balanced diet and motivate him/her to take fluids. Should.

-Monitor weight regularly.

-Take care of the patient’s mouth.

Maintain personal hygiene.

-Keep a clean environment so that infection does not occur.

-Clean and dry the skin to promote healthy skin.

-Take proper care of the patient’s hair. And comb and oil it.

-Hand and toenails should be cleaned properly.

-Hand, foot and back massage will improve the patient’s circulation and muscle tone.

Improve sleep patterns.

-Ask the patient to do activities like music and relaxation exercises to prepare for sleep.

-Sleep not  Avoid strenuous exercise 1 hour before.

-Give a high carbohydrate diet before bedtime.

-Give prescribed medicine.

Provide rehabilitation.

-Provide physiotherapy.

-Speech therapy should be provided.

-Hearing Aids should be provided.

c) Write down Role of nurse in primary level prevention of psychiatric illness.

Many things within the community affect mental health, so a community health nurse works for mental health at the community level for the promotion of mental health, prevention, treatment and rehabilitation of mental illness. Here we will see the role of a nurse in primary prevention, which is as follows.

Personal measures

There are many drugs that can have side effects on the mother and her fetus, so avoid taking unnecessary and self-medication during pregnancy. Conduct delivery safely because during this time, brain damage can be seen due to hypoxia or injury to the baby’s head. If a child is physically or mentally challenged, then provide counseling and support. Strengthen the mother-child relationship.

Participate in school health programs

Community health nurses can visit schools and provide care for children. Can detect abnormal behavior and take appropriate professional steps to correct it as soon as possible. Teachers should learn to recognize any abnormal behavior in children. Such cases can be identified and referred immediately.

Family Care

Activities done in the family in which there should be respect, love, trust and affection between each family member. Family is an important medium for raising a child, so adjustment and coping skills can be taught to the child from here. Training can be given to parents regarding child rearing through Child Guidance Clinic. Problems related to the child’s mental health can be discussed and guidance can be given to them if there is not a good relationship with each other at home, especially between husband and wife. Then marital guidance can be given to him.

Adolescence Care

For developmental mental crises, when a child goes through adolescence, there are many hormonal and body changes, so it affects his mental health.

Age and socio-cultural changes

In addition, retirement and menopause are also such situations where family crises are seen, such as the death of a breadwinner in the family, divorce, etc. There are many places like mental health clinics, first aid walking clinics, etc. that can handle this situation.

Programs for families living in culturally deprived communities, families whose living conditions are not good, do not get food, education, health and any other recreation facilities. Such people turn to alcoholism, drug addiction, crime and mental

Preventive measures for society: Comforting mothers before the birth of their children, trying to improve the content of children’s education methods, trying to overcome the crisis, using different biological data, i.e. white data Do

To conduct community development programs, in primary prevention, nurses play the roles of counselor, educator, facilitator, advocate, etc. Apart from this, they also inform health workers working in the periphery about the prevention and promotion of mental health.

d) Prevention of mental retardation – Write about the steps to prevent mental retardation.

Prevention is better than cure’ means we should take steps to prevent a condition before it occurs and stop it from happening.

There are three types of prevention of mental retardation:
1) Primary prevention
2)Secondary prevention
3)Tertiary prevention

1) Primary prevention :

• Primary prevention involves preventing the causes and factors that lead to mental retardation.
• Providing good antenatal, intranatal and postnatal care to the mother.
• Providing universal immunization to the child. Such as providing BCG vaccine, polio vaccine, DPT vaccine and MMR vaccine.
• Immunizing the mother and child against rubella so that mental retardation can be prevented.
• Giving folic acid medicine to the mother during the antenatal period in the first trimester. So that neural tube defects in the child can be prevented.
• Ask the mother to avoid toxic substances, alcohol, nicotine and cocaine during pregnancy.
  -Prohibit the mother from coming into contact with radiation.
• Provide nutritional supplementation during pregnancy.
• Use iodized salt so that diseases caused by iodine deficiency can be prevented.
• Genetic counseling of parents at risk To do.
• To eliminate the misconception in the community and provide health education to the people.
• To improve the socio-economic condition of the people.
• Avoid pregnancy before 21 years and after 35 years so that complications can be prevented.
• Keep the period between two pregnancies to be at least three years.
• In the mother’s Prevent Rh isoimmunization.
• Screening pregnant women for diseases like syphilis and rubella.
• Examining the fetus through immunostaining, fetoscopy, biopsy and ultrasound.
• Treating childhood diseases like diarrhea, brain infection and protein energy malnutrition.
• Providing a proper environment for the mental development of the child.
• Long-term exposure to lead affects brain development, so reduce pollution.
• Provide health education to the community about the causes and prevention of mental retardation.

2) Secondary prevention:

• Identify preventable diseases like measles, rubella early And to treat them properly.
• Identify conditions like hydrocephalus, galactosemia and provide treatment for them.
• Treat emotional and behavioral problems.

3) Tertiary prevention : (Tertiary prevention)

• Physical and To solve psychological problems.
• Hospitalizing severely mentally retarded patients and providing special care.
• Providing education and training to mentally retarded children so that they can be prevented from becoming mentally handicapped.
• Sending such children to special institutions where they are given education, training and work according to their capacity.

