Psychiatric Nursing Flashcards

What does 'therapeutic milieu' mean in a psychiatric setting?

Answer: A safe, structured environment designed to promote therapeutic change through social interactions

Therapeutic milieu refers to the planned, structured, safe environment of a psychiatric unit where all aspects — physical layout, rules, staff interactions, group activities — are used as therapeutic tools to promote healing and behavioral change.

A patient with bipolar disorder is in a manic phase. Which nursing intervention is the priority?

Answer: Ensure safety, provide a low-stimulation environment, and meet physical needs

During mania, patients are at risk for injury (from impulsivity and poor judgment), dehydration (forgetting to eat/drink), and exhaustion. A low-stimulation environment reduces escalation. Safety and physical needs are the priority.

Which medication is the first-line mood stabilizer for bipolar disorder?

Answer: Lithium carbonate

Lithium is the gold standard mood stabilizer for bipolar disorder with strong evidence for preventing both manic and depressive episodes and reducing suicide risk. It requires regular serum level monitoring (therapeutic range: 0.6–1.2 mEq/L for maintenance).

A patient with obsessive-compulsive disorder (OCD) insists on washing their hands 50 times per day. What is the most therapeutic nursing approach?

Answer: Allow the ritual initially while building therapeutic alliance, then gradually work on reducing it

Abruptly stopping OCD rituals causes extreme anxiety. The therapeutic approach involves building trust, psychoeducation, and gradually implementing exposure and response prevention (ERP) therapy. Forcing immediate cessation is counterproductive and harmful.

What is the correct nursing response to a patient experiencing a panic attack?

Answer: Stay with the patient, speak calmly, guide slow controlled breathing, reassure they are safe

During a panic attack, the nurse's presence, calm demeanor, and controlled breathing guidance reduce sympathetic stimulation. Reassurance that the symptoms are the panic attack itself (not a heart attack) and that it will pass helps de-escalate the physiological response.

Which term describes a patient's false belief that is firmly held despite evidence to the contrary?

Answer: Delusion

A delusion is a fixed, false belief not consistent with cultural norms, maintained despite clear evidence to the contrary. Hallucinations are sensory perceptions without external stimuli. Illusions are misinterpretations of real stimuli. Confabulation is unconscious fabrication of memories.