WESTERN NEVADA COMMUNITY COLLEGE
Mental Health and Illness Theory & Lab
NURSING 149-150
Revised: SPRING 2010
Professor Cheryl E. Moreland, RN, MS, APN
E-mail address: moreland@wnc.edu
Cell phone: (775) 721—3216
Office Phone: (775) 445—4295
Nurs. 149-150 Revised Jan.2010
Page 1
NURS 149: Mental Health and Illness Theory
Revision Date: January 2010
Number of Credits: 2 (30 clock hours)
Transferability of course within Nevada: General Elective
Prerequisite courses: Successful completion of the first semester of the nursing program.
Co-requisite courses: NURS 150 & Nurs.151
Students must pass NURS 149, 150 and 151 to continue on in the program. This series of
courses must be repeated if the student is unsuccessful with any of the three courses.
Course Description
This course assists students to gain knowledge of nursing care for patients across the lifespan
experiencing common alterations in psychosocial health. The course examines the principles
and practice of psychiatric nursing through a variety of theoretical frameworks and legal and
ethical values that guide its practice. The course is organized by the nursing process and
emphasizes the use of culturally relevant therapeutic communication skills, development of
therapeutic nurse/patient relationships, and interventions that are grounded in evidence-based
practice.
Course Objectives
Upon successful completion of the course the student will be able to:
1. Discuss a variety of theoretical frameworks used in the provision of culturally competent
care to patients experiencing common alterations in psychosocial health.
2. Utilize knowledge grounded in evidence-based practice to utilize the nursing process in a
classroom setting for patients experiencing anxiety disorders, stress, mood disorders,
personality disorders, substance abuse, aggression and violence, thought disorders,
disorders of self-regulation, psychosomatic disorders, and psychiatric emergencies.
3. Articulate nursing responsibilities associated with carrying out a medical plan of care.
4. Prioritize appropriate therapeutic modalities that are designed to promote healthy
bio/psycho/social/cultural and spiritual functioning while maintaining patient safety.
5. Explain how the ethical and legal rights of patients guide the practice of psychiatric
nursing.
6. Analyze psychopharmacological issues important in the provision of safe patient care.
Textbooks
The following textbooks are required for NURS 149
Varcarolis, E., & Halter, M., (2010) Foundations of Psychiatric Mental Health Nursing, (6th Ed.).
ST. Louis: Saunders Elsevier.
Nurs. 149-150 Revised Jan.2010
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III. Methods of Instruction
Methods of instruction include lecture, required readings, discussion, student presentations, and
video materials.
IV. Grading System
1. Three examinations will constitute 75% of the final grade.
Student must achieve at least a 75% cumulative average on the three examinations to
successfully complete this course. Students who do not earn a 75% cumulative average on
examinations will not be allowed to continue in the nursing program, and will receive the
earned average of examinations as the grade for the course.
2. Clicker Quizzes will constitute 25% of the grade. Please bring your clicker, with a
fresh/extra battery and to each class. The course calendar outlines when quizzes will be
given. Students must be present for the quiz as there will be no make-up time for a missed
quiz. The lowest quiz grade will be deleted and the ten quizzes will be averaged to count for
25% of the grade.
Students should consult the Nursing Program Student Handbook for additional information
regarding the grading system.
3. Calculation of Theory Grade
Weekly Clicker Quizzes
Exam 1
Exam 2
Exam 3
25%
25%
25%
25%
Total 100%
If you have a disability for which you will need to request accommodation, please contact
Disability Support Services office (Bristlecone Building, Room 103) as soon as possible to
arrange for appropriate accommodations.
Nurs. 149-150 Revised Jan.2010
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NURS 150: Mental Health & Illness Laboratory
Revision Date: Jan. 2010
Number of Credits: 1 (45 clock hours)
Transferability of course within Nevada: General Elective
Prerequisite courses: Successful completion of the first semester of the nursing program
Co-requisite courses: NURS 149 and NURS 151
Students must pass NURS149, 150 and 151 to progress in the nursing program. This series of
courses must be repeated if the student is unsuccessful with any of the three courses.
Course Description
This course provides the opportunity for students to utilize the nursing process in a simulated
laboratory setting to understand the care of patients experiencing common alterations in
psychosocial health. Through the use of active learning modalities, including classroom
presentations and group work, students are encouraged to scrutinize their beliefs regarding
alterations in psychosocial health. Students will explore nurse/patient relationships, the
importance of therapeutic communication, and examine psychotherapeutic approaches designed
to meet the bio/psycho/social/cultural and spiritual needs of patients.
Course Objectives
Upon successful completion of the course the student will be able to:
1. Apply the nursing process in a laboratory setting in the provision of culturally relevant
care to patients across the lifespan experiencing common alterations in psychosocial
health.
2. Compare and contrast a variety of treatment modalities.
3. Evaluate the degree to which the student was able to achieve a therapeutic use of self.
4. Analyze thoughts, feelings and behaviors commonly encountered in the care of patients
that illustrate healthy and unhealthy psychosocial functioning.
5. Compare and contrast the primary roles of nurses as they provide and direct nursing care
that promotes and supports the bio/psycho/social/cultural and spiritual needs of patients.
6. Utilize therapeutic communication skills while role-playing simulated patient scenarios.
7. Analyze how the nurse uses ethical values and knowledge of legal parameters in the
provision of care to patients experiencing common alterations in psychosocial health.
8. Demonstrate competency in the application of the nursing process to the care of patients
with common alterations in psychosocial health by developing appropriate outcome
criteria based on an understanding of pathology and prognosis of the alteration.
