RN Mental Health Nursing
REVIEW MODULE EDITION 10.0
Contributors
Norma Jean E. Henry, MSN/Ed, RN Consultants
Mendy McMichael, DNP, MSN Susan Adcock, RN, MS
Janean Johnson, MSN, RN, CNE Katherine McKinley, APRN, FNP-C, MSN
Agnes DiStasi, DNP, RN, CNE Sheri Stone, MSN, RN, APRN‑AGCNS, CCRN, MICT
Kellie L. Wilford, MSN, RN Deb Johnson-Schuh, RN, MSN, CNE
Terri Lemon, DNP, MSN, RN Lisa Kongable, MA, PMH‑CNS, ARNP, CNE
INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2016 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
RN MENTAL HEALTH NURSING I
, Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Janet Hines, Nicole Burke
Coordination of content review: Norma Jean E. Henry, Mendy McMichael
Copy editing: Kelly Von Lunen, Derek Prater
Layout: Spring Lenox, Randi Hardy
Illustrations: Randi Hardy
Online media: Morgan Smith, Ron Hanson, Nicole Lobdell, Brant Stacy
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
informational and educational purposes only and may be modified or updated by the publisher at any time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
products and procedures described or the correctness, sufficiency, or completeness of stated information, opinions, or
recommendations. The publisher does not recommend or endorse any specific tests, providers, products, procedures,
processes, opinions, or other information that may be mentioned in this publication. Treatments and side effects described
in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
and government regulations often change the accepted standard in this field. When consideration is being given to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
specific determination should be made only with the aid of legal counsel. Some images in this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
II CONTENT MASTERY SERIES
, User’s Guide
Welcome to the Assessment Technologies Institute® ACTIVE LEARNING SCENARIOS
RN Mental Health Nursing Review Module Edition 10.0. AND APPLICATION EXERCISES
The mission of ATI’s Content Mastery Series® Review
Each chapter includes opportunities for you to test your
Modules is to provide user-friendly compendiums of
knowledge and to practice applying that knowledge. Active
nursing knowledge that will:
Learning Scenario exercises pose a nursing scenario
●● Help you locate important information quickly.
and then direct you to use an ATI Active Learning
●● Assist in your learning efforts.
Template (included at the back of this book) to record
●● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
●● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more content into less space and have done so in a you with opportunities to practice answering the kinds of
way that will make it even easier for you to find and questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION
This Review Module is organized into units covering
NCLEX® CONNECTIONS
foundations for mental health nursing, traditional To prepare for the NCLEX-RN, it is important to
nonpharmacological therapies, psychobiologic disorders, understand how the content in this Review Module
psychopharmacological therapies, specific populations, and is connected to the NCLEX-RN test plan. You can find
psychiatric emergencies. Chapters within these units conform information on the detailed test plan at the National
to one of four organizing principles for presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
●● Nursing concepts org. When reviewing content in this Review Module,
●● Procedures regularly ask yourself, “How does this content fit into
●● Disorders the test plan, and what types of questions related to this
●● Medications content should I expect?”
Nursing concepts chapters begin with an overview To help you in this process, we’ve included NCLEX
describing the central concept and its relevance to nursing. Connections at the beginning of each unit and with each
Subordinate themes are covered in outline form to question in the Application Exercises Answer Keys. The
demonstrate relationships and present the information in a NCLEX Connections at the beginning of each unit point
clear, succinct manner. out areas of the detailed test plan that relate to the content
within that unit. The NCLEX Connections attached to the
Procedures chapters include an overview describing the
Application Exercises Answer Keys demonstrate how each
procedure(s) covered in the chapter. These chapters provide
exercise fits within the detailed content outline.
nursing knowledge relevant to each procedure, including
These NCLEX Connections will help you understand how
indications, nursing considerations, and complications.
the detailed content outline is organized, starting with
Disorders chapters include an overview describing the major client needs categories and subcategories and
disorder. These chapters cover assessments, including risk followed by related content areas and tasks. The major
factors and expected findings, and patient-centered care, client needs categories are:
including nursing care, medications, therapeutic procedures, ●● Safe and Effective Care Environment
and interprofessional care. ◯◯ Management of Care
◯◯ Safety and Infection Control
Medications chapters include an overview describing a ●● Health Promotion and Maintenance
disorder or group of disorders. Medications used to treat ●● Psychosocial Integrity
these disorders are grouped according to classification. ●● Physiological Integrity
A specific medication can be selected as a prototype or ◯◯ Basic Care and Comfort
example of the characteristics of medications in this ◯◯ Pharmacological and Parenteral Therapies
classification. These sections include information about ◯◯ Reduction of Risk Potential
how the medication works and its therapeutic uses. ◯◯ Physiological Adaptation
Next, you will find information about complications,
contraindications/precautions, and interactions, as well as An NCLEX Connection might, for example, alert you that
nursing interventions and client education to help prevent content within a unit is related to:
and/or manage these issues. Finally, the chapter includes ●● Psychosocial Integrity
information on nursing administration of the medication and ◯◯ Behavioral Interventions
evaluation of the medication’s effectiveness. ■■ Incorporate behavioral management techniques
when caring for a client.
