Psychiatric Mental Health Nursing Success 2022

Cathy Melfi Curtis, MSN, RN-BC Psychiatric Mental Health Nurse Trident Technical College Charleston, South Carolina Audra Baker Fegley, MSN, APRN-BC Psychiatric Mental Health Nurse Practitioner Trident Technical College Charleston, South Carolina Carol Norton Tuzo, MSN, RN-BC Psychiatric Mental Health Nurse Trident Technical College Charleston, South Carolina F. A. DAVIS COMPANY • Philadelphia F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 Copyright © 2009 by F. A. Davis Company Copyright © 2009 by F. A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher, Nursing: Robert G. Martone Director of Content Development: Darlene D. Pedersen Project Editor: Padraic J. Maroney Design and Illustration Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circum- stances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.10 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of pay- ment has been arranged. The fee code for users of the Transactional Reporting Service is: /04 0 + $.10. The authors dedicate this book to the nursing students of Trident Technical College, whose eager- ness to learn motivates us to teach mental health nursing concepts in a way that is clear and read- ily understood. We have a passion for promoting mental health and hope to transfer this passion to our students by encouraging our students to critically think through application test questions. We would like to thank Bob Martone, Alan Sorkowitz, and Padraic Maroney for giving us the opportunity to realize this goal. Working together has increased our knowledge, deepened our friendships, and reinforced our appreciation for good wine. A special thanks to Ramsay Hawkins for his patience during crisis situations, technical expertise, and memory sticks, all of which contributed to a successful project. —Cathy Melfi Curtis Audra Fegley Carol Norton Tuzo I would like to dedicate this book to the memory of my sister, Sally. She was also a nursing instruc- tor and would have appreciated the time and effort that went into this book. Also, I would like to thank my children, Scott, Emily, and Katie, who were supportive and patient during the project development. I’m now available to babysit the grandchildren, Tessa, Bobby, Eve, Willie, and Addy. —Cathy Melfi Curtis This book is dedicated to my loving husband, Damon, whose patience and understanding gave me strength; to my parents, Bonnie and Stan Baker, who listened attentively, always believed in me, and reminded me to laugh; and, lastly, to “the girls,” my fellow authors. I would never have wanted to be on this journey without the both of you. Much love. —Audra Fegley I would like to dedicate this book to the memory of my husband, George Lawrence Tuzo, whose support and encouragement saw me through nursing school; also, to the memory of my parents, Astrid and Eric Norton, who always encouraged me to pursue my dreams and have fun along the way. Thanks also to my children, Steve, David, and Monique, for the many uplifting phone calls. —Carol Norton Tuzo Georgia Anderson, MSN Professor Salt Lake Community College Salt Lake City, Utah Linda L. Austin, BSN, MSN, PhDc Assistant Professor University of North Alabama Florence, Alabama Bonnie Bar, RN, MS, AHN-C Associate Professor University of West Georgia Carrollton, Georgia Barbara Chamberlain, MSN, APN, C, CCRN, WCC Critical Care Advanced Practice Nurse Kennedy Health System Turnersville, New Jersey Beth Amy Clouse, RN, BSEd Educational Program Manager Maryland General Hospital Baltimore, Maryland Martha M. Colvin, PhD, RN, CNS Professor & Chair of Department of Undergraduate Nursing Georgia College and State University Milledgeville, Georgia Perri-Anne Concialdi, RN, MSN, CNS Instructor II Aultman College of Nursing and Health Sciences Canton, Ohio Aaron D. Doyle, RN, MSN, CRRN Nurse Educator Eastern Iowa Community College Clinton, Iowa vii viii REVIEWERS Kendra Ericson, RN, MSNc Nursing Faculty Columbia College of Nursing Milwaukee, Wisconsin Jennifer Gambal, RN, BSN, CHPN Adjunct Instructor DeSales University Center Valley, Pennsylvania Marybeth Gillis, MSN Assistant Professor Elmira College Elmira, New York Joan Hoover, BSN, MSEd Nursing Instructor Butler Community College El Dorado, Kansas Katharine M. Howard, MS, RN, BC Nursing Instructor Charles E. Gregory School of Nursing/Raritan Bay Medical Center Perth Amboy, New Jersey Melissa Lickteig, EdD, RN Assistant Professor Georgia Southern University Statesboro, Georgia Angela Luciani, RN, BScN, MN Nursing Instructor Nunavut Arctic College Iqluit, Nunavut, Canada Patricia A. Mahoney, MSN, RN, CNE President NursEducator Consultants Carver, Massachusetts Judith Mariani, RN, BSN, MSN, ONC Assistant Professor/Adjunct Nursing Instructor Mercer County Community College West Windsor, New Jersey DeAnne Parrott, Med, MSN, CNE Clinical Instructor Oklahoma City University Oklahoma City, Oklahoma REVIEWERS ix Linda