| Discussion Topics | Learning Objective |
1. During her first semester of nursing school, Felecia was assigned to a patient belonging to the American Indian culture. Felicia began to compare her own cultural beliefs with that of her patient. a. To what ethnic, socioeconomic class, and community do you feel a part of or belong? b. What are the values of your cultural group? c. What are your attitudes toward people who are different from you in appearance or behavior? |
1, 2, 10 |
| 2. When caring for an individual who belongs to a different culture, there may be variations in health concept and promotion.
a. List a cultural group, what their concept of health may be, and discuss variations as well as potential health promotion beliefs. |
6 |
| 3. Maria is a 26-year-old woman who lived in Mexico until the age of 20. She has been experiencing severe depression but is afraid to seek treatment.
a. List and explain one of the reasons why minority groups may display resistance to, and feel uncomfortable about, seeking mental health services. b. What religious or spiritual influences may be affecting Maria’s decision? c. How could racial bias affect Maria? d. Identify some cultural barriers to treatment Maria may face. |
4, 5 |
| 4. During your fourth semester of nursing school, you are peer mentoring a first-semester nursing student. You are discussing culturally competent nursing care.
a. Identify the four critical skills that nurses need in order to provide culturally sensitive and competent care for the mental health client. b. Describe an example of how each of these skills could be incorporated into the care of a client of Asian descent. |
8, 9 |
Discussion Topics, Mohr
Chapter 7, Spirituality in Psychiatric Care
| Discussion Topics | Learning Objective |
| 1. While caring for a mental health client, the client begins to discuss issues he is having related to religion and spirituality. He says, “My parents go to church all the time and because I don’t go, they think I am not a good person. I believe in God, I just don’t believe in everything my parents’ religion teaches.”
a. In your opinion, what is the difference between spirituality and religion? b. Would you feel comfortable talking with a client about religious or spiritual issues? Why or why not? c. If you do not feel comfortable talking with a client about religion or spirituality, to whom would you refer the client? |
1, 5, 6 |
| 2. You are having a conversation with a client about values. After the conversation, you begin to think about your own values and what they mean to you.
a. What values are important to you? b. What influences your values? c. Why is it important to be aware of your own values? |
5 |
| 3. Shandra is a 54-year-old woman who has severe clinical depression. She was diagnosed with breast cancer 5 years ago and went through chemotherapy. She describes the experience as “the worst time of my life.” Six months ago, she was told that the cancer had returned. She has made the decision not to go through chemotherapy a second time. She has been overheard saying, “What did I do to deserve this?” and “God must really be mad at me for something.” After talking with Shandra, the mental health nurse arrives at a nursing diagnosis of Readiness for Enhanced Spiritual Well-being.
a. What interventions may be implemented for Shandra? b. When would spiritual interventions be contraindicated? c. What ethical concerns need to be considered when developing nursing interventions related to religion and spirituality? |
5, 8, 9 |
| 4. A mental health client presents to your psychiatric facility. You are the nurse conducting the spiritual assessment.
a. Why do you believe a spiritual assessment is important? b. What are the components of a spiritual assessment? c. What are some open-ended questions you could ask to facilitate better communication with the client? |
Discussion Topics, Mohr
Chapter 8, Nursing Values, Attitudes, and Self-Awareness
| Discussion Topics | Learning Objective |
| 1. It has been found that in a group setting, people may act in a way that is not within their typical character.
a. Read the information in the chapter about Zimbardo’s “Stanford Prison Experiment.” How do you think you would have acted as a prison guard or as a prisoner? b. Have you ever been influenced by a group to behave in a manner that you normally would not have if you were alone? How do you feel about that behavior now? |
2 |
| 2. Jessica is a 24-year-old woman who is suffering from depression. Her boyfriend of 2 years recently committed suicide, and she has been trying to figure out why.