Nurs. 149-150 Revised Jan.2010
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Methods of Instruction
Teaching/learning modalities utilized in this course include lecture, clicker questions, student
presentations, discussion groups, audio-video, required readings, guest speakers, case studies,
field trips, role playing and video tape of data collection for the completion of a genogram, with
self-critique and peer critique.
Attendance Policy
Students are expected to be on time and attend all laboratory experiences. Students missing
more than one laboratory experience will make arrangements with the instructor for a make-up
assignment. Failure to do so will result in a grade of failure (F) for the course.
Grading System
Students will earn a grade of pass (P) or fail (F) in the course. Students must complete all lab
assignments at a satisfactory level (75% or higher) in order to pass the course.
Lab Assignments include:
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Lab attendance and participation
Mental Health letter
Clicker questions
Process Recording
Psycho-Social Assessment
AIMS Test (Abnormal Involuntary Muscle Scale)
Mini-Mental Status Exam
Student presentation on selected Psychotropic medications
MAST Test (Michigan Alcoholism Screening Test)
DSM—IV—TR Exercise
Zung Depression Scale
SAD Persons Screening Tool (Suicide Assessment Tool)

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Video tape of data collection for the completion of a genogram, with self-critique and
peer critique.
Values Clarification Group Therapy
Life Changing Events Questionnaire

Legal 2000 Group Work
Nurs. 149-150 Revised Jan.2010
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QUIZZES: A clicker quiz will be given throughout the lecture and lab. The quiz will be taken from the assigned
reading for that week. Students must be present, on time and prepared for class to take the quiz. There will be no
make up for a missed quiz. The lowest quiz grade will be deleted and ten quizzes will be averaged and count as 25%
of your grade.
CLASS SCHEDULE
Assigned reading from Text: Varcarolis, Foundations of Psychiatric Mental Health Nursing, 6th Ed.
Reading
Assignments
Date:
Class Topic
2010
Class 1
Jan. 25
Quiz
Mental Health Letter; Genogram;
DSM—IV—TR Exercise;
Psycho-Social Assessment;
Process Recording
Management of Assaultive Behavior
Welcome
Practical safety tips for working
with clients in the Acute Care
Setting; Psychosis; Mania;
Physical Assessment;
Class 2
Feb. 1
Foundations in Theory
Mental Health and Illness
Biological Basis
Chapters
1—2—3
75 pages
1
Class 3
Feb. 8
Foundations for Practice in the
Acute Care and Community
Setting; Cultural Implications;
Legal and Ethical Guidelines
Chapters
4—5—6—7
62 pages
2
Class 4
Feb. 15
Class 5
Feb. 22
President’s Day Holiday
Class 6
March 1
Class 7
March 8
Class 8
March 15
Psycho-Social Nursing Tools:
Nursing Process and Standards of
Care; Therapeutic Relationships,
Communication, Clinical
Interviewing, Stress, Group
Therapy
Lab Learning
Activities
Chapters
8—9—10
11—34
87 pages
3
AIMS Test Group Work
Video: Mental Status Assessment
Case Study; Discussion
Role Playing
Legal 2000 Group Work
Video: Exploring Roadblocks:
Basic Counseling Skills
Case Study; Discussion;
Role Playing
Values Clarification Group Therapy
Life Changing Events Questionnaire
Video: I’m Normal, You’re Weird
Video: Conducting the Patient
Interview
DVD: Group Work
Role Playing; Discussion;
Case Study; Video tape with selfcritique and peer critique.
EXAM 1
Anxiety and Depression
Bi-Polar and Schizophrenia
Nurs. 149-150 Revised Jan.2010
Chapters
12—13
68 pages
4
Chapters
14—15
64 pages
5
Student presentations;
Zung Depression Scale
Video: Psychotropic meds:
Depression
Video: Panic & Agoraphobia,
Phobia: OCD, ATSD,
PTSD, GAD
Group Work; Case Study; Discussion;
Role Playing
Student presentations;
Video: The Hallucination Patient
Video: Delusions
Video: Affective Disorders: Mania
Page 6
& Depression
Video: Bipolar Disorder
Video: Communicating with
Mania
Video: Psychotropic meds: Bipolar
Video: Affective Disorders: Mania
Group Work; Case Study;
Discussion; Role Playing
Class 9
March 22
Class 10
March 29
Spring Vacation
Eating, Cognitive and Addictive
Disorders
Chapters
16—17—18
89 pages
Class 11
April 5
Personality Disorders; Sleep
Disorders; Sexual Disorders;
Somatoform, Factitious and
Dissociative Disorders
Chapters
19—20
21—22
94 pages
Class 12
April 12
Class 13
April 19
Exam 2
Trauma Interventions: Crisis and
Disaster, Suicide
Class 14
April 26
Anger, Aggression and Violence,
Child, Older Adult, and Intimate
Partner Abuse and Sexual Assault
Class 15
May 3
Disorders of Children and
Adolescents, Psycho-Social
Needs of the Older Adult, Serious
Mental Illness
Psychological Needs of Patients
with Medical Conditions; Care
for the Dying and Those Who
Grieve; Forensic Psychiatric
Nursing;
Family Interventions and
Integrative Care
Class 16
May 10
Class 17
May 17
Chapters
23—24
37 pages
Chapters
25—26—27
60 pages
Chapters
28—29—30
68 pages
6
7
8
9
10
11
Chapters
31—32—33
35—36
75 pages
Student presentations;
MAST Test
Mini-Mental Status Exam
Video: Substance Abuse:
Assessment and
Intervention
Video: Losing It All
Group Work; Case Study;
Discussion; Role Playing
Student presentations;
Video: Mental Status Assessment
(Borderline) Abnormal
Abnormal Psych:
Antisocial, Narcissistic
& Borderline
Group Work; Case Study
Discussion; Role Playing
SAD Screening Tool
Group Work; Case Study;
Discussion; Role Playing
Rape Trauma Kit
Video: Mental Health Nursing:
Verbal and Physical Aggression
Group Work; Case Study
Discussion; Role Playing
Student presentations;
Group Work; Case Study
Discussion; Role Playing
Video:
Dealing with Death and Dying
Group Work
Case Study
Discussion
Role Playing
Final Exam
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class I
Welcome: Practical Safety Tips
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Compare and contrast a social relationship and a therapeutic relationship regarding purpose,
focus, communications style, and goals.
