Study Help with Psyciatric Nursing

[RNwannabeme]

Hello, I have this one semester left then I graduate with my RN!!! I am so excited. I am very worried also that I may not make it. :-( I have always done really good in school but last semester nearly had me out. I ended up with an 80 average when we have to have a 78 to pass! It was very stressfull! We are going to have our psych test soon and I must admit, I just don't get it. I wonderd if someone could give me advice on the whole psych thing. We are going from the Townsend book. I seem to like it this far. Some of the care plans freak me out though because I am not sure if they are in order as to what you would do first....like first priority or not. For example...In chapter 10 Intervening in crises...page 171 :-) It has a care plan for the pt who expresses anger inappropriatly. The first Nrs DX is ineffective coping rt possible negativer role modeling;dysfunctional family system aeb yelling name calling hitting others temper tantrums as expressions of anger.........It comes before a nsg dx of risk for self directed or other directed violence. rt possibly having een nurtured in an atmosphere of violence. Why is it that the first dx comes before the last? I would miss that on a test because I don't really understand what makes one more important than the next. could someone please shed somelight on this for me? I know I can't be the only one who is thinking about this stuff :-)

[itsmejuli]

It has a care plan for the pt who expresses anger inappropriatly. The first Nrs DX is ineffective coping rt possible negativer role modeling;dysfunctional family system aeb yelling name calling hitting others temper tantrums as expressions of anger.........It comes before a nsg dx of risk for self directed or other directed violence. rt possibly having een nurtured in an atmosphere of violence. Why is it that the first dx comes before the last? I would miss that on a test because I don't really understand what makes one more important than the next. could someone please shed somelight on this for me? I know I can't be the only one who is thinking about this stuff :-)

Think about it.....the second nursing dx is "risk for".

Have you been using an NCLEX book to help you study for your exams at school? You'll get really good at prioritizing when you practice lots of NCLEX questions. Saunders is a great book with thousands of questions on the cd.

[eyeball]

Ditto to previous post. get an NCLEX book (I used Mosby's) and practice the psych questions. There are repeating themes to the types of questions and it really helped me get the hang of how to determine the correct response of the nurse. Good Luck!

[NurseThis21, BSN, RN]

Hi There!

I would think of it as, the first diagnosis deals directly with why the patient is acting the way that they are. There is no "maybe", "could be" or "might be risky" behavior; it's straight forward in alerting the nurse that there is a legitimate COPING issue with the patient, not exactly a safety issue yet. Unless the questions states that the patient recently hit someone, then I would go with the first diagnosis as well. I don't know if your book stresses the notion that "safety is always first" and that may be why you would want to pick the second diagnosis. However, I believe that safety phrase is used mostly if the patient is actually in the act of hurting himself or others. I suppose that would be when you want to include the "risk for". However, at that point, it wouldn't be risk since it's already happening, but I hope I'm getting my point across!

So it would be best to look at your answer options by thinking of:

1. what directly explains your patient's behavior

2. if violent or at risk, what would immediately make them safe

3. With verbal communication, it's best to deescalate with words and not ask "why"

Those are the big things I focused on in school and it helped me to decipher which option is best for whatever phase the patient may be going through. Hope that helps and good luck in your last semester!

NurseThis21, RN, BSN

UIC Alumna

[RNwannabeme]

Thank you so much for the tips guys! I love this site. I am sure I will have more questions because I don't know why this is not lining out in my head the way it should. I will prolly post more questions as I run into them. I am not good at prioritizing at all!!! I had the Saunders for my LPN but We are using some other book now. I don't know who the author is but I think the questions in it are too easy. I know that may sound crazy but they are not like the ones the teachers make our tests with. They can take the most simple thing (taking blood pressure) and word it in a way that we will miss the question! lol...maybe we are just nervous

[pinkiepie_RN]

In addition to the NCLEX review books, textbooks often have companion websites with related questions and study material that can be helpful. I think all the other advice has been well said.