a. What is the difference between dispositional and situational factors? b. Jessica overhears someone say that Jessica has been a “psycho” ever since her boyfriend killed himself. Discuss the implications of labeling and social perception. c. Discuss Rosenhan’s study and how it relates to labeling. |
2, 3 |
| 3. Mark is a psychiatric nurse who has been working in a mental health facility for 15 years. At the end of his shift, the nurse to whom he needs to give report walks into the nurse’s station. Mark says, “I can’t wait to get out of here, I can’t deal with these crazy people any more.” A patient overhears his statement and begins to cry.
a. What are the signs of professional burnout in the workplace? b. What methods could Mark use to manage his stress/burnout? |
5, 6 |
| 4. You are a nursing student doing your clinical rotation in the local emergency department. You witness a case of horizontal violence between a nurse of 25 years’ experience against a new graduate nurse. Your nursing instructor asks you to discuss in class what you witnessed.
a. What is horizontal violence? b. From what you witnessed, how do you believe horizontal violence affects the nurse? |
4 |
Discussion Topics, Mohr
Chapter 9, The Nursing Process in Psychiatric–Mental Health Care
| Discussion Topics | Learning Objective |
| 1. Wanda is a 34-year-old woman who was raped at the age of 17. She has never told anyone about her experience. Whenever she starts to think about the event, Wanda drinks heavily to forget about the emotional pain. She has been avoiding social situations because being in a crowd makes her very anxious. Two weeks ago while shopping, she suffered a panic attack and had to be taken to the hospital. She has pushed away all family members and has no one left in her immediate support system.
a. Develop a nursing diagnosis that would be appropriate for Wanda. b. What assessment information from the case supports your diagnosis? c. Create a list of at least three short-term and one long-term outcome for the nursing diagnosis. |
1, 3, 5 |
| 2. You are conducting an admission interview with Linda, a 47-year-old woman whose husband died from a car accident 2 months ago. She was admitted due to a suicide attempt and states during the interview that she has “nothing to live for.” She says that she has been drinking alcohol regularly to “numb the pain” and to help her sleep at night. After the interview, you develop a list of nursing diagnoses, which includes the following:
· Dysfunctional Grieving related to lack of adequate support secondary to loss of spouse as evidenced by client’s statement of having “nothing to live for.” · Ineffective Individual Coping related to substance abuse and inappropriate coping mechanisms as evidenced by client’s statement of using alcohol to “numb the pain.” · Sleep Pattern Disturbance related to lifestyle disruption as evidenced by client’s statement that alcohol is used to assist with sleeping. a. For each nursing diagnosis, develop appropriate long-term and short-term goals. b. For each nursing diagnosis, develop appropriate interventions. c. How will you evaluate if these nursing diagnoses were effective? d. Where will you document these nursing diagnosis and interventions and why? |
7, 8, 9 |
| 3. After completing a care plan for a mental health client, you have been asked to document in the client’s record.
a. Why is documenting in the care record necessary? b. When documenting the nursing process, why key components and principles need to remain consistent? c. Compare and contract narrative, SOAP, and PIE charting. |
9 |
| 4. Your nursing instructor has just demonstrated a psychosocial assessment for you in the clinical setting. Your fellow nursing student did not see this demonstration, so you decide to enlighten her.
a. What is a psychosocial assessment? b. Explain the components of the psychosocial assessment. c. Provide an example question for each dimension. |
2 |
| 5. You are doing your student nurse clinical rotation on the inpatient psychiatric unit when you hear the physician mention the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). This interests you and you decide to investigate.
a. What is the DSM-IV-TR? What is its purpose? b. Why do you believe knowledge of the DSM-IV-TR is important for psychiatric nurses? |
Discussion Topics, Mohr
Chapter 10, The Interview and Assessment Process
| Discussion Topics | Learning Objective |
| 1. You have been asked to conduct an interview for a psychiatric–mental health client.
