Varcarolis’ Foundations of Psychiatric-Mental Health Nursing is Elsevier’s RN-level psychiatric nursing textbook, written by Margaret Jordan Halter and now in its 10th edition (January 2026). It has 36 chapters in seven units, and its clinical chapters follow the nursing process. Study it one disorder at a time: key features, safety priority, medications, then communication.
Key takeaways
- The current Foundations edition is the 10th (Elsevier, January 2026; copyright 2027; ISBN 978-0-443-12723-6). The 9th (2021; ISBN 978-0-323-69707-1) is the previous edition.
- The 8th, 9th and 10th editions share the same 36-chapter order, so chapter numbers carry over, but the content inside was updated.
- Essentials is a separate, shorter book: the 5th edition by Chyllia D. Fosbre has 512 pages and 27 chapters, against 696 pages and 36 chapters for Foundations.
- Psychosocial Integrity makes up 6–12% of NCLEX-RN items under NCSBN’s 2026 test plan, and its activity list includes therapeutic communication, violence risk and substance misuse.
- The current FDA lithium label targets 0.8–1.2 mEq/L for acute mania and puts toxic concentrations at 1.5 mEq/L and above, a narrow margin.
What Varcarolis’ Foundations of Psychiatric-Mental Health Nursing Covers
It’s a clinical textbook for undergraduate nursing students that moves from theory and care settings to communication tools, then to disorders, crises and special populations. Elsevier calls it a market leader in RN psychiatric nursing.
The book carries Elizabeth M. Varcarolis’s name, but the current editions list Margaret Jordan Halter as author. Elsevier’s 10th-edition page describes Halter as a former clinical nurse specialist at Cleveland Clinic Akron General.
Per the publisher’s 10th-edition description:
- Clinical chapters follow a six-step nursing process, so every disorder chapter has the same layout.
- Disorder chapters follow DSM-5-TR order, and many include DSM-5-TR diagnostic criteria.
- Nursing diagnoses use International Classification for Nursing Practice (ICNP) terms.
- Each clinical chapter ends with Next-Generation NCLEX (NGN) style case studies and questions, alongside Key Points to Remember and Chapter Review items.
Foundations vs Essentials: Which Varcarolis Book Is on Your Syllabus?
Foundations is the longer, clinically detailed text; Essentials is a shorter book with a stronger communication focus. Their chapter numbers differ, so a study plan or question set written for one won’t line up with the other.
Varcarolis’ Essentials of Psychiatric Mental Health Nursing carries the subtitle A Communication Approach to Evidence-Based Care. The 4th edition (2020) was written by Varcarolis and Fosbre, and Elsevier pitched it at shorter psychiatric nursing courses. The 5th edition lists Fosbre, a psychiatric mental health nurse practitioner, as sole author and adds NGN-style case studies.
| Feature | Foundations, 10th | Essentials, 5th |
|---|---|---|
| Author | Margaret Jordan Halter | Chyllia D. Fosbre |
| Published | Jan 2026 (© 2027) | 2022 (© 2023) |
| Size | 696 pages, 36 chapters, 7 units | 512 pages, 27 chapters, 5 units |
| Approach | Clinical; six-step nursing process in each disorder chapter | Communication; “Applying the Art” nurse–patient scenarios |
| Bipolar chapter | Chapter 13 | Chapter 16 |
Varcarolis Edition Notes and ISBNs
For Foundations, the 10th edition (2026) is current and the 9th (2021) is the previous one. For Essentials, the 5th (2022) is current and the 4th (2020) came before it. Match the ISBN-13 on your copyright page, not the cover design.
| Book | Edition | Released | Print ISBN-13 |
|---|---|---|---|
| Foundations | 8th | 2017 | 978-0-323-38967-9 |
| Foundations | 9th | 2021 | 978-0-323-69707-1 |
| Foundations | 10th | Jan 2026 | 978-0-443-12723-6 |
| Essentials | 4th | 2020 | 978-0-323-62511-1 |
| Essentials | 5th | 2022 | 978-0-323-81030-2 |
What changed in the 10th edition
The chapter list barely moved: Elsevier’s posted contents show the same 36 chapters in the same order across the 8th, 9th and 10th editions, with a few titles reworded. The changes are inside the chapters. Elsevier says the 10th reflects the 2021 AACN Essentials and DSM-5-TR (the 9th cites DSM-5), uses ICNP nursing diagnoses and lists trauma-informed care among its features.
An honest note on our own catalog: our newest Foundations test bank matches the 9th edition, and our Essentials test bank matches the 4th. Neither was written for the newest edition, so if your syllabus lists the 10th or the 5th, those questions won’t reflect the updates above. Our guide on how to find the ISBN of a book shows where the number sits in print and e-book copies.
Chapter Map of Varcarolis’ Foundations of Psychiatric-Mental Health Nursing
Unit IV, Psychobiological Disorders, is the core of the book: 14 of the 36 chapters (11–24). The three units before it build your tools (theory, settings, law, communication), and the three after it cover crises, special populations and group or family work.
