Chapter01:MentalHealthandMent alIl
lnessHal t
er:
Varcarol
is’
FoundationsofPsychiat
ricMent alHeal th
Nursing:ACli
nicalApproach,8t
hEdi t
ion.Bybl
ac
kdo
lar
4
MUL
TIPL
ECHOI
CE
1
. As t
affnur
sec ompl
etesori
entat
iontoapsyc
hiat
ri
cun
it.Th
isnurs
e
maye xpec
ta nadva
ncedpract
icen u
rsetop
erfo
rmwhic
ha ddi
ti
onal
i
n t
erven
tion?a.Con duc
tme nt
al h
ealt
h
a
sse s
sme nt
s.
.P
b rescr
ibep sy
chot
ropi
cme di
ca t
ion.
.E
c stabl
is
ht her
apeut
icrel
ati
onships.
.I
d ndi
vidua
lizenur
sin
gc ar
ep l
ans.
ANS:B
Inmoststat
es,pre
scri
pti
vep r
ivi
le
ge saregra
n t
edtomaster
’s-
prepar
ednursepract
it
ione
rsandc l
inic
alnursespec
ial
is
tswhoh ave
tak
ens pec
ialcour
sesonp r
escri
bingme di
cat
ion.Thenur
seprepar
ed
atthebasi
cleveli
spermit
tedtoperformme nt
alheal
thass
essments,
est
ab l
is
hrela
tio
nships,
andp r
ovideindi
vidua
liz
edcarepl
anning.
PTS:1DIF:Cogni
ti
veLeve
l:Unders
tan
d(Co
mp r
ehen
sio
n)RE
F:
Page1-
23TOP:Nu rsi
ngProce
ss:Impl
ement
ati
on
MSC:Cli
entNe e
ds:Saf
e,Ef
fect
iveCar
eEnv
iron
ment
. An
2 urs
ings
tud
ente
xpr
ess
esc
onc
ern
sth
atme
nta
lhe
alt
hnu
rse
s“l
ose
all
thei
rcli
nic
a l
nursi
ngs k
il
ls.
”Selectth
eb es
tre
sponsebyt
hementa
l
heal
thnurse
.
.“
a Psych
iat
ricnurse
sp r
acti
ceinsaferenv
iro
nmentst
hanot
her
speci
alt
ies
.Nu r
se-to
-pati
entra
tio
smu stbebet
terb
ecaus
eofth
e
natu
reofthep a
tie
nts’pr
oblems.
”
1
, .“
b Ps
ych
iat
ri
cnu
rse
sus
eco
mpl
exc
ommu
nic
ati
ons
kil
lsa
swe
lla
s
c
rit
ica
lthink
ingtosolvemu l
ti
dimensio
n a
lp robl
ems.Iam
c
hall
engedb yt
hoses i
tuati
ons.
”
.“
c That’
sami sconcep
tion.Psyc
h i
atr
icnursesf r
equent
lyu
sehigh
t
echnol
ogymon it
ori
nge qui
pme ntandma nagec o
mp l
exi
ntr
avenou
s
t
herapi
es.”
.“
d Psychiat
ri
cn u
rsesdon othavetodealwit
ha smuchpai
nand
s
uffer
ingasme di
cal–surgi
calnursesdo.Th atappe
alst
ome .
”
ANS:B
Thepract
iceofpsychia
tricnu r
singrequi
resad if
ferentsetofski
ll
s
th
anme dical
–sur
gicalnursing,thoughthereissubsta
n t
ialover
lap.
Psychi
atr
icnurse
smu s
tb ea bl
et ohelppati
entswithme dica
laswe l
l
asme n
talheal
thp r
oblems ,
reflecti
ngtheho l
ist
icperspecti
vethese
nurs
esmu sthave.Nurse–pa t
ientrat
iosandwo rkl
oadsinp sychi
atr
ic
set
ti
ngsh avei
ncreased,justli
keot he
rsp e
c i
alt
ies
.Ps ychi
atri
c
nurs
inginvol
vescli
nicalpracti
ce,notjustdocumentatio
n.
