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Psychiatric Mental Health Nursing Success

A Course Review Applying Critical Thinking to Test Taking

Psychiatric Mental Health Nursing Success

A Course Review Applying Critical Thinking to Test Taking

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

Psychiatric Mental Health Nurse Trident Technical College Charleston, South Carolina F. A. DAVIS COMPANY • Philadelphia

F. A. DAVIS COMPANY • Philadelphia

F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com

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: 8036-1169-2/04 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

Reviewers

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

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

TableContentsof Contents

A. Fundamentals of Critical Thinking Related to Test Taking:

The RACE Model

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GUIDELINES FOR USING THIS BOOK

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PREPARING

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PREPARING

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. UNDERSTANDING THE TYPES OF NURSING

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RACE MODEL: APPLICATION OF CRITICAL THINKING TO MULTIPLE-CHOICE

 

QUESTIONS

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B. Basic Concepts in Psychiatric Mental Health

 

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1. Mental Health/Mental Illness: Theoretical Concepts

 

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PRACTICE

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. Diagnostic and Statistical Manual of Mental Disorders IV-TR (DSM-IV-TR)

Major Theoretical Models

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PRACTICE QUESTIONS ANSWERS AND RATIONALES

 

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2. Psychiatric

Nursing

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PRACTICE

QUESTIONS

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Mental Health Nursing

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Role of the Nurse

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Nursing Process

Nurse-Client Relationship

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Transference/Countertransference

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3. Communication

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47

PRACTICE

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. Therapeutic Communication Facilitators

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Blocks to Therapeutic Communication

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Therapeutic Communication Interventions

 

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Nonverbal Communication Cultural Considerations

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4. Psychopharmacology

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71

PRACTICE

QUESTIONS

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. Medication Administration Considerations in Mental Health

Psychobiology

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. Sedative/Hypnotic Medications

Antianxiety Medications

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Antipsychotic Medications Antidepressant Medications

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Medication Calculations

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xi

xii

CONTENTS

5. Legal and Ethical Considerations

99

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100

Legal and Ethical Concepts

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Safety Issues

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Client Rights

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Voluntary and Involuntary Commitment

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Confidentiality

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Potential Liability

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Advanced Directives

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6. Stress Adaptation Throughout the Life Span

 

113

PRACTICE

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114

Theory

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Ego Defense Mechanisms

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Responses

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Crisis Intervention

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. Safety Issues Related to Stress Adaptation PRACTICE QUESTIONS ANSWERS AND RATIONALES

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C.

Management of Care for Individuals with Psychiatric

 

Disorders

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131

7. Anxiety and Sleep

131

PRACTICE

Theory

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