RASMUSSEN MENTAL HEALTH EXAM
2 WITH CORRECT QUESTIONS AND
ANSWERS
Mood:3
Depression3
Define3common3symptoms3-3answer-mrs.3a:3
low3energy,3low3or3high3appetite,3general3weakness,3no3initiating3(hard3to3make3
decisions),3introverted,3not3social,3no3pleasure3in3anything.3
book
the3following3symptoms3are3most3prevalent3in3all3types3of3depression:3
•3Mood3of3sadness,3despair,3emptiness3
•3Negative,3pessimistic3thinking
3•3Loss3of3ability3to3experience3pleasure3in3life3(anhedonia)3
•3Low3self-esteem3
•3Apathy,3low3motivation,3and3social3withdrawal3
•3Excessive3emotional3sensitivity3
•3Irritability3and3low3frustration3tolerance3
•3Insomnia3or3hypersomnia3
•3Disruption3(mild3to3severe)3in3concentration3or3ability3to3make3decisions3
•3Suicidal3ideation3
•3Excessive3guilt3
•3Indecisiveness
Mood:3
Depression
Beck's3Cognitive3Triad3(p.3199)3-3answer-
Beck3found3that3depressed3people3process3information3in3negative3ways,3even3in
3the3midst3of3positive3factors3that3affect3the3person's3life.3Beck3believed3that3thre
e3automatic3negative3thoughts—called3Beck's3cognitive3triad—
are3responsible3for3the3development3of3depression:
,1.3A3negative,3self-
deprecating3view3of3self:3"I3really3never3do3anything3well;3everyone3else3seems3s
marter."3
2.3A3pessimistic3view3of3the3world:3"Once3you're3down,3you3can't3get3up.3Look3a
round,3poverty,3homelessness,3sickness,3war,3and3despair3are3every3place3you3lo
ok."3
3.3The3belief3that3negative3reinforcement3(or3no3validation3for3the3self)3will3contin
ue:3"It3doesn't3matter3what3you3do;3nothing3ever3gets3better.3I'll3be3in3this3stupid
3job3the3rest3of3my3life."3
The3phrase3automatic3negative3thoughts3refers3to3thoughts3that3are3repetitive,3uni
ntended,3and3not3readily3controllable.3This3cognitive3triad3seems3to3be3consistent
3in3all3types3of3depression,3regardless3of3clinical3subtype.3
The3goal3of3CBT3is3to3change3the3way3a3patient3thinks,3which3will3in3turn3help3
relieve3the3depressive3syndrome.3This3is3accomplished3by3assisting3the3patient3in
3the3following:3
1.3Identifying3and3testing3negative3cognition3
2.3Developing3alternative3thinking3patterns3
3.3Rehearsing3new3cognitive3and3behavioral3responses
Mood:3
Depression
Risk3for3suicide-3Questions3to3ask
High3vs3low3risk3(Ch323)3-3answer-mrs.a
anytime3you3answer3a3question3about3depression,3think3suicide.3
for3ex
if3she3asked3you3about3a3pt3dx3with3depression,3and3they3stay3indoors3all3the3ti
me,3and3all3of3a3sudden3the3mood3gets3elated,3that3is3the3time3to3take3caution,
3if3i3ask3you3about3someone3in3this3relm,3know3she3is3talking3about3someone3w
ho3is3deeply3depressed,3and3as3much3as3they3elation3came3on3that3could3be3D
ECEPTIVE,3that3maybe3a3scenario3where3a3pt3can3come3and3commit3suicide.3
question:
which3pt3is3most3likely3to3commit3suicide
,Answer:
someone3who3is3lonely3eg.3divorced3person
Someone3with3alot3of3health3problems3that3might3overwhelm3them3to3point3they3
want3to3commit3suicide.
