5 of Psychiatric and Mental
Health Nursing: Key Points
Smartprep Examinations
Since 2010
Chapter 1: Mental Health and Mental Illness
1. Overall health is not possible without good mental health
2. Mental Health vs Mental Illness
a. There is a mental health and mental illness continuum that can demonstrate how
functioning changes over time; MI and MH are endpoints on the continuum.
b. Mental health:
i. Able to recognize own potential
ii. Cope with normal stress/ Adaptive healthy behavior
iii. Work productively
iv. Make contribution to community
v. is able to differentiate reality from fantasy; reality oriented
vi. Adequate self -concept
vii. control over own behavior
viii. Sees self as capable of achieving ideals and meeting demands
ix. Fulfilling stable relationships
x. Traits( Mental health provides people with these traits)
1. Ability to Think rationally
2. Communicate appropriately
3. Learn
4. Grow emotionally
5. Be resilient (Characterized by Optimism (positive outlook on life), Sense of
mastery, Competence
a. Don’t take other’s moods of words personally; let them own
it
b. Calm down before you express you point of view;
communication with respect always can open doors of
understanding.
6. Have a healthy self-esteem; adequate self- concept
, 7. Realistic goals and reasonable function within the individual’s role
c. Mental Illness: all psychiatric disorders with definable diagnoses that cause significant
dysfunction in development, biological and psychological disturbances.
i. unable to differentiate reality from fantasy; consistently abnormal moods, as
sadness elation, hopelessness, helplessness
ii. behaves without considering the consequences of personal actions
iii. aggressively meets own needs without considering rights of others
iv. unfulfilling relationships that are intense and unstable; may idealize one minute
then devalue leading to feelings of emptiness and in some BPD( borderlines) to
suicidality
d. Compromised mental health of greatest concern for nurse is patients appraisal of
reality, control over impulse and faulty self- concept.
e. Mental illness changes with culture, time in history, political systems and groups
defining it
3. Psychiatric disorders
a. WHO ( World health organization describes health as a state of complete physical,
mental and social well being and not merely the absence of disease or infirmity;
i. There is a strong relationship between physical and mental health
ii. Poor physical health can lead to mental distress and mental distress can lead to
poor physical health
b. Mental Illness is brain based and is therefore a physical illness
c. Psychiatric disorders are generally the result of nature and nurture
d. A diathesis-stress model-in which diathesis represent biological predisposition and
stress represent environmental stress or trauma is the most accepted explanation for
mental illness
4. Risk Factors that increase risk of mental health outcomes
a. Inborn vulnerability
b. poor social environment
c. Economic hardship
d. Poor health policy
5. Protective factors as resiliency improve a persons ability to respond to stress, trauma and loss.
a. Individual attributes, social and economic, environmental factors.
b. Resilience is closely related to process of adapting; it is the ability and capacity for
people to secure the resource they need to support their well being.
i. helps people facing tragedies, loss, trauma and severe stress
6. Recovery
a. The recovery movement has shifted the focus of decision making from a paternalistic
system where compliance is emphasized to a focus on self -determination and self-
direction.
7. DSM-V
, a. DSM-V Classifies disorders people have.
i. Details the diagnostic criteria for psychiatric clinical conditions i
i. Gives
iii. Official guideline
criteria usedfor
to diagnosing
establish a psychiatric
diagnosis disorders
b. DSM-V diagnosis guides medical treatment (this differs with nursing diagnosis which is a
framework for identifying interventions for pts human responses
8. International Classification of Diseases, 10e
a. Clinical descriptions of mental and behavior disorders
b. 2 broad classifications
2
..
, c. Subclassifications
9. Psychiatric Nursing
a. Promoting mental health through assessment, diagnosis, and treatment of behavioral
and mental disorders
b. Use nursing, psychosocial, cultural neurobiological theories and research
c. Work with people throughout the life span
d. Employed in a variety of settings and among varied populations
10. Levels of Psychiatric Nursing
a. Basic Level
i. Psychiatric mental health registered nurse (PMH-RN)
1. 2 years full-time work, 2000 clinical hours, 30 hours continuing
education, followed by certification exam to add “BC” to the RN title
(RN-BC)
2. Perform mental health assessments, establish relationship and provide
individualized care planning; teach coping skills
b. Advanced Practice
i. Psychiatric mental health advanced practice registered nurse (PMH-APRN)
ii. Master of Science or Doctorate
iii. Advanced Practice Psychiatric nurse/Masters prepared nurse practitioners and
clinical nurse specialist who have taken special course on prescribing
medications.
1. All of the above plus
2. Psychotherapy
3. prescribe psychotropic medications
11. Practice of psychiatric nursing
a. Requires different set of skills than medical surgical nursing, although there is overlap.
b. Psychiatric nurses must be able to help patients with medical as well as mental health
problems, reflecting the holistic perspective
c. Psych nursing used complex communication skills as well as critical thinking to solve
multidimensional problems
d. Teach others that the patient is not the disease but has the disease; the patient has
schizophrenic symptoms, don’t say the patient is schizophrenic
e. Psych nursing deal with pain and suffering on emotional level,
f. Avoid labeling patients
g. Recognize cultural bias and work on it
h. They do not use high technology, equipment or intravenous therapy; they use “ self”
called therapeutic use of self.
