Mental Health Nursing
Mary Ann Hogan (MSN.)
INTRODUCTION Welcome to the new Prentice Hall Reviews and Rationales Series! This 9-book series has been specifically designed to provide a clear and concentrated review of important nursing knowledge in the following content areas: Child Health Nursing Maternal-Newborn Nursing Mental Health Nursing Medical-Surgical Nursing Pathophysiology Pharmacology Nursing Fundamentals Nutrition and Diet Therapy Fluids, Electrolytes, & Acid-Base Balance The books in this series have been designed for use either by current nursing students as a study aid for nursing course work or NCLEX-RN licensing exam preparation, or by practicing nurses seeking a comprehensive yet concise review of a nursing specialty or subject area. This series is truly unique. One of its most special features is that it has been authored by a large team of nurse educators from across the United States and Canada to ensure that each chapter is written by a nurse expert in the content area under study. Prentice Hall Health representatives from across North America submitted names of nurse educators and/or clinicians who excel in their respective fields, and these authors were then invited to write a chapter in one or more books. The consulting editor for each book, who is also an expert in that specialty area, then reviewed all chapters submitted for comprehensiveness and accuracy. The series editor designed the overall series in collaboration with a core Prentice Hall team to take full advantage of Prentice Hall's cutting edge technology, and also reviewed the chapters in each book. All books in the series are identical in their overall design for your convenience (further details follow at the end of this section). As an added value, each book comes with a comprehensive support package, including free CD-ROM, free companion website access, and a Nursing Notes card for quick clinical reference. STUDY TIPS Use of this review book should help simplify your study. To make the most of your valuable study time, also follow these simple but important suggestions: Use a weekly calendar to schedule study sessions. Outline the timeframes for all of your activities (home, school, appointments, etc.) on a weekly calendar. Find the "holes" in your calendar—the times in which you can plan to study. Add study sessions to the calendar at times when you can expect to be mentally alert and follow it! Create the optimal study environment. Eliminate external sources of distraction, such as television, telephone, etc. Eliminate internal sources of distraction, such as hunger, thirst, or dwelling on items or problems that cannot be worked on at the moment. Take a break for 10 minutes or so after each hour of concentrated study both as a reward and an incentive to keep studying. Use pre-reading strategies to increase comprehension of chapter material. Skim the headings in the chapter (because they identify chapter content). Read the definitions of key terms, which will help you learn new words to comprehend chapter information. Review all graphic aids (figures, tables, boxes) because they are often used to explain important points in the chapter. Read the chapter thoroughly but at a reasonable speed. Comprehension and retention are actually enhanced by not reading too slowly. Do take the time to reread any section that is unclear to you. Summarize what you have learned. Use questions supplied with this book, CD-ROM, and companion website to test your recall of chapter content. Review again any sections that correspond to questions you answered incorrectly or incompletely. TEST TAKING STRATEGIES Use the following strategies to increase your success on multiple-choice nursing tests or examinations: Get sufficient sleep and have something to eat before taking a test. Take deep breaths during the test as needed. Remember, the brain requires oxygen and glucose as fuel. Avoid concentrated sweets before a test, however, to avoid rapid upward and then downward surges in blood glucose levels. Read each question carefully, identifying the stem, the four options, and any key words or phrases in either the stem or options. Key words in the stem such as "most important" indicate the need to set priorities, since more than one option is likely to contain a statement that is technically correct. Remember that the presence of absolute words such as "never" or "only" in an option is more likely to make that option incorrect. Determine who is the client in the question; often this is the person with the health problem, but it may also be a significant other, relative, friend, or another nurse. Decide whether the stem is a true response stem or a false response stem. With a true response stem, the correct answer will be a true statement, and vice-versa. Determine what the question is really asking, sometimes referred to as the issue of the question. Evaluate all answer options in relation to this issue, and not strictly to the "correctness" of the statement in each individual option. Eliminate options that are obviously incorrect, then go back and reread the stem. Evaluate the remaining options against the stem once more. If two answers seem similar and correct, try to decide whether one of them is more global or comprehensive. If the global option includes the alternative option within it, it is likely that the more global response is the correct answer. THE NCLEX-RN LICENSING EXAMINATION The NCLEX-RN licensing examination is a Computer Adaptive Test (CAT) that ranges in length from 75 to 265 individual (stand-alone) test items, depending on individual performance during the examination. Upon graduation from a nursing program, successful completion of this exam is the gateway to your professional nursing practice. The blueprint for the exam is reviewed and revised every three years by the National Council of State Boards of Nursing according to the results of a job analysis study of new graduate nurses (practicing within the first six months after graduation). Each question on the exam is coded to oneClient Need Categoryand one or moreIntegrated Concepts and Processes. Client Need Categories There are 4 categories of client needs, and each exam will contain a minimum and maximum percent of questions from each category. Each major category has subcategories within it. TheClient Needcategories according to the NCLEX-RN Test Plan effective April 2001 are as follows: Safe, Effective Care Environment Management of Care (7-13%) Safety and Infection Control (5-11 %) Health Promotion and Maintenance Growth and Development Throughout the Lifespan (7-13%) Prevention and Early Detection of Disease (5-11 %) Psychosocial Integrity Coping and Adaptation (5-11%) Psychosocial Adaptation (5-11%) Physiological Integrity Basic Care and Comfort (7-13%) Pharmacological and Parenteral Therapies (5-11%) Reduction of Risk Potential (12-18.