older3person,3age3703white3male3who3lives3alone3and3divorced3with3alot3of3healt
h3problems3is3a3candite3for3someone3who3can3commit3suicide3
CHOOSE3THE3ONE3W/3LONELINESS,3NO3FAMILY/
SOCIAL3SUPPORT3very3likely3to3commit3suicide
not3likely:
church3goer3bc3they3have3support
book
Risk3for3suicide3is3the3most3immediately3important3nursing3diagnosis,3and3self-
restraint3from3suicide3is3the3ideal3outcome.3Other3nursing3diagnoses3include3Ineff
ective3coping,3Hopelessness,3Social3isolation,3Spiritual3distress,3Chronic3low3self-
esteem,3Post-trauma3syndrome,3and3Anxiety.
Risk3Factors3Suicidal3behavior:3
history3of3prior3suicide3attempts,3aborted3suicide3attempts3or3self-
injurious3behavior3
•3Current/
past3psychiatric3disorders:3especially3mood3disorders,3psychotic3disorders,alcohol/
substance3abuse,3ADHD,3TBI,3PTSD,3Cluster3B3personality3disorders,3conduct3dis
orders3(antisocial3behavior,3aggression,3impulsivity).3Co-
morbidity3and3recent3onset3of3illness3increase3risk3
•3Key3symptoms:3anhedonia,3impulsivity,3hopelessness,3anxiety/
panic,3insomnia,3command3hallucinations
•3Family3history:3of3suicide,3attempts3or3psychiatric3disorders3requiring3hospitalizati
on3•Precipitants/Stres
Mood:3
Depression
Nursing3Diagnosis3(Table315-2)3-3answer--Disturbed3sleep3pattern
-Constipation3
-Sexual3dysfunction
-Risk3for3loneliness
-3Ineffective3role3performance
*Risk3for3suicide/3Risk3for3self-mutilation*
, Previous3suicidal3attempts,3putting3affairs3in3order,3giving3away3prized3possession
s,3suicidal3ideation3(has3plan,3ability3to3carry3it3out),3overt3or3covert3statements3r
egarding3killing3self,3feelings3of3worthlessness,3hopelessness,3helplessness
*Decisional3conflict3Impaired3memory3Acute3confusion*
Lack3of3judgment,3memory3difficulty,3poor3concentration,3inaccurate3interpretation3
of3environment,3negative3ruminations,3cognitive3distortions
*Ineffective3coping/3Interrupted3family3processes/3Risk3for3impaired3parent/infant/
child3attachment*
Difficulty3with3simple3tasks,3inability3to3function3at3previous3level,3poor3problem3s
olving,3poor3cognitive3functioning,3verbalizations3of3inability3to3cope
*Decisional3conflict*
Difficulty3making3decisions,3poor3concentration,3inability3to3take3action
*Hopelessness*
Feelings3of3helplessness,3hopelessness,3powerlessness
*Powerlessness3Ineffective3coping*
Feelings3of3inability3to3make3positive3change3in3one's3life3or3have3a3sense3of3co
ntrol3over3one's3destiny
*Spiritual3distress/Impaired3religiosity/Risk3for3impaired3religiosity*
Questioning3meaning3of3life3and3own3existence,3inability3to3participate3in3usual3re
ligious3practices,3conflict3over3spiritual3beliefs,3anger3toward3spiritual3deity3or3relig
ious3representatives
*Chronic3low3self-esteem/Situational3low3self-esteem*
Feelings3of3worthlessness,3poor3self-image,3negative3sense3of3self,3self-
negating3verbalizations,3feeling3of3being3a3failure,3expressions3of3shame3or3guilt,3
hypersensitivity3to3slights3or3criticism
*Impaired3social3interaction/3Social3isolation*
Withdrawal,3noncommunicativeness,3speech3that3is3only3in3monosyllables,3avoidan
ce3of3contact3with3others
*Self-
Mood:3
Depression
Communication3Interventions3(Table315-4)3-3answer-
1.3Help3the3patient3question3underlying3assumptions3and3beliefs3and3consider3alt
ernate3explanations3to3problems.
