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Copyright, ii
About the Author, iii
Thank You!, iv
Contributors, vi
Acknowledgments, vii
Preface, viii
Focus Your Study for Success, x
Special Features, xv
The ROAD to Critical Thinking, IFC-1
Unit 1. Foundations of Mental Health Nursing, 1
Chapter 1. Introduction to Mental Health Nursing, 2
Mental Health and Mental Illness, 3
Mental Illness, 4
Mental Health, 4
Significance of Mental Disorders, 6
Theories of Mental Disorders, 6
Neurobiological Theory, 6
Genomics, 7
Gender, 9
Neurotransmission, 9
Biological Rhythms, 9
Importance of the Neurobiological Model, 9
Older Theories, 10
Intrapersonal Theory, 10
Social–Interpersonal Theory, 13
Behavioral Theory, 17
Cognitive Theory, 18
Personality, 19
Nursing Research, 20
The Therapeutic Relationship, 20
Student Concerns, 20
Caring: The Art and Essence of Nursing, 20
The Nurse–Client Relationship, 22
Introductory Phase, 22
Working Phase, 22
Termination Phase, 23
Components of the Relationship, 23
Boundaries of the Relationship, 24
Nursing Process in Mental Health Nursing, 24
Critical Thinking, 24
Characteristics of Critical Thinking, 24
The Nursing Process, 25
Standard I: Assessment, 25
Standard II: Diagnosis, 28
Standard III: Outcome Identification, 29
Standard IV: Planning, 29
Standard V: Implementation, 29
Standard VI: Evaluation, 31
Meeting the Challenges of the Twenty-first Century, 31
Evidence-Based Practice, 31
Information Technology, 32
Nursing Today, 33
Chapter 2. The Family in Mental Health Nursing, 36
Family Systems, 37
Family Communication, 37
Boundaries, 38
Family Cohesion, 38
Family Flexibility, 39
Emotional Availability, 39
Family Competency, 39
Death and the Family System, 40
Grief, 40
Disenfranchised Grief, 41
Complicated Grief, 41
Severe Mental Illness and the Family System, 42
Family Burden, 42
Family Recovery, 43
Mental Disorders Across the Life Span, 44
Youth, 44
Pregnancy, 45
Parenting, 45
Couples, 46
Adult Children, 46
Older Adults, 46
Family Nursing Practice, 46
Family Assessment, 47
Assessing Relapse Vulnerability, 47
Cultural Assessment, 48
The Nurse as Educator, 49
The Nurse as Life Coach, 49
The Nurse as Referral Agent, 50
The Nurse as Spiritual Caregiver, 50
Chapter 3. The Community in Mental Health Nursing, 54
The Mental Health System, 55
History, 55
Current System, 55
Obstacles to Care, 55
Community Mental Health, 56
Principles, 56
Treatment Settings and Services, 56
Hospitals, 56
Outpatient Services, 57
Housing, 57
Schools, 58
Home Care, 58
Disenfranchised Populations, 58
Rural Communities, 58
Homeless Populations, 59
Correctional Systems, 60
Community Mental Health Services, 60
Screening Programs, 60
Case Management, 60
Crisis Response Services, 61
Bridging Strategies, 61
Support Services, 62
Psychosocial Rehabilitation, 62
Education, 63
Employment, 63
Telehealth, 64
Transforming the Mental Health System, 64
Chapter 4. The Role of Cultural Diversity in Mental Health Nursing, 68
Culture and Mental Health, 70
Problems Related to Culture, 70
Immigration, 70
Alienation From Group, 70
Socio-economic Status, 70
Culture-Specific Syndromes, 71
Values, 72
Value Orientations, 72
Humans and Nature, 72
Humans and the Universe, 72
Sense of Time, 72
Productivity, 72
Interpersonal Relationships, 72
Predominant American Values, 73
Nursing Values, 73
Attitudes and Perceptions, 74
Generalizations, Stereotypes, and Prejudice, 74
Discrimination, 74
Caring for a Diverse Population, 77
Cultural Knowledge, 77
Cultural Sensitivity, 77
Skills in Culturally Congruent Nursing Care, 78