2. Complete a genogram on a fellow student.
3. Discuss the 5 Axises used in the diagnosis of a patient with mental health problems.
4. Explain the components of a psychosocial assessment.
5. Examine personal beliefs about mental health and mental illness.
6. Identify behaviors that increase student and client safety in the clinical setting.
7. At a beginning level, understand the symptoms of mania and psychosis.
8. Embrace the importance of maintaining patient confidentiality with patients experiencing
alterations in mental health.
9. Discuss the role of the student in the psychiatric acute care inpatient setting.
10. Differentiate between transference and counter transference.
11. Explain appropriate therapeutic boundaries when working with clients with alterations in mental
health.
12. Describe the process of dealing safely with an assaultive patient.
13. Differentiate among techniques that facilitate and obstruct therapeutic communication.
14. Discuss ways to address the mental health client that the student knows from the community.
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 2/Quiz 1
FOUNDATIONS IN THEORY
LEARNING ACTIVITIES: Read: Varcarolis: 75 pages
 Chapter 1: Mental Health and Mental Illness, pp. 2
 Chapter 2: Relevant Theories and Therapies for Nursing Practice, pp. 24
 Chapter 3: Biological Basis for Understanding Psychotropic Drugs, pp. 45
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Discuss some dynamic factors (including social climate, politics, myths, and biases) that contribute to
making a clear-cut definition of mental health elusive.
2. Explain how epidemiological studies can improve medical and nursing care.
4. Compare and contrast a DSM-IV-TR diagnosis with a nursing diagnosis.
5. Give examples of how personal norms and other cultural influences can affect making an accurate
DSM-IV-TR diagnosis.
6. Define psychiatric mental health nursing and discuss the patient population served by the psychiatric
nurse.
7. Explain the reasons for using standardized classification systems (e.g., North American Nursing
Diagnosis Association International [NANDA-I], Nursing Interventions Classification [NIC], and
Nursing Outcomes Classification [NOC]) in psychiatric nursing practice.
8. Compare and contrast the nursing actions of the basic level psychiatric mental health nurse with those
of the advanced level psychiatric mental health nurse.
9. Describe recent developments that have increased the biological emphasis in psychiatric mental health
nursing.
10. Explore emerging and future roles for psychiatric mental health nursing related to scientific and social
trends.
11. Evaluate the premises behind the various therapeutic models discussed in this chapter.
14. Drawing on clinical experience, provide the following:
a. An example of how a patient’s irrational beliefs influenced behavior.
b. An example of counter-transference in your relationship with a patient.
c. An example of the use of behavior modification with a patient.
15. Identify Peplau’s framework for the nurse-patient relationship.
17. Discuss at least eight functions of the brain and the way these functions can be altered by
psychotropic drugs.
18. Describe how a neurotransmitter functions as a neuromessenger.
20. Identify how specific brain functions are altered in certain mental disorders (e.g., depression, anxiety,
and schizophrenia).
21. Describe how the use of imaging techniques can be helpful for understanding mental illness.
22. Develop a teaching plan that includes side effects from dopamine blockage, such as motor
abnormalities.
Nurs. 149-150 Revised Jan.2010
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23. Describe the result of blockage of the muscarinic receptors and the 1 receptors by the standard
neuroleptic drugs.
24. Briefly identify the main neurotransmitters affected by the following psychotropic drugs and their
subgroups:
a. Antianxiety agents
b. Sedative-hypnotic agents
c. Antidepressants
d. Mood stabilizers
e. Antipsychotic agents
f. Anticholinesterase drugs
25. Identify special dietary and drug restrictions in a teaching plan for a patient taking a monoamine
oxidase inhibitor.
26. Identify specific cautions you might incorporate into your medication teaching plan with regard to:
a. Herbal medicine
b. Genetic pharmacology (i.e., variations in effects and therapeutic actions of medications among
different ethnic groups)
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 3/Quiz 2
FOUNDATIONS FOR PRACTICE
LEARNING ACTIVITIES: Read: Varcarolis: 62 Pages
 Chapter 4: Psychiatric Mental Health Nursing in Acute Care Settings, pp. 76
 Chapter 5: Psychiatric Mental Health Nursing in Community Settings, pp. 87
 Chapter 6: Cultural Implications for Psychiatric Mental Health Nursing, pp. 101
 Chapter 7: Legal and Ethical Guidelines for Safe Practice, pp. 118
OBJECTIVES: After completion of the objectives the student will be able to:
1. Describe the population served by inpatient psychiatric care.
2. Identify funding options for acute care of psychiatric conditions and legislation related to
insurance reimbursement.