i. Focuses on relationships (family, partner, etc) as mental health includes rational
thinking, communication skills, learning, emotional growth, resilience and self esteem
3
Health Nursing: Key Points
Smartprep Examinations
Since 2010
Chapter 1: Mental Health and Mental Illness
1. Overall health is not possible without good mental health
2. Mental Health vs Mental Illness
a. There is a mental health and mental illness continuum that can demonstrate how
functioning changes over time; MI and MH are endpoints on the continuum.
b. Mental health:
i. Able to recognize own potential
ii. Cope with normal stress/ Adaptive healthy behavior
iii. Work productively
iv. Make contribution to community
v. is able to differentiate reality from fantasy; reality oriented
vi. Adequate self -concept
vii. control over own behavior
viii. Sees self as capable of achieving ideals and meeting demands
ix. Fulfilling stable relationships
x. Traits( Mental health provides people with these traits)
1. Ability to Think rationally
2. Communicate appropriately
3. Learn
4. Grow emotionally
5. Be resilient (Characterized by Optimism (positive outlook on life), Sense of
mastery, Competence
a. Don’t take other’s moods of words personally; let them own
it
b. Calm down before you express you point of view;
communication with respect always can open doors of
understanding.
6. Have a healthy self-esteem; adequate self- concept
, 7. Realistic goals and reasonable function within the individual’s role
c. Mental Illness: all psychiatric disorders with definable diagnoses that cause significant
dysfunction in development, biological and psychological disturbances.
i. unable to differentiate reality from fantasy; consistently abnormal moods, as
sadness elation, hopelessness, helplessness
ii. behaves without considering the consequences of personal actions
iii. aggressively meets own needs without considering rights of others
iv. unfulfilling relationships that are intense and unstable; may idealize one minute
then devalue leading to feelings of emptiness and in some BPD( borderlines) to
suicidality
d. Compromised mental health of greatest concern for nurse is patients appraisal of
reality, control over impulse and faulty self- concept.
e. Mental illness changes with culture, time in history, political systems and groups
defining it
3. Psychiatric disorders
a. WHO ( World health organization describes health as a state of complete physical,
mental and social well being and not merely the absence of disease or infirmity;
i. There is a strong relationship between physical and mental health
ii. Poor physical health can lead to mental distress and mental distress can lead to
poor physical health
b. Mental Illness is brain based and is therefore a physical illness
c. Psychiatric disorders are generally the result of nature and nurture
d. A diathesis-stress model-in which diathesis represent biological predisposition and
stress represent environmental stress or trauma is the most accepted explanation for
mental illness
4. Risk Factors that increase risk of mental health outcomes
a. Inborn vulnerability
b. poor social environment
c. Economic hardship
d. Poor health policy
5. Protective factors as resiliency improve a persons ability to respond to stress, trauma and loss.
a. Individual attributes, social and economic, environmental factors.
b. Resilience is closely related to process of adapting; it is the ability and capacity for
people to secure the resource they need to support their well being.
i. helps people facing tragedies, loss, trauma and severe stress
6. Recovery
a. The recovery movement has shifted the focus of decision making from a paternalistic
system where compliance is emphasized to a focus on self -determination and self-
direction.
7. DSM-V
, a. DSM-V Classifies disorders people have.
i. Details the diagnostic criteria for psychiatric clinical conditions i
i. Gives
iii. Official guideline
criteria usedfor
to diagnosing
establish a psychiatric
diagnosis disorders
b. DSM-V diagnosis guides medical treatment (this differs with nursing diagnosis which is a
framework for identifying interventions for pts human responses
8. International Classification of Diseases, 10e
a. Clinical descriptions of mental and behavior disorders
b. 2 broad classifications
2
..
, c. Subclassifications
9. Psychiatric Nursing
a. Promoting mental health through assessment, diagnosis, and treatment of behavioral
and mental disorders
b. Use nursing, psychosocial, cultural neurobiological theories and research
c. Work with people throughout the life span
d. Employed in a variety of settings and among varied populations
10. Levels of Psychiatric Nursing
a. Basic Level
i. Psychiatric mental health registered nurse (PMH-RN)
1. 2 years full-time work, 2000 clinical hours, 30 hours continuing
education, followed by certification exam to add “BC” to the RN title
(RN-BC)
2. Perform mental health assessments, establish relationship and provide
individualized care planning; teach coping skills
b. Advanced Practice
i. Psychiatric mental health advanced practice registered nurse (PMH-APRN)
ii. Master of Science or Doctorate
iii. Advanced Practice Psychiatric nurse/Masters prepared nurse practitioners and
clinical nurse specialist who have taken special course on prescribing
medications.
1. All of the above plus
2. Psychotherapy
3. prescribe psychotropic medications
11. Practice of psychiatric nursing
a. Requires different set of skills than medical surgical nursing, although there is overlap.
b. Psychiatric nurses must be able to help patients with medical as well as mental health
problems, reflecting the holistic perspective
c. Psych nursing used complex communication skills as well as critical thinking to solve
multidimensional problems
d. Teach others that the patient is not the disease but has the disease; the patient has
schizophrenic symptoms, don’t say the patient is schizophrenic
e. Psych nursing deal with pain and suffering on emotional level,
f. Avoid labeling patients
g. Recognize cultural bias and work on it
h. They do not use high technology, equipment or intravenous therapy; they use “ self”
called therapeutic use of self.
i. Focuses on relationships (family, partner, etc) as mental health includes rational
thinking, communication skills, learning, emotional growth, resilience and self esteem
3