C. Peterson, RN, EdD, NPP Professor The Sage Colleges Troy, New York Christine E. Pilon-Kacir, PhD, RN Professor Winona State University Rochester, Minnesota Carla E. Randall, PhD Assistant Professor University of Southern Maine Lewiston, Maine Cherie Rebar, MSN, MBA, RN, FNP, ND Assistant Professor Kettering College of Medical Arts Kettering, Ohio Debra Renna, MSN, CCRN Nursing Instructor Keiser University Fort Lauderdale, Florida Judi Satereri, RN, MSN Associate Professor St. Olaf College Northfield, Minnesota Jana C. Saunder, PhD, RN, CS Professor Texas Tech University Health Sciences Center Lubbock, Texas Rosalee J. Seymour, EdD, RN Professor Emeritus East Tennessee State University Johnson City, Tennessee Anna Shanks, RN, MN, ARNP Professor Shoreline Community College Shoreline, Washington Ardith Suddith, PhD, MSN, APRN-BC Assistant Professor University of Louisiana at Lafayette Lafayette, Louisiana A. Fundamentals of Critical Thinking Related to Test Taking: The RACE Model 1 GUIDELINES FOR USING THIS BOOK 1 PREPARING FOR LECTURE 2 PREPARING FOR AN EXAMINATION 3 TAKING THE EXAMINATION 4 UNDERSTANDING THE TYPES OF NURSING QUESTIONS 5 RACE MODEL: APPLICATION OF CRITICAL THINKING TO MULTIPLE-CHOICE QUESTIONS 6 B. Basic Concepts in Psychiatric Mental Health Nursing. 7 1. Mental Health/Mental Illness: Theoretical Concepts 7 PRACTICE QUESTIONS 8 Major Theoretical Models 8 Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR) 11 PRACTICE QUESTIONS ANSWERS AND RATIONALES 13 2. Psychiatric Nursing 23 PRACTICE QUESTIONS 24 Mental Health Nursing 24 Role of the Nurse 25 Nursing Process 26 Nurse-Client Relationship 28 Transference/Countertransference 31 PRACTICE QUESTIONS ANSWERS AND RATIONALES 32 3. Communication 47 PRACTICE QUESTIONS 48 Therapeutic Communication Facilitators 48 Blocks to Therapeutic Communication 50 Therapeutic Communication Interventions 50 Nonverbal Communication 53 Cultural Considerations 54 PRACTICE QUESTIONS ANSWERS AND RATIONALES 57 4. Psychopharmacology 71 PRACTICE QUESTIONS 72 Psychobiology 72 Medication Administration Considerations in Mental Health 73 Antianxiety Medications 73 Sedative/Hypnotic Medications 74 Medications Used in the Treatment of Alcohol Dependency 75 Antipsychotic Medications 75 Antidepressant Medications 77 Mood Stabilization Medications 78 Attention-Deficit Hyperactivity Disorder Medications 79 Medication Calculations 80 PRACTICE QUESTIONS ANSWERS AND RATIONALES 82 xi xii CONTENTS 5. Legal and Ethical Considerations 99 PRACTICE QUESTIONS 100 Legal and Ethical Concepts 100 Safety Issues 100 Client Rights 101 Voluntary and Involuntary Commitment 102 Confidentiality 103 Potential Liability 104 Advanced Directives 104 PRACTICE QUESTIONS ANSWERS AND RATIONALES 105 6. Stress Adaptation Throughout the Life Span 113 PRACTICE QUESTIONS 114 Theory 114 Ego Defense Mechanisms 115 Responses to Stress 116 Crisis Intervention 117 Safety Issues Related to Stress Adaptation 118 PRACTICE QUESTIONS ANSWERS AND RATIONALES 120 C. Management of Care for Individuals with Psychiatric Disorders 131 7. Anxiety and Sleep Disorders 131 PRACTICE QUESTIONS 132 Theory 132 Defense Mechanisms 133 Nursing Process—Assessment 133 Nursing Process—Diagnosis 135 Nursing Process—Planning 136 Nursing Process—Intervention 137 Nursing Process—Evaluation 139 Psychopharmacology 139 PRACTICE QUESTIONS ANSWERS AND RATIONALES 140 8. Psychophysiological and Somatoform Disorders 155 PRACTICE QUESTIONS 156 Theory 156 Nursing Process—Assessment 156 Nursing Process—Diagnosis 157 Nursing Process—Planning 158 Nursing Process—Intervention 158 Nursing Process—Evaluation 159 Psychopharmacology 160 PRACTICE QUESTIONS ANSWERS AND RATIONALES 161 9. Delirium, Dementia, HIV, and Amnestic Disorders 169 PRACTICE QUESTIONS 170 Theory 170 Nursing Process—Assessment 170 Nursing Process—Diagnosis 171 Nursing Process—Planning 172 Nursing Process—Intervention 172 Nursing Process—Evaluation 173 Psychopharmacology 173 PRACTICE QUESTIONS ANSWERS AND RATIONALES 174 CONTENTS xiii 10. Eating Disorders 183 PRACTICE QUESTIONS 184 Theory 184 Nursing Process—Assessment 184 Nursing Process—Diagnosis 186 Nursing Process—Planning 186 Nursing Process—Intervention 186 Nursing Process—Evaluation 187 Psychopharmacology 188 PRACTICE QUESTIONS ANSWERS AND RATIONALES 189 11. Personality Disorders 199 PRACTICE QUESTIONS 200 Theory 200 Defense Mechanisms 200 Nursing Process—Assessment 201 Nursing Process—Diagnosis 203 Nursing Process—Planning 204 Nursing Process—Intervention 205 Nursing Process—Evaluation 206 Psychopharmacology 207 PRACTICE QUESTIONS ANSWERS AND RATIONALES 208 12. Dissociative and Sexual/Gender Identity Disorders 225 PRACTICE QUESTIONS 226 Theory 226 Nursing Process—Assessment 226 Nursing Process—Diagnosis 227 Nursing Process—Planning 227 Nursing Process—Intervention 228 Nursing Process—Evaluation 228 PRACTICE QUESTIONS ANSWERS AND RATIONALES 230 13. Substance-Related Disorders 237 PRACTICE QUESTIONS 238 Theory