3. List the criteria for admission to inpatient care.
4. Discuss the purpose of identifying the rights of hospitalized psychiatric patients.
5. Explain how the multidisciplinary treatment team collaborates to plan and implement care for the
hospitalized patient.
6. Explain the importance of monitoring patient safety during hospitalization.
7. Describe the role of the nurse as advocate and provider of care for the patient.
8. Discuss the managerial and coordinating roles of nursing on an inpatient acute care unit.
9. Discuss the process for preparing patients to return to the community for ongoing care.
10. Explain the evolution of the community mental health movement.
11. Identify elements of the nursing assessment that are critically important to the success of
community treatment.
12. Discuss the continuum of psychiatric treatment.
13. Describe the role of the community psychiatric mental health nurse in disaster preparedness.
14. Describe the role of the psychiatric nurse in four specific settings: partial hospitalization program,
psychiatric home care, assertive community treatment, and community mental health center.
15. Discuss barriers to mental health treatment.
16. Examine influences on the future of community psychiatric mental health nursing.
17. Explain the importance of culturally relevant care in psychiatric mental health nursing practice.
18. Discuss potential problems in applying Western psychological theory to patients of other
cultures.
19. Compare and contrast Western nursing beliefs, values, and practices with the beliefs, values, and
practices of patients from diverse cultures.
20. Perform culturally sensitive assessments that include risk factors and barriers to quality mental
health care that culturally diverse patients frequently encounter.
21. Develop culturally appropriate nursing care plans for patients of diverse cultures.
22. Compare and contrast the terms ethics and bioethics, and identify five principles of bioethics.
Nurs. 149-150 Revised Jan.2010
Page 11
23. Discuss at least five patient rights, including the patient’s right to treatment, right to refuse
treatment, and right to informed consent.
24. Identify the steps nurses are advised to take if they suspect negligence or illegal activity on the
part of a professional colleague or peer.
25. Apply legal considerations of patient privilege (a) after a patient has died, (b) if the patient tests
positive for human immunodeficiency virus, or (c) if the patient’s employer states a “need to know.”
26. Provide explanations for situations in which health care professionals have a duty to break
patient confidentiality.
27. Discuss a patient’s civil rights and how they pertain to restraint and seclusion.
28. Develop awareness of the balance between the patient’s rights and the rights of society with
respect to the following legal concepts relevant in nursing and psychiatric mental health nursing: (a)
duty to intervene, (b) documentation, and (c) confidentiality.
29. Identify legal terminology (e.g., torts, negligence, malpractice) applicable to psychiatric nursing,
and explain the significance of each term.
Feb 15th NO Class 4: Presidents Day Holiday
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 5/Quiz 3
Psychosocial Nursing Tools
LEARNING ACTIVITIES: Read: Varcarolis: 87 pages
 Chapter 8: The Nursing Process and Standards of Care for Psychiatric Mental Health
Nursing, pp. 138
 Chapter 9: Therapeutic Relationships, pp. 156
 Chapter 10: Communication and the Clinical Interview, pp. 174
 Chapter 11: Understanding Responses to Stress, pp. 195
 Chapter 34: Therapeutic Groups, pp. 736
OBJECTIVES: After completion of the objectives the student will be able to:
1. Compare the different approaches you would consider when performing an assessment with a
child, an adolescent, and an older adult.
2. Differentiate between the use of an interpreter and a translator when performing an assessment
with a non–English speaking patient.
3. Conduct a mental status examination (MSE).
4. Explain three principles a nurse follows in planning actions to reach agreed-upon outcomes
criteria.
5. Construct a plan of care for a patient with a mental or emotional health problem.
6. Identify three advanced practice psychiatric mental health nursing interventions.
7. Demonstrate basic nursing interventions and evaluation of care following the ANA’s Standards
of Practice.
8. Compare and contrast Nursing Interventions Classification (NIC), Nursing Outcomes
Classification (NOC), and evidence-based practice (EBP).
9. Compare and contrast the three phases of the nurse-patient relationship.
10. Identify at least four patient behaviors a nurse may encounter in the clinical setting.
11. Explore qualities that foster a therapeutic nurse-patient relationship and qualities that contribute
to a non-therapeutic nursing interactive process.
12. Define and discuss the roles of empathy, genuineness, and positive regard on the part of the nurse
in a nurse-patient relationship.
13. Identify two attitudes and four actions that may reflect the nurse’s positive regard for a patient.
14. Analyze what is meant by boundaries and the influence of transference and counter-transference
on boundary blurring.
15. Understand the use of attending behaviors (eye contact, body language, vocal qualities, and
verbal tracking).
16. Discuss the influences of disparate values and cultural beliefs on the therapeutic relationship.
17. Identify three personal and two environmental factors that can impede communication.
18. Discuss the differences between verbal and nonverbal communication, and identify five examples
of nonverbal communication.
Nurs. 149-150 Revised Jan.2010
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19. Identify two attending behaviors the nurse might focus on to increase communication skills.
20. Compare and contrast the range of verbal and nonverbal communication of different cultural
groups in the areas of (a) communication style, (b) eye contact, and (c) touch. Give examples.
21. Relate problems that can arise when nurses are insensitive to cultural aspects of patients’
communication styles.
22. Demonstrate the use of four techniques that can enhance communication, highlighting what
makes them effective.
23. Demonstrate the use of four techniques that can obstruct communication, highlighting what
makes them ineffective.
