Post RN BSN Advance Concepts in Nursing-III – Clinical Objectives Explained with Tools, Checklists and Examples

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Posted by POST RN BSN Resources · Original syllabus post: May 4, 2017 · Category: Post RN BSN Nursing Course Syllabus

Post RN BSN Nursing – Advance Concepts in Nursing-III (Psychiatric and Mental Health Nursing), Course No. 715 – Part 7 of 8. Exam-style answers and practical study aids for the eight clinical objectives of the LUMHS Post RN BSN syllabus: applying theory, self-awareness, therapeutic communication, nursing process, prevention, health education, safe skills and evaluating community services. Includes sample process recording, care plan, lesson plan, reflective journal and checklists.

Please note: The syllabus lists topics only. These are exam-style questions and model answers prepared from those topics; they are not an official LUMHS paper or answer key. Case examples are made up for learning. Drug names are given for study only, without doses; always follow the current prescription, hospital policy and a drug reference.

📚 Course syllabus: Advance Concepts in Nursing-III (Course No. 715), LUMHS Post RN BSN – read the full course syllabus here.

Psychiatric Nursing Clinical Objectives Explained | Post RN BSN Use as a revision guide and verify with your course notes.

Clinical Objectives: The Eight Clinical Objectives Explained with Tools and Examples

Course syllabus · Model exam answers

B.Sc NURSING (POST-RN), SECOND YEAR, SEMESTER-III

ADVANCE CONCEPTS IN NURSING-III – COURSE NO. 715

CLINICAL OBJECTIVES: THE EIGHT CLINICAL OBJECTIVES EXPLAINED WITH TOOLS AND EXAMPLES

Credit hours: 6 (Theory 3, Clinical 3)Source: course syllabus

Evaluation: Assignment 10%, Internal 10%, Final 80%

Syllabus topics: Clinical objectives: (1) apply theory to psychiatric-mental health practice; (2) self-awareness; (3) therapeutic communication; (4) nursing process; (5) factors promoting mental health and preventing mental illness; (6) health educator role and health education sessions; (7) skills with client safety; (8) community mental health services.

Note: the syllabus page lists the clinical objectives only. The number of case studies, care plans, process recordings, teaching sessions and clinical hours, and the grading forms, are set by your institution and clinical supervisor; I could not verify them from the syllabus page. The formats below are study aids, not official LUMHS forms. All patient examples are made up; never write real names or identifiers in student work.

Q-1. State the clinical objectives of Advance Concepts in Nursing-III (psychiatric and mental health nursing) and explain how they are assessed.

On clinical days the student is expected to meet the following objectives (as listed on the course syllabus page).

No.	Objective	How to show it in the ward
1	Apply theory to psychiatric-mental health practice in hospitals	Link every client’s symptoms, drugs and care to the theory from Units I–IV in your care plan
2	Show growing self-awareness in clinical work	Reflective journal; discuss feelings and biases with supervisor
3	Use therapeutic communication with clients	Process recordings; direct observation by supervisor
4	Carry out the nursing process for clients with mental health problems	Complete care plans from assessment to evaluation
5	Analyze factors that promote mental health and prevent mental illness	Written analysis of protective and risk factors for a client or community
6	Recognize the nurse’s role as health educator; plan and conduct health education sessions	Lesson plan and a taught session with evaluation
7	Perform required skills while keeping clients safe	Skill checklists: MSE, medication, ECT preparation, observation, de-escalation
8	Identify and evaluate community mental health services	Visit report with evaluation of a service

Assessment is usually by clinical supervisor observation, written work and records, and an end-of-rotation evaluation; confirm the method and weightage with your institution. The course has 3 clinical credits (alongside 3 theory credits).

Q-2. Objective 1: How can a student apply theory to psychiatric-mental health practice in hospitals?

Clinical learning cycle: theory is applied, evaluated and reflected upon.

Theory (this course)	Application in the ward
Unit I: continuum, causes, culture, stigma	Take a respectful history; ask about family explanation of illness; avoid labels
Unit II: communication, MSE, anxiety, mood disorders, family therapy	Interview the client, record an MSE, observe sleep and mood, teach relaxation, assess family coping
Unit III: schizophrenia, personality disorders, antipsychotics	Observe positive and negative symptoms; check side effects; set limits with calm consistency
Unit IV: therapies, anger, coping, crisis, suicide, ethics, community	Use de-escalation, assess suicide risk, run a group or OT activity, respect consent and confidentiality, plan discharge and follow-up

Practical steps

Before duty: revise the diagnosis, drugs and nursing diagnoses of your assigned client.
During duty: gather data from client, family, chart and team; practise skills under supervision.
After duty: compare what you observed with the textbook; write a short reflection.
Ask “why?” for each action: which theory or evidence supports it?