Diversity Within the Profession, 79
Chapter 5. Legal and Ethical Issues, 84
Types of Admission, 85
Competency, 86
Client Rights, 86
Confidentiality and Privacy, 86
Informed Consent, 87
Right to Treatment, 87
Right to Refuse Treatment, 87
Least Restrictive Environment, 88
The Right to Communicate With Others, 88
The Right to Freedom From Unnecessary Restraints or Seclusion, 88
The Right to Participate in Legal Matters, 88
Right to Consensual Sexual Relationships, 89
Reporting Laws, 89
Duty to Disclose/Protect, 89
Leaving Against Medical Advice, 89
Clients with Legal Charges, 90
The Mentally Ill in Correctional Settings, 90
Caring: A Prerequisite to Ethical Behavior, 91
Nursing Ethics, 91
Principalism, 91
Values, 91
Competent Care, 91
Research, 91
Ethics of Care, 92
Chapter 6. Neurobiology and Behavior, 96
Development of the Brain, 97
Genes and Environment, 97
Fetal Brain, 97
Infant Brain, 98
Childhood Brain, 98
Teenage Brain, 98
Adult Brain, 98
Aging Brain, 99
Gender Differences, 99
Neuroplasticity, 99
Brain Repair, 100
Neuroanatomy, 100
Brain Cells, 100
Nerve Tracts, 100
Brain Stem, 101
Cerebellum, 101
Cerebrum, 102
Frontal Lobe, 102
Parietal Lobe, 103
Temporal Lobe, 103
Occipital Lobe, 103
Subcortical Structures, 103
Limbic System, 103
Basal Ganglia, 104
Ventricles, 106
Blood–Brain Barrier, 106
Neurophysiology, 106
Neuroendocrine Function, 106
Neurotransmission, 107
Neurotransmitters, 108
Biogenic Amines, 108
Amino Acids, 110
Neuropeptides, 110
Neurohormones, 111
Cyclic Patterns, 112
Functions of the Brain, 112
Executive Functions, 112
Memory, 112
Working/Short-Term Memory, 113
Long-Term Memory, 113
Cognition and Language, 114
Emotion, 114
Motivation, 115
Psychoneuroimmunology, 116
Nutritional Neuroscience, 116
Dysregulation, 117
Unit 2. Illness Management and Recovery, 121
Chapter 7. Illness Management: Communication and Psychoeducation, 122
Relating, 123
Characteristics of Caring Helpers, 123
Nonjudgmental Approach, 123
Acceptance, 123
Warmth, 124
Empathy, 124
Authenticity, 124
Congruency, 124
Patience, 124
Respect, 124
Trustworthiness, 124
Self-Disclosure, 125
Humor, 125
Communicating, 126
The Nature of Communication, 126
Nonverbal Communication, 127
Listening, 129
Levels of Messages, 130
Communication Difficulties, 130
Effective Communication, 131
Techniques That Contribute to Ineffective Communication, 134
Communicating With Families and Groups, 135
Communicating With Children and Adolescents, 137
Communicating With Older Adults, 137
Educating, 138
Assessment, 138
Diagnosis, 138
Planning, 139
Implementation, 139
General Areas of Learning, 139
The Problem-Solving Process, 140
Family Education, 142
Evaluation, 142
Documentation, 142
Chapter 8. Illness Management: Common Clinical Behaviors, 146
The ROAD to Critical Thinking: A Client Experiencing Paranoid Delusions, 147
Clients Experiencing Hallucinations, 147
Types of Hallucinations, 148
Assessment, 148
Interventions, 148
Clients Experiencing Delusions, 149
Types of Delusions, 150
Assessment, 151
Interventions, 152
Clients Who Self-Mutilate, 152
Forms of Self-Mutilation, 153
Assessment, 153
Interventions, 153
Clients Who are Aggressive, 154
Triggers to Aggression, 155
Assessment, 155
Interventions, 157
Prevention, 157
Interpersonal Skills, 157
Nonverbal Communication Skills, 159
Verbal Communication Skills, 159
Seclusion and Restraints, 159
Critical Incident Review, 159
Chapter 9. Illness Management: Treatment Decisions, 164
Mental Health Care Clients, 165
Mental Health Care Professionals, 165
Nurses, 166
Basic Level of Practice, 166