RN MENTAL HEALTH NURSING USER’S GUIDE III
, QSEN COMPETENCIES ICONS
As you use the Review Modules, you will note the Icons are used throughout the Review Module to draw
integration of the Quality and Safety Education for your attention to particular areas. Keep an eye out for
Nurses (QSEN) competencies throughout the chapters. these icons.
These competencies are integral components of the
curriculum of many nursing programs in the United States This icon is used for NCLEX Connections.
and prepare you to provide safe, high-quality care as a
This icon indicates gerontological considerations,
newly licensed nurse. Icons appear to draw your attention
or knowledge specific to the care of older
to the six QSEN competencies.
adult clients.
Safety: The minimization of risk factors that could
This icon is used for content related to safety
cause injury or harm while promoting quality care
and is a QSEN competency. When you see this
and maintaining a secure environment for clients, self,
icon, take note of safety concerns or steps that
and others.
nurses can take to ensure client safety and a
Patient-Centered Care: The provision of caring and safe environment.
compassionate, culturally sensitive care that addresses
This icon is a QSEN competency that indicates
clients’ physiological, psychological, sociological, spiritual,
the importance of a holistic approach to
and cultural needs, preferences, and values.
providing care.
Evidence-Based Practice: The use of current knowledge
This icon, a QSEN competency, points out the
from research and other credible sources, on which to base
integration of research into clinical practice.
clinical judgment and client care.
This icon is a QSEN competency and highlights
Informatics: The use of information technology as a
the use of information technology to support
communication and information-gathering tool that
nursing practice.
supports clinical decision-making and scientifically based
nursing practice. This icon is used to focus on the QSEN
competency of integrating planning processes to
Quality Improvement: Care related and organizational
meet clients’ needs.
processes that involve the development and
implementation of a plan to improve health care services This icon highlights the QSEN competency of care
and better meet clients’ needs. delivery using an interprofessional approach.
Teamwork and Collaboration: The delivery of client care This icon appears at the top-right of pages
in partnership with multidisciplinary members of the and indicates availability of an online media
health care team to achieve continuity of care and positive supplement, such as a graphic, animation, or
client outcomes. video. If you have an electronic copy of the
Review Module, this icon will appear alongside
clickable links to media supplements. If you have
a hard copy version of the Review Module, visit
www.atitesting.com for details on how to access
these features.
FEEDBACK
ATI welcomes feedback regarding this Review Module.
Please provide comments to .
IV USER’S GUIDE CONTENT MASTERY SERIES
REVIEW MODULE EDITION 10.0
Contributors
Norma Jean E. Henry, MSN/Ed, RN Consultants
Mendy McMichael, DNP, MSN Susan Adcock, RN, MS
Janean Johnson, MSN, RN, CNE Katherine McKinley, APRN, FNP-C, MSN
Agnes DiStasi, DNP, RN, CNE Sheri Stone, MSN, RN, APRN‑AGCNS, CCRN, MICT
Kellie L. Wilford, MSN, RN Deb Johnson-Schuh, RN, MSN, CNE
Terri Lemon, DNP, MSN, RN Lisa Kongable, MA, PMH‑CNS, ARNP, CNE
INTELLECTUAL PROPERTY NOTICE
ATI Nursing is a division of Assessment Technologies Institute®, LLC.
Copyright © 2016 Assessment Technologies Institute, LLC. All rights reserved.
The reproduction of this work in any electronic, mechanical or other means, now known or hereafter
invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the
content in this publication, including, for example, the cover, all of the page headers, images, illustrations,
graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual
property rights or licenses held by Assessment Technologies Institute, LLC, one of its affiliates, or by
third parties who have licensed their materials to Assessment Technologies Institute, LLC.