Psychos
ocialpai
na ndsufferi
nga reasrealasp hy
sicalpainand
suf
feri
ng.
PTS:1 DI F
:Co gnit
iveLevel
:Ap pl
y(Appli
cation)
REF:Pages1- 2,21 TOP:Nu rsi
ngProcess:Imple
me n
tati
on
MSC:Cl i
entNe eds:Safe,Ef
fect
iveCa r
eE nv
iro
n ment
. Wh
3 enan ewb i
lli
ntroducedinCo ngr
essreducesfundi
n gforcareof
personsdiagnosedwithme ntalil
lne
ss,agroupofn ur
s eswrit
elett
ers
tothei
re l
ectedrepresent
ati
v e
si nopposi
ti
ontot helegi
s l
ati
on.Which
rol
eh avethen u
rsesfulfi
ll
ed?a .Recover
y
b.A t
tendi
ng
c.A dv
o ca
cy
d.Evidence-basedp r
acti
ce
ANS:C
2
, Ana dvocat
ed ef
endso rasser
tsanother’
scause, p
arti
cularl
ywh enthe
ot
he rpersonla
c k
sth eabi
li
tytodot ha
tforself
.E xampleso f
i
ndividualadv
oc a
cyin c
ludehelpi
ngp a
tient
su nderst
andth ei
rri
ghtsor
mak edecis
ions.Onac ommu ni
tys c
ale,adv
o c
ac yincl
udesp ol
it
ical
act
ivit
y,publi
cs pea
k i
ng,andpublic
ati
oninthein t
erestofimp r
oving
th
eh uma ncondit
ion.Sinc
ef un
dingisnecessarytod e
liv
e rqual
ity
programmingforpersonswithme nt
alil
lness,
theletter
-wr i
ti
ng
camp ai
gna dv
ocatesforthatcauseonbehalfofp at
ient
swh oa r
e
unabletoarti
cula
tetheirownneed s
.
PTS:1DIF:Cogni
ti
veLeve
l:Unders
tan
d(Compr
ehe
nsi
on)RE
F:
Page1-
26TOP:Nu rsi
ngProce
ss:Eval
uat
ion
MSC:Cli
entNe e
ds:Saf
e,Ef
fect
iveCar
eEnvi
ron
ment
4
. Afamilyhasal on
gh i
sto
ryo fconfl
ic
tedrel
ati
o n
s hi
psamo ngt
he
memb ers
.Wh i
c hfami
lymemb e r
’scommentbestrefl
ectsame nt
all
y
heal
thyperspecti
ve?
.“
a I’
vema demistak
esb uteveryo
nee l
seinthisfamil
yh a
salso.
”
.“
b Irememb erj
oyandmu tualrespec
tfr
omo urear
lyyearst
ogether
.”
.“
c Iwil
lma kesomec han
ge sinmyb ehav
iorforthegoodofthe
famil
y.”
.“
d It
’sbestformetomo vea wayfr
ommyf amily
.Thingswil
lnever
change.
”
ANS:C
Thecorr
ectresponsedemo nst
rat
estheb e
ste v
ide
nceo fahealt
hy
re
cognit
ionoftheimpo r
tanceofrel
ati
onshi
p s
.Me nt
alhealt
hincl
udes
ra
tio
nalthi
nkin
g, c
ommu ni
cati
onskil
ls,l
earni
ng,emoti
o n
algrowth
,
re
sil
ienc
e,andse l
f-
e s
teem.Re ca
ll
ingjoyfr
o mearl
ieri
nlif
ema ybe
heal
thy
,butthecorrectres
po n
seshowsah igherl
evelofme nt
al
3
, h
eal
th.Th
eot
heri
nco
rre
ctr
esp
ons
ess
howb
lami
nga
nda
voi
dan
ce.
