2nd Year GNM Nursing KARNATAKA Mental Health Nursing FEBRUARY 2025
KARNATAKA
STATE DIPLOMA IN NURSING EXAMINATION BOARD
GNM
THEORY EXAMINATION – FEBRUARY 2025
2nd
YEAR – PAPER III - MENTAL HEALTH NURSING
I. Give the meaning of the following
Answer :
1. Psychosomatic
disorder
A condition in which psychological factors (such as stress, anxiety, emotional
conflicts) significantly influence or worsen physical illness or bodily
symptoms. In other words, the mind (psyche) affects the body (soma)
2. Paralalia
A speech disorder characterised by distortion of sounds or substitution of
letters/sounds during speech (for example, producing wrong sounds/spoken
words).
3. Grief
The emotional response to a loss (actual, perceived or anticipated) of someone
or something valued. It involves feelings like sadness, loneliness, regret etc,
and can affect a person’s physical, psychological, social and spiritual
domains.
4. Delirium
An acute (rapid-onset) disturbance in consciousness, attention, cognition and
awareness of the environment. It often develops over hours to days, shows
fluctuating course, and typically is caused by an underlying medical condition
or multiple contributing factors.
II. Fill in the blanks
Answer :
- An ability to put oneself in
patient’s situation is known as Empathy
- Meaningless and incoherent
mixtures of words or phrases is known as Word Salad
- The unconscious filling of
memory gaps by imagined or untrue experiences due to memory impairment is
known as Confabulation
- Derealization means a person’s subjective
sense of being unreal, strange or unfamiliar
III. Write short notes for any FOUR of the following
Answer :
9. Admission Procedure
- Admission in a psychiatric
unit is the process of formally receiving a patient into a mental health
facility.
- Types: Voluntary admission,
Involuntary admission, Emergency admission, Admission by court order.
- Steps include:
- Initial assessment (history
taking, mental status examination)
- Physical examination and
investigation
- Legal paperwork / consent
- Informing the patient and
family about ward rules and routines
- Orientation to ward
environment, bed allotment
- Nurse’s role:
- Provide emotional support
- Collect baseline data
- Ensure patient safety
(remove harmful objects)
- Document the admission
details
10. Phases of Therapeutic Nurse-Patient Relationship
- Orientation Phase: Establish rapport,
introduce self, explain role, identify patient’s problems and goals.
- Working Phase: Explore feelings, encourage
expression, behavior modification, problem solving, use therapeutic
communication.
- Termination Phase: Evaluation of goals
achieved, planning follow-up care, prepare patient for discharge, summarize
progress.
11. Family Therapy
- A type of psychotherapy in
which the whole family is treated as a unit.
- Aim: Improve communication,
resolve conflicts, support coping.
- Indications:
- Family conflicts
- Marital problems
- Substance abuse
- Childhood behavioral
disorders
- Techniques:
- Communication training
- Problem-solving
- Role playing
- Reframing
- Nurse’s role: Assist
therapist, educate family about illness, encourage participation.
12. Causes and Clinical Features of Mania
Causes:
- Biological –
neurotransmitter imbalance (↑ dopamine, ↑ norepinephrine)
- Genetic predisposition
- Stressful life events
- Substance abuse (alcohol,
drugs)
- Medical conditions (thyroid
dysfunction)
Clinical
Features:
- Elevated or irritable mood
- Over-activity and increased
talking (pressured speech)
- Decreased need for sleep
- Grandiosity (exaggerated
ideas)
- Flight of ideas
- Distractibility
- Increased involvement in
risky activities (spending, sexual activity)
13. Phobic Anxiety Disorder
- A phobia is an irrational,
persistent and excessive fear of a specific object, person, place or
situation.
- Types:
- Specific phobia (e.g. fear
of animals, heights)
- Social phobia (fear of
social situations/being embarrassed)
- Agoraphobia (fear of open
spaces or leaving home)
- Symptoms:
- Panic symptoms when exposed
to phobic stimulus (palpitations, sweating, trembling)
- Avoidance behavior
- Insight present — patient
knows fear is irrational but cannot control it.
- Treatment:
- Behavior therapy
(systematic desensitization)
- Relaxation techniques
- Cognitive behavioral
therapy (CBT)
- Anti-anxiety /
antidepressant medications
IV. Answer the following
Answer :
14. Define Mental Health Nursing (2 marks)
Mental Health Nursing is a specialized branch of nursing which deals with
the care, treatment, rehabilitation and prevention of mental illness, by using
therapeutic communication and scientifically planned nursing interventions to
promote mental health and well-being of individuals, families and communities.
15. List the Principles of Mental Health Nursing (3 marks)
·
Accept the patient as a person without judgement.
·
Build a therapeutic and trusting relationship.
·
Maintain confidentiality and privacy.
·
Use therapeutic communication techniques.
·
Provide a safe and secure environment.
·
Encourage patient’s independence and
participation in care.
·
Use scientific / evidence-based nursing
interventions.
·
Maintain professional boundaries.
16. Explain Mental Health Team (4 marks)
Mental health team is a group of different health professionals who work
together to provide comprehensive care to mentally ill persons.
Members include:
·
Psychiatrist – diagnosis, treatment, medication.
·
Psychiatric Nurse – patient care, assessment,
counseling, health education.
·
Clinical Psychologist – psychological tests,
psychotherapy, behavior therapy.
·
Social Worker – family and social assessment,
rehabilitation, community resources.
·
Occupational Therapist – vocational training,
activity therapy.
·
Other members – counselor, pharmacist,
dietician, physiotherapist as needed.
Purpose:
To provide holistic, coordinated and multi-disciplinary care for better
recovery and rehabilitation of the patient.
