NUR 256 Exam 1

Why Psych??

• Not just for psychiatric nursing

All clients can have

Anxiety, fear, body image issues and grief 

PSYCH Patients are

Your clients with: 

• delirium

• Dementia

• Anxiety – Often worried about future

• Substance abuse 

• Anger or aggression issues

• Personality disorders – Will never admit to personality disorders.

• Mood swings

• Depression - Lives in the past

• Schizophrenia

• Grief and loss

Mental Health Vs Mental Illness

• How are we functioning? 

• Emotionally, Cognitively, Socially, Physically

• Are we coping?

• Are we achieving?

• Are we functioning?

• The old definition of “being different” does not fit (think of Abraham Lincoln, Mother Teresa, Albert Einstein, 

etc.)

Factors affecting Mental Health

 Physical health

 Genetics/Biological predisposition

 Individual Factors RESILIENCE, COPING SKILLS, TEMPERMENT 

 Our Socioeconomic circumstances and support systems

 Our ENVIRONMENTAL influences

Diathesis – Stress Model

• This is the most accepted explanation for mental illness. Combination of genetic vulnerability and negative 

environmental stressors

• Diathesis – biological predisposition

• Stress – environmental stress or trauma

• Diathesis-stress model - Nature PLUS Nurture:

 Biological predisposition plus Environmental stress and traumas

Scope of Practice

• Know scope of practice for R.N. vs ARNP vs mental health technicians and licensed social workers

RN - Can work in general or specialty areas

PMH-RN - Works in psychiatric setting

• RN-BC - after 2 yrs full time work in psychiatric setting (2000 hours) , 30 hours of continuing psychiatric education

, and having a BSN, can take a certification exam (ANCC) to be board certified in psychiatric mental health 

nursing. 

• Psychiatric-Mental Health Advanced Practice Registered Nurse (PMH-APRN) - possesses a MSN or DNP, passes 

certification exam and keeps up requirements

Chapter 2 – Theorists

• Freud - transference/counter transference defines defense mechanisms 

• Levels of awareness

• Conscious – Everything the individual is aware of

• Preconscious – Retrievable through effort by individual

• Unconscious - repressed memories, passions, feelings, traumas, are placed here as a protective 

way to manage painful stimuli

• Personality structure

• Id - Pleasure principle- screaming baby

• Ego - Problem solver vs Reality tester

• Superego - Moral component-seeks perfection instead of pleasure or reasoning.

• Defense mechanisms and anxiety

• Operate on unconscious level

• Deny, falsify, or distort reality to make it less threatening to the individual’s view of self