Advanced Practice, 166
Consultation, 166
Nurse Informaticists, 166
Psychiatrists, 167
Psychologists, 167
Psychiatric Social Workers, 167
Occupational Therapists, 167
Recreational Therapists, 167
Specialists, 167
Clergy, 167
Collaboration, 167
Milieu Therapy, 168
Characteristics of the Therapeutic Milieu, 168
Clear Communication, 168
Safe Environment, 168
Activity Schedule With Therapeutic Goals, 168
Support Network, 169
Psychosocial Nursing Interventions, 169
Social Skills Training, 169
Activities of Daily Living Skills, 169
Vocational Skills, 169
Leisure-Time Skills, 169
Communication Skills, 170
Conflict-Management Skills, 170
Self-Esteem Interventions, 170
Remotivation Therapy, 171
Reminiscence Therapy, 171
Physical Exercise, 171
Crisis Intervention, 172
Cognitive–Behavioral Therapy, 174
Behavioral Therapy, 175
Play Therapy, 175
Art Therapy, 176
Individual Psychotherapy, 176
Family Therapy, 176
Groups, 178
Task Groups, 178
Psychoeducation Groups, 178
Group Therapy, 178
Support Groups, 180
Twelve-Step Programs, 180
Technology and Therapies, 181
Biological Therapies, 181
Electroconvulsive Therapy, 181
Transcranial Magnetic Stimulation, 182
Magnetic Seizure Therapy, 183
Vagus Nerve Stimulation, 183
Deep Brain Stimulation, 183
Psychosurgery, 183
Light Therapy, 183
Sleep Deprivation, 184
Gene Therapy, 184
Seclusion and Restraint, 184
Complementary/Alternative Therapies, 184
Acupuncture, 186
Animal-Assisted Therapy, 186
Aromatherapy, 186
Ayurveda, 187
Traditional Chinese Medicine, 187
Chiropractic, 187
Curanderismo, 187
Herbal Medicine, 187
Homeopathy, 188
Hypnotherapy and Guided Imagery, 188
Kinesiology/Applied Kinesiology, 188
Massage Therapy, 188
Meditation, 188
Native American Healing, 188
Naturopathy, 189
Prayer, 189
Reiki, 189
Spiritual/Shamanic Healing, 189
T’ai Chi, 189
Therapeutic Touch, 189
Yoga, 191
Chapter 10. Illness Management: Medications, 196
Introductory Concepts, 197
Pharmacokinetics, 197
Pharmacodynamics, 197
Pharmacogenomics, 197
Discontinuation Syndrome, 197
Smoking, Alcohol, Hydration, and Nutrition, 198
Off-Label Use, 198
Psychotropic Medications, 198
Antipsychotic Medications, 198
Physiological Effects, 198
Therapeutic Effects, 198
First-Generation Antipsychotics, 199
Second-Generation Antipsychotics, 199
Side Effects, 200
First-Generation Antipsychotics, 200
Second-Generation Antipsychotics, 201
Toxicity and Overdose, 202
Administration, 202
Adjunctive Medications for EPS, 202
Antidepressant Medications, 202
Physiological Effects, 202
Therapeutic Effects, 203
Side Effects, 203
Toxicity and Overdose, 205
Administration, 205
Mood-Stabilizing Medications, 206
Physiological Effects, 206
Lithium, 206
Anticonvulsants/Calcium Channel Blockers/Antihypertensives, 207
Therapeutic Effects, 207
Side Effects, 207
Toxicity and Overdose, 208
Administration, 208
Antianxiety Medications, 209
Physiological Effects, 209
Benzodiazepines, 209
Azaspirones, 209
Therapeutic Effects, 209
Side Effects, 209
Benzodiazepines, 209
Azaspirones, 210
Toxicity and Overdose, 210
Administration, 210
Central Nervous System Stimulants, 210
Anticraving Medications, 211
Special Populations and Psychopharmacological Treatment, 212
Older Adults, 212
Pregnant Women, 213
Children, 213
Medically Complex Clients, 214
Severely and Persistently Mentally Ill Clients, 214
Culturally Diverse Clients, 215
Nursing Interventions, 215
Client and Family Participation, 215
Teaching: Prescribed Medication, 215
Medication Teaching Groups, 216
Teaching: Medication Management, 216
Teaching: Weight Management, 217
