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🧠 PSYCH 2520 PSYCHIATRY
EXAM MASTER STUDY GUIDE
(A+ LEVEL) WITH 100%
CORRECT ANSWERS +
RATIONALES 2026
1. Mental Status Examination (MSE)
Components of the MSE
1. Appearance – grooming, hygiene, posture, eye contact
2. Behavior/Psychomotor activity – agitation, retardation, wandering
3. Speech – rate, volume, coherence
4. Mood – subjective emotional state (“How do you feel?”)
5. Affect – objective emotional expression (flat, blunted, labile)
6. Thought process – logical, linear vs. loose associations
7. Thought content – delusions, obsessions, suicidal ideation
8. Perception – hallucinations, illusions
9. Cognition – orientation, memory, attention, judgment
10. Insight & judgment – awareness of illness, decision-making ability
MSE in a Client With Dementia
• Appearance: disheveled, inappropriate clothing
• Speech: word-finding difficulty, aphasia
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1
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• Mood/Affect: flat or labile
• Thought process: confused, disorganized Cognition:
o Disorientation (time → place →
person) o Impaired short-term
memory o Poor attention span
• Insight/Judgment: severely impaired
2. Psychotherapy for Depressive DisordersEffective therapies:
• Cognitive Behavioral Therapy (CBT) – reframes negative thoughts
• Interpersonal Therapy (IPT) – focuses on relationships
• Supportive therapy – validation and coping
• Group therapy – reduces isolation Nursing focus:
• Encourage expression of feelings
• Monitor suicide risk
• Reinforce coping strategies
• Promote medication adherence
3. Plan of Care: Alzheimer’s Disease
Goals
• Minimize confusion
• Promote safety
• Maintain independence as long as possible
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2
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Nursing Interventions
• Consistent routines
• Simple one-step directions Low-stimulus environment
• Reality orientation (clocks, calendars)
• Identification bracelet
• Avoid confrontation → use distraction
4. Teaching Family About Dementia Progression
• Dementia is progressive and irreversible Expect:
o Memory loss o Personality
changes o Wandering o
Sundowning
• Teach safety planning and caregiver self-care
• Normalize caregiver stress
5. Nurse’s Responsibility: Abuse (Children, Elder, Vulnerable)
• MANDATED REPORTER
• Must report suspected, not proven abuse Report to:
o Child Protective Services (CPS)
o Adult Protective Services (APS)
• Document objectively
• Ensure patient safety
FOR MORE EXAMS
EMAIL:
3
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6. Sociocultural Context of the FamilyAssess:
• Cultural beliefs about illness
• Family roles and decision-makers
• Health literacy
• Religious/spiritual practices
• Language barriers
• Socioeconomic resources
7. Therapeutic Communication With Families (Dietary Needs)
• Use clear, respectful language
• Include family preferences
• Validate concerns
• Avoid medical jargon
• Confirm understanding (teach-back)
8. Reflecting Technique
Purpose: shows interest and encourages communication
Example:
“It sounds like you’re feeling overwhelmed caring for your mother.”
9. Formulating a Plan of Action
• Collaborative Client-centered Example:
FOR MORE EXAMS
EMAIL:
4
EMAIL:
🧠 PSYCH 2520 PSYCHIATRY
EXAM MASTER STUDY GUIDE
(A+ LEVEL) WITH 100%
CORRECT ANSWERS +
RATIONALES 2026
1. Mental Status Examination (MSE)
Components of the MSE
1. Appearance – grooming, hygiene, posture, eye contact
2. Behavior/Psychomotor activity – agitation, retardation, wandering
3. Speech – rate, volume, coherence
4. Mood – subjective emotional state (“How do you feel?”)
5. Affect – objective emotional expression (flat, blunted, labile)
6. Thought process – logical, linear vs. loose associations
7. Thought content – delusions, obsessions, suicidal ideation
8. Perception – hallucinations, illusions
9. Cognition – orientation, memory, attention, judgment
10. Insight & judgment – awareness of illness, decision-making ability
MSE in a Client With Dementia
• Appearance: disheveled, inappropriate clothing
• Speech: word-finding difficulty, aphasia
FOR MORE EXAMS
EMAIL:
1
,FOR MORE EXAMS
EMAIL:
• Mood/Affect: flat or labile
• Thought process: confused, disorganized Cognition:
o Disorientation (time → place →
person) o Impaired short-term
memory o Poor attention span
• Insight/Judgment: severely impaired
2. Psychotherapy for Depressive DisordersEffective therapies:
• Cognitive Behavioral Therapy (CBT) – reframes negative thoughts
• Interpersonal Therapy (IPT) – focuses on relationships
• Supportive therapy – validation and coping
• Group therapy – reduces isolation Nursing focus:
• Encourage expression of feelings
• Monitor suicide risk
• Reinforce coping strategies
• Promote medication adherence
3. Plan of Care: Alzheimer’s Disease
Goals
• Minimize confusion
• Promote safety
• Maintain independence as long as possible
FOR MORE EXAMS
EMAIL:
2
,FOR MORE EXAMS
EMAIL:
Nursing Interventions
• Consistent routines
• Simple one-step directions Low-stimulus environment
• Reality orientation (clocks, calendars)
• Identification bracelet
• Avoid confrontation → use distraction
4. Teaching Family About Dementia Progression
• Dementia is progressive and irreversible Expect:
o Memory loss o Personality
changes o Wandering o
Sundowning
• Teach safety planning and caregiver self-care
• Normalize caregiver stress
5. Nurse’s Responsibility: Abuse (Children, Elder, Vulnerable)
• MANDATED REPORTER
• Must report suspected, not proven abuse Report to:
o Child Protective Services (CPS)
o Adult Protective Services (APS)
• Document objectively
• Ensure patient safety
FOR MORE EXAMS
EMAIL:
3
, FOR MORE EXAMS
EMAIL:
6. Sociocultural Context of the FamilyAssess:
• Cultural beliefs about illness
• Family roles and decision-makers
• Health literacy
• Religious/spiritual practices
• Language barriers
• Socioeconomic resources
7. Therapeutic Communication With Families (Dietary Needs)
• Use clear, respectful language
• Include family preferences
• Validate concerns
• Avoid medical jargon
• Confirm understanding (teach-back)
8. Reflecting Technique
Purpose: shows interest and encourages communication
Example:
“It sounds like you’re feeling overwhelmed caring for your mother.”
9. Formulating a Plan of Action
• Collaborative Client-centered Example:
FOR MORE EXAMS
EMAIL:
4
