1
Varacolis Foundations of Psychiatric Health
Nursing
Table of Contents
Table of Contents 1
Chapter 01: Mental Health and Mental Illness C
, 2
hapter 02: Theories and Therapies 2
Chapter 03: Psychobiology and Psychopharmacology 14
Chapter 04: Treatment Settings 30
Chapter 05: Cultural Implications 45
Chapter 06: Legal and Ethical Considerations 62
Chapter 07: The Nursing Process and Standards of Care 78
Chapter 08: Therapeutic Relationships 92
Chapter 09: Therapeutic Communication 106
Chapter 10: Stress Responses and Stress Management 120
Chapter 11: Childhood and Neurodevelopmental Disorders 132
Chapter 12: Schizophrenia Spectrum Disorders 144
Chapter 13: Bipolar and Related Disorders 157
Chapter 14: Depressive Disorders 175
Chapter 15: Anxiety and Obsessive-Compulsive Disorders 192
Chapter 16: Trauma, Stressor-Related, and Dissociative Disorders 207
Chapter 17: Somatic Symptom Disorders 223
Chapter 18: Eating and Feeding Disorders 237
Chapter 19: Sleep-Wake Disorders 250
Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias 264
Chapter 21: Impulse Control Disorders 276
Chapter 22: Substance Related and Addictive Disorders 288
Chapter 23: Neurocognitive Disorders 299
Chapter 24: Personality Disorders 315
Chapter 25: Suicide and Nonsuicidal Self-Injury 329
Chapter 26: Crisis and Disaster 344
Chapter 27: Anger, Aggression, and Violence 357
Chapter 28: Child, Older Adult, and Intimate Partner Violence 370
Chapter 29: Sexual Assault 383
Chapter 30: Dying, Death, and Grieving 394
Chapter 31: Older Adults 405
Chapter 32: Serious Mental Illness 415
Chapter 33: Forensic Nursing 431
Chapter 34: Therapeutic Groups 447
Chapter 35: Family Interventions 458
Chapter 36: Integrative Care 472
485
, 3
Chapter 01: Mental Health and Mental Illness
MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse
to perform which additional intervention?
a. Conduct mental health assessments. c. Establish therapeutic relationships.
b. Prescribe psychotropic medication. d. Individualize nursing care plans.
ANS: B
In most states, prescriptive privileges are granted to masters-prepared nurse practitioners who have taken
special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform mental
health assessments, establish relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 15 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. When a nursing student expresses concerns about how mental health nurses lose all their nursing skills, the
best response by the mental health nurse is:
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must
be better because of the nature of the patients problems.
b. Psychiatric nurses use complex communication skills as well as critical thinking to solve
multidimensional problems. I am challenged by those situations.
c. Thats a misconception. Psychiatric nurses frequently use high technology monitoring equipment and
manage complex intravenous therapies.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical-surgical nurses do.
That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing, though there
is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as mental health
problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in
psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not
just documentation. Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons with mental illness, a group of
, 4
nurses writes letters to their elected representatives in opposition to the legislation. Which role have the nurses
fulfilled?
a. Recovery c. Advocacy
b. Attending d. Evidence-based practice
ANS: C
An advocate defends or asserts anothers cause, particularly when the other person lacks the ability to do that
for self. Examples of individual advocacy include helping patients understand their rights or make decisions.
On a community scale, advocacy includes political activity, public speaking, and publication in the interest of
improving the human condition. Since funding is necessary to deliver quality programming for persons with
mental illness, the letter- writing campaign advocates for that cause on behalf of patients who are unable to
articulate their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 16 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
4. Which comment best indicates that a patient perceived the nurse was caring? My nurse:
a. always asks me which type of juice I want to help me swallow my medication.
b. explained my treatment plan to me and asked for my ideas about how to make it better.
c. spends time listening to me talk about my problems. That helps me feel like I am not alone.
d. told me that if I take all the medicines the doctor prescribes, then I will get discharged sooner.
ANS: C
Caring evidences empathetic understanding as well as competency. It helps change pain and suffering into a
shared experience, creating a human connection that alleviates feelings of isolation. The distracters give
examples of statements that demonstrate advocacy or giving advice.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 7 TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The
patient:
a. reports occasional sleeplessness and anxiety.
b. reports a consistently sad, discouraged, and hopeless mood.
c. is able to describe the difference between as if and for real.