Daily routine of a psychiatric ward (general pattern)

Handover and safety round (check environment, observation levels).
Morning care, medication round, therapeutic activities (groups, OT, recreation).
Meals, individual interaction, family visits, health education.
Documentation, evening handover and night safety checks.

Routines differ between hospitals; follow your ward’s policy.

Q-3. Objective 2: Describe how a student develops and demonstrates growing self-awareness. Use a reflective journal.

Self-awareness (Unit II A) is shown when the student can name her own feelings, recognize her biases and explain how they affected care. Common feelings in the first week: fear, curiosity, pity, anger, disgust, and worry about saying the wrong thing. These are normal.

Gibbs’ reflective cycle	Question	Example (made up)
Description	What happened?	A client with mania spoke loudly and refused to eat; I tried to persuade him many times
Feelings	What did I think and feel?	I felt embarrassed and frustrated; I wanted him to obey
Evaluation	What was good or bad?	He became more irritable; later, when I offered a sandwich to carry, he ate
Analysis	Why did it happen? What does theory say?	Mania needs low stimulation, finger foods and no power struggles
Conclusion	What else could I have done?	Offer choices, shorter explanation, portable food, ask the senior for support
Action plan	What will I do next time?	Stay calm, use short sentences, plan food that can be eaten on the move

Ways to build self-awareness

Daily journal; discuss in pre- and post-conference.
Ask supervisors and peers for feedback.
Notice your reactions to certain symptoms or behaviours (e.g. aggression, suicide, sexual talk).
Examine your own beliefs about mental illness and culture.
Practise self-care: sleep, breaks, talking to someone after difficult events; use debriefing.

A growing student shows a change from “I was scared of him” to “I recognized my fear, stayed calm, and asked for help.”

Q-4. Objective 3: How does a student practise therapeutic communication? Prepare a process recording.

A process recording is a written word-for-word account of an interaction with a client, analysed for communication techniques, barriers, the nurse’s feelings and outcomes. It is the standard tool for learning therapeutic communication.

Format and sample (made up)

Nurse (verbal / non-verbal)	Client (verbal / non-verbal)	Nurse’s thoughts and feelings	Technique / barrier	Analysis and better response
“Good morning, Mr A. I am the student nurse. How are you today?” (sits at his level)	“Not good.” (looks down, speaks softly)	A little nervous	Broad opening; offering self	Open start, calm tone: effective
“Tell me what is not good.”	“I cannot sleep. I keep thinking I am a burden.” (eyes fill with tears)	Worried; thought of suicide risk	Open-ended question; listening	Client shared hopelessness: need to assess risk
“Do not think like that, everything will be fine.”	(silent, turns away)	Wanted to comfort him	Barrier: false reassurance	Better: “It sounds very heavy. Tell me more.” then ask about thoughts of ending life
“You feel like a burden. Have you had thoughts of harming yourself?”	“Sometimes I wish I was not here.”	Scared but stayed calm	Reflection; direct question	Informed the supervisor immediately; safety assessment

Checklist for communication in the ward

Introduce yourself; use the client’s name; explain purpose and time.
Choose a quiet private place; sit at the same level; keep a respectful distance.
Open questions; reflection; clarification; silence; summarizing.
Avoid advice, false reassurance, “why” questions, arguing with delusions.
Observe non-verbal signals; match your tone.
End the interaction clearly and report important information (risk, new symptoms) to the supervisor.

Q-5. Objective 4: How should a student carry out the nursing process for a client with a mental health problem? Give a format and a sample care plan.

Case study format

Identification: age, sex, marital status, occupation, religion, date of admission (no real names).
Presenting complaints and history of present illness, past, family, personal and social history.
Physical examination and investigations.
Mental status examination (ASEPTIC, Unit II A).
Diagnosis and treatment (drugs with class, action, side effects and nursing responsibilities).
Nursing process: assessment, nursing diagnoses (priority order), goals, interventions with rationale, evaluation.
Health education, discharge plan and follow-up; family and community support.
Reflection and references.

Sample care plan (made up client with depression)

Assessment (data)	Nursing diagnosis	Goal	Interventions and rationale	Evaluation
Says she is worthless; sleeps 3 hours; poor intake; passive thoughts of death	Risk for self-directed violence	Remains safe during admission	Ask about suicidal thoughts every shift; observe at ordered level; safe environment; inform team (to prevent harm)	Remained safe; reports no plan
Eats less than half of meals; lost 2 kg	Imbalanced nutrition	Eats at least 75% of meals in 3 days	Small, preferred meals; sit with her; record intake and weight (maintain nutrition)	Eats 60%; continue
Stays in bed; says “I am a failure”	Low self-esteem	Names two strengths in 1 week	Accept without judging; point out small achievements; activity schedule (builds self-worth)	Named one strength; partially met
Does not know her medicine	Knowledge deficit	States purpose and side effects of her antidepressant	Teach simply; use teach-back (supports adherence)	Able to state purpose; side effects partly

Prioritize safety first, then physical needs, then psychological needs and education.