Teaching: Temperature Regulation, 217
Collaboration: Family Support, 217
Unit 3. Mental Disorders, 223
Chapter 11. Anxiety, Dissociative, and Somatoform Disorders, 224
The ROAD to Critical Thinking: A Client Experiencing Anxiety Disorder, 225
Knowledge Base, 226
Anxiety Disorders, 226
Generalized Anxiety Disorder, 226
Panic Disorder, 227
Phobic Disorders, 228
Obsessive–Compulsive Disorder, 229
Posttraumatic Stress Disorder, 231
Acute Stress Disorder, 232
Dissociative Disorders, 232
Somatoform Disorders, 235
Factitious Disorder, 236
Malingering, 236
Comorbid Disorders, 236
Etiologies, 237
Genetics, 237
Neurobiology, 237
Intrapersonal Factors, 238
Interpersonal Factors, 238
Cognitive Theory, 239
Learning Theory, 239
Behavioral Theory, 239
Gender-Bias Factors, 239
Psychopharmacological Interventions, 239
Multidisciplinary Interventions, 241
Alternative Therapies, 242
Nursing Process, 243
Chapter 12. Eating Disorders, 264
The ROAD to Critical Thinking: A Client Experiencing Eating Disorder, 265
Anorexia Nervosa and Bulimia Nervosa, 265
Knowledge Base, 265
Purging Disorder, 266
Binge Eating Disorder, 266
Nocturnal Sleep-Related Eating Disorder, 266
Obesity, 266
Prader–Willi Syndrome, 268
Comorbid Disorders, 268
Etiologies, 269
Genetics, 269
Neurobiology, 269
Intrapersonal Factors, 269
Cognitive Theory, 269
Behavioral Theory, 270
Family Factors, 270
Gender-Bias Factors, 270
Psychopharmacological Interventions, 270
Multidisciplinary Interventions, 270
Alternative Therapies, 271
Nursing Process, 271
Chapter 13. Mood Disorders, 296
The ROAD to Critical Thinking: A Client Experiencing Bipolar Disorder, 297
Knowledge Base, 297
Types of Disorders, 297
Pregnancy and Postpartum, 299
Onset and Course of Disorders, 301
Comorbid Disorders, 302
Etiologies, 302
Genetics, 303
Neurobiology, 303
Intrapersonal Theory, 304
Learning Theory, 305
Cognitive Theory, 305
Sociocultural Factors, 305
Gender-Bias Theory, 306
Psychopharmacological Interventions, 306
Multidisciplinary Interventions, 308
Alternative Therapies, 308
Transcranial Magnetic Stimulation, 308
Vagus Nerve Stimulation, 308
Exercise, 309
St. John’s Wort, 309
SAMe, 309
Vitamin B, 309
Tyrosine, 309
DHEA, 309
Omega-3 Fatty Acids, 309
Aromatherapy, 310
Acupuncture, 310
Animal-Assisted Therapy, 310
Music Therapy, 310
Nursing Process, 310
Chapter 14. Schizophrenic Disorders, 341
The ROAD to Critical Thinking: A Client Experiencing Paranoid Schizophrenia, 342
Knowledge Base, 342
Comorbid Disorders, 345
Etiologies, 345
Genetics, 345
Neurobiology, 346
Diathesis-Stress Model, 347
Psychopharmacological Interventions, 348
Multidisciplinary Interventions, 348
Psychiatric Rehabilitation, 348
Group Therapy, 348
Assertive Community Treatment, 349
Electroconvulsive Therapy, 349
Alternative Therapies, 350
Transcranial Magnetic Stimulation, 350
Omega-3 Fatty Acids, 350
Aromatherapy, 350
Acupuncture, 350
Nursing Process, 350
Chapter 15. Substance-Related Disorders, 375
The ROAD to Critical Thinking: A Client Experiencing a Substance-Related Disorder, 376
Knowledge Base, 379
Comorbid Disorders/Dual Diagnosis of the Mentally Ill Chemical Abuser, 379
Alcohol, 379
Site of Action, 379
Effects, 379
Complications, 380
Withdrawal, 381
Overdose, 381
Sedatives/Hypnotics/Antianxiety Agents, 381
Site of Action, 382
Effects, 382
Complications, 382
Withdrawal, 382
Overdose, 382
Opioids, 382
Site of Action, 382
Effects, 382
Complications, 383
Withdrawal, 383
Overdose, 383
Cannabis, 383
Site of Action, 383
Effects, 383
Complications, 384
Withdrawal, 384
Overdose, 384
Cocaine, 384