Varacolis Foundations of Psychiatric Health
Nursing
Table of Contents
Table of Contents 1
Chapter 01: Mental Health and Mental Illness C
, 2
hapter 02: Theories and Therapies 2
Chapter 03: Psychobiology and Psychopharmacology 14
Chapter 04: Treatment Settings 30
Chapter 05: Cultural Implications 45
Chapter 06: Legal and Ethical Considerations 62
Chapter 07: The Nursing Process and Standards of Care 78
Chapter 08: Therapeutic Relationships 92
Chapter 09: Therapeutic Communication 106
Chapter 10: Stress Responses and Stress Management 120
Chapter 11: Childhood and Neurodevelopmental Disorders 132
Chapter 12: Schizophrenia Spectrum Disorders 144
Chapter 13: Bipolar and Related Disorders 157
Chapter 14: Depressive Disorders 175
Chapter 15: Anxiety and Obsessive-Compulsive Disorders 192
Chapter 16: Trauma, Stressor-Related, and Dissociative Disorders 207
Chapter 17: Somatic Symptom Disorders 223
Chapter 18: Eating and Feeding Disorders 237
Chapter 19: Sleep-Wake Disorders 250
Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias 264
Chapter 21: Impulse Control Disorders 276
Chapter 22: Substance Related and Addictive Disorders 288
Chapter 23: Neurocognitive Disorders 299
Chapter 24: Personality Disorders 315
Chapter 25: Suicide and Nonsuicidal Self-Injury 329
Chapter 26: Crisis and Disaster 344
Chapter 27: Anger, Aggression, and Violence 357
Chapter 28: Child, Older Adult, and Intimate Partner Violence 370
Chapter 29: Sexual Assault 383
Chapter 30: Dying, Death, and Grieving 394
Chapter 31: Older Adults 405
Chapter 32: Serious Mental Illness 415
Chapter 33: Forensic Nursing 431
Chapter 34: Therapeutic Groups 447
Chapter 35: Family Interventions 458
Chapter 36: Integrative Care 472
485
, 3
Chapter 01: Mental Health and Mental Illness
MULTIPLE CHOICE
1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse
to perform which additional intervention?
a. Conduct mental health assessments. c. Establish therapeutic relationships.
b. Prescribe psychotropic medication. d. Individualize nursing care plans.
ANS: B
In most states, prescriptive privileges are granted to masters-prepared nurse practitioners who have taken
special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform mental
health assessments, establish relationships, and provide individualized care planning.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 15 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. When a nursing student expresses concerns about how mental health nurses lose all their nursing skills, the
best response by the mental health nurse is:
a. Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must
be better because of the nature of the patients problems.
b. Psychiatric nurses use complex communication skills as well as critical thinking to solve
multidimensional problems. I am challenged by those situations.
c. Thats a misconception. Psychiatric nurses frequently use high technology monitoring equipment and
manage complex intravenous therapies.
d. Psychiatric nurses do not have to deal with as much pain and suffering as medical-surgical nurses do.
That appeals to me.
ANS: B
The practice of psychiatric nursing requires a different set of skills than medical-surgical nursing, though there
is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as mental health
problems, reflecting the holistic perspective these nurses must have. Nurse-patient ratios and workloads in
psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not
just documentation. Psychosocial pain and suffering are as real as physical pain and suffering.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 10 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
3. When a new bill introduced in Congress reduces funding for care of persons with mental illness, a group of
, 4
nurses writes letters to their elected representatives in opposition to the legislation. Which role have the nurses
fulfilled?
a. Recovery c. Advocacy
b. Attending d. Evidence-based practice
ANS: C
An advocate defends or asserts anothers cause, particularly when the other person lacks the ability to do that
for self. Examples of individual advocacy include helping patients understand their rights or make decisions.
On a community scale, advocacy includes political activity, public speaking, and publication in the interest of
improving the human condition. Since funding is necessary to deliver quality programming for persons with
mental illness, the letter- writing campaign advocates for that cause on behalf of patients who are unable to
articulate their own needs.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 16 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
4. Which comment best indicates that a patient perceived the nurse was caring? My nurse:
a. always asks me which type of juice I want to help me swallow my medication.
b. explained my treatment plan to me and asked for my ideas about how to make it better.
c. spends time listening to me talk about my problems. That helps me feel like I am not alone.
d. told me that if I take all the medicines the doctor prescribes, then I will get discharged sooner.
ANS: C
Caring evidences empathetic understanding as well as competency. It helps change pain and suffering into a
shared experience, creating a human connection that alleviates feelings of isolation. The distracters give
examples of statements that demonstrate advocacy or giving advice.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: 7 TOP: Nursing Process: Evaluation
MSC: Client Needs: Psychosocial Integrity
5. Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The
patient:
a. reports occasional sleeplessness and anxiety.
b. reports a consistently sad, discouraged, and hopeless mood.
c. is able to describe the difference between as if and for real.
