Psychiatric Nursing Certification Review Guide for the Generalist and Advanced Practice Psychiatric and Mental Health Nurse Third Edition Victoria Mosack, PhD, RN, APNP, BC Assistant Professor School of Nursing Wichita State University Wichita, Kansas World Headquarters Jones and Bartlett Publishers Jones and Bartlett Publishers Jones and Bartlett Publishers 40 Tall Pine Drive Canada International Sudbury, MA 01776 6339 Ormindale Way Barb House, Barb Mews 978-443-5000 Mississauga, Ontario L5V 1J2 London W6 7PA [email protected] Canada United Kingdom www.jbpub.com Jones and Bartlett’s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jbpub.com. Substantial discounts on bulk quantities of Jones and Bartlett’s publications are available to corporations, professional associa- tions, and other qualified organizations. 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Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. Production Credits Publisher: Kevin Sullivan V.P., Manufacturing and Inventory Control: Therese Connell Acquisitions Editor: Amy Sibley Composition: Datastream Content Solutions, LLC Associate Editor: Patricia Donnelly Cover Design: Kristin E. Parker Editorial Assistant: Rachel Shuster Cover Image: © Hocusfocus/Dreamstime.com Production Editor: Amanda Clerkin Printing and Binding: Courier Stoughton, Inc. Marketing Manager: Rebecca Wasley Cover Printing: Courier Stoughton, Inc. Library of Congress Cataloging-in-Publication Data Mosack, Victoria. Psychiatric nursing certification review guide for the generalist and advanced practice psychiatric and mental health nurse / Victoria Mosack.—3rd ed. p. ; cm. Rev. ed. of: Psychiatric certification review guide for the generalist and clinical specialist in adult, child, and adolescent psychiatric and mental health nursing / editor, Clare Houseman . 2nd ed. c1998. Includes bibliographical references and index. ISBN-13: 978-0-7637-7599-5 (alk. paper) ISBN-10: 0-7637-7599-1 (alk. paper) 1. Psychiatric nursing. 2. Psychiatric nursing—Examinations, questions, etc. I. Psychiatric certification review guide for the generalist and clinical specialist in adult, child, and adolescent psychiatric and mental health nursing. II. Title. [DNLM: 1. Psychiatric Nursing—Examination Questions. 2. Mental Disorders—nursing—Examination Questions. WY 18.2 M893p 2011] RC440.P72985 2011 616.8990231—dc22 2009033393 6048 Printed in the United States of America 14 13 12 11 10 10 9 8 7 6 5 4 3 2 1 Contents Preface vii Interdisciplinary Treatment & the Healthcare Team 16 Acknowledgments ix Client Advocacy 17 Chapter 1 Case Management 17 Psychiatric Liaison Nursing 18 Test Taking Strategies and Techniques 1 Milieu 18 Strategy #1 Know Yourself 1 Principles of Prescriptive Authority 19 Strategy #2 Develop Your Thinking Skills 1 Mental Health Education 21 Strategy #3 Know the Content 3 Family Therapy 21 Strategy #4 Become Test-Wise 6 Group Dynamics & Group Process Strategy #5 Apply Basic Rules of Test Theory 22 Taking 7 Ethical Considerations 23 Strategy #6 Psych Yourself Up: Taking a Test Questions 25 is Stressful 8 Answers 32 Summary 9 Bibliography 33 Bibliography 9 Chapter 3 Chapter 2 Major Theoretical Frameworks for Essentials of Psychiatric Nursing Care 11 Psychiatric Nursing 35 Mental Health 11 Theory 35 Change 11 Evidence-Based Practice (EBP) 35 The Nursing Process 12 Research 36 Nurse–Client Relationship 12 Nursing Theoretical Models 37 Communication 13 Nursing Theories 37 Cultural & Ethnic Factors 15 Personality Theories 39 iii iv Contents Theories of Growth and Development 42 Chapter 7 Social/Interpersonal Theories 43 Mood Disorders 137 Existential/Humanistic Theories 43 Mood Disorders—Overview 137 Behavioral Theories 45 Depressive Disorders 139 Cognitive Theories 45 Bipolar Disorders 140 Theories of Communication 46 Mood Disorder Due to . (Indicate General Theories of Group Behavior and Medical Condition) 141 