24. Identify and give rationales for suggested (a) setting, (b) seating, and (c) methods for beginning
the nurse-patient interaction.
25. Recognize the short- and long-term physiological consequences of stress.
26. Compare and contrast Cannon’s (fight-or-flight), Selye’s (general adaptation syndrome), and
psycho-neuro-immunological models of stress.
27. Describe how responses to stress are mediated through perception, personality, social support,
culture, and spirituality.
28. Assess life change units using the classic Life-Changing Events Questionnaire.
29. Identify and describe holistic approaches to stress management.
30. Explain how cognitive techniques can help increase a person’s tolerance for stressful events.
31. Identify basic concepts related to group work.
32. Describe the phases of group development.
33. Define task and maintenance roles of group members.
34. Discuss the therapeutic factors that operate in all groups.
35. Discuss four types of groups commonly led by basic level registered nurses.
36. Describe a group intervention for (1) a member who is silent or (2) a member who is
monopolizing the group.
Class 6: March 1—Exam 1
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 7/Quiz 4
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 68 Pages
 Chapter 12: Anxiety and Anxiety Disorders, pp.212
 Chapter 13: Depressive Disorders, pp. 246
OBJECTIVES: After completion of the objectives the student will be able to:
1. Compare and contrast the four levels of anxiety in relation to perceptual field, ability to learn,
and physical and other defining characteristics.
2. Identify defense mechanisms, and consider one adaptive and one maladaptive use of each.
3. Identify genetic, biological, psychological, and cultural factors that may contribute to anxiety
disorders.
4. Describe clinical manifestations of each anxiety disorder.
5. Formulate four appropriate nursing diagnoses that can be used in treating a person with an
anxiety disorder.
6. Name three defense mechanisms commonly found in patients with anxiety disorders.
7. Describe feelings that may be experienced by nurses caring for patients with anxiety disorders.
8. Propose realistic outcome criteria for a patient with (a) generalized anxiety disorder, (b) panic
disorder, and (c) posttraumatic stress disorder.
9. Describe five basic nursing interventions used for patients with anxiety disorders.
10. Discuss three classes of medications appropriate for anxiety disorders.
11. Describe advanced practice and basic level interventions for anxiety disorders.
12. Compare and contrast major depressive disorder and dysthymic disorder.
13. Discuss the links between the stress model of depression and the biological model of depression.
14. Assess behaviors in a patient with depression in regard to each of the following areas: (a) affect,
(b) thought processes, (c) feelings, (d) physical behavior, and (e) communication.
15. Formulate five nursing diagnoses for a patient with depression, and include outcome criteria.
16. Name unrealistic expectations a nurse may have while working with a patient with depression,
and compare them to your own personal thoughts.
17. Role-play six principles of communication useful in working with patients with depression.
18. Evaluate the advantages of the selective serotonin reuptake inhibitors (SSRIs) over the tricyclic
antidepressants (TCAs).
19. Explain the unique attributes of two of the atypical antidepressants for use in specific
circumstances.
20. Write a nursing care plan incorporating the recovery model of mental health.
21. Describe the types of depression for which electroconvulsive therapy (ECT) is most helpful.
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 8/Quiz 5
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 64 Pages
 Chapter 14: Bipolar Disorders, pp. 280
 Chapter 15: Schizophrenia, pp. 306
OBJECTIVES: After completion of the objectives the student will be able to:
1. Assess a patient with mania for (a) mood, (b) behavior, and (c) thought processes, and be alert to
possible dysfunction.
2. Formulate three nursing diagnoses appropriate for a patient with mania, and include supporting
data.
3. Explain the rationales behind five methods of communication that may be used with a patient
experiencing mania.
4. Distinguish between signs of early and severe lithium toxicity.
5. Compare and contrast basic clinical conditions that may respond better to anticonvulsant therapy
with those that may respond better to lithium therapy.
6. Evaluate specific indications for the use of seclusion for a patient experiencing mania.
7. Defend the use of electroconvulsive therapy for a patient in specific situations.
8. Review at least three of the items presented in the patient and family teaching plan (see Box 14-2)
with a patient with bipolar disorder.
9. Distinguish the focus of treatment for a person in the acute manic phase from the focus of
treatment for a person in the continuation or maintenance phase.
10. Describe the progression of symptoms, focus of care, and intervention needs for the pre-psychotic
through maintenance phases of schizophrenia.
11. Discuss at least three of the neurobiological-anatomical-genetic findings that indicate that
schizophrenia is a brain disorder.
12. Differentiate among the positive and negative symptoms of schizophrenia in terms of
psychopharmacological treatment and effect on quality of life.
13. Discuss how to deal with common reactions the nurse may experience while working with a
patient with schizophrenia.
14. Compare and contrast the conventional antipsychotic medications with atypical antipsychotics.
15. Create a nursing care plan that incorporates evidence-based interventions for key areas of
dysfunction in schizophrenia, including hallucinations, delusions, paranoia, cognitive
disorganization, anosognosia, and impaired self-care.
16. Role-play intervening with a patient who is hallucinating, delusional, and exhibiting disorganized
thinking.
Class 9: March 22—Spring 3 Vacation
Nurs. 149-150 Revised Jan.2010
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Nurs. 149 Mental Health and Illness Theory
Class 10/Quiz 6
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 89 Pages
 Chapter 16: Eating Disorders, pp. 344
 Chapter 17: Cognitive Disorders, pp. 369
 Chapter 18: Addictive Disorders, pp. 402
OBJECTIVES: After completion of the objectives the student will be able to:
1. Discuss four theories of eating disorders.
2. Compare and contrast the signs and symptoms (clinical picture) of anorexia nervosa and bulimia
nervosa.