Site of Action, 384
Effects, 384
Complications, 384
Withdrawal, 385
Overdose, 385
Amphetamines, 385
Site of Action, 385
Effects, 385
Complications, 385
Withdrawal, 386
Overdose, 386
Hallucinogens, 386
Site of Action, 386
Effects, 386
Complications, 386
Withdrawal, 386
Overdose, 386
Inhalants, 386
Site of Action, 387
Effects, 387
Complications, 387
Withdrawal, 387
Overdose, 387
Anabolic Steroids, 387
Site of Action, 387
Effects, 387
Complications, 387
Withdrawal, 388
Overdose, 388
Caffeine, 388
Site of Action, 388
Effects, 388
Complications, 388
Withdrawal, 388
Overdose, 388
Nicotine, 388
Site of Action, 388
Effects, 388
Complications, 389
Withdrawal, 389
Overdose, 389
Etiologies, 389
Genetics, 389
Neurobiology, 390
Intrapersonal Factors, 391
Behavioral Theory, 391
Learning Theory, 391
Sociocultural Theory, 391
Gender-Bias Factors, 391
Psychopharmacological Interventions, 392
Multidisciplinary Interventions, 394
Alternative Therapies, 396
Herbs and Nutrients, 396
Acupuncture, 396
Qigong, 396
Guided Imagery, 396
Nursing Process, 397
Chapter 16. Personality Disorders, 424
The ROAD to Critical Thinking: A Client Experiencing Borderline Personality Disorder, 425
Knowledge Base, 426
Cluster A Personality Disorders, 426
Paranoid Personality Disorder, 426
Schizoid Personality Disorder, 427
Schizotypal Personality Disorder, 427
Cluster B Disorders, 427
Antisocial Personality Disorder, 427
Borderline Personality Disorder, 430
Histrionic Personality Disorder, 431
Narcissistic Personality Disorder, 432
Cluster C Disorders, 432
Avoidant Personality Disorder, 432
Dependent Personality Disorder, 433
Obsessive–Compulsive Personality Disorder, 433
Personality Disorders Not Otherwise Specified, 434
Depressive Personality Disorder, 434
Passive–Aggressive Personality Disorder, 434
Comorbid Disorders, 434
Etiologies, 435
Genetics, 435
Neurobiology, 436
Intrapersonal Factors, 436
Sociocultural Factors, 436
Family Theory, 437
Gender-Bias Theory, 437
Psychopharmacological Interventions, 437
Alternative Therapies, 438
Nursing Process, 438
Chapter 17. Disorders of Children and Adolescents, 457
The ROAD to Critical Thinking: A Client Experiencing Oppositional Defiant Disorder and Attention Deficit Hyperactivity Disorder, 458
Knowledge Base, 461
Attention Deficit/Hyperactivity Disorder, 461
Oppositional Defiant Disorder, 463
Conduct Disorder, 463
Tourette Disorder, 463
Bipolar Disorder, 464
Asperger Disorder, 464
Autistic Disorder, 465
Comorbid Disorders, 465
Etiologies, 466
Genetics, 466
Neurobiology, 466
Nutritional Factors, 467
Interpersonal Factors, 467
Psychopharmacological Interventions, 467
Multidisciplinary Interventions, 469
Alternative Therapies, 469
Nursing Process, 471
Chapter 18. Gender Identity and Sexual Disorders, 488
Knowledge Base, 489
Sexual Health, 489
Gender and Transgender, 489
Gender Identity, 489
Gender Roles, 489
Paraphilias, 490
Noncoercive Paraphilias, 490
Coercive Paraphilias, 492
Altered Sexual Function, 492
Sexual Desire Disorders, 492
Sexual Arousal Disorders, 492
Orgasmic Disorders, 493
Sexual Pain Disorders, 493
Problems With Satisfaction, 493
Increased Sexual Interest, 494
Sexual Addiction, 494
Sexual Problems Among Gay Men and Lesbians, 494
Etiologies, 495
Biology, 495
Intrapersonal Factors, 496
Behavioral Theory, 496
Interpersonal Factors, 496
Sociocultural Factors, 496
Multidisciplinary Interventions, 497
Nursing Process, 497
Unit 4. Neurobehavioral Brain Disorders, 511
Chapter 19. Cognitive Impairment Disorders, 512
Knowledge Base: Dementia, 513
Comorbid Disorders, 515
Etiologies, 516