%) Physiological Adaptation (12-18%) Integrated Concepts and Processes The integrated concepts and processes identified on the NCLEX-RN Test Plan effective April 2001, with condensed definitions, are as follows: Nursing Process: a scientific problem-solving approach used in nursing practice; consisting of assessment, analysis, planning, implementation, and evaluation. Caring: client-nurse interaction(s) characterized by mutual respect and trust and directed toward achieving desired client outcomes. Communication and Documentation: verbal and/or nonverbal interactions between nurse and others (client, family, health care team); a written or electronic recording of activities or events that occur during client care. Cultural Awareness: knowledge and sensitivity to the client's beliefs/values and how these might impact on the client's healthcare experience. Self-Care: assisting clients to meet their health care needs, which may include maintaining health or restoring function. Teaching/Learning: facilitating client's acquisition of knowledge, skills, and attitudes that lead to behavior change. More detailed information about this examination may be obtained by visiting the National Council of State Boards of Nursing website athttp://www.ncsbn.organd viewing theNCLEX-RN Examination Test Plan for the National Council Licensure Examination for Registered Nurses. HOW TO GET THE MOST OUT OF THIS BOOK Chapter Organization Each chapter has the following elements to guide you during review and study: Chapter Objectives: describe what you will be able to know or do after learning the material covered in the chapter. OBJECTIVES: Review basic principles of growth and development. Describe major physical expectations for each developmental age group. Identify developmental milestones for various age groups. Discuss the reactions to illness and hospitalization for children at various stages of development. Review at a Glance: contains a glossary of key terms used in the chapter, with definitions provided up-front and available at your fingertips, to help you stay focused and make the best use of your study time. Pretest: this 10-question multiple choice test provides a sample overview of content covered in the chapter and helps you decide what areas need the most—or the least—review. Practice to Pass questions: these are open-ended questions that stimulate critical thinking and reinforce mastery of the chapter content. NCLEX Alerts: the NCLEX icon identifies information or concepts that are likely to be tested on the NCLEX licensing examination. Be sure to learn the information flagged by this type of icon. Case Study: found at the end of the chapter, it provides an opportunity for you to use your critical thinking and clinical reasoning skills to "put it all together;" it describes a true-to-life client case situation and asks you open-ended questions about how you would provide care for that client and/or family. Posttest: a 10-question multiple-choice test at the end of the chapter provides new questions that are representative of chapter content, and provide you with feedback about mastery of that content following review and study. All pretest and posttest questions contain rationales for the correct answer, and are coded according to the phase of the nursing process used and the NCLEX category of client need (called the Test Plan). The Test plan codes are PHYS (Physiological Integrity), PSYC (Psychosocial Integrity), SECE (Safe Effective Care Environment), and HPM (Health Promotion and Maintenance). CD-ROM For those who want to practice taking tests on a computer, the CD-ROM that accompanies the book contains the pretest and posttest questions found in all chapters of the book. In addition, it contains 10 NEW questions for each chapter to help you further evaluate your knowledge base and hone your test-taking skills. In several chapters, one of the questions will have embedded art to use in answering the question. Some of the newly developed NCLEX test items are also designed in this way, so these items will give you valuable practice with this type of question. Companion Website (CW) The companion website is a "virtual" reference for virtually all your needs! The CW contains the following: 50 NCLEX-style questions: 10 pretest, 10 posttest, 10 CD-ROM, and 20 additional new questions Definitions of key terms: the glossary is also stored on the companion website for ease of reference In Depth With NCLEX: features drawings or photos that are each accompanied by a one- to two-paragraph explanation. These are especially useful when describing something that is complex, technical (such as equipment), or difficult to mentally visualize. Suggested Answers to Practice to Pass and Case Study Questions: easily located on the website, these allow for timely feedback for those who answer chapter questions on the web. Nursing Notes Clinical Reference Card This laminated card provides a reference for frequently used facts and information related to the subject matter of the book. These are designed to be useful in the clinical setting, when quick and easy access to information is so important! ABOUT THE MENTAL HEALTH NURSING BOOK Chapters in this book cover "need-to-know" information about mental health nursing, including major diagnostic categories. Additional chapters focus on special topics such as crisis intervention and suicide; victims of abuse; loss and grief; and the psychological adaptation to medical illness. Since mental health questions are unique and cause many students distress, Chapter 1 discusses effective test-taking techniques and strategies that will be specifically helpful when answering mental health questions. Mastery of the information in this book and effective use of the test-taking strategies described will help the student be confident and successful when answering psychosocial integrity questions on the NCLEX-RN.