m m m m m m
Essentials of Psychiatric Mental Health Nursing
m m m m m m
9th Edition Karyn Morgan
m m m
Chapters 1 - 32 | Complete
m m m m m m
,TABLE OF CONTENTS m m
INTRODUCTION TO PSYCHIATRIC MENTAL HEALTH CONCEPTS m m m m m
1. Mental Health and Mental Illness
m m m m m
2. Biological Implications
m m
3. Ethical and Legal Issues
m m m m
4. Psychopharmacology
m
II. PSYCHIATRIC MENTAL HEALTH NURSING INTERVENTIONS
m m m m m
5. Relationship Development and Therapeutic Communication
m m m m m
6. The Nursing Process in Psychiatric/Mental Health Nursing
m m m m m m m
7. Psychosocial Interventions and Spiritual Care
m m m m m
8. Intervention in Groups
m m m
9. Crisis Intervention
m m
10. The Recovery Model
m m m
11. Suicide Prevention
m m
III. CARE OF PATIENTS WITH PSYCHIATRIC DISORDERS
m m m m m m
12. Caring for Patients with Mental Illness and Substance Use Disorders in General Practice Settings
m m m m m m m m m m m m m m
13. Neurocognitive Disorders
m m
14. Substance Use and Addiction Disorders
m m m m m
15. Schizophrenia Spectrum and Other Psychotic Disorders
m m m m m m
16. Depressive Disorders
m m
17. Bipolar and Related Disorders
m m m m
18. Anxiety, Obsessive-Compulsive, and Related Disorders
m m m m m
19. Trauma- and Stressor-Related Disorders
m m m m
20. Somatic Symptom and Dissociative Disorders
m m m m m
21. Eating Disorders
m m
22. Personality Disorders
m m
IV. PSYCHIATRIC MENTAL HEALTH NURSING OF SPECIAL POPULATIONS
m m m m m m m
23. Children and Adolescents
m m m
24. The Aging Individual
m m m
25. Survivors of Abuse or Neglect
m m m m m
26. Community Mental Health Nursing
m m m m
27. The Bereaved Individual
m m m
28. Military Families
m m
V. ONLINE CHAPTERS
m m
29. Concepts of Personality Development
m m m m
30. Complementary and Integrative Therapies
m m m m
31. Cultural Concepts Relevant to Psychiatric Mental Health Nursing
m m m m m m m m
32. Issues Related to Human Sexuality and Gender Dysphoria
m m m m m m m m m
,Chapter 1. MentalHealth and Mental m m m m m
IllnessMultiple Choice
m m m
1. A nurse is assessing a client who is experiencing occasional feelings of sadness because oftherecent
m m m m m m m m m m m m m m m m m
death of a beloved pet. The clients appetite, sleep patterns, and daily routine have not changed. How
m m m m m m m m m m m m m m m m m
should the nurse interpret the clients behaviors?
m m m m m m m
1. The clients behaviors demonstrate mental illness inthe form ofdepression.
m m m m m m m m m m
2. The clients behaviors are extensive, which indicates the presence of mentalillness.
m m m m m m m m m m m
3. The clients behaviors are not congruent with cultural norms.
m m m m m m m m
4. The clients behaviors demonstrate no functional impairment, indicating no mentalillness.
m m m m m m m m m m
ANSWER: 4 m
Rationale: The nurse should assess that the clients dailyfunctioning is not impaired. The clientwho
m m m m m m m m m m m m m m m
experiences feelings of sadness after the loss of a pet is responding within normal expectations.
m m m m m m m m m m m m m m m
Without significant impairment, the clients distress does not indicate a mental illness.
m m m m m m m m m m m m
Cognitive Level: Analysis m m
IntegratedProcess:Assessment
m m m
2. At what point should the nurse determine that a client is at risk for developing a
m m m m m m m m m m m m m m m m
mentalillness?