Use this crosswalk to find the same topic in either book. Foundations numbers apply to the 8th through 10th editions; Essentials numbers apply to the 4th and 5th.
| Topic | Foundations / Essentials |
|---|---|
| Brain biology and drugs | 3 / 4 |
| Legal and ethical issues | 6 / 6 |
| Therapeutic communication | 9 / 8 |
| Schizophrenia spectrum | 12 / 17 |
| Bipolar disorders | 13 / 16 |
| Depressive disorders | 14 / 15 |
| Anxiety and OCD | 15 / 11 |
| Trauma and stressor-related | 16 / 10 |
| Substance use | 22 / 19 |
| Delirium and dementia | 23 / 18 |
| Personality disorders | 24 / 13 |
| Suicide | 25 / 23 |
| Anger, aggression, violence | 27 / 24 |
A One-Page Disorder Study Template
Write every disorder on one page under the same five headings: key features, safety priority, medications and labs, communication, and teaching. A fixed order makes disorders easy to compare and puts safety ahead of treatment, the order priority questions expect.
- Key features: four to six cues you would actually see or hear on the unit.
- Safety priority: the one risk you act on first, and why.
- Medications and labs: first-line drug classes, their monitoring and the toxicity or interaction that can hurt the patient.
- Communication: two things to do and two to avoid, written for this disorder, not in general.
- Teaching: what the patient and family should report or keep doing at home.
Example: bipolar disorder (manic episode)
Here is the template filled in for Foundations chapter 13. Cues and nursing approaches come from the open-access Open RN mental health text, and the lithium numbers come from the current FDA-approved lithium carbonate label.
| Heading | Bipolar, manic episode |
|---|---|
| Key features | Euphoric or irritable mood, little need for sleep, pressured speech, flight of ideas, grandiosity, risky spending, poor insight. |
| Safety first | Danger to self or others (suicidal or homicidal thoughts, impulsivity), plus exhaustion and dehydration from days without food or sleep. Screen for suicide risk. |
| Meds and labs | Lithium as a first-line mood stabilizer; anti-seizure mood stabilizers such as valproate, carbamazepine or lamotrigine; second-generation antipsychotics. Lithium per the label: 0.8–1.2 mEq/L acute, 0.8–1.0 maintenance, toxic at 1.5 or above, drawn 12 hours after the last dose. NSAIDs, diuretics and ACE inhibitors or ARBs can raise levels; dehydration and sodium loss raise toxicity risk. |
| Do | Use a calm, firm approach with short, concrete statements. Keep limits identical across all staff. Redirect energy into structured, non-competitive activity in a low-stimulation setting. |
| Avoid | Long explanations, competitive games, noisy group settings and limits that change from shift to shift. |
| Teach | Take lithium exactly as prescribed and keep every blood test. Report diarrhea, vomiting, drowsiness, weakness, poor coordination or ringing in the ears. Stay hydrated, keep a normal salt intake and ask the prescriber before taking NSAIDs. |
Lithium ranges differ by source. The FDA label uses 0.8–1.2 mEq/L for acute treatment, while Open RN’s medication table lists 0.6–1.2 mEq/L. Use the range in your program’s textbook and your facility’s lab, and follow your instructor and facility policy.
High-Yield Varcarolis Chapters for Psych Nursing Exams
Put chapter 9 (therapeutic communication), chapter 3 (psychobiology and psychopharmacology) and chapter 25 (suicide) first, then the schizophrenia, bipolar, depressive and anxiety chapters (12–15). That’s a study-priority judgment, not a published statistic, and your syllabus overrides it.
It follows NCSBN’s 2026 NCLEX-RN Test Plan, where Psychosocial Integrity accounts for 6–12% of items. Its activity statements include therapeutic communication, violence risk and safety precautions, substance misuse and withdrawal, abuse or neglect, and grief or loss. In Foundations, those map to chapters 9, 27, 22, 28 and 30.
Therapeutic communication
On “best response” items, pick the answer that keeps the patient talking about their feelings or experience. Open RN’s therapeutic communication section lists the replies that block communication, including false reassurance, “why” questions, personal opinions, approving or disapproving, arguing, defensive replies and changing the subject.
A patient says, “Nobody on this unit listens to me.” A therapeutic reply reflects and invites more: “You feel nobody is listening. Tell me what happened.” Weaker options defend the staff, promise things will improve or ask the patient to justify the feeling. One exception: when a patient is escalating and someone could be hurt, safety comes first.
Psychopharmacology
Chapter 3 holds the drug content, and the same facts return in every disorder chapter. After lithium monitoring, learn three linked points. Open RN notes that an antidepressant given without a mood stabilizer or antipsychotic can trigger mania in bipolar disorder. The FDA lithium label warns that lithium plus serotonergic drugs such as SSRIs raises serotonin syndrome risk, and that lithium plus an antipsychotic has been linked to an encephalopathic syndrome that may resemble neuroleptic malignant syndrome.
For a method that works across drug classes, see our guide on how to study pharmacology in nursing school.
Safety and suicide risk
Chapters 25 (suicide and nonsuicidal self-injury) and 27 (anger, aggression and violence) carry the safety content. Know the core moves: ask directly about suicidal thoughts, screen with a validated tool, assess plan, intent, past attempts, and risk and protective factors, then remove environmental hazards.
