Mental Health Final Review
Unit 1:
Plan nursing care based on evidence-based practice in caring for individuals with complex
mental health needs, prioritizing safety, therapeutic communication, and multidisciplinary
communication.
● Evidence-Based Approaches:
● Assertive Community Treatment (ACT): A multidisciplinary team provides a range
of services directly to the consumer, avoiding the need for multiple agencies.
● Cognitive-Behavioral Therapy (CBT): focuses on identifying and changing
distorted patterns of thinking and using “self-talk” to control situations.
● Cognitive-Enhancement Therapy (CET): Utilizes computer-based exercises to
strengthen brain function.
● Nursing Strategies: Interventions should involve the patient in goal setting, emphasize quality
of life over mere symptom management, and focus on current coping rather than past
issues.
Implement individualized teaching plans to educate clients and families about mental health
conditions, treatment adherence, symptoms management, and available support services.
● Support Models: The Clubhouse model focuses on providing opportunities for consumers to
build job skills and run their own programming.
● Education topics: Nurses should educate patients on the recovery process, which
emphasizes client empowerment and strengths, and teach them how to respond to social
stigma.
● Community Resources: Teaching should include information on partial hospitalization
programs (PHPs), intensive outpatient programs (IOPs), and family therapy.
Evaluate the client’s adherence to the treatment plan and the effectiveness of their support
system in promoting recovery and continuity of care.
● Barriers to Adherence: A major obstacle is anosognosia, which is the biological inability of
a person to recognize that they are ill.
● Risk Assessment: Evaluation must include monitoring for signs of impending relapse,
treatment nonadherence, and risks for depression or hopelessness.
Unit 2:
Explain the legal responsibility of the Psychiatric nurse, including adherence to standards of
care, institutional policies and procedures, and professional nursing associations.
● Standards of Care: Nurses are held to standards defined by the Board of Nursing (BON),
the American Nurses Association (ANA), and the APNA.
● Legal Roles: The nurse must be familiar with the legal processes for admission and
discharge, as well as the patient’s rights.
● Documentation: Medical records are used for quality improvement and serve as crucial
legal evidence.
Differentiate voluntary psychiatric admission versus involuntary commitment.
● Voluntary Admission: Sought directly by the patient or their guardian.
, ● Involuntary Commitment: Performed without the patient’s consent. Criteria include being
mentally ill a danger to self or others, or being unable to provide for basic necessities.
● Due Process: Patients have the right to a Writ of Habeas Corpus to challenge their
detention and must be treatment under the Least Restrictive Alternative Doctrine.
Describe patients’ right and legal concerns with regard to restraint, informed consent, and
the right to refuse treatment.
● Restraint and Seclusion: The rule is to use the least restrictive method for the shortest term
possible. Chemical interventions are often considered less restrictive than physical restraints.
● Informed Consent: The prescriber (not the nurse) is responsible for obtaining informed
consent for procedures like electroconvulsive therapy (ECT).
● Right to Refuse: Patients generally maintain the right to refuse treatment.
Identify appropriate actions as a nurse should take when witnessing or suspecting
negligence, malpractice, or illegal activity.
● Duty to Intervene: Nurses have a legal duty to intervene and report incompetence,
impairment, or criminal activity.
● Negligence Elements: To prove negligence or malpractice, five elements must be met:
Duty, Breach of Duty, Cause in Fact, Proximate Cause, and Damages.
● Duty to Warn: In cases where a client threatens a third party, the nurse may have a “duty to
warn” that supersedes normal confidentiality.
Unit 3
Describe the therapeutic and common side effects of psychotropic medications including
antianxiety, antidepressants, mood stabilizers, and antipsychotics.
● Antianxiety (Benzodiazepines): Used for anxiety, panic, and alcohol withdrawal. Common
examples include diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan).
● Antidepressants:
● SSRIs: fluoxetine (Prozac), sertraline (Zoloft)
● NDRIs: bupropion (Wellbutrin)
● Mood Stabilizers: Include Lithium and anticonvulsants such as valproate (Depakote),
carbamazepine (Tegretol), and lamotrigine (Lamictal.
● Antipsychotics: These medications block dopamine (D2) receptors to reduce dopaminergic
transmission
Identify patient education needs with the use of psychotropic medications.
● Focus of Education: Teaching plans must cover therapeutic effects, side effects, and
specific needs such as diet and toxicity monitoring.
Identify cautions in teaching plan in regard to interactions with age, over the counter
medications, and herbal therapies.
● Herbal Concerns: Many herbal treatments lack adequate safety/efficacy data and are not
regulated by the FDA. They may not contain the active ingredients listed on the label, posing
a risk for drug interactions.