3. Identify three life-threatening conditions, stated in terms of nursing diagnoses, for a patient with
an eating disorder.
4. Identify three realistic outcome criteria for (a) a patient with anorexia nervosa and (b) a patient
with bulimia nervosa.
5. Describe therapeutic interventions appropriate for anorexia nervosa and bulimia nervosa in the
acute phase and long-term phase of treatment.
6. Explain the basic premise of cognitive-behavioral therapy in the treatment of eating disorders.
7. Differentiate between the long-term prognoses of anorexia nervosa, bulimia nervosa, and binge
eating disorder.
8. Compare and contrast the clinical picture of delirium with that of dementia.
9. Discuss three critical needs of a person with delirium, stated in terms of nursing diagnoses.
10. Identify three outcomes for patients with delirium.
11. Summarize the essential nursing interventions for a patient with delirium.
12. Recognize the signs and symptoms occurring in the four stages of Alzheimer’s disease.
13. Give an example of the following symptoms assessed during the progression of Alzheimer’s
disease: (a) amnesia, (b) apraxia, (c) agnosia, and (d) aphasia.
14. Formulate three nursing diagnoses suitable for a patient with Alzheimer’s disease, and define
two outcomes for each.
15. Compose a list of appropriate referrals in the community—including a support group, hotline for
information, and respite services—for persons with dementia and their caregivers.
16. Compare and contrast the terms substance abuse and substance dependence, as defined by the
Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IVTR).
17. Discuss four components of the assessment process to be used with a person who is chemically
dependent.
18. Describe the difference between the behaviors of a person with alcoholism and a nondrinker in
relation to blood alcohol level.
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19. Discuss the symptoms of alcohol withdrawal and alcohol delirium and the recommended
treatments for each.
20. Describe the signs of alcohol poisoning and the appropriate treatment based on the individual’s
presentation.
21. List the appropriate steps to take if one observes an impaired co-worker.
22. Describe aspects of enabling behaviors and give examples.
23. Compare and contrast the signs and symptoms of intoxication, overdose, and withdrawal for
cocaine and amphetamines.
24. Distinguish between the symptoms of narcotic intoxication and those of narcotic withdrawal.
25. Identify two short-term goals for a person who abuses alcohol in terms of (a) withdrawal, (b)
active treatment, and (c) health maintenance.
26. Analyze the pros and cons of the following treatments for narcotic addictions: (a) methadone or lα-acetylmethadol (LAAM), (b) therapeutic communities, and (c) abstinence-oriented self-help
programs.
27. Recognize the phenomenon of relapse as it affects people who abuse substances during different
phases of treatment.
28. Evaluate four indications that a person is successfully recovering from substance abuse.
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Nurs. 149 Mental Health and Illness Theory
Class 11/Quiz 7
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 94
 Chapter 19: Personality Disorders, pp. 433
 Chapter 20: Sleep Disorders, pp. 461
 Chapter 21: Sexual Dysfunction and Sexual Disorders, pp. 480
 Chapter 22: Somatoform , Factitious, and Dissociative Disorders, pp. 502
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Analyze the interaction of biological determinants and psychosocial stress factors in the etiology of
personality disorders.
2. Identify the three clusters of personality disorders as currently defined.
3. Describe the major characteristic of one personality disorder from each cluster and give an example.
4. Formulate two nursing diagnoses for cluster B personality disorders.
5. Describe the emotional and clinical needs of nurses and other staff when working with patients who
meet criteria for personality disorders.
6. Discuss two nursing outcomes for patients with borderline personality disorder.
7. Plan basic interventions for a patient with impulsive, aggressive, or manipulative behaviors.
8. Identify interventions the advanced practice nurse can employ when working with nursing staff caring
for patients with personality disorders.
9. Discuss the impact of inadequate sleep on overall health and well-being.
10. Describe the social and economic impact of sleep disturbance and chronic sleep deprivation.
11. Recognize the risks to personal and community safety imposed by sleep disturbance and chronic
sleep deprivation.
12. Describe normal sleep physiology, and explain the variations in normal sleep.
13. Differentiate between dys-somnias and para-somnias, and identify at least two examples of each.
14. Identify the predisposing, precipitating, and perpetuating factors for patients with insomnia.
15. Identify and describe the use of two assessment tools in the evaluation of patients experiencing sleep
disturbance.
16. Formulate three nursing diagnoses for patients experiencing a sleep disturbance.
17. Develop a care plan for the patient experiencing sleep disturbance, incorporating basic sleep hygiene
principles.
18. Describe the four phases of the sexual response cycle.
19. Define at least three areas of sexual dysfunction, and describe the treatment of each.
20. Consider the impact of medical problems and treatments on normal sexual functioning.
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21. Examine the importance of nurses being knowledgeable about and comfortable discussing topics
pertaining to sexuality.
22. Describe treatments available for sexual dysfunction.
23. Apply assessment techniques by role-playing with a classmate the taking of a sexual history. Discuss
how you feel and how your feelings influence your ability to perform this assessment.
24. Identify sexual preoccupations considered to be sexual disorders.
25. Discuss personal values and biases regarding sexuality and sexual behaviors.
26. Develop a plan of care for individuals diagnosed with sexual disorders.
27. Compare and contrast essential characteristics of the somatoform, factitious, and dissociative
disorders.
