NSG 526 EXAM 3
STUDY GUIDE + REVIEW
Clinical Modalities in Advanced Psychiatric Mental
Health Nursing Practice - Wilkes
THIS GUIDE CONTAINS:
● NSG 526 Exam 3 STUDY GUIDE + REVIEW
● Modules 9 to 12 Covered
● Chapters Modules Covered
● focuses on advanced, integrative, and specialized clinical
applications:
, Exam 3 Study Guide
Module 9 - Perese Chapter 11
Crisis Intervention/phases (9 questions)
● Levels of prevention:
o Primary – actually preventing the thing
o Secondary – early identification and treatment
o Tertiary – avoidance of complications
● Norms are considered the "right" patterns of behavior for a society.
● Crisis:
o A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks
o Internal or external demands that are perceived as threats to a person’s physical or
emotional functioning can initiate a crisis. The precipitating event is not only stressful,
but unusual or rare.
o Maturational – Describes unfavorable person-environment relationships that relate to
maturational events, such as leaving home for the first time, completing school, or
accepting the responsibility of adulthood.
o Situational - Occurs whenever a specific stressful event threatens a person’s
biopsychosocial integrity and results in some degree of psychological disequilibrium.
o Adventitious - Initiated by an unexpected unusual events that can affect an individual or
a multitude of people. National and natural disasters.
▪ During an adventitious crisis (e.g., flood, hurricane, forest fire) that affects the
well-being of many people, the interventions of the PMH-APRN will be a part of
the community’s efforts to respond to the event.
o The goal for people experiencing a crisis is to return to the pre-crisis level of functioning.
o The role of the PMH-APRN is to provide a framework of support systems that guide the
client through the crisis and facilitate the development and use of positive coping skills.
▪ Assess risk of homicide/suicide/self-injury
▪ Assess coping skills
▪ Assess perception of problem and support mechanisms
▪ Assess biologic items – sleep, eating, hygiene, etc
▪ Assess psychological – emotions and coping
▪ Asses social – individual, family, community. Social support
o Disaster:
▪ A disaster is a sudden ecological or man-made phenomenon that is of sufficient
magnitude to require external help to address the psychosocial needs as well as
the physical needs of the victims.
▪ Mass Casualty Incident Triage categories:
● Expectant: Injuries are extensive and chances of survival are unlikely
even with definitive care. Separate and provide comfort
o Unresponsive patients with penetrating head wounds, high
spinal cord injuries, wounds involving multiple anatomical sites
and organs, 2nd/3rd degree burns in excess of 60% of body
, surface area, seizures or vomiting within 24hr after radiation
exposure, profound shock with multiple injuries, agonal
respirations; no pulse, no BP, pupils fixed and dilated
● Immediate: Injuries are life-threatening but survivable with minimal
intervention. Individuals in this group can progress rapidly to expectant
if treatment is delayed.
o Sucking chest wound, airway obstruction secondary to
mechanical cause, shock, hemothorax, tension pneumothorax,
asphyxia, unstable chest and abdominal wounds, incomplete
amputations, open fractures of long bones, and 2nd/3rd degree
burns of 15%–40% total body surface area.
● Delayed: Injuries are significant and require medical care but can wait
hours without threat to life or limb. Individuals in this group receive
treatment only after immediate casualties are treated.
o Stable abdominal wounds without evidence of significant
hemorrhage; soft tissue injuries; maxillofacial wounds without
airway compromise; vascular injuries with adequate collateral
circulation; genitourinary tract disruption; fractures requiring
open reduction, débridement, and external fixation; most eye
and CNS injuries.
● Minimal: Injuries are minor and treatment can be delayed hours to days.
Individuals in this group should be moved away from the main triage
area.
o Upper extremity fractures, minor burns, sprains, small
lacerations without significant bleeding, behavioral disorders or
psychological disturbances.
▪ Psychological assessment: Assess the victim for behaviors that indicate a
depressed state, presence of confusion, uncontrolled weeping or screaming,
disorientation, or aggressive behavior. Ideally, the PMH-APRN should assess the
coping strategies the victim uses to normally manage stressful situations.
● The ABCs of psychological first aid include focusing on A (arousal), B
(behavior), and C (cognition). When arousal is present, the intervention
goal is to decrease excitement by providing safety, comfort, and
consolation. When abnormal or irrational behavior is present, survivors
should be assisted to function more effectively in the disaster and when
cognitive disorientation occurs, reality testing and clear information
should be provided.
● After the initial interventions, the PMH-APRN should support the
development of resilience, coping, and recovery while providing
technical assistance, training, and consultation.