Unit 4
Unit 1:
Plan nursing care based on evidence-based practice in caring for individuals with complex
mental health needs, prioritizing safety, therapeutic communication, and multidisciplinary
communication.
● Evidence-Based Approaches:
● Assertive Community Treatment (ACT): A multidisciplinary team provides a range
of services directly to the consumer, avoiding the need for multiple agencies.
● Cognitive-Behavioral Therapy (CBT): focuses on identifying and changing
distorted patterns of thinking and using “self-talk” to control situations.
● Cognitive-Enhancement Therapy (CET): Utilizes computer-based exercises to
strengthen brain function.
● Nursing Strategies: Interventions should involve the patient in goal setting, emphasize quality
of life over mere symptom management, and focus on current coping rather than past
issues.
Implement individualized teaching plans to educate clients and families about mental health
conditions, treatment adherence, symptoms management, and available support services.
● Support Models: The Clubhouse model focuses on providing opportunities for consumers to
build job skills and run their own programming.
● Education topics: Nurses should educate patients on the recovery process, which
emphasizes client empowerment and strengths, and teach them how to respond to social
stigma.
● Community Resources: Teaching should include information on partial hospitalization
programs (PHPs), intensive outpatient programs (IOPs), and family therapy.
Evaluate the client’s adherence to the treatment plan and the effectiveness of their support
system in promoting recovery and continuity of care.
● Barriers to Adherence: A major obstacle is anosognosia, which is the biological inability of
a person to recognize that they are ill.
● Risk Assessment: Evaluation must include monitoring for signs of impending relapse,
treatment nonadherence, and risks for depression or hopelessness.
Unit 2:
Explain the legal responsibility of the Psychiatric nurse, including adherence to standards of
care, institutional policies and procedures, and professional nursing associations.
● Standards of Care: Nurses are held to standards defined by the Board of Nursing (BON),
the American Nurses Association (ANA), and the APNA.
● Legal Roles: The nurse must be familiar with the legal processes for admission and
discharge, as well as the patient’s rights.
● Documentation: Medical records are used for quality improvement and serve as crucial
legal evidence.
Differentiate voluntary psychiatric admission versus involuntary commitment.
● Voluntary Admission: Sought directly by the patient or their guardian.
, ● Involuntary Commitment: Performed without the patient’s consent. Criteria include being
mentally ill a danger to self or others, or being unable to provide for basic necessities.
● Due Process: Patients have the right to a Writ of Habeas Corpus to challenge their
detention and must be treatment under the Least Restrictive Alternative Doctrine.
Describe patients’ right and legal concerns with regard to restraint, informed consent, and
the right to refuse treatment.
● Restraint and Seclusion: The rule is to use the least restrictive method for the shortest term
possible. Chemical interventions are often considered less restrictive than physical restraints.
● Informed Consent: The prescriber (not the nurse) is responsible for obtaining informed
consent for procedures like electroconvulsive therapy (ECT).
● Right to Refuse: Patients generally maintain the right to refuse treatment.
Identify appropriate actions as a nurse should take when witnessing or suspecting
negligence, malpractice, or illegal activity.
● Duty to Intervene: Nurses have a legal duty to intervene and report incompetence,
impairment, or criminal activity.
● Negligence Elements: To prove negligence or malpractice, five elements must be met:
Duty, Breach of Duty, Cause in Fact, Proximate Cause, and Damages.
● Duty to Warn: In cases where a client threatens a third party, the nurse may have a “duty to
warn” that supersedes normal confidentiality.
Unit 3
Describe the therapeutic and common side effects of psychotropic medications including
antianxiety, antidepressants, mood stabilizers, and antipsychotics.
● Antianxiety (Benzodiazepines): Used for anxiety, panic, and alcohol withdrawal. Common
examples include diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan).
● Antidepressants:
● SSRIs: fluoxetine (Prozac), sertraline (Zoloft)
● NDRIs: bupropion (Wellbutrin)
● Mood Stabilizers: Include Lithium and anticonvulsants such as valproate (Depakote),
carbamazepine (Tegretol), and lamotrigine (Lamictal.
● Antipsychotics: These medications block dopamine (D2) receptors to reduce dopaminergic
transmission
Identify patient education needs with the use of psychotropic medications.
● Focus of Education: Teaching plans must cover therapeutic effects, side effects, and
specific needs such as diet and toxicity monitoring.
Identify cautions in teaching plan in regard to interactions with age, over the counter
medications, and herbal therapies.
● Herbal Concerns: Many herbal treatments lack adequate safety/efficacy data and are not
regulated by the FDA. They may not contain the active ingredients listed on the label, posing
a risk for drug interactions.
Unit 4
