VARCAROLIS’ ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING:
A COMMUNICATION APPROACH TO EVIDENCE-BASED CARE 4TH EDITION
BY CHYLLIA D FOSBRE MSN RN PMHNP-BC
4th edition
,table of contents
unit i: essential theoretical concepts for practice ....................................................................................... 3
chapter 01: science and the therapeutic use of self in psychiatric mental health nursing ...................... 3
chapter 02: mental health and mental illness ........................................................................................ 11
chapter 03: theories and therapies......................................................................................................... 24
chapter 05: settings for psychiatric care................................................................................................. 76
chapter 06: legal and ethical basis for practice ...................................................................................... 94
unit ii: tools for practice of the art ............................................................................................................ 118
chapter 07: the nursing process in psychiatric–mental health nursing ................................................ 118
chapter 08: communication skills: medium for all nursing practice ..................................................... 137
chapter 09: therapeutic relationships and the clinical interview ......................................................... 156
unit iii: caring for patients with psychobiological disorders ..................................................................... 181
chapter 10: trauma and stress-related disorders and dissociative disorders ...................................... 181
chapter 11: anxiety, anxiety disorders, and obsessive-compulsive and related disorders .................. 201
chapter 12: somatic symptom disorders .............................................................................................. 235
chapter 13: personality disorders ......................................................................................................... 260
chapter 14: eating disorders ................................................................................................................. 283
chapter 15: mood disorders: depression .............................................................................................. 303
chapter 16: bipolar spectrum disorders ............................................................................................... 332
chapter 17: schizophrenia spectrum disorders and other psychotic disorders ................................... 364
chapter 18: neurocognitive disorders................................................................................................... 388
chapter 19: substance-related and addictive disorders ....................................................................... 409
unit iv: caring for patients experiencing psychiatric emergencies ........................................................... 433
chapter 20: crisis and mass disaster ..................................................................................................... 433
chapter 21: child, partner, and elder violence...................................................................................... 448
chapter 22: sexual violence .................................................................................................................. 464
chapter 23: suicidal thoughts and behavior ......................................................................................... 478
chapter 24: anger, aggression, and violence ........................................................................................ 493
chapter 25: care for the dying and those who grieve ........................................................................... 511
chapter 26: children and adolescents ................................................................................................... 529
chapter 27: adults ................................................................................................................................. 543
chapter 28: older adults ........................................................................................................................ 560
, unit i: essential theoretical concepts for practice
chapter 01: science and the therapeutic use of self in psychiatric mental health nursing
MULTIPLE CHOICE
1. which outcome, focused on recovery, would be expected in the plan of care for a patient living
in the community and diagnosed with serious and paebrisrbis.ctoemn/ttemst ental illness? within 3
months, the patient will demonstrate what behavior?
a. denying suicidal ideation
b. reporting a sense of well-being
c. taking medications as prescribed
d. attending clinic appointments on time
ACCURATE ANS>>b
recovery emphasizes managing symptoms, reducing psychosocial disability, and improving role
performance. the goal of recovery is to empower the individual with mental illness to achieve a sense of
meaning and satisfaction in life and to function at the highest possible level of wellness. the incorrect
options focus on the classic medabicirba.lcommo/tedset l rather than recovery.
2. a patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce.
select the nurse’s most caring comment.
a. “let’s discuss healthy means of coping when you have suicidal feelings.”
b. “i understand why you’re so depressed. when i got divorced, i was devastated too.”
c. “you should forget about your marriage and move on awbiirtbh.coymo/uterstlife.”
d. “how did you get so depressed that hospitalization was necessary?”
ACCURATE ANS>>a
the nurse’s communication should evidence caring and a acboirmb.cmomit/tmeset nt to work with the
patient. this commitment lets the patient know the nurse will help. probing and advice are not helpful
for therapeutic interventions.
3. in the shift-change report, an off-going nurse criticizes a paabtiirbe.ncotmw/tehsot wears
extremely heavy makeup. which comment by the nurse who receives the report best demonstrates
advocacy?
a. “this is a psychiatric hospital, so we expect our patients to behave bizarrely.”
b. “let’s all show acceptance of this patient by wearing laobtisrbo.cfomm/teaskt eup too.”
, c. “your comments are inconsiderate and inappropriate. keep the report objective.”
d. “our patients need our help to learn behaviors that will help them get along in society.”
ACCURATE ANS>>d
accepting patients’ needs for self-expression and seeking to teach skills that will contribute to their well-
being demonstrate respect and are important parts of advocacy. the on-coming nurse needs to take
action to ensure that others are not prejaubidrbi.cceomd/taegstainst the patient. humor can be
appropriate within the privacy of a shift report but not at the expense of respect for patients. judging
the off-going nurse in a critical way will create conflict. nurses must show compassion for each other.
4. a nurse assesses a newly admitted patient diagnosed with major depressive disorder. which
statement is an example of “attending”?
a. “we all have stress in life. being in a psychiatric hospital is not the end of the
world.”
b. “tell me why you felt you had to be hospitalized to receive treatment for your depression.”
c. “you will feel better after we get some antidepressant ambirebd.ciocma/ttieostn started for
you.”
d. “i’d like to sit with you for a while, so you may feel more comfortable talking with
me.”
ACCURATE ANS>>d
attending is a technique that demonstrates the nurse’s commitment to the relationship and reduces
feelings of isolation. this technique shows respect for the patient and demonstrates caring.
generalizations, probing, and false reassurances are nontherapeutic.
dif: cognitive level: application (applying)
top: nursing process: implementation msc: nclex: psychosocial integrity
5. a patient shows the nurse an article from the internet abouatbiarb.hcoemal/ttehstproblem.
which characteristic of the website’s address most alerts the nurse that the site may have biased and
prejudiced information?