RN MENTAL HEALTH NURSING I
, Director of content review: Kristen Lawler
Director of development: Derek Prater
Project management: Janet Hines, Nicole Burke
Coordination of content review: Norma Jean E. Henry, Mendy McMichael
Copy editing: Kelly Von Lunen, Derek Prater
Layout: Spring Lenox, Randi Hardy
Illustrations: Randi Hardy
Online media: Morgan Smith, Ron Hanson, Nicole Lobdell, Brant Stacy
Cover design: Jason Buck
Interior book design: Spring Lenox
IMPORTANT NOTICE TO THE READER
Assessment Technologies Institute, LLC, is the publisher of this publication. The content of this publication is for
informational and educational purposes only and may be modified or updated by the publisher at any time. This
publication is not providing medical advice and is not intended to be a substitute for professional medical advice,
diagnosis, or treatment. The publisher has designed this publication to provide accurate information regarding the
subject matter covered; however, the publisher is not responsible for errors, omissions, or for any outcomes related to
the use of the contents of this book and makes no guarantee and assumes no responsibility or liability for the use of the
products and procedures described or the correctness, sufficiency, or completeness of stated information, opinions, or
recommendations. The publisher does not recommend or endorse any specific tests, providers, products, procedures,
processes, opinions, or other information that may be mentioned in this publication. Treatments and side effects described
in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect
that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by
the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice,
and government regulations often change the accepted standard in this field. When consideration is being given to use
of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the
drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations
on dose, precautions, and contraindications and determining the appropriate usage for the product. Any references
in this book to procedures to be employed when rendering emergency care to the sick and injured are provided solely
as a general guide. Other or additional safety measures may be required under particular circumstances. This book
is not intended as a statement of the standards of care required in any particular situation, because circumstances
and a patient’s physical condition can vary widely from one emergency to another. Nor is it intended that this book
shall in any way advise personnel concerning legal authority to perform the activities or procedures discussed. Such
specific determination should be made only with the aid of legal counsel. Some images in this book feature models.
These models do not necessarily endorse, represent, or participate in the activities represented in the images. THE
PUBLISHER MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, WITH
RESPECT TO THE CONTENT HEREIN. THIS PUBLICATION IS PROVIDED AS-IS, AND THE PUBLISHER AND ITS AFFILIATES
SHALL NOT BE LIABLE FOR ANY ACTUAL, INCIDENTAL, SPECIAL, CONSEQUENTIAL, PUNITIVE, OR EXEMPLARY
DAMAGES RESULTING, IN WHOLE OR IN PART, FROM THE READER’S USE OF, OR RELIANCE UPON, SUCH CONTENT.
II CONTENT MASTERY SERIES
, User’s Guide
Welcome to the Assessment Technologies Institute® ACTIVE LEARNING SCENARIOS
RN Mental Health Nursing Review Module Edition 10.0. AND APPLICATION EXERCISES
The mission of ATI’s Content Mastery Series® Review
Each chapter includes opportunities for you to test your
Modules is to provide user-friendly compendiums of
knowledge and to practice applying that knowledge. Active
nursing knowledge that will:
Learning Scenario exercises pose a nursing scenario
●● Help you locate important information quickly.
and then direct you to use an ATI Active Learning
●● Assist in your learning efforts.
Template (included at the back of this book) to record
●● Provide exercises for applying your nursing knowledge.
the important knowledge a nurse should apply to the
●● Facilitate your entry into the nursing profession as a
scenario. An example is then provided to which you can
newly licensed nurse.
compare your completed Active Learning Template. The
This newest edition of the Review Modules has been Application Exercises include NCLEX-style questions, such
redesigned to optimize your learning experience. We’ve as multiple-choice and multiple-select items, providing
fit more content into less space and have done so in a you with opportunities to practice answering the kinds of
way that will make it even easier for you to find and questions you might expect to see on ATI assessments or
understand the information you need. the NCLEX. After the Application Exercises, an answer key
is provided, along with rationales.
ORGANIZATION
This Review Module is organized into units covering
NCLEX® CONNECTIONS
foundations for mental health nursing, traditional To prepare for the NCLEX-RN, it is important to
nonpharmacological therapies, psychobiologic disorders, understand how the content in this Review Module
psychopharmacological therapies, specific populations, and is connected to the NCLEX-RN test plan. You can find
psychiatric emergencies. Chapters within these units conform information on the detailed test plan at the National
to one of four organizing principles for presenting the content. Council of State Boards of Nursing’s website, www.ncsbn.
●● Nursing concepts org. When reviewing content in this Review Module,
●● Procedures regularly ask yourself, “How does this content fit into
●● Disorders the test plan, and what types of questions related to this
●● Medications content should I expect?”
