Board-certified psychiatric-mental health nursing exam content: therapeutic milieu management and psychopharmacology monitoring, beyond the entry-level NCLEX Mental Health deck.
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- In Gunderson's model of therapeutic milieu, what does the function of 'containment' provide?
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Physical safety and control of behavior so patients can express feelings without acting on unsafe impulses.- In Gunderson's model of therapeutic milieu, what does the function of 'support' provide?
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Explicit encouragement and reassurance that helps patients feel accepted and cared for.- In Gunderson's model of therapeutic milieu, what does the function of 'structure' provide?
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Predictable routines, rules, and schedules that organize the unit and reduce patient anxiety.- In Gunderson's model of therapeutic milieu, what does the function of 'involvement' provide?
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Active patient participation in the therapeutic community and their own treatment.- In Gunderson's model of therapeutic milieu, what does the function of 'validation' provide?
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Recognition of each patient's individuality and unique response to treatment.- What ethical and legal principle requires using the least restrictive intervention necessary to manage a patient's behavior?
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The least restrictive environment principle.- On an inpatient psychiatric unit, what does a 'Q15' observation level mean?
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Staff visually check the patient's location and safety every 15 minutes.- What is continuous (1:1) observation?
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A staff member remains within arm's reach of the patient at all times, used for high suicide or violence risk.- What is line-of-sight observation?
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Staff must be able to see the patient at all times, though not necessarily be within arm's reach.- After a restraint or seclusion episode begins for an adult, how soon must a physician or licensed independent practitioner complete a face-to-face evaluation?
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Within 1 hour.- For an adult, what is the maximum duration of a single physician's order for behavioral restraint or seclusion before it must be renewed?
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4 hours.- For an adolescent aged 9 to 17, what is the maximum duration of a single physician's order for behavioral restraint or seclusion before it must be renewed?
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2 hours.- For a child under age 9, what is the maximum duration of a single physician's order for behavioral restraint or seclusion before it must be renewed?
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1 hour.- What is the main purpose of a post-seclusion or post-restraint debriefing?
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To review the event with the patient and staff, identify triggers, and plan alternatives to reduce future use.- What is the purpose of a daily community meeting in a therapeutic milieu?
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To give patients a voice in unit governance and address shared concerns.
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