28. Give a clinical example of what would be found in each of the somatoform disorders.
29. Describe five psychosocial interventions that would be appropriate for a patient with somatic
complaints.
30. Plan interventions for a patient with conversion disorder who is receiving a great deal of secondary
gain from his or her “blindness.”
31. Describe disorders that are conscious attempts to deceive health care professionals.
32. Explain the key symptoms of the four dissociative disorders.
33. Compare and contrast dissociative amnesia and dissociative fugue.
34. Identify three specialized elements in the assessment of a patient with a dissociative disorder.
35. Identify nursing interventions for patients with somatoform and dissociative disorders.
Class 12: April 12—Exam 2
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Nurs. 149 Mental Health and Illness Theory
Class 13/Quiz 8
Trauma Interventions
LEARNING ACTIVITIES: Read: Varcarolis: 37 Pages
 Chapter 23: Crisis and Disaster, pp. 528
 Chapter 24: Suicide, pp. 547
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Differentiate among the three types of crisis.
2. Delineate six aspects of crisis that have relevance for nurses involved in crisis intervention.
3. Develop a handout describing areas to assess during crisis.
4. Discuss four common problems in the nurse-patient relationship that are frequently encountered
by beginning nurses when starting crisis intervention.
5.
Identify interventions for problems in nurse-patient relationships.
6. Compare and contrast the differences among primary, secondary, and tertiary intervention,
including appropriate intervention strategies.
7. List at least five resources in the community that could be used as referrals for a patient in crisis.
8. Describe the profile of suicide in the United States, noting psychosocial and cultural factors that
affect risk.
9. Identify three common precipitating events of suicide.
10. Describe risk factors for suicide, including coexisting psychiatric disorders.
11. Name the most frequent coexisting psychiatric disorders.
12. Use the SAD PERSONS scale to assess suicide risk.
13. Describe three expected reactions a nurse may have when beginning work with suicidal patients.
14. Give examples of primary, secondary, and tertiary interventions.
15. Describe basic-level interventions for suicidal patients/clients that take place in the hospital or
community.
16. Identify key elements of suicide precautions and environmental safety factors in the hospital.
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Nurs. 149 Mental Health and Illness Theory
Class 14/Quiz 9
Trauma Interventions
LEARNING ACTIVITIES: Read: Varcarolis: 60 Pages
 Chapter 25: Anger Aggression, and Violence, pp. 565
 Chapter 26: Child, Older Adult, and Intimate Partner Abuse, pp. 584
 Chapter 27: Sexual Assault, pp. 609
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Compare and contrast three theories that explore the determinants for anger, aggression, and
violence.
2. Compare and contrast interventions for a patient with healthy coping skills with those for a
patient with marginal coping behaviors.
3. Apply at least four principles of de-escalation with a moderately angry patient.
4. Describe two criteria for the use of seclusion or restraint over verbal intervention.
5. Discuss two types of assessment and their value in the nursing process.
6. Identify three indicators of (a) physical abuse, (b) sexual abuse, (c) neglect, and (d) emotional
abuse.
7. Discuss the epidemiological theory of abuse in terms of stresses on the perpetrator, vulnerable
person, and environment that could escalate anxiety to the point at which abuse becomes the
relief behavior.
8. Compare and contrast three characteristics of perpetrators with three characteristics of a
vulnerable person.
9. Describe four areas to assess when interviewing a person who has experienced abuse.
10. Identify two common emotional responses the nurse might experience when faced with a person
subjected to abuse.
11. Formulate four nursing diagnoses for the survivor of abuse, and list supporting data from the
assessment.
12. Write out a safety plan with the essential elements for a victim of intimate partner abuse.
13. Compare and contrast primary, secondary, and tertiary levels of intervention, giving two
examples of intervention for each level.
14. Describe at least three possible referrals for an abusive family, including the telephone numbers
of appropriate agencies in the community.
15. Discuss three psychotherapeutic modalities useful in working with abusive families.
16. Define sexual assault, attempted rape, and rape.
17. Discuss the underreporting of sexual assault.
18. Describe the profile of the victim and the perpetrator of sexual assault.
19. Distinguish between the acute and long-term phases of the rape-trauma syndrome, and identify
some common reactions during each phase.
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20. Identify and give examples of five areas to assess when working with a person who has been
sexually assaulted.
21. Formulate two long-term outcomes and two short-term goals for the nursing diagnosis Rapetrauma syndrome.
22. Analyze one’s own thoughts and feelings regarding the myths about rape and its impact on
survivors.
23. Identify six overall guidelines for nursing interventions related to sexual assault.
24. Describe the role of the sexual assault nurse examiner to a colleague.
25. Discuss the long-term psychological effects of sexual assault that might lead to a survivor’s
seeking psychotherapy.
26. Identify three outcome criteria that would signify successful interventions for a person who has
suffered a sexual assault.
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Nurs. 149 Mental Health and Illness Theory
Class 15/Quiz 10
Interventions for Special Populations
LEARNING ACTIVITIES: Read: Varcarolis: 68 Pages
 Chapter 28: Disorders of Children and Adolescents, pp. 626
 Chapter 29: Psychosocial Needs of the Older Adult, pp. 653
 Chapter 30: Serious Mental Illness, pp. 677
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Explore factors and influences contributing to child and adolescent mental disorders, and develop
intervention strategies for these young patients.
2. Identify characteristics of mental health and positive youth development in children and
adolescents.