2 WITH CORRECT QUESTIONS AND
ANSWERS
Mood:3
Depression3
Define3common3symptoms3-3answer-mrs.3a:3
low3energy,3low3or3high3appetite,3general3weakness,3no3initiating3(hard3to3make3
decisions),3introverted,3not3social,3no3pleasure3in3anything.3
book
the3following3symptoms3are3most3prevalent3in3all3types3of3depression:3
•3Mood3of3sadness,3despair,3emptiness3
•3Negative,3pessimistic3thinking
3•3Loss3of3ability3to3experience3pleasure3in3life3(anhedonia)3
•3Low3self-esteem3
•3Apathy,3low3motivation,3and3social3withdrawal3
•3Excessive3emotional3sensitivity3
•3Irritability3and3low3frustration3tolerance3
•3Insomnia3or3hypersomnia3
•3Disruption3(mild3to3severe)3in3concentration3or3ability3to3make3decisions3
•3Suicidal3ideation3
•3Excessive3guilt3
•3Indecisiveness
Mood:3
Depression
Beck's3Cognitive3Triad3(p.3199)3-3answer-
Beck3found3that3depressed3people3process3information3in3negative3ways,3even3in
3the3midst3of3positive3factors3that3affect3the3person's3life.3Beck3believed3that3thre
e3automatic3negative3thoughts—called3Beck's3cognitive3triad—
are3responsible3for3the3development3of3depression:
,1.3A3negative,3self-
deprecating3view3of3self:3"I3really3never3do3anything3well;3everyone3else3seems3s
marter."3
2.3A3pessimistic3view3of3the3world:3"Once3you're3down,3you3can't3get3up.3Look3a
round,3poverty,3homelessness,3sickness,3war,3and3despair3are3every3place3you3lo
ok."3
3.3The3belief3that3negative3reinforcement3(or3no3validation3for3the3self)3will3contin
ue:3"It3doesn't3matter3what3you3do;3nothing3ever3gets3better.3I'll3be3in3this3stupid
3job3the3rest3of3my3life."3
The3phrase3automatic3negative3thoughts3refers3to3thoughts3that3are3repetitive,3uni
ntended,3and3not3readily3controllable.3This3cognitive3triad3seems3to3be3consistent
3in3all3types3of3depression,3regardless3of3clinical3subtype.3
The3goal3of3CBT3is3to3change3the3way3a3patient3thinks,3which3will3in3turn3help3
relieve3the3depressive3syndrome.3This3is3accomplished3by3assisting3the3patient3in
3the3following:3
1.3Identifying3and3testing3negative3cognition3
2.3Developing3alternative3thinking3patterns3
3.3Rehearsing3new3cognitive3and3behavioral3responses
Mood:3
Depression
Risk3for3suicide-3Questions3to3ask
High3vs3low3risk3(Ch323)3-3answer-mrs.a
anytime3you3answer3a3question3about3depression,3think3suicide.3
for3ex
if3she3asked3you3about3a3pt3dx3with3depression,3and3they3stay3indoors3all3the3ti
me,3and3all3of3a3sudden3the3mood3gets3elated,3that3is3the3time3to3take3caution,
3if3i3ask3you3about3someone3in3this3relm,3know3she3is3talking3about3someone3w
ho3is3deeply3depressed,3and3as3much3as3they3elation3came3on3that3could3be3D
ECEPTIVE,3that3maybe3a3scenario3where3a3pt3can3come3and3commit3suicide.3
question:
which3pt3is3most3likely3to3commit3suicide
,Answer:
someone3who3is3lonely3eg.3divorced3person
Someone3with3alot3of3health3problems3that3might3overwhelm3them3to3point3they3
want3to3commit3suicide.
older3person,3age3703white3male3who3lives3alone3and3divorced3with3alot3of3healt
h3problems3is3a3candite3for3someone3who3can3commit3suicide3
CHOOSE3THE3ONE3W/3LONELINESS,3NO3FAMILY/
SOCIAL3SUPPORT3very3likely3to3commit3suicide
not3likely:
church3goer3bc3they3have3support
book
Risk3for3suicide3is3the3most3immediately3important3nursing3diagnosis,3and3self-
restraint3from3suicide3is3the3ideal3outcome.3Other3nursing3diagnoses3include3Ineff
ective3coping,3Hopelessness,3Social3isolation,3Spiritual3distress,3Chronic3low3self-
esteem,3Post-trauma3syndrome,3and3Anxiety.