PTS:1 DI F
:Cogni
ti
veLevel
:Ana
lyze(
Analy
sis)
REF:Page
s1- 2,3,32( F
igur
e1-1)TOP:Nu rs
ingPro
ces
s:
Assess
mentMSC:Cli
entNeed
s:Psy
chosoc
ialI
ntegr
it
y
5
. Wh i
chassessmentfi
ndingmo stc
learl
yindi
ca t
esthatapat
ientmaybe
experi
enci
ngame ntalil
lne
ss?Thep at
ient
.r
a epor
tsoccasi
onal s
leepl
essnessandanx i
ety
.
.r
b epor
tsac o
nsist
en t
lysad,di
scouraged
,a ndhopel
essmoo d
.
.i
c sabl
etod escr
ibethedif
fere
nceb etween“asif
”and“forreal
.”
.p
d e
rcei
vesdif
fic
ultyma k
ingad e
c i
si
ona boutwhethe
rtochange
jobs.
ANS:B
Thecorr
ectr
espons
ed es
cri
besamoodalte
rati
on,whi
chref
lec
ts
mentali
ll
nes
s.Thedis
tra
cter
sdescr
ibeb
e ha
vior
sthatar
eme n
tal
ly
heal
thyorwi
thi
ntheusuals
copeofhumanexper
ienc
e.
PTS:1 DI F
:Cogni
ti
veLe
ve l
:Appl
y(Appl
ic
ati
on)
REF:Page
s1- 2t
o4 TOP: Nu rsi
ng Pr oces
s:
Assess
me ntMSC:Cl
ien
tNeeds:Ps
ychos
ocialI
nte
gri
ty
6
. Wh i
chfi
n d
ingbesti
ndicat
e stha
tth egoal“Demonst
rat
eme ntal
lyhealt
hy
behavi
or”wasachie
vedfora nadultpati
ent?Thepati
ent
.s
a eesselfascapab
leo fachi
evingidealsandmeeti
ngd e
ma n
d s.
.b
b ehaveswith
outconsideri
ngth econsequenc
esofperson a
la c
tio
ns.
.a
c ggressi
vel
yme et
so wnn eedswithoutconsi
deri
ngtherightsof
others
.
.s
d eekshelpfr
omo the
rswh ena ssumingrespons
ibi
li
tyforma jo
r
4
lnessHal t
er:
Varcarol
is’
FoundationsofPsychiat
ricMent alHeal th
Nursing:ACli
nicalApproach,8t
hEdi t
ion.Bybl
ac
kdo
lar
4
MUL
TIPL
ECHOI
CE
1
. As t
affnur
sec ompl
etesori
entat
iontoapsyc
hiat
ri
cun
it.Th
isnurs
e
maye xpec
ta nadva
ncedpract
icen u
rsetop
erfo
rmwhic
ha ddi
ti
onal
i
n t
erven
tion?a.Con duc
tme nt
al h
ealt
h
a
sse s
sme nt
s.
.P
b rescr
ibep sy
chot
ropi
cme di
ca t
ion.
.E
c stabl
is
ht her
apeut
icrel
ati
onships.
.I
d ndi
vidua
lizenur
sin
gc ar
ep l
ans.
ANS:B
Inmoststat
es,pre
scri
pti
vep r
ivi
le
ge saregra
n t
edtomaster
’s-
prepar
ednursepract
it
ione
rsandc l
inic
alnursespec
ial
is
tswhoh ave
tak
ens pec
ialcour
sesonp r
escri
bingme di
cat
ion.Thenur
seprepar
ed
atthebasi
cleveli
spermit
tedtoperformme nt
alheal
thass
essments,
est
ab l
is
hrela
tio
nships,
andp r
ovideindi
vidua
liz
edcarepl
anning.
PTS:1DIF:Cogni
ti
veLeve
l:Unders
tan
d(Co
mp r
ehen
sio
n)RE
F:
Page1-
23TOP:Nu rsi
ngProce
ss:Impl
ement
ati
on
MSC:Cli
entNe e
ds:Saf
e,Ef
fect
iveCar
eEnv
iron
ment
. An
2 urs
ings
tud
ente
xpr
ess
esc
onc
ern
sth
atme
nta
lhe
alt
hnu
rse
s“l
ose
all
thei
rcli
nic
a l
nursi
ngs k
il
ls.