Q-5

Define Following (any six) Type the following definition. (any six) 12

a) Delirium

      This is an acute common clinical syndrome, which is a reversible and organic condition, in which the person becomes confused and in which there is a disturbance in disorientation and perception, and consciousness is impaired. The person cannot concentrate and there is acute cognitive dysfunction, which is called delirium. Delirium is a syndrome, not a disease, and it has many causes.

b) Psychosomatic Psychosomatic

Psychosomatic is a medical term that refers to physical conditions or Used for disorders in which symptoms arise from brain and mental states such as stress, depression, anxiety, etc., but no clear organic pathological cause is found. In such cases, neurobiological and psychosocial factors directly affect the body and cause real physical symptoms such as tension headache, functional diarrhea, peptic ulcer, palpitation, etc. Psychosomatic diseases have a syndromic nature and the interplay between physical and psychological factors is important, therefore a biopsychosocial approach is necessary for their treatment.

c) Hallucination – Hallucination

The experience of perception (sensation) without any external stimulation is called a hallucination. In which there is a lack of any stimulation, the patient experiences a perception that is not reality.

E.g. Auditory hallucinations, i.e. the patient hearing different external sounds that are not actually there

OR
A False sensory perception occurring without the external stimulation of the sensory involvement.
Hallucination, i.e. the perception of an object even though it is not there. For example, hearing voices (auditory hallucinations), feeling like someone is about to hit you (visual hallucinations), etc.

d) Pica-Pika

Pica is when a person eats things that they should not eat. Like clay, chalk, ghosts etc., it is an eating disorder but is a result of an existing mental illness.

e) Echolalia – Echolalia

In this, the person has the tendency to repeat the words spoken by another person, which is known as echolalia.

For example… a person is asked how are you? So he will say to the person, “How are you?”… “Are you fine?”… “Will the person also say, “Are you fine?”

f) Word salad – Word salad

Word Salad is a Thought Disorder in which a person speaks words in an incoherent, illogical, and meaningless manner, in which Neologisms, Perseveration, and Improper Syntax are seen, and this condition is usually a symptom of severe Psychiatric Conditions like Schizophrenia. (Psychiatric Conditions)

g) Dejavu – Dejavu

In this, the person feels that he has seen this person, place or scene somewhere but does not know where and when. In reality, he experiences that situation for the first time, which is called deja vu.

h) Thought broadcast- Thought broadcast

The patient feels that people know my thoughts and tell others…..

Q-6(A) Fill in the blanks Fill in the blanks.05

1.Fear of high places is called…….Fear of high places is called……. style=”background-color:#fffc00″ class=”has-inline-color”> Acrophobia

2.ECT stands for…… full name of ECT……. Has : Electro Convulsive Therapy

3.Therapeutic level of serum lithium is……. The therapeutic level of serum lithium is…….is: 0.6 to 1.2 mEq/L

4.Sleep walking is also known as…….Sleep walking is also known as……..Somnambulism

5.Loss of memory is known as……. Memory loss is called Amnesia. B)True or False – Tell me the truth or the lies.05

1.Excessive sleep is known as insomnia. Excessive sleepiness is called insomnia : ❌ False
🔹 Correct term: Hypersomnia
🔹 Insomnia means difficulty in sleeping or inability to sleep.

2.Touching one’s body without consent is known as battery. Touching one’s body without consent is known as battery : ✅ True
🔹 Battery is unauthorized physical contact, even without injury.

3.Face to face interaction between two persons known as interview. Face-to-face interaction between two people is called an interview.

4.Clag association means impaired verbal communication. : ✅ True
🔹 Clang association is speech in which words are chosen for their sound rather than meaning — seen in schizophrenia.

5.Doctor shopping is a characteristic of hypochondriac disease. Doctor shopping is a characteristic of hypochondriac disease: ✅ True
🔹 Hypochondriacs often consult multiple doctors due to constant worry about having a serious illness.

(C) Multiple Choice Questions- Write the correct option from the following.

1.Korsakoff’s syndrome results due to deficiency of……..This deficiency causes Korsakoff’s syndrome.

a) Cyanocobalamin

b) Thiamin

c) Riboflavin

d) Biotin

✅ b) Thiamin
🔹 Explanation: Thiamin (Vitamin B1) deficiency causes Korsakoff’s psychosis, commonly seen in chronic alcoholism.

2.Teeth grinding termed as………Teeth grinding should be known as is.

a) Sleep talking

b) Sleep walking

c) Bruxism

d) Night terror

✅ c) Bruxism
🔹 Explanation: Bruxism is involuntary grinding of teeth during sleep, often related to stress or anxiety.

3.False sensory perception is known as……

a) Hallucination

b) Delusion

c) Illusion

d) Though of insertion

a) Hallucination Explanation: Hallucination is perceiving something that doesn’t exist, like hearing voices without stimuli.

4.IQ of trainable mentally retarded child is….. IQ of trainable mentally retarded child is

a) 50-70

b) 20-35

c) 35-50

d) < 20

🔹 Explanation:

• Mild (Educable): IQ 50–70
• Moderate (Trainable): IQ 35–50
• Severe: 20–35
• Profound: <20

5.The most common side effect of ECT is…….
The most common side effect of ECT is……..

a) Permanent memory loss

b) Temporary memory loss

c) Fracture of cranial bone

d) Cardiac arrest

✅ b) Temporary memory loss
🔹 Explanation: ECT may cause short-term memory issues, but these usually resolve over time.