Genetics, 516
Neurobiology, 516
Environmental Risk Factors, 518
Protective Factors, 518
Psychopharmacological Interventions, 518
Multidisciplinary Interventions, 519
Alternative Therapies, 519
Antioxidants, 519
Omega-3 Fish Oil, 519
Phosphatidyl Serine, 519
Melatonin, 519
Dehydroepiandrosterone, 519
SAMe, 520
Lecithin, 520
Music Therapy, 520
Touch Therapy, 520
Animal-Assisted Therapy, 520
Knowledge Base: Delirium, 520
Comorbid Disorders, 520
Etiologies, 520
Neurobiology, 520
Environmental Factors, 521
Psychopharmacological Interventions, 521
Nursing Process, 521
Chapter 20. Neuropsychiatric Problems, 542
Knowledge Base, 543
Degenerative Disorders, 543
Parkinson Disease, 543
Huntington Disease, 544
Frontal Lobe Dementias, 544
Pick Disease, 544
Creutzfeldt–Jakob Disease, 544
Epilepsy, 545
Multifocal Disruptions, 545
Multiple Sclerosis, 545
Brain Attack, 545
Infections, 546
HIV/AIDS, 546
Pediatric Autoimmune Neuropsychiatric Disorders, 546
Lyme Disease, 547
Traumatic Brain Injury, 547
Psychopharmacological Interventions, 547
Multidisciplinary Interventions, 548
Alternative Therapies, 548
Nursing Process, 548
Unit 5. Violence, 559
Chapter 21. Suicide, 560
The ROAD to Critical Thinking: A Client Contemplating Suicide, 561
Knowledge Base, 561
Reasons, 562
Assisted Suicide, 562
Comorbid Disorders, 563
Causes of Suicide, 563
Genetics, 563
Neurobiology, 563
Interpersonal Factors, 564
Behavioral Theory, 564
Nursing Process, 564
Chapter 22. Interpersonal Violence, 579
The ROAD to Critical Thinking: A Client Experiencing Interpersonal Violence, 580
Knowledge Base, 581
Sibling Abuse, 581
Child Abuse, 582
Intimate Partner Violence—Heterosexual, 583
Intimate Partner Violence—Homosexual, 584
Elder Abuse, 584
Abuse of Pregnant Women, 585
Emotional Abuse, 585
Stalking, 585
Comorbid Disorders, 586
Etiologies, 586
Neurobiology, 586
Intrapersonal Theory, 587
Social Learning Theory, 587
Gender-Bias Factors, 587
Nursing Process, 587
Chapter 23. Sexual Violence, 604
Sexual Harassment, 605
Rape, 606
Knowledge Base: Rape, 606
Victims, 606
Perpetrators, 606
Comorbid Disorders, 607
Etiologies, 607
Intrapersonal Factors, 607
Interpersonal Factors, 607
Sociocultural Factors, 608
Gender-Bias Factors, 608
Nursing Process, 608
Childhood Sexual Abuse, 615
Knowledge Base: Childhood Sexual Abuse, 615
Types of Offenders, 615
Juvenile Offenders, 615
Male Offenders, 616
Female Offenders, 616
Internet Offenders, 616
Comorbid Disorders, 616
Etiologies, 616
Intrapersonal Factors, 616
Family Systems Theory, 617
Nursing Process, 617
Chapter 24. Community Violence, 633
Knowledge Base, 634
Types of Violence, 634
Affective Violence, 634
Predatory Violence, 634
Types of Homicide, 635
Settings of Community Violence, 636
Workplace Violence, 636
School Violence, 636
Street Violence, 636
Comorbid Disorders, 637
Etiologies, 637
Neurobiology, 637
Learning Theory, 637
Contextual Sensitivity Hypothesis, 637
Nursing Process, 638
Chapter 25. Nursing Management of the Problems Associated With Exposure to Natural Disasters and Terrorism, 650
Knowledge Base, 651
Types of Traumatic Events, 651
Motivation of Terrorists, 651
Types of Terrorism, 651
Individual Responses to the Threat of Terrorism and Disaster, 652
High-Risk Groups, 652
Nursing Process, 652
Appendix A. DSM-IV-TR Classification, 663
Appendix B. 2007-2008 NANDA International–Approved Nursing Diagnoses, 677
Appendix C. ROAD Chapter 8 Answers, 679
Appendix D. Answers to NCLEX-RN^® Review Questions, 683
Glossary, 703
Index, 711

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