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NURS 3381 Exam 1 Study GuideChapter 1: Practicing the Science and the Art of Psychiatric Nursing
1. Discuss, define, and give examples of the important roles and characteristics related
to the Art of Nursing
(1) Caring
Empathic understanding, actions, and patience on another’s behalf
Caring for another through actions, words, and being present leads to
happiness and touches the heart
Giving of self while preserving the importance of self
Can transform fear, pain, and suffering into a tolerable, shared experience
Involves comforting- providing social, emotional, physical, spiritual
support
Economic strain and nursing shortages are barriers to the practice of
caring and comforting
(2) Attending
An “intensity of presence,” being there for and in tune with a patient
Minimizes or eliminates a patient’s sense of isolation
Includes active listening skills, touching, or giving attentive physical care
(3) Patient Advocacy
Patient advocates speak up for another’s cause and help others by
defending and comforting
Includes a commitment to patient’s health, well-being, and safety across
the life span, the alleviation of suffering, and the promotion of a peaceful,
comfortable, and dignified death
Ex) advising patients of their rights, providing accurate and current
information to allow patients to make informed decisions, and supporting
the decisions of patients
2. Discuss and define evidence-based practice (EBP), giving examples of steps of
integrating into clinical practice
EBP: clinical decision making that synthesizes (1) best available research
evidence, (2) clinical expertise, (3) patient preferences
Integrating EBP into clinical practice can be achieved via the “5 A’s:”
Ask a question
Acquire the literature
Appraise the literature
Apply the evidence
Assess the performance
Resources that nurses can use as guidelines for best-evidence interventions
include:
Internet resources
Clinical practice guidelines: systematically developed statements based on
literature review that appraise and summarize the best evidence to guide
clinicians in making informed decisions about specific health problems
, Clinical algorithms: step-by-step guidelines prepared in a flowchart or
decision-tree format. Useful in deciding what medication to use
considering a patient’s characteristics
Clinical/critical pathways: institution-specific; serve as a map for
specified treatments and interventions to occur within specific time frames
There is a wide gap between the best evidence treatments and their effective
translation into practice (“The Research-Practice Gap”). There is a need for
continued research on how best to apply findings of clinically relevant issues
Recovery model: emphasizes rehabilitation and recovery, instead of illness and
disease
Focus on managing symptoms, reducing psychosocial disability, and
improving role performance
The patient is a partner. Care is patient and family driven, with patients
being partners in all aspects of care
Encourage supportive relationships
The primary goal is to empower patients to realize their full potential and
independence within the limitations of their illness
Care focused on increasing patient’s ability with coping, facilitating
recovery, and building resilience- not just managing symptoms
Individualized care with focus on the nurse-patient relationship
Trauma-informed care: recognizes that trauma is almost universal in mental
health patients and is a contributor to mental health issues, substance abuse,
chronic health conditions, and contact with the criminal justice system
Provides guidelines for integrating an understanding of how trauma affects
patients into clinical practice
Avoidance of new trauma in treatments (i.e. restraints, coercion)
Collaborative therapeutic relationship, empowerment, and cultural respect
Chapter 2: Mental Health and Mental Illness
Mental health: the successful performance of mental functions, resulting in the
ability to engage in productive activities, enjoy fulfilling relationships, adapt to
change, and cope with adversity
Mental illness: medical conditions (dysfunctions of the brain and
neurotransmitters) that affect a person’s thinking, feeling, mood, ability to relate
to others, and daily functioning
1. Discuss and define epidemiology as it relates to mental health and mental illness
Epidemiology: the study of the distribution (# of cases) of disorders in human
populations
The distribution of disorders can be used to identify high-risk groups and risk
factors, as well as learn the etiology of mental disorders
Results of studies involves groups of individuals with particular mental
illnesses/symptoms can help clinicians understand the frequency and factors
associated with a particular diagnosis
2. Define, discuss, and give examples of incidence, prevalence, comorbidity, and their
relevance to mental health disorders [Table 2-2, page 13]
, Prevalence rate: the proportion of a population with a mental disorder at a given
time
Ex)
Major depressive disorder: leading cause of disability in the U.S. Affects
2:1 women to men
Schizophrenia: affects 1:1 women to men; appears earlier in men
Bipolar affective disorder: affects 1:1 women to men
Anxiety disorder: frequently co-occurs with depressive disorders, eating
disorders, and/or substance abuse
Panic disorder: typically develops in adolescence. 1/3 develops
agoraphobia
OCD: first symptoms begin in childhood or adolescence
Generalized anxiety disorder: highest risk between childhood and middle
age
Social phobia: typically begins in childhood or adolescence
Chapter 3: Relevant Theories and Therapies for Nursing Practice
Theoretical models serve as a basis for understanding and treating psychiatric
alterations and mental health issues
1. Discuss, define, and give examples of the Stress-Diathesis model and its importance
in mental illnesses
2. Compare, contrast, define, and give examples of important characteristics of the
therapies that were identified by Carl Rogers, including genuineness, positive
regard
Person-centered therapy
Humans are healthy and good
People have innate self-actualizing tendencies to grow, develop, and to
realize their full potential
People were in the best position to explore, understand, and identify
solutions to their own problems
Emphasis on self-awareness and on the present
Therapist’s role is as a nondirective facilitator who seeks clarification and
provides encouragement in the process; therapist must possess
genuineness, empathy, and respect (without, the therapy will be
unsuccessful)
3. Discuss the theories and related concepts of Harry Stack Sullivan, Hildegarde
Peplau, Carl Rogers giving examples of the influence they have had on the practice
of psychiatric mental health nursing and the therapeutic relationship
Henry Stack Sullivan- Interpersonal theory: the purpose of all behavior is to get
needs met through interpersonal interactions and to decrease or avoid anxiety
Focuses on what occurs between people; personality disorders are caused
primarily by social forces and interpersonal situations
Emphasis on the early relationship with the “significant other” (parenting
figure) as crucial for personality development
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