Psychiatric-Mental Health Nursing Foundations — NCLEX-PN Review | Chapter 61: Saunders

Psychiatric-Mental Health Nursing Foundations — NCLEX-PN Review | Chapter 61: Saunders

Chapter 61 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri introduces the essential principles of psychiatric-mental health nursing, focusing on the therapeutic nurse-client relationship, communication techniques, and the legal and ethical standards of care. This foundation supports NCLEX-PN candidates in developing safe, culturally sensitive, and client-centered psychiatric nursing practices.

Watch the lecture above for a complete overview of psychiatric nursing foundations, then review the detailed breakdown below to strengthen your NCLEX preparation.

Saunders NCLEX-PN Examination Review book cover

Therapeutic Nurse-Client Relationship

  • Core characteristics: empathy, trust, respect, professional boundaries, and cultural sensitivity.
  • Phases of the relationship:
    • Preinteraction: self-reflection and chart review.
    • Orientation: establishing rapport, setting goals.
    • Working: therapeutic interventions, progress evaluation.
    • Termination: closure and discharge planning.

Therapeutic Communication Techniques

  • Active listening, reflection, restating, summarizing, focusing, open-ended questions.
  • Avoid nontherapeutic techniques such as giving false reassurance, changing the subject, or offering unsolicited advice.
  • Incorporate family as collaborators, respecting cultural and spiritual beliefs.

Mental Health & Illness

  • Mental health: the ability to adapt to stress, maintain relationships, and function in society.
  • Mental illness: maladaptive responses to stress, impaired functioning, or distress.

Coping & Defense Mechanisms

  • Coping mechanisms: constructive (problem-solving, seeking support) vs. destructive (avoidance, substance use).
  • Defense mechanisms: denial, projection, repression, displacement, regression, intellectualization, sublimation.

Legal & Ethical Considerations

  • HIPAA and confidentiality in psychiatric settings.
  • Informed consent and client rights in mental health care.
  • Voluntary vs. involuntary admissions, conditional release, and discharge planning.
  • Seclusion and restraint: legal requirements, documentation, and safety monitoring.

Therapeutic Modalities

  • Milieu therapy: structured, supportive environment focusing on safety, empowerment, and interdisciplinary collaboration.
  • Group therapy: formation, working, and termination stages; promotes shared experiences and peer support.
  • Self-help groups: AA, grief support, chronic illness support groups.
  • Family therapy: improving communication, roles, and boundaries for systemic change.

NCLEX-Priority Points

  • Identify therapeutic vs. nontherapeutic communication in clinical scenarios.
  • Recognize defense mechanisms and their impact on client behavior.
  • Apply legal standards to psychiatric admission, treatment, and discharge.
  • Promote a culturally sensitive and respectful therapeutic relationship.

Conclusion

Chapter 61 builds the conceptual framework for psychiatric-mental health nursing, integrating therapeutic communication, relationship-building, coping support, and ethical care. Mastering these principles prepares nurses for both NCLEX success and effective client-centered psychiatric care.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and study resources.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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