a. What part of conducting an interview to obtain psychosocial data on a client is most difficult for you? b. What part of conducting an interview to obtain psychosocial data on a client is relatively easy for you? c. What are your strengths as an interviewer and what skills do you need to develop? |
1, 2 |
| 2. You are working at a psychiatric–mental health facility that uses the PERSONS acronym for collecting data in the initial patient assessment.
a. Choose one of the letters of this acronym and explain the data that would be collected under that letter. b. For your chosen area, list five questions that you would ask to elicit information from a psychiatric–mental health client. |
2 |
| 3. The nurse is caring for a 39-year-old American Indian psychiatric mental health client.
a. What is the importance of assessing cultural needs in a psychiatric–mental health client? b. What is the importance of assessing spiritual needs in a psychiatric–mental health client? |
4 |
| 4. Your nursing instructor lectured on standardized tools in class today. You took good notes and you are attempting to explain these tools for a fellow nursing student who was sick and missed class.
a. What are some of the standardized tools your instructor discussed? Which healthcare professional would use the tools discussed? What are the tools used for? b. Why do healthcare professionals use standardized tools? |
3 |
Discussion Topics, Mohr
Chapter 11, Therapeutic Relationships and Communication
| Discussion Topics | Learning Objective |
| 1. You are learning about therapeutic communication in your mental health nursing course and begin to evaluate your own communication techniques.
a. List two therapeutic communication techniques that you could use more often and how you would incorporate these techniques into your communication patters. b. List a nontherapeutic communication technique that you use, explain why it is nontherapeutic, and tell how you can change it to a therapeutic technique. |
6 |
| 2. Your nursing instructor tells you that therapeutic relationships are very important in mental healthcare to help clients solve problems, cope more effectively, and achieve developmental goals.
a. Choose one of the essential elements of a therapeutic relationship and describe how you can develop this element with a mental health client. b. List one of the obstacles to establishing a therapeutic relationship and describe how you can prevent this obstacle in your own professional relationships. |
1, 2 |
| 3. You are working as a mental health nurse and you are caring for a patient suffering from anxiety and another suffering from psychoses.
a. What techniques would you use to therapeutically communicate with an individual suffering from anxiety? b. What techniques would you use to therapeutically communicate with an individual suffering from psychoses? |
7 |
| 4. You are working on the psychiatric nursing unit and the charge nurse assigns you a client with a depressive disorder. You must implement the phases of the therapeutic relationship.
a. What are the phases of the therapeutic relationship? Describe each phase. b. What would you do at each phase to develop a relationship with the depressed client? |
3 |
| 5. Your nursing instructor has just been lecturing in the mental health course about the importance of listening in the therapeutic nurse-client relationship.
a. Describe what active listening means to you. What are the components of active listening? b. How will you incorporate active listening into your practice as a nurse? |
5 |
Discussion Topics, Mohr
Chapter 12, Working With the Multidisciplinary Team
| Discussion Topics | Learning Objective |
| 1. As a nurse, you are a part of the multidisciplinary team. While working in a hospital, you are able to interact with individuals from several different specialties.
a. Describe your experience in coordinating services with occupational therapists, psychologists, psychiatrists, registered dietitians, and social workers. If you have not had this experience, describe the interactions that you have witnessed in the healthcare setting. b. What do you believe the benefits are to working with individuals within these specialties? |
1 |
| 2. A child is experiencing unusually high activity and is diagnosed with attention-deficit/hyperactivity disorder (ADHD). The child is admitted to a mental health facility that incorporates a multidisciplinary approach. When the child returns to school, an individualized education program (IEP) is developed.
a. Describe the role that a school psychologist, occupational therapist, social worker, and a registered dietitian would play in the care of this child. b. Explain the purpose of the IEP and what is included in an IEP. |
2, 4 |
| 3. After being assessed by an occupational therapist, it is determined that Katie, a 38-year-old woman, would benefit from sensory integration.
a. Describe the systems, components, purpose, and dysfunction manifestations identified in sensory integration. |
