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Barkleys Curriculum Review for Psychiatric Mental Health Nurse Practitioners Thomas W. Barkley Jr. PhD ACNP-BC ANP FAANP President Barkley Associates Los Angeles California and Professor Director of Nurse Practitioner Programs California State University Los Angeles School of Nursing P.O. Box 69901 West Hollywood CA 90069 BARKLEYS CURRICULUM REVIEW FOR PSYCHIATRICMENTAL HEALTH NURSE PRACTITIONERS Copyright 2016 by Barkley Associates All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means electronic or mechanical including photocopying recording or any information storage and retrieval system without permission from the publisher. Permissions may be sought directly from Barkley Associates by the following phone 1.866.938.5557 or 1.323.656.1606 fax 1. 323.656.1620 e-mail Notice Knowledge and best practices are subject to change as new research and further experience expand knowledge. Changes in practice treatment and drug therapy may be warranted or appropriate. It is recommended that readers verify the most up-to-date information regarding procedures featured or check the manufacturers of administered products so as to verify the recommended dose formula methods of administration and contradindications. It is the duty of practitioners relying on their experience and knowledge of the patients circumstances to determine dosages and the best treatment for each patient while taking all safety precautions. To the fullest extend of the law neither the Publisher nor the Editor Contributors or Reviewers assume any liability for any injury andor damage to persons or property arising out of or related to any use of the content in this book. The Publisher Preface Barkleys Curriculum Review for PsychiatricMental Health Nurse Practitioners is a long-overdue resource in advanced practice nurse practitioner education. The text is written at a level appropriate for psychiatric mental health nurse practitioner PMHNP students faculty and practicing nurse practitioners. For students and faculty the text can be strategically utilized in several ways to enhance nurse practitioner curricula. First the text can be used as an excellent culminating work to review key subject areas of the entire PMHNP curriculum prior to national certification. For most faculty who adopt a modular approach to systems and special topics learning the book can be extremely valuable throughout the PMHNP students entire course of studies. Assigning chapter by chapter in conjunction with course topical outlines serves to reinforce classroom lectures and other learning activities as either pre- or post-class assignments. For the certified PMHNP a comprehensive review of the PMHNP curriculum is always rewarding to assist in revisiting those not-so-commonly seen patient diagnoses in individual practice. Whether being used by student faculty or certified nurse practitioner Barkleys Curriculum Review for PsychiatricMental Health Nurse Practitioners is an outstanding asset. In light of the varied needs of the readers the text is designed for both practicality and flexibility. Barkleys Curriculum Review for PsychiatricMental Health Nurse Practitioners is essentially two books in one comprising a Practice QuestionRationale Section and a comprehensive Discussion Section complete with case studies for specific conditions. Extensive question rationales feature not only why the correct answer is correct but also why all other answer choices are either incorrect or not the best answer. After the Practice Question Section in each chapter an extensive Discussion Section includes the following Overview incidencepredisposing factors Presentation signs and symptoms Workup laboratory diagnostic tests and Treatment management options for all common diagnoses presented in the chapter. Further the book is supplemented with relevant figures tables and diagrams in color. As editor I sincerely thank the Distinguished Contributors and Reviewers of this text who represent some of the most exceptional nurse practitioner experts in the country. In addition I am extremely grateful to the talented staff of Barkley Associates Inc. who tirelessly produced this work with never-ending enthusiasm. I trust that you will find Barkleys Curriculum Review for PsychiatricMental Health Nurse Practitioners to be an invaluable educational tool. Thomas W. Barkley Jr. PhD ACNP-BC ANP FAANP Editor iv Table of Contents Unit 1Assessment andTheory 1. PsychiatricMental Health Nurse Practitioner Assessment 3 2. Safety Needs Therapeutic Alliance and Frame of Care 20 3. Crisis Intervention 40 4. Health Promotion and Risk Management 60 5. ReferralCollaboration 92 6. Theoretical Models Interactive Therapies Nursing Theories 118 Unit II Pediatrics 7. Developmental Aspects of Children and Adolescents 136 8. Disorders of Children and Adolescents 153 Unit III Emotional and Cultural Issues 9. Violence 182 10. Cultural Issues 198 Unit IV Nursing Practice 11. Evidence-Based Cultural Considerations 219 12. Personality Disorders 241 13. Substance-Related Disorders 261 14. Stress Anxiety and Somatic Disorders 278 15. Mood Disorders 301 16. Feeding and Eating Disorders 320 17. Schizophrenia Spectrum Disorders and Psychosis 349 18. Serious Mental Illness 365 19. Neurcognitive Disorders 372 20. Disruptive Impulse Control and Conduct Disorders 379 UnitV Psychobiology and Psychopharmacology 21. Psychobiology and Psychopharmacology 391 Text Overview Includes 300 test questions covering diagnosis laboratorydiagnostics assessment pharmacology managementtreatment and professional practice Conditions are organized by disorder classification for quick reference when treating patients Practice questions allow students to identify areas of knowledge and extensive discussions provide a comprehensive overview to supplement areas of weakness Over 250 pages of questions rationales and case studies along with discussion tables and figures Simply the Best