Nursing concepts chapters begin with an overview To help you in this process, we’ve included NCLEX
describing the central concept and its relevance to nursing. Connections at the beginning of each unit and with each
Subordinate themes are covered in outline form to question in the Application Exercises Answer Keys. The
demonstrate relationships and present the information in a NCLEX Connections at the beginning of each unit point
clear, succinct manner. out areas of the detailed test plan that relate to the content
within that unit. The NCLEX Connections attached to the
Procedures chapters include an overview describing the
Application Exercises Answer Keys demonstrate how each
procedure(s) covered in the chapter. These chapters provide
exercise fits within the detailed content outline.
nursing knowledge relevant to each procedure, including
These NCLEX Connections will help you understand how
indications, nursing considerations, and complications.
the detailed content outline is organized, starting with
Disorders chapters include an overview describing the major client needs categories and subcategories and
disorder. These chapters cover assessments, including risk followed by related content areas and tasks. The major
factors and expected findings, and patient-centered care, client needs categories are:
including nursing care, medications, therapeutic procedures, ●● Safe and Effective Care Environment
and interprofessional care. ◯◯ Management of Care
◯◯ Safety and Infection Control
Medications chapters include an overview describing a ●● Health Promotion and Maintenance
disorder or group of disorders. Medications used to treat ●● Psychosocial Integrity
these disorders are grouped according to classification. ●● Physiological Integrity
A specific medication can be selected as a prototype or ◯◯ Basic Care and Comfort
example of the characteristics of medications in this ◯◯ Pharmacological and Parenteral Therapies
classification. These sections include information about ◯◯ Reduction of Risk Potential
how the medication works and its therapeutic uses. ◯◯ Physiological Adaptation
Next, you will find information about complications,
contraindications/precautions, and interactions, as well as An NCLEX Connection might, for example, alert you that
nursing interventions and client education to help prevent content within a unit is related to:
and/or manage these issues. Finally, the chapter includes ●● Psychosocial Integrity
information on nursing administration of the medication and ◯◯ Behavioral Interventions
evaluation of the medication’s effectiveness. ■■ Incorporate behavioral management techniques
when caring for a client.
RN MENTAL HEALTH NURSING USER’S GUIDE III
, QSEN COMPETENCIES ICONS
As you use the Review Modules, you will note the Icons are used throughout the Review Module to draw
integration of the Quality and Safety Education for your attention to particular areas. Keep an eye out for
Nurses (QSEN) competencies throughout the chapters. these icons.
These competencies are integral components of the
curriculum of many nursing programs in the United States This icon is used for NCLEX Connections.
and prepare you to provide safe, high-quality care as a
This icon indicates gerontological considerations,
newly licensed nurse. Icons appear to draw your attention
or knowledge specific to the care of older
to the six QSEN competencies.
adult clients.
Safety: The minimization of risk factors that could
This icon is used for content related to safety
cause injury or harm while promoting quality care
and is a QSEN competency. When you see this
and maintaining a secure environment for clients, self,
icon, take note of safety concerns or steps that
and others.
nurses can take to ensure client safety and a
Patient-Centered Care: The provision of caring and safe environment.
compassionate, culturally sensitive care that addresses
This icon is a QSEN competency that indicates
clients’ physiological, psychological, sociological, spiritual,
the importance of a holistic approach to
and cultural needs, preferences, and values.
providing care.
Evidence-Based Practice: The use of current knowledge
This icon, a QSEN competency, points out the
from research and other credible sources, on which to base
integration of research into clinical practice.
clinical judgment and client care.
This icon is a QSEN competency and highlights
Informatics: The use of information technology as a
the use of information technology to support
communication and information-gathering tool that
nursing practice.
supports clinical decision-making and scientifically based
nursing practice. This icon is used to focus on the QSEN
competency of integrating planning processes to
Quality Improvement: Care related and organizational
meet clients’ needs.
processes that involve the development and
implementation of a plan to improve health care services This icon highlights the QSEN competency of care
and better meet clients’ needs. delivery using an interprofessional approach.
Teamwork and Collaboration: The delivery of client care This icon appears at the top-right of pages
in partnership with multidisciplinary members of the and indicates availability of an online media
health care team to achieve continuity of care and positive supplement, such as a graphic, animation, or
client outcomes. video. If you have an electronic copy of the
Review Module, this icon will appear alongside
clickable links to media supplements. If you have
a hard copy version of the Review Module, visit
www.atitesting.com for details on how to access
these features.
FEEDBACK
ATI welcomes feedback regarding this Review Module.
Please provide comments to .
IV USER’S GUIDE CONTENT MASTERY SERIES