Risk3Factors3Suicidal3behavior:3
history3of3prior3suicide3attempts,3aborted3suicide3attempts3or3self-
injurious3behavior3
•3Current/
past3psychiatric3disorders:3especially3mood3disorders,3psychotic3disorders,alcohol/
substance3abuse,3ADHD,3TBI,3PTSD,3Cluster3B3personality3disorders,3conduct3dis
orders3(antisocial3behavior,3aggression,3impulsivity).3Co-
morbidity3and3recent3onset3of3illness3increase3risk3
•3Key3symptoms:3anhedonia,3impulsivity,3hopelessness,3anxiety/
panic,3insomnia,3command3hallucinations
•3Family3history:3of3suicide,3attempts3or3psychiatric3disorders3requiring3hospitalizati
on3•Precipitants/Stres
Mood:3
Depression
Nursing3Diagnosis3(Table315-2)3-3answer--Disturbed3sleep3pattern
-Constipation3
-Sexual3dysfunction
-Risk3for3loneliness
-3Ineffective3role3performance
*Risk3for3suicide/3Risk3for3self-mutilation*
, Previous3suicidal3attempts,3putting3affairs3in3order,3giving3away3prized3possession
s,3suicidal3ideation3(has3plan,3ability3to3carry3it3out),3overt3or3covert3statements3r
egarding3killing3self,3feelings3of3worthlessness,3hopelessness,3helplessness
*Decisional3conflict3Impaired3memory3Acute3confusion*
Lack3of3judgment,3memory3difficulty,3poor3concentration,3inaccurate3interpretation3
of3environment,3negative3ruminations,3cognitive3distortions
*Ineffective3coping/3Interrupted3family3processes/3Risk3for3impaired3parent/infant/
child3attachment*
Difficulty3with3simple3tasks,3inability3to3function3at3previous3level,3poor3problem3s
olving,3poor3cognitive3functioning,3verbalizations3of3inability3to3cope
*Decisional3conflict*
Difficulty3making3decisions,3poor3concentration,3inability3to3take3action
*Hopelessness*
Feelings3of3helplessness,3hopelessness,3powerlessness
*Powerlessness3Ineffective3coping*
Feelings3of3inability3to3make3positive3change3in3one's3life3or3have3a3sense3of3co
ntrol3over3one's3destiny
*Spiritual3distress/Impaired3religiosity/Risk3for3impaired3religiosity*
Questioning3meaning3of3life3and3own3existence,3inability3to3participate3in3usual3re
ligious3practices,3conflict3over3spiritual3beliefs,3anger3toward3spiritual3deity3or3relig
ious3representatives
*Chronic3low3self-esteem/Situational3low3self-esteem*
Feelings3of3worthlessness,3poor3self-image,3negative3sense3of3self,3self-
negating3verbalizations,3feeling3of3being3a3failure,3expressions3of3shame3or3guilt,3
hypersensitivity3to3slights3or3criticism
*Impaired3social3interaction/3Social3isolation*
Withdrawal,3noncommunicativeness,3speech3that3is3only3in3monosyllables,3avoidan
ce3of3contact3with3others
*Self-
Mood:3
Depression
Communication3Interventions3(Table315-4)3-3answer-
1.3Help3the3patient3question3underlying3assumptions3and3beliefs3and3consider3alt
ernate3explanations3to3problems.
