Guide for Evidence-Based Practice, 3rd Edition (2025,Kathleen Wheeler )
Chapter 1. The Nurse Psychotherapist and a Framework for Practice
Question1
Type: MCSA
The psychiatricmental health nurse is working with the new graduate nurse who is orienting to the
psychiatric unit. Which comment by the new graduate indicates further clarification of the generalist-nursing
role is needed?
1. I would feel better if you would look at my documentation that addresses progress toward treatment goals.
2. I will spend time each day evaluating the effectiveness of the therapeutic milieu.
3. I am a little nervous about conducting psychotherapy with clients.
4. I am doing some reading on how to incorporate complementary interventions into treatment plans.
Correct Answer: 3
Rationale 1: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the
generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and
indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward
treatment goals, and incorporating complementary interventions are consistent with the roles of the
psychiatricmental health nurse practicing at the generalist level.
Rationale 2: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at
the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and
indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward
treatment goals, and incorporating complementary interventions are consistent with the roles of the
psychiatricmental health nurse practicing at the generalist level.
,Rationale 3: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at
the generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and
indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward
treatment goals, and incorporating complementary interventions are consistent with the roles of the
psychiatricmental health nurse practicing at the generalist level.
Rationale 4: The intent to conduct psychotherapy with clients is not consistent with the role of the nurse at the
generalist level of practice as outlined in the PsychiatricMental Health Nursing Standards of Practice and
indicates a need for role clarification. Evaluation of the therapeutic milieu, documenting progress toward
treatment goals, and incorporating complementary interventions are consistent with the roles of the
psychiatricmental health nurse practicing at the generalist level.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: Apply knowledge of current practice and professional performance standards to
the delivery of contemporary psychiatricmental health nursing.
Question 2
Type: MCSA
The client on the psychiatric unit is asking questions about prevention of sexually transmitted diseases. Given
the PsychiatricMental Health Nursing Standards of Practice, which action would be most appropriate for the
nurse to take at this time?
1. Consult with the mental health care team.
2. Teach safer sexual practices.
3. Investigate the questions in individual psychotherapy.
4. Notify the attending psychiatrist.
, Correct Answer: 2
Rationale 1: The psychiatricmental health nurse employs strategies to promote health and a safe environment
and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and
consulting with the mental health care team is not necessary as health teaching is within the independent
practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist
nurse.
Rationale 2: The psychiatricmental health nurse employs strategies to promote health and a safe environment
and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and
consulting with the mental health care team is not necessary as health teaching is within the independent
practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist
nurse.
Rationale 3: The psychiatricmental health nurse employs strategies to promote health and a safe environment
and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and
consulting with the mental health care team is not necessary as health teaching is within the independent
practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist
nurse.
Rationale 4: The psychiatricmental health nurse employs strategies to promote health and a safe environment
and teaches safer sexual practices to the client who is asking for the information. Notifying the psychiatrist and
consulting with the mental health care team is not necessary as health teaching is within the independent
practice of the RN. Conducting individual psychotherapy is not within the practice standards for the generalist
nurse.
Global Rationale:
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: Apply knowledge of current practice and professional performance standards to
the delivery of contemporary psychiatricmental health nursing.
Question 3