”Selectth
eb es
tre
sponsebyt
hementa
l
heal
thnurse
.
.“
a Psych
iat
ricnurse
sp r
acti
ceinsaferenv
iro
nmentst
hanot
her
speci
alt
ies
.Nu r
se-to
-pati
entra
tio
smu stbebet
terb
ecaus
eofth
e
natu
reofthep a
tie
nts’pr
oblems.
”
1
, .“
b Ps
ych
iat
ri
cnu
rse
sus
eco
mpl
exc
ommu
nic
ati
ons
kil
lsa
swe
lla
s
c
rit
ica
lthink
ingtosolvemu l
ti
dimensio
n a
lp robl
ems.Iam
c
hall
engedb yt
hoses i
tuati
ons.
”
.“
c That’
sami sconcep
tion.Psyc
h i
atr
icnursesf r
equent
lyu
sehigh
t
echnol
ogymon it
ori
nge qui
pme ntandma nagec o
mp l
exi
ntr
avenou
s
t
herapi
es.”
.“
d Psychiat
ri
cn u
rsesdon othavetodealwit
ha smuchpai
nand
s
uffer
ingasme di
cal–surgi
calnursesdo.Th atappe
alst
ome .
”
ANS:B
Thepract
iceofpsychia
tricnu r
singrequi
resad if
ferentsetofski
ll
s
th
anme dical
–sur
gicalnursing,thoughthereissubsta
n t
ialover
lap.
Psychi
atr
icnurse
smu s
tb ea bl
et ohelppati
entswithme dica
laswe l
l
asme n
talheal
thp r
oblems ,
reflecti
ngtheho l
ist
icperspecti
vethese
nurs
esmu sthave.Nurse–pa t
ientrat
iosandwo rkl
oadsinp sychi
atr
ic
set
ti
ngsh avei
ncreased,justli
keot he
rsp e
c i
alt
ies
.Ps ychi
atri
c
nurs
inginvol
vescli
nicalpracti
ce,notjustdocumentatio
n.
Psychos
ocialpai
na ndsufferi
nga reasrealasp hy
sicalpainand
suf
feri
ng.
PTS:1 DI F
:Co gnit
iveLevel
:Ap pl
y(Appli
cation)
REF:Pages1- 2,21 TOP:Nu rsi
ngProcess:Imple
me n
tati
on
MSC:Cl i
entNe eds:Safe,Ef
fect
iveCa r
eE nv
iro
n ment
. Wh
3 enan ewb i
lli
ntroducedinCo ngr
essreducesfundi
n gforcareof
personsdiagnosedwithme ntalil
lne
ss,agroupofn ur
s eswrit
elett
ers
tothei
re l
ectedrepresent
ati
v e
si nopposi
ti
ontot helegi
s l
ati
on.Which
rol
eh avethen u
rsesfulfi
ll
ed?a .Recover
y
b.A t
tendi
ng
c.A dv
o ca
cy
d.Evidence-basedp r
acti
ce
ANS:C
2
, Ana dvocat
ed ef
endso rasser
tsanother’
scause, p
arti
cularl
ywh enthe
ot
he rpersonla
c k
sth eabi
li
tytodot ha
tforself
.E xampleso f
i
ndividualadv
oc a
cyin c
ludehelpi
ngp a
tient
su nderst
andth ei
rri
ghtsor
mak edecis
ions.Onac ommu ni
tys c
ale,adv
o c
ac yincl
udesp ol
it
ical
act
ivit
y,publi
cs pea
k i
ng,andpublic
ati
oninthein t
erestofimp r
oving
th
eh uma ncondit
ion.Sinc
ef un
dingisnecessarytod e
liv
e rqual
ity
programmingforpersonswithme nt
alil
lness,
theletter
-wr i
ti
ng
camp ai
gna dv
ocatesforthatcauseonbehalfofp at
ient
swh oa r
e
unabletoarti
cula
tetheirownneed s
.