Q-6. Objective 5: How can a student analyze factors that promote mental health and prevent mental illness?

Use the biopsychosocial model (Part 1) and the levels of prevention (Part 6) to analyze a client, family or community.

Domain	Protective (promoting) factors	Risk factors	Possible prevention action
Biological	Good physical health, sleep, adherence to treatment	Substance use, chronic disease, family history, brain injury	Regular treatment; avoid substances; sleep routine
Psychological	Self-esteem, coping skills, optimism, problem solving	Trauma, perfectionism, low self-esteem, poor coping	Counselling, stress management, life-skills training
Family and social	Supportive family, friends, education, employment, faith community	Conflict, violence, isolation, poverty, stigma	Family education, support groups, social services
Cultural and environmental	Safe community, respect, access to care	Discrimination, disaster, unsafe housing, lack of services	Community mobilization; anti-stigma work; disaster preparedness

Format for a short written analysis

Brief description of the client or community (no identifiers).
Protective factors found; risk factors found.
Level of prevention needed (primary, secondary or tertiary) with justification.
Three realistic actions by the nurse, family and community; references.

Q-7. Objective 6: Describe the nurse’s role as health educator in mental health. Prepare and conduct a health education session.

The nurse teaches clients, families and communities about illness, treatment, safety, coping and prevention. Good teaching is simple, repeated, culturally suitable and uses the teach-back method.

Steps

Identify the learning need (assessment of knowledge, attitude, practice).
Write objectives that are specific and measurable.
Select content, language, methods (talk, discussion, demonstration, role play, poster, leaflet) and aids.
Prepare a lesson plan; rehearse; arrange a quiet place and time.
Conduct: introduction, body, summary; encourage questions.
Evaluate: questions, return demonstration, feedback form; revise.

Sample lesson plan (made up)

Item	Plan
Topic	Medication adherence and early warning signs of relapse in schizophrenia
Audience	Family caregivers of clients with schizophrenia (8–10 persons), 30 minutes
General objective	To improve caregivers’ understanding of treatment and relapse
Specific objectives	After the session caregivers will: (1) state two reasons for continuing medicine; (2) list three early warning signs of relapse; (3) say whom to contact in a crisis
Content	Nature of illness (not caused by weakness or spirits only); purpose of medicines; common side effects and what to report; do not stop suddenly; warning signs (poor sleep, withdrawal, suspiciousness); reducing criticism and stress at home; crisis plan; follow-up clinic
Methods and aids	Discussion, flip chart, pictorial leaflet in Urdu or local language, role play of a calm response
Evaluation	Teach-back: each caregiver names one warning sign and one action; feedback form
Follow-up	Review at next clinic visit

Other topic ideas: stress management, sleep hygiene, anti-stigma talk, early signs of depression, safe use of lithium, preventing substance use among youth.

Q-8. Objective 7: List the skills a student must perform while keeping clients safe. Give checklists.

Skill	Key safety points
Admission and orientation	Verify papers and consent; check belongings for hazardous items per policy; explain ward rules and rights; assess risk
Suicide risk assessment and observation	Ask directly; follow ordered observation level; remove hazards; never leave a high-risk client alone; document and report
Mental status examination	Respectful interview; objective wording; include risk and insight; report findings
Medication administration (psychotropics)	Right client, drug, dose, route, time; check mouth to confirm swallowing; monitor vital signs and side effects; know lithium and clozapine monitoring; document
ECT preparation and aftercare	Consent verified; nil by mouth as ordered; remove dentures and jewellery; baseline vitals; post-ECT airway, vitals and reorientation
De-escalation and aggression management	Calm voice, safe distance, exit access, team help, least restrictive measures; restraint only by trained team as per policy; debrief
Handling hallucinations and delusions	No arguing or colluding; acknowledge feelings; orientation; assess command hallucinations
Relaxation and grounding teaching	Teach breathing and grounding; practise together
Group activities and OT supervision	Count tools; supervise; assess participation
Documentation and handover	Objective, dated, signed; use the client’s own words; use SBAR: Situation, Background, Assessment, Recommendation

Student safety

Never be alone with a client in a closed room if you feel unsafe; keep an exit; know alarm procedure.
Do not carry sharp objects or personal items that could be used as weapons; remove neck cords.
Report any threat or injury at once.
Keep professional boundaries; do not exchange personal contact details.

Always work under supervision until the supervisor certifies competence; never perform a restricted skill alone.

Q-9. Objective 8: How should a student identify and evaluate community mental health services? Prepare a visit report.