m m
1. When thoughts, feelings, and behaviors are not reflective oftheDSM-5 criteria.
m m m m m m m m m m m
2. When maladaptive responses to stress are coupled with interference indailyfunctioning.
m m m m m m m m m m m
3. When a client communicates significant distress.
m m m m m
4. When a client uses defense mechanisms as ego protection.
m m m m m m m m
ANSWER: 2 m
Rationale: The nurse should determine that the client is at risk for mental illness when responsesto
m m m m m m m m m m m m m m m m
stress are maladaptive and interfere with daily functioning. The DSM-5 indicates that in orderto be
m m m m m m m m m m m m m m m m
diagnosed with a mental illness, daily functioning must be significantly impaired. The clients ability
m m m m m m m m m m m m m m
to communicate distress would be considered a positive attribute.
m m m m m m m m m
Cognitive Level: Application m m
IntegratedProcess:Assessment
m m m
3. A nurse is assessing a set of15-year-old identical twins who respond verydifferentlyto stress.One
m m m m m m m m m m m m m m m m m
twin becomes anxious and irritable, and the other withdraws and cries. How should the nurse explain
m m m m m m m m m m m m m m m m
these different stress responses to the parents?
m m m m m m m
1. Reactions to stress are relative rather than absolute; individual responses to stressvary.
m m m m m m m m m m m m
2. It isabnormal for identical twins to react differentlyto similar stressors.
m m m m m m m m m m m
3. Identical twins should share the sametemperament and respond similarlyto stress.
m m m m m m m m m m m
4. Environmental influences to stress weigh more heavilythan genetic influences. m m m m m m m m m
, ANSWER: 1 m
Rationale: The nurse should explain to the parents that, although the twins have identical DNA,there
m m m m m m m m m m m m m m m
are several other factors that affect reactions to stress. Mental health is a stateof being thatis relative to
m m m m m m m m m m m m m m m m m m m m
the individual client. Environmental influences and temperament can affect stress reactions.
m m m m m m m m m m m
Cognitive Level: Application m m
IntegratedProcess:Implementation
m m m
4. Whichclient should the nurse anticipate to be most receptive to psychiatric treatment?1. A
m m m m m m m m m m m m m m m
Jewish, female social worker.
m m m m
2. A Baptist, homeless male.
m m m
3. ACatholic, black male.
m m m
4. A Protestant, Swedish businessexecutive.
m m m m
ANSWER: 1 m
Rationale: The nurse should anticipate that the client of Jewish culture would place a high importance
m m m m m m m m m m m m m m m
on preventative health care and would consider mental health as equally important asphysical health.
m m m m m m m m m m m m m m m
Women are also more likely to seek treatment for mental health problems than men.
m m m m m m m m m m m m m m
Cognitive Level: m
ApplicationIntegrated
m m
Process: Planning
m m
5. A psychiatric nurse intern states, This clients use ofdefense mechanisms should be
m m m m m m m m m m m m
eliminated.Which is a correct evaluation of this nurses statement?
m m m m m m m m m m
1. Defense mechanisms can be appropriate responses to stress and need not be eliminated.
m m m m m m m m m m m m
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety
m m m m m m m m m m m
andshouldalways be eliminated.
m m m m
3. Defense mechanisms, used by individuals with weak ego integrity, should be discouragedandnot
m m m m m m m m m m m m
eliminated.
m
4. Defense mechanisms cause disintegration ofthe ego and should be fostered andencouraged.
m m m m m m m m m m m m
ANSWER: 1 m
Rationale: The nurse should determine that defense mechanisms can be appropriate during timesof
m m m m m m m m m m m m m
stress. The client with no defense mechanisms may have a lower tolerance for stress, thus leading to
m m m m m m m m m m m m m m m m m
anxiety disorders. Defense mechanisms should be confronted when they impede the client from
m m m m m m m m m m m m m
developing healthycoping skills.
m m m m
Cognitive Level: Application m m
IntegratedProcess: Evaluation
m m m
6. During an intake assessment, a nurse asks bothphysiological and psychosocial questions. Theclient
m m m m m m m m m m m m m m
angrily responds, Im here for my heart, not my head problems. Which is the nurses best response?
m m m m m m m m m m m m m m m m m
1. Its just aroutine part ofour assessment. Allclients are asked these samequestions.
m m m m m m m m m m m m m m
2. Why are you concerned about these types ofquestions?
m m m m m m m m
3. Psychological factors, like excessive stress, have been found to affect medicalconditions. m m m m m m m m m m m
4. Wecanskip these questions, ifyou like. It isnt imperative that wecomplete this section.
m m m m m m m m m m m m m m m