Mental Health and Psychiatric Nursing
Core concepts
Psychiatric nursing questions focus on safety, therapeutic communication, and medication effects. Know risk assessment for suicide and self-harm, the signs of withdrawal and delirium tremens, the therapeutic relationship boundaries, and the major psychotropic side effects (extrapyramidal symptoms, neuroleptic malignant syndrome, serotonin syndrome, lithium toxicity).
Traps to expect
- Safety first: for a suicidal patient, the priority is environmental safety and observation, not exploring feelings in depth.
- Therapeutic versus social responses: avoid advice, false reassurance, and "why" questions; use reflection, clarification, and open-ended prompts.
- Acute dystonia versus tardive dyskinesia: acute dystonia (neck spasm, oculogyric crisis) is an emergency treated with anticholinergics; tardive dyskinesia is late and persistent.
- Neuroleptic malignant syndrome: fever, rigidity, autonomic instability, and raised creatine kinase; stop the drug and escalate.
- Alcohol withdrawal: tremor, sweating, and seizures peak early; benzodiazepines are the mainstay.
Worked rule of thumb
When a question presents a distressed patient, ask: is there an immediate risk to life or safety? If yes, act on safety. If no, choose the response that invites the patient to elaborate rather than the one that solves the problem for them.
Study approach
Group drugs by side-effect signature and learn one distinguishing feature for each emergency.