Visit a community or institutional mental health service (e.g. outpatient clinic, day-care centre, rehabilitation unit, school counselling service, helpline, NGO or primary care centre) with permission and supervision. Use Part 6 as the theoretical base.

Evaluation area	Questions to ask
Accessibility	Where is it located? Hours? Transport? Referral needed?
Affordability	Fees? Free medicines? Support for poor patients?
Availability of staff	Psychiatrist, nurse, psychologist, social worker, community health worker? Training?
Services offered	Assessment, medicines, counselling, groups, home visits, rehabilitation, education, crisis help
Quality and safety	Privacy, confidentiality, cleanliness, safe environment, records, referral and follow-up
Rights and culture	Respect, language, involvement of family, handling of stigma, consent
Prevention and promotion activities	Awareness sessions, school or community programmes
Strengths, gaps, recommendations	What works? What is missing? What would improve it?

Report format

Name and type of service (with permission), date and purpose of the visit.
Services and staff observed; client flow.
Evaluation using the table above.
Strengths, problems and recommendations (realistic, specific).
Learning gained and references.

Do not record identifiable client details; follow the host institution’s rules.

Q-10. What are the common clinical viva (oral exam) questions in psychiatric nursing? Give brief model answers.

Question	Short model answer
Define mental health.	A state of well-being in which a person realizes his abilities, copes with normal stress, works productively and contributes to the community.
What is the difference between a hallucination and an illusion?	Hallucination: perception without a stimulus; illusion: misinterpretation of a real stimulus.
Name two signs of lithium toxicity.	Coarse tremor and vomiting/diarrhoea; also unsteady walking and confusion in severe toxicity.
What is the first step in de-escalation?	Stay calm, use a low voice, keep a safe distance and listen; call for help early.
What is the antidote for benzodiazepine overdose?	Flumazenil (given by the doctor or emergency team).
Name three extrapyramidal side effects.	Acute dystonia, akathisia, parkinsonism (and tardive dyskinesia later).
What would you do for a client who says he wants to die?	Stay with him, ask directly, remove hazards, call the team, follow the observation order, document.
What is a process recording?	A written record of a nurse–client interaction analysed for communication techniques and the nurse’s feelings.
What is the stress–vulnerability model?	Illness occurs when stress exceeds the coping ability of a vulnerable person.
Name the levels of prevention.	Primary (reduce new cases), secondary (early detection and treatment), tertiary (rehabilitation, relapse prevention).

Q-11. What mistakes should the student avoid in the psychiatric clinical area?

Arguing with delusions or laughing at the client.
Promising secrecy or sharing information with other clients or outsiders.
Giving personal advice, gifts or contact details.
Leaving a client at risk unobserved.
Giving or helping with restraint without training and a supervisor.
Writing opinions or labels instead of observations in the chart.
Skipping self-care and reflection after difficult events.
Copying care plans from textbooks without assessing the actual client.

Q-12. Write the importance of the clinical component for a Post RN BSN nurse.

Clinical practice converts knowledge about mental illness into safe, therapeutic skills.
Self-awareness and communication are developed only through practice and reflection.
Supervised practice builds confidence in medicine administration, risk assessment and de-escalation.
Health education and community visits prepare the nurse for roles in hospitals, clinics and public health.

Conclusion: The eight clinical objectives form a cycle: apply theory, know yourself, communicate, use the nursing process, promote health, teach, keep clients safe and connect with the community.

Suggested references (the syllabus page lists topics only): Videbeck, S. L. Psychiatric-Mental Health Nursing (latest edition). Lippincott Williams & Wilkins.
Townsend, M. C. Essentials of Psychiatric Mental Health Nursing (latest edition). F. A. Davis.
World Health Organization. Mental health fact sheets and the ICD-11 classification (current versions).
American Psychiatric Association. DSM-5-TR (2022).

Source syllabus: LUMHS Post RN BSN Advance Concepts in Nursing-III (course syllabus) (original post dated May 4, 2017).

Series (Advance Concepts in Nursing-III, Course No. 715): Part 1: Unit I – Mental Health and Mental Illness. Part 2: Unit II (A) – Communication, Self and Anxiety-Related Disorders. Part 3: Unit II (B) – Mood Disorders and Family Therapy. Part 4: Unit III – Schizophrenia and Personality Disorders. Part 5: Unit IV (A) – Therapeutic Interventions, Suicide and Crisis. Part 6: Unit IV (B) – Ethical, Legal and Community Mental Health. Part 7: Clinical Objectives. Part 8: Learning Psychiatric Nursing – facts, skills, uses, benefits and hurdles.

Independent educational resource: POST RN BSN Nursing Resources is not affiliated with, endorsed by or an official publication of LUMHS or PNMC. Model answers are study aids; verify against your course notes and textbooks.

POST RN BSN Nursing Resources