Open RN’s safety section notes that asking about suicide does not put the idea in someone’s head, and that clients aged 12 and older admitted for acute care should be screened with a validated tool such as the Patient Safety Screener. It also covers The Joint Commission’s National Patient Safety Goal on suicide risk, including environmental checks such as removing anchor points and hooks on psychiatric units.
In the US, call or text 988 or use the chat at 988lifeline.org. The 988 Suicide & Crisis Lifeline is free, confidential and available 24/7.
Studying Varcarolis With Practice Questions
Read a chapter, answer its review items closed-book, then self-test with chapter-matched questions and track which kind you miss. Our guide to practice testing explains why spaced retrieval practice beats rereading.
- Read the chapter once, then fill in your one-page template from memory.
- Answer the chapter review questions and the end-of-chapter NGN-style case study.
- Self-test with 15–25 chapter-matched questions. Tag each miss as communication, safety, medication or content.
- Reread only the sections behind your misses, then retest that chapter two or three days later.
A test bank fits step 3: chapter-by-chapter practice questions with rationales, matched to one edition. Publishers write test banks mainly for instructors. Some programs restrict them, so read your student handbook or honor code and ask your instructor; if your program prohibits them, don’t use one. Our guide on how to use a nursing test bank covers the self-quizzing approach.
Browse mental health nursing test banks by textbook, or all nursing test banks if your psych course shares a semester with med-surg or pharmacology.
Chapter-matched questions with rationales for the Varcarolis edition on your syllabus. They are self-assessment practice, not your course’s exam.
- Varcarolis’ Foundations 9th Edition Test Bank (Halter) — for the 2021 edition (978-0-323-69707-1). The 10th keeps its chapter numbers but updates the content.
- Varcarolis’ Foundations 8th Edition Test Bank — for courses still on the 8th edition (978-0-323-38967-9).
- Essentials of Psychiatric Mental Health Nursing 4th Edition Test Bank — for the 4th edition of Essentials (978-0-323-62511-1), not the 5th.
- Psychiatric-Mental Health Nursing 7th Edition Test Bank (Videbeck) — if your course uses Videbeck’s 7th edition instead of Varcarolis.
Each test bank is matched to one edition and ISBN-13. Check the number on your book before you buy.
Frequently asked questions
What is the latest edition of Varcarolis Foundations?
The 10th edition is the latest. Elsevier lists it as published in January 2026 with a 2027 copyright, written by Margaret Jordan Halter, with print ISBN 978-0-443-12723-6 and 696 pages. The 9th edition (2021, ISBN 978-0-323-69707-1) came before it. Some courses stay on an earlier edition, so follow your syllabus rather than assuming you need the newest.
What is the difference between Foundations and Essentials?
Foundations is the longer clinical text: 36 chapters in seven units, written by Halter. Essentials is a shorter book with a communication focus, written by Chyllia D. Fosbre in its 5th edition and co-written with Elizabeth Varcarolis in the 4th. The current Essentials has 27 chapters in five units. Chapter numbers differ, so check which title your syllabus lists before buying any study aid.
Is Varcarolis good for NCLEX psych review?
It’s a course textbook rather than an NCLEX review book, but it covers the content NCSBN places under Psychosocial Integrity, which is 6–12% of NCLEX-RN items under the 2026 test plan. The 10th edition ends each clinical chapter with NGN-style case studies. For final review, pair your Varcarolis notes with a dedicated NCLEX question bank and study schedule.
How do I study for a psych nursing exam?
Study by disorder, not by page count. For each disorder, write one page with key features, safety priority, medications and labs, communication do’s and don’ts, and teaching. Then answer practice questions closed-book and sort your misses into communication, safety, medication or content errors. Give therapeutic communication extra time, since best-response questions appear in every disorder unit.
Which Varcarolis chapters are most important?
Your syllabus decides. As a starting priority in Foundations, take therapeutic communication (chapter 9), psychobiology and psychopharmacology (chapter 3), suicide and self-injury (chapter 25), and the schizophrenia, bipolar, depressive and anxiety chapters (12–15). In Essentials, the matching chapters are 8, 4, 23, 17, 16, 15 and 11. Ask your instructor which chapters each exam covers.
Bottom line: match the book, then build one page
Find the ISBN-13 on your copy and confirm whether it’s Foundations or Essentials, and which edition. Then fill in the one-page template for the first disorder on your syllabus, using the bipolar example as your model, and quiz yourself on that chapter before starting the next.
Sources & further reading
- Elsevier — Varcarolis’ Foundations, 10th Edition (description and contents)
- Elsevier — Varcarolis’ Foundations, 9th Edition (description and contents)
- Elsevier Health (US) — Varcarolis’ Essentials, 5th Edition (product details and contents)
- NCSBN — 2026 NCLEX-RN Test Plan (PDF)
- Open RN (WTCS) — Nursing Mental Health and Community Concepts 2e: Applying the Nursing Process to Bipolar Disorders
- DailyMed (NLM) — Lithium carbonate tablets and capsules, prescribing information
- 988 Suicide & Crisis Lifeline