PTS:1DIF:Cogni
ti
veLeve
l:Unders
tan
d(Compr
ehe
nsi
on)RE
F:
Page1-
26TOP:Nu rsi
ngProce
ss:Eval
uat
ion
MSC:Cli
entNe e
ds:Saf
e,Ef
fect
iveCar
eEnvi
ron
ment
4
. Afamilyhasal on
gh i
sto
ryo fconfl
ic
tedrel
ati
o n
s hi
psamo ngt
he
memb ers
.Wh i
c hfami
lymemb e r
’scommentbestrefl
ectsame nt
all
y
heal
thyperspecti
ve?
.“
a I’
vema demistak
esb uteveryo
nee l
seinthisfamil
yh a
salso.
”
.“
b Irememb erj
oyandmu tualrespec
tfr
omo urear
lyyearst
ogether
.”
.“
c Iwil
lma kesomec han
ge sinmyb ehav
iorforthegoodofthe
famil
y.”
.“
d It
’sbestformetomo vea wayfr
ommyf amily
.Thingswil
lnever
change.
”
ANS:C
Thecorr
ectresponsedemo nst
rat
estheb e
ste v
ide
nceo fahealt
hy
re
cognit
ionoftheimpo r
tanceofrel
ati
onshi
p s
.Me nt
alhealt
hincl
udes
ra
tio
nalthi
nkin
g, c
ommu ni
cati
onskil
ls,l
earni
ng,emoti
o n
algrowth
,
re
sil
ienc
e,andse l
f-
e s
teem.Re ca
ll
ingjoyfr
o mearl
ieri
nlif
ema ybe
heal
thy
,butthecorrectres
po n
seshowsah igherl
evelofme nt
al
3
, h
eal
th.Th
eot
heri
nco
rre
ctr
esp
ons
ess
howb
lami
nga
nda
voi
dan
ce.
PTS:1 DI F
:Cogni
ti
veLevel
:Ana
lyze(
Analy
sis)
REF:Page
s1- 2,3,32( F
igur
e1-1)TOP:Nu rs
ingPro
ces
s:
Assess
mentMSC:Cli
entNeed
s:Psy
chosoc
ialI
ntegr
it
y
5
. Wh i
chassessmentfi
ndingmo stc
learl
yindi
ca t
esthatapat
ientmaybe
experi
enci
ngame ntalil
lne
ss?Thep at
ient
.r
a epor
tsoccasi
onal s
leepl
essnessandanx i
ety
.
.r
b epor
tsac o
nsist
en t
lysad,di
scouraged
,a ndhopel
essmoo d
.
.i
c sabl
etod escr
ibethedif
fere
nceb etween“asif
”and“forreal
.”
.p
d e
rcei
vesdif
fic
ultyma k
ingad e
c i
si
ona boutwhethe
rtochange
jobs.
ANS:B
Thecorr
ectr
espons
ed es
cri
besamoodalte
rati
on,whi
chref
lec
ts
mentali
ll
nes
s.Thedis
tra
cter
sdescr
ibeb
e ha
vior
sthatar
eme n
tal
ly
heal
thyorwi
thi
ntheusuals
copeofhumanexper
ienc
e.
PTS:1 DI F
:Cogni
ti
veLe
ve l
:Appl
y(Appl
ic
ati
on)
REF:Page
s1- 2t
o4 TOP: Nu rsi
ng Pr oces
s:
Assess
me ntMSC:Cl
ien
tNeeds:Ps
ychos
ocialI
nte
gri
ty
6
. Wh i
chfi
n d
ingbesti
ndicat
e stha
tth egoal“Demonst
rat
eme ntal
lyhealt
hy
behavi
or”wasachie
vedfora nadultpati
ent?Thepati
ent
.s
a eesselfascapab
leo fachi
evingidealsandmeeti
ngd e
ma n
d s.
.b
b ehaveswith
outconsideri
ngth econsequenc
esofperson a
la c
tio
ns.
.a
c ggressi
vel
yme et
so wnn eedswithoutconsi
deri
ngtherightsof
others
.
.s
d eekshelpfr
omo the
rswh ena ssumingrespons
ibi
li
tyforma jo
r
4
