,Psychiatric-
Table of contents
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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 Loss
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• 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. Schizophreniam
• 17. Mood Disorders and Suicide
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• 18. Personality Disorders
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• 19. Addiction m
• 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 nurseis assessing thefactors contributing to thewell-being of a newly admitted
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mclient. Which ofthe followingwould thenurse identifyas havinga positive impact on the
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mindividual's mental health? m m
A) Not needingothers forcompanionship m m m m
B) The abilityto effectivelymanage stress v m m
C) Afamilyhistoryofmental illness m m m
D) Strivingfortotalself-reliance m m m
mAns: B m
Feedback:
Individual factors influencing mental health include biologic makeup, autonomy,
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mindependence, self-esteem, capacity for growth, vitality, abilityto find meaning in life,
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memotionalresilienceorhardiness,senseofbelonging,realityorientation,andcopingorstress
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mmanagement abilities. Interpersonal factors such as intimacy and a balance of separateness and
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connectedness arebothneeded forgood mentalhealth, and therefore a
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, healthyperson would need others for companionship. Afamilyhistoryof mentalillness
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could relatetothebiologicmakeup ofan individual, which mayhaveanegativeimpact on an
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individual'smentalhealth,aswellasanegativeimpactonanindividual'sinterpersonal and
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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. Whichofthe following statements aboutmentalillness aretrue? Select all that apply.
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A) Mentalillnesscan causesignificantdistress,impaired functioning, orboth. m m m m m
B) Mentalillness isonlydueto social/culturalfactors. m m m m
C) Social/culturalfactorsthat relatetomentalillness include excessivedependency on m m v m
or withdrawal from relationships.
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D) Individuals sufferingfrom mentalillness areusuallyabletocopeeffectively with m m m m m
dailylife. m m
E) Individualssuffering frommentalillnessmayexperiencedissatisfactionwith m v m m m
relationships and self.
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Ans:A,D,E m m m
Feedback:
Mental illness can cause significant distress, impaired functioning, or both. Mental illness may
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be related to individual, interpersonal, or social/cultural factors. Excessive dependency on or
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withdrawal from relationships are interpersonal factors that relate to mentalillness.
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Individualssufferingfrommentalillnesscanfeeloverwhelmedwithdaily life. Individuals
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sufferingfrommentalillnessmayexperiencedissatisfaction with relationships and self.
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3. Whichofthe following are trueregardingmental health and mental illness?
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A) Behaviorthatmaybeviewed asacceptableinonecultureisalwaysunacceptable in m v m m m
othercultures.
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B) Itiseasytodetermineif a personismentallyhealthyormentallyill.
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C) In most cases, mental health is a state of emotional, psychological, and social
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wellnessevidencedbysatisfying interpersonalrelationships,effectivebehavior
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and coping, positive self-concept, and emotional stability.
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D) Persons whoengageinfantasiesarementallyill. v m
mAns: C m
Feedback:
Whatonesocietymayview as acceptableand appropriate behavior, another societymay see m m m m m m m
mthat as maladaptive, and inappropriate. Mental health and mental illness aredifficult to define
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precisely. In most cases, mental health is a state of emotional, psychological, and social
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wellness evidenced bysatisfyinginterpersonal relationships, effective behaviorand coping,
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positive self-concept, and emotional stability. Persons who engage in fantasies may be
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mentallyhealthy, but the inabilityto distinguish reality from fantasy is an individual factor that
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may contributeto mental illness.
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4. Aclient grieving therecent loss ofherhusband asks ifsheis becomingmentallyill
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because she is so sad. Thenurse's best response would be,
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A) ìYoumayhaveatemporarymental illness because youareexperiencingso much m m m m m
pain.î m
B) ìYouarenotmentallyill.Thisisan expectedreactiontotheloss youhave m m m v m m m m m
experienced.î m
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, C) ìWereyougenerallydissatisfiedwithyourrelationshipbeforeyourhusband's
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death?î m
D) ìTrynottoworryaboutthat right now. Youneverknowwhatthefuturebrings.î Ans: 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. Additionallythe behavior must not be
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culturallyexpected.Acutegriefreactionsareexpectedandthereforenotconsideredmental
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illness. Falsereassurance oroveranalysis doesnotaccuratelyaddress theclient's concerns.
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5. Thenurseconsults theDSM forwhich of thefollowingpurposes? m m m m m
A) Todevise aplanofcarefor a newlyadmitted client
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B) Topredicttheclient's prognosisoftreatment outcomes
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C) Todocument theappropriatediagnosticcodein theclient's medical record m m m m m
D) Toserveasaguideforclientassessment m
Ans: D
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Feedback:
TheDSMprovidesstandard nomenclature,presentsdefiningcharacteristics,andidentifies
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underlying causes of mental disorders. It does not providecare plans or prognostic outcomes
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of treatment. Diagnosis of mental illness is not within thegeneralist RN'sscope of practice,
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sodocumenting thecodein themedical record would be inappropriate.
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6. Whichwould beareason fora student nurse to usetheDSM?
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A) Identifyingthemedical diagnosis m
B) Treatclients
C) Evaluatetreatments
D) Understand thereason fortheadmission and thenatureof psychiatric illnesses. v m m m m m m m
Ans: D
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Feedback:
Although student nurses do not usethe DSM to diagnose clients, they will find it a helpful
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resourcetounderstandthereasonfortheadmissionandtobeginbuildingknowledgeabout
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the natureofpsychiatricillnesses. Identifying themedical diagnosis, treating, and
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evaluating treatments arenot a part of the nursing process.
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7. Thelegislationenactedin1963waslargelyresponsibleforwhichofthefollowingshiftsin
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care for the mentally ill?
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A) The widespread useofcommunity-based services v m m
B) The advancement inpharmacotherapies v m
C) Increasedaccess tohospitalization m
D) Improved rights forclientsinlong-terminstitutionalcare v v
Ans: A
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Feedback:
The CommunityMental HealthCentersConstructionActof1963accomplishedthe release of
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individuals from long-term stays in state institutions, the decrease in admissions to hospitals,
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and thedevelopment of community-based services as an alternative to hospital care.
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