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,Psychiatric-MentalHealthNursing 8theditionby SheliaVidebeck c c c c c c c
Table of contentsc c
UNIT 1 Current Theories and Practice
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• 1. Foundations of Psychiatric–Mental Health Nursing
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• 2. Neurobiologic Theories and Psychopharmacology
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• 3. Psychosocial Theories and Therapy
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• 4. Treatment Settings and Therapeutic Programs
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UNIT 2 Building the Nurse–Client Relationship
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• 5. Therapeutic Relationships
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• 6. Therapeutic Communication
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• 7. Client’s Response to Illness
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• 8. Assessment
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UNIT 3 Current Social and Emotional Concerns
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• 9. Legal and Ethical Issues
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• 10. Grief and Lossc c c
• 11. Anger, Hostility, and Aggression
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• 12. Abuse and Violence
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UNIT 4 Nursing Practice for Psychiatric Disorders
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• 13. Trauma and Stressor-Related Disorders
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• 14. Anxiety and Anxiety Disorders
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• 15. Obsessive–Compulsive and Related Disorders
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• 16. Schizophrenia c
• 17. Mood Disorders and Suicide
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• 18. Personality Disorders
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• 19. Addiction c
• 20. Eating Disorders
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• 21. Somatic Symptom Illnesses
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• 22. Neurodevelopmental Disorders
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• 23 Disruptive Behavior Disorders
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• 24 Cognitive Disorders
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Chapter 1 Foundations of Psychiatric–Mental Health Nursing
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1. The nurse is assessing the factors contributing to the well-being of a newly admitted
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client. Which of the following would the nurse identify as having a positive impact on the
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individual's mental health?
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A) Not needing others for companionship c c c c
B) The ability to effectively manage stress c c c c c
C) A familyhistory of mental illness c c c c c
D) Striving for total self-reliance c c c
Ans: B
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Feedback:
Individual factors influencing mental health include biologic makeup, autonomy,
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independence, self-esteem, capacity for growth, vitality, ability to find meaning in life,
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emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress
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management abilities. Interpersonal factors such as intimacy and a balance of separateness
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and connectedness are both needed for good mental health, and therefore a
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, healthy person would need others for companionship. A family history of mental illness
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could relate to the biologic makeup of an individual, which may have a negative impact on
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an individual's mental health, as well as a negative impact on an individual's interpersonal
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and socialñcultural factors of health. Total self-reliance is not possible, and a positive
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social/cultural factor is access to adequate resources.
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2. Which of the following statements about mental illness are true? Select all thatapply.
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A) Mental illness can cause significant distress, impaired functioning, orboth. c c c c c c c c c
B) Mental illness is onlydue to social/cultural factors. c c c c c c c
C) Social/cultural factors that relate to mental illness include excessive dependency on c c c c c c c c c c
or withdrawal from relationships.
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D) Individuals suffering from mental illness are usually able to cope effectively with c c c c c c c c c c c
daily life. c c
E) Individuals suffering from mental illness mayexperience dissatisfaction with c c c c c c c c
relationships and self. c c c
Ans: A, D, E c c c
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illness
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may be related to individual, interpersonal, or social/cultural factors. Excessive
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dependency on or withdrawal from relationships are interpersonal factors that relate to
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mental illness. Individuals suffering from mental illness can feel overwhelmed with daily
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life. Individuals suffering from mental illness mayexperience dissatisfaction with
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relationships and self.
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3. Which of the following are true regarding mental health and mental illness?
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A) Behavior that maybeviewed as acceptable in one culture is always unacceptable in c c c c c c c c c c c c c
other cultures. c c
B) It is easy to determine if a person is mentally healthy or mentally ill.
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C) In most cases, mental health is a state of emotional, psychological, and social
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wellness evidenced by satisfying interpersonal relationships, effective behavior
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and coping, positive self-concept, and emotional stability.
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D) Persons who engage in fantasies are mentally ill. c c c c c c c
Ans: C
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Feedback:
What one society may view as acceptable and appropriate behavior, another society may see
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that as maladaptive, and inappropriate. Mental health and mental illness are difficult to
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define precisely. In most cases, mental health is a state of emotional, psychological, and
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social wellness evidenced by satisfying interpersonal relationships, effective behavior and
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coping, positive self-concept, and emotional stability. Persons who engage in fantasies may
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be mentally healthy, but the inability to distinguish reality from fantasy is an individual
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factor that may contribute to mental illness.
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4. A client grieving the recent loss of her husband asks if she is becoming mentally ill
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because she is so sad. The nurse's best response would be,
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A) ìYou mayhave a temporarymental illness because you are experiencing so much c c c c c c c c c c c c
pain.î c
B) ìYou are not mentally ill. This is an expected reaction to the loss you have c c c c c c c c c c c c c c
experienced.î c
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, C) ìWere you generally dissatisfied with your relationship before your husband's
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death?î
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D) ìTry not to worry about that right now. You never know what the future brings.î Ans:
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B
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Feedback:
Mental illness includes general dissatisfaction with self, ineffective relationships,
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ineffective coping, and lack of personal growth. Additionally the behavior must not be
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culturally expected. Acute grief reactions are expected and therefore not considered mental
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illness. False reassurance or overanalysis does not accurately address the client's concerns.
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5. The nurse consults the DSM for which of the following purposes?
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A) To devise a plan of care for a newly admitted client
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B) To predict the client's prognosis of treatment outcomes
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C) To document the appropriate diagnostic code in the client's medical record
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D) To serveas a guide forclient assessment
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Ans: D
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Feedback:
The DSM provides standard nomenclature, presents defining characteristics, and identifies
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underlying causes of mental disorders. It does not provide care plans or prognostic
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outcomes of treatment. Diagnosis of mental illness is not within the generalist RN's scope of
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practice, so documenting the code in the medical record would be inappropriate.
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6. Which would be a reason for a student nurse to use the DSM?
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A) Identifying the medical diagnosis c c c
B) Treat clients c
C) Evaluate treatments c
D) Understand the reason for the admission and the nature of psychiatric illnesses. c c c c c c c c c c c
Ans: D
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Feedback:
Although student nurses do not use the DSM to diagnose clients, they will find it a helpful
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resource to understand the reason for the admission and to begin building knowledge about
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the nature of psychiatric illnesses. Identifying the medical diagnosis, treating, and
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evaluating treatments are not a part of the nursing process.
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7. The legislation enacted in 1963 was largely responsible for which of the following shifts in
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care for the mentally ill?
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A) Thewidespread use of community-based services c c c c c
B) The advancement in pharmacotherapies c c c
C) Increased access to hospitalization c c c
D) Improved rights forclients in long-term institutional care c c c c c c c
Ans: A
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Feedback:
TheCommunityMental Health Centers Construction Act of 1963 accomplished the release
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of individuals from long-term stays in state institutions, the decrease in admissions to
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hospitals, and the development of community-based services as an alternative to hospital
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care.
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