17. Define ADHD (2 marks)
ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental
disorder characterized by persistent pattern of inattention, hyperactivity and
impulsive behavior that interferes with functioning or development.
18. Clinical Features and Nursing Management of ADHD (6
marks)
Clinical Features
·
Short attention span / difficulty concentrating
·
Easily distracted
·
Hyperactivity (always moving, restless,
fidgeting)
·
Impulsive behavior (acts without thinking)
·
Difficulty in following instructions
·
Poor academic performance
·
Disruptive behavior in class/home
Nursing Management
·
Provide structured and consistent routine
·
Break tasks into small, simple steps
·
Use positive reinforcement / reward desirable
behavior
·
Avoid overstimulation, provide quiet study
environment
·
Teach parents about behavior modification
techniques
·
Collaborate with teacher for classroom
management
·
Monitor medication (e.g. stimulants) for side
effects
·
Encourage physical activity to release excess
energy
V. State the following statement is True / False
Answer :
|
No. |
Statement |
True / False |
|
19 |
Suicide
is psychiatric emergency |
True |
|
20 |
Token
economy is a negative reinforcement of behaviour |
False (Token economy is positive
reinforcement) |
|
21 |
Bulimia
nervosa is Eating disorder |
True |
|
22 |
Hallucination
is a negative symptom of schizophrenia |
False (Hallucination is a positive
symptom) |
VI. Write short notes for any THREE of the following
Answer :
23. Mental Status Examination (MSE)
·
MSE is a systematic assessment of a patient’s
present mental state.
·
It helps in diagnosis, treatment planning and
evaluation.
·
Major Components include:
o
Appearance & Behavior
(grooming, posture, psychomotor activity)
o
Speech (rate, tone, volume)
o
Mood & Affect
o
Thought Process & Thought Content
o
Perception (hallucinations,
illusions)
o
Cognition (orientation, memory,
attention, concentration)
o
Insight & Judgment
24. Community Mental Health Services
·
Services provided at community level to prevent
mental illness and promote mental health.
·
Aim: early detection, treatment, rehabilitation
and reintegration of mentally ill persons into society.
·
Important community services include:
o
OPD Clinics
o
Day care centers
o
Halfway homes / sheltered homes
o
Rehabilitation centers & vocational training
o
Home visits
o
Mental health awareness programs
·
Advantages: reduces hospitalization, increases
accessibility, cost-effective, reduces stigma.
25. Causes & Clinical Features of OCD
Causes:
·
Neurochemical imbalance – ↑ serotonin
disturbance
·
Genetic factors
·
Stressful life events
·
Personality traits (perfectionism)
Clinical Features:
·
Recurrent intrusive thoughts (obsessions) → e.g.
fear of contamination
·
Repetitive behavior / mental acts (compulsions)
→ e.g. washing, checking
·
Patient realizes thoughts are irrational but
cannot control
·
Anxiety increases if ritual is prevented
·
Excessive time spent in rituals → affects social
& occupational functioning
26. Electro Convulsive Therapy (ECT)
·
ECT is a treatment method in which controlled
electric current is passed through the brain to produce a therapeutic seizure.
·
Indications: severe depression, suicidal risk,
catatonia, treatment resistant mania & schizophrenia.
·
Procedure: given under anesthesia + muscle
relaxant, electrodes are placed on scalp.
·
Nursing responsibilities:
o
Pre-ECT: obtain consent, NPO status, remove
dentures/jewelry, baseline vitals
o
During ECT: maintain airway, assist anesthetist
o
Post-ECT: monitor vitals, reorientation, observe
for confusion/headache
·
Side effects: headache, muscle soreness, temporary
memory loss.
VII. Answer the following
Answer :
27. Define Alcohol Dependence Syndrome (2 marks)
Alcohol Dependence Syndrome (ADS) is a maladaptive pattern of alcohol use in
which a person becomes physically and psychologically dependent on alcohol,
characterized by tolerance, withdrawal symptoms, craving, loss of control and
continued drinking despite harmful consequences.
28. Write the Complications and Management of ADS (5 marks)
Complications:
·
Gastritis, liver cirrhosis, pancreatitis
·
Nutritional deficiency (Vitamin B1 deficiency) →
Wernicke–Korsakoff syndrome
·
Hypertension, cardiomyopathy
·
Accidents / injuries, violence
·
Relationship problems, job loss, social
isolation
·
Psychiatric problems – depression, suicide
Management:
·
Detoxification (Controlled withdrawal in
hospital)
·
Medications – Benzodiazepines for withdrawal,
Disulfiram / Naltrexone for relapse prevention
·
Thiamine and vitamin supplements
·
Counseling & Motivation therapy
(Motivational enhancement therapy)
·
Cognitive Behavioral Therapy (CBT)
·
Family therapy and support groups (e.g.
Alcoholics Anonymous)
·
Rehabilitation and relapse prevention programmes
29. Define Schizophrenia (2 marks)
Schizophrenia is a chronic, severe mental disorder characterized by
disturbances in thinking, perception, emotion and behavior, with symptoms such
as delusions, hallucinations, disorganized speech, social withdrawal, and
decline in functioning, lasting for at least six months.
30. Causes and Management of Schizophrenia (5 marks)
Causes:
·
Genetic factors / family history
·
Biochemical factors – dopamine hypothesis (↑
dopamine activity)
·
Brain structural abnormalities
·
Stressful life events / psychosocial factors
·
Substance abuse (e.g. cannabis)
Management:
·
Antipsychotic medications (e.g. haloperidol,
risperidone)
·
Hospitalization in acute episodes
·
Psychotherapy – supportive therapy, CBT
·
Social skills training & vocational
rehabilitation
·
Family education to reduce relapse and improve
support
·
Maintain medication adherence to prevent relapse
·
Provide safe environment and monitor for
self-harm