Therapy 47 Substance-Induced Mood Disorder 141 Family Theories 48 Suicide 141 Neurobiological Theories 49 Etiology of Mood Disorders 142 Miscellaneous Theories 51 Diagnostic Studies/Tests 143 Questions 52 Screening Instruments 143 Answers 60 Interventions 144 Bibliography 61 Questions 156 Chapter 4 Answers 164 Bibliography 164 Substance-Related Mental Disorders 63 Substance-Related Disorders 63 Chapter 8 Questions 76 Behavioral Syndromes and Disorders of Answers 80 Adult Personality 165 Bibliography 80 Eating Disorders 165 Chapter 5 Sexual and Gender Identity Disorders 168 Sexual Dysfunctions 170 Anxiety and Stress-Related Disorders 83 Sleep Disorders 171 Anxiety Disorders 83 Impulse Control Disorders 173 Somatoform Disorders 95 Personality Disorders—Coded on Axis II of Factitious Disorders 98 the DSM-IV-TR Multiaxial Classification Dissociative Disorders 99 System 174 Adjustment Disorder 104 Questions 179 Questions 105 Answers 184 Answers 111 Bibliography 184 Bibliography 111 Chapter 9 Chapter 6 Cognitive Mental Disorders and Schizophrenia and Other Psychotic Geropsychiatric Nursing 187 Disorders 115 Cognitive Disorders 187 Overview of Disorders 115 Geropsychiatric Nursing 196 Information Common to Schizophrenia Questions 197 and Other Psychotic Disorders 118 Answers 202 Questions 129 Bibliography 202 Answers 134 Bibliography 134 Contents v Chapter 10 Chapter 11 Behavioral and Emotional Disorders of The Larger Mental Health Environment Childhood and Adolescence 205 Mental Healthcare Delivery System 253 Child and Adolescent Psychiatric and Managed Care—An Internal Force of Mental Health Nursing 205 Change within the Mental Health Mental Disorders Diagnosed in Children & Delivery System 257 Adolescents 208 Reimbursement for Mental Health Other Disorders of Infancy, Childhood, or Services 257 Adolescence 227 Types of Healthcare Insurance Plans 257 Treatment Modalities for Mental Disorders External Forces Interacting with the Mental in Childhood and Adolescence 231 Health System 258 Questions 240 Leadership and Management 261 Answers 249 Questions 270 Bibliography 249 Answers 276 Bibliography 276 Index 279 Preface This is the third edition of a book developed especially The book has been organized to provide the reviewer for nurses preparing to take certification examinations with test taking strategies and techniques. This is offered by the American Nurses Credentialing Center followed by chapters on the Essentials of Psychiatric (ANCC). Major revisions were needed in a number of Nursing Care, Major Theoretical Frameworks for Psychi- areas to accommodate changes in the field of psychi- atric Nursing, Substance-Related Mental Disorders, atric and mental health nursing and to incorporate Anxiety and Stress-Related Disorders, Schizophrenia more recent references as well as evidence-based prac- and Other Psychotic Disorders, Mood Disorders, tice guidelines that may have become available since Behavioral Syndromes and Disorders of Adult Person- the previous revision was published. ality, Cognitive Mental Disorders and Geropsychiatric The book is inclusive in that it contains both basic Nursing, Behavioral and Emotional Disorders of Child- and advanced content, and may be used by nurses hood and Adolescence, and The Larger Mental Health seeking certification as generalists as well as nurses Environment. seeking certification in advanced practice psychiatric Following each chapter are test questions, which and mental health nursing. It is assumed that the reader are intended to serve as an introduction to the testing of this review guide has completed a course of study in arena. In addition, a bibliography is included for those psychiatric and mental health nursing. The Psychiatric who desire a more in-depth discussion of the subject Nursing Certification Review Guide for the Generalist matter in each chapter. These references can serve as and Advanced