3. Discuss holistic assessment of a child or adolescent.
4. Explore areas in the assessment of suicide that may be unique to children or adolescents.
5. Compare and contrast at least six treatment modalities for children and adolescents.
6. Describe clinical features and behaviors of at least three child and adolescent psychiatric
disorders.
7. Formulate three nursing diagnoses, stating patient outcomes and interventions for each.
8. Discuss facts and myths about aging.
9. Describe mental health disorders that may occur in older adults.
10. Analyze how ageism may affect attitudes and willingness to care for older adults.
11. Explain the importance of a comprehensive geriatric assessment.
12. Describe the role of the nurse in different settings of care.
13. Identify the requirements for the use of physical and chemical restraints.
14. Discuss the importance of pain assessment, and identify three tools used to assess pain in older
adults.
15. Identify legislation and legal documents that protect the rights of older patients, and describe their
impact on nursing care.
16. Recognize the significance of health care costs for older adults.
17. Discuss the effects of serious mental illness on daily functioning, interpersonal relationships, and
quality of life.
18. Describe three common problems associated with serious mental illness.
19. Discuss five evidence-based practices for the care of the person with serious mental illness.
20. Explain the role of the nurse in the care of the person with serious mental illness.
21. Develop a nursing care plan for a person with serious mental illness.
22. Discuss the causes of treatment non-adherence, and plan interventions to promote treatment
adherence.
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Nurs. 149 Mental Health and Illness Theory
Class 16/Quiz 11
Interventions for Special Populations
LEARNING ACTIVITIES: Read: Varcarolis: 75 Pages
 Chapter 31: Psychological Needs of Patients With Medical Conditions, pp. 694
 Chapter 32: Care for the Dying and for Those Who Grieve, pp. 707
 Chapter 33: Forensic Psychiatric Nursing, pp. 725
 Chapter 35: Family Interventions, pp. 749
 Chapter 36: Integrative Care, pp. 767
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Describe the influence of stress on general medical conditions.
2. Construct a nursing diagnosis for an individual who has HIV and depression.
3. Explain the importance of nurses teaching relaxation techniques and coping skills to patients with
medical illness.
4. Perform a comprehensive nursing assessment for a patient with a medical illness.
5. Assess the patient’s coping skills by identifying (a) areas for psycho-education and (b) areas of
strength.
6. Identify two instances in which a consultation with a psychiatric liaison nurse might have been
useful for one of your medical-surgical patients.
7. Compare and contrast the specific goals of end-of-life care inherent in the hospice model with
those of the medical model.
8. Analyze the effects of specific interventions nurses can implement when working with a dying
person and his or her family and loved ones.
9. Analyze how the Four Gifts of Resolving Relationships (forgiveness, love, gratitude, and
farewell) can be used to help people respond to a dying loved one.
10. Identify the relationship between the way a person responds to life and how the same person
responds to death.
11. Explain how the distinction between the terms grief and mourning as presented in this chapter can
help enhance the effectiveness of a holistic approach.
12. Differentiate among some of the characteristics of normal bereavement and dysfunctional
grieving.
13. Explain how the various models of understanding grieving (dual process, four tasks of mourning)
can enhance your care of those who grieve.
14. Discuss at least five guidelines for dealing with catastrophic loss, and identify appropriate support
for someone in acute grief.
15. Define forensic nursing, forensic psychiatric nursing, and correctional nursing.
16. Describe the educational preparation required for the forensic nurse generalist and the advanced
practice forensic nurse.
17. Identify the functions of forensic nurses.
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18. Discuss the specialized roles in forensic nursing.
19. Identify three roles of psychiatric nurses in the specialty of forensic nursing.
20. Discuss the differences between a fact witness and an expert witness.
21. Compare and contrast the roles of forensic nurses and correctional nurses.
22. Identify basic concepts related to group work.
23. Describe the phases of group development.
24. Define task and maintenance roles of group members.
25. Discuss the therapeutic factors that operate in all groups.
26. Discuss four types of groups commonly led by basic level registered nurses.
27. Describe a group intervention for (1) a member who is silent or (2) a member who is
monopolizing the group.
28. Discuss the characteristics of a healthy family using clinical examples.
29. Differentiate between functional and dysfunctional family patterns of behavior as they relate to
the five family functions.
30. Compare and contrast insight-oriented family therapy and behavioral family therapy.
31. Identify five family theorists and their contributions to the family therapy movement.
32. Analyze the meaning and value of the family’s socio-cultural context when assessing and
planning intervention strategies.
33. Construct a genogram using a three-generation approach.
34. Formulate seven outcome criteria that a counselor and family might develop together.
35. Identify some strategies for family intervention.
36. Distinguish between the nursing intervention strategies of a basic level nurse and those of an
advanced practice nurse with regard to counseling and psychotherapy and psychobiological
issues.
37. Explain the importance of the nurse’s role in psycho-educational family therapy.
38. Define the terms integrative medicine, integrative care, and complementary and alternative
medicine.
39. Identify trends in the use of nonconventional health treatments and practices.
40. Explore the category of alternative medical systems, along with the four domains of integrative
care: mind-body approaches, biologically based interventions, manipulative approaches, and
energy therapies.
41. Discuss the techniques used in major complementary therapies and potential applications to
psychiatric mental health nursing practice.
42. Discuss how to educate the public in the safe use of integrative modalities and avoidance of false
claims and fraud related to the use of alternative and complementary therapies.
43. Explore information resources available through literature and online sources.
Class 17, May 17—Final Exam—Good Luck!
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