● Goals of care include helping the victims prioritize and match available
resources with their needs, and preventing further complications,
monitoring the environment, disseminating information, and
implementing disease control strategies
STUDY GUIDE + REVIEW
Clinical Modalities in Advanced Psychiatric Mental
Health Nursing Practice - Wilkes
THIS GUIDE CONTAINS:
● NSG 526 Exam 3 STUDY GUIDE + REVIEW
● Modules 9 to 12 Covered
● Chapters Modules Covered
● focuses on advanced, integrative, and specialized clinical
applications:
, Exam 3 Study Guide
Module 9 - Perese Chapter 11
Crisis Intervention/phases (9 questions)
● Levels of prevention:
o Primary – actually preventing the thing
o Secondary – early identification and treatment
o Tertiary – avoidance of complications
● Norms are considered the "right" patterns of behavior for a society.
● Crisis:
o A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks
o Internal or external demands that are perceived as threats to a person’s physical or
emotional functioning can initiate a crisis. The precipitating event is not only stressful,
but unusual or rare.
o Maturational – Describes unfavorable person-environment relationships that relate to
maturational events, such as leaving home for the first time, completing school, or
accepting the responsibility of adulthood.
o Situational - Occurs whenever a specific stressful event threatens a person’s
biopsychosocial integrity and results in some degree of psychological disequilibrium.
o Adventitious - Initiated by an unexpected unusual events that can affect an individual or
a multitude of people. National and natural disasters.
▪ During an adventitious crisis (e.g., flood, hurricane, forest fire) that affects the
well-being of many people, the interventions of the PMH-APRN will be a part of
the community’s efforts to respond to the event.
o The goal for people experiencing a crisis is to return to the pre-crisis level of functioning.
o The role of the PMH-APRN is to provide a framework of support systems that guide the
client through the crisis and facilitate the development and use of positive coping skills.
▪ Assess risk of homicide/suicide/self-injury
▪ Assess coping skills
▪ Assess perception of problem and support mechanisms
▪ Assess biologic items – sleep, eating, hygiene, etc
▪ Assess psychological – emotions and coping
▪ Asses social – individual, family, community. Social support
o Disaster:
▪ A disaster is a sudden ecological or man-made phenomenon that is of sufficient
magnitude to require external help to address the psychosocial needs as well as
the physical needs of the victims.
▪ Mass Casualty Incident Triage categories:
● Expectant: Injuries are extensive and chances of survival are unlikely
even with definitive care. Separate and provide comfort
o Unresponsive patients with penetrating head wounds, high
spinal cord injuries, wounds involving multiple anatomical sites
and organs, 2nd/3rd degree burns in excess of 60% of body
, surface area, seizures or vomiting within 24hr after radiation
exposure, profound shock with multiple injuries, agonal
respirations; no pulse, no BP, pupils fixed and dilated
● Immediate: Injuries are life-threatening but survivable with minimal
intervention. Individuals in this group can progress rapidly to expectant
if treatment is delayed.
o Sucking chest wound, airway obstruction secondary to
mechanical cause, shock, hemothorax, tension pneumothorax,
asphyxia, unstable chest and abdominal wounds, incomplete
amputations, open fractures of long bones, and 2nd/3rd degree
burns of 15%–40% total body surface area.
● Delayed: Injuries are significant and require medical care but can wait
hours without threat to life or limb. Individuals in this group receive
treatment only after immediate casualties are treated.
o Stable abdominal wounds without evidence of significant
hemorrhage; soft tissue injuries; maxillofacial wounds without
airway compromise; vascular injuries with adequate collateral
circulation; genitourinary tract disruption; fractures requiring
open reduction, débridement, and external fixation; most eye
and CNS injuries.
● Minimal: Injuries are minor and treatment can be delayed hours to days.
Individuals in this group should be moved away from the main triage
area.
o Upper extremity fractures, minor burns, sprains, small
lacerations without significant bleeding, behavioral disorders or
psychological disturbances.
▪ Psychological assessment: Assess the victim for behaviors that indicate a
depressed state, presence of confusion, uncontrolled weeping or screaming,
disorientation, or aggressive behavior. Ideally, the PMH-APRN should assess the
coping strategies the victim uses to normally manage stressful situations.
● The ABCs of psychological first aid include focusing on A (arousal), B
(behavior), and C (cognition). When arousal is present, the intervention
goal is to decrease excitement by providing safety, comfort, and
consolation. When abnormal or irrational behavior is present, survivors
should be assisted to function more effectively in the disaster and when
cognitive disorientation occurs, reality testing and clear information
should be provided.
● After the initial interventions, the PMH-APRN should support the
development of resilience, coping, and recovery while providing
technical assistance, training, and consultation.
● Goals of care include helping the victims prioritize and match available
resources with their needs, and preventing further complications,
monitoring the environment, disseminating information, and
implementing disease control strategies
