NR605/NR 605 Midterm Exam 1 2025/2026
Diagnosis & Management In Psychiatric-
Mental Health Across The Lifespan
Questions With Correct Answers A+ Graded
Actual Exam Ohio State University
Disparities in Mental Health Services
Racial, ethnic, gender, and sexual minorities
-often experience poor mental health outcomes due to inaccessibility of quality mental
health services, discrimination, a cultural stigma surrounding mental health care, and
lack of knowledge about mental health
• To address disparities, the American Psychological Association (2022) advocates for
the expansion and use of culturally and linguistically competent psychological and
behavioral research and services
Legal & Ethical Considerations
Provider initiated termination for cause
Termination letters
Court mandated treatment
Process and progress notes
Code of Ethics for Nurses
Respect for the Individual
Commitment to the Healthcare Consumer
Advocacy for the Healthcare Consumer
Responsibility and Accountability for Practice
Duties to Self and Others
Contributions to Healthcare Environments
Advancement of the Nursing Profession
Collaboration to Meet Health Needs
Promotion of the Nursing Profession
A client who is alert and oriented declines the PMHNP's treatment recommendation for
an antipsychotic in a non-emergent situation.
Informed consent required
Exception to informed consent
,Informed consent required
Rationale: The client has the capacity to consent and the situation is not emergent. The
ethic of autonomy provides for the client to refuse treatment options.
An agitated, hallucinating client with a diagnosis of schizophrenia and no designated
decision-maker threatens to shoot his neighbors. The client acts out violently towards
the security guard in the emergency department. The PMHNP orders haloperidol and
lorazepam for the client.
Exception to informed consent
Informed consent required
Exception to informed consent
Rationale: The client does not have the capacity to provide consent.
A very anxious client is seeking treatment for anxiety symptoms. When the PMHNP
begins to explain the treatment options, the client says she is too anxious to hear them
and asks that the PMHNP select the best option.
Exception to informed consent
Informed consent required
Exception to informed consent
Rationale: Clients may choose to waive their right to informed consent.
A client with depression is unhappy about the performance of the anti-depressant that
has been prescribed and would like to discuss alternate treatment options with the
PMHNP.
Informed consent required
Exception to informed consent
Informed consent required
Rationale: Clients have a right to information about treatment options with associated
risks and benefits.
Circumstances that increase suicide risk: Individual Risk Factors
Previous suicide attempt
History of depression and other mental illnesses
Serious illness such as chronic pain
,Criminal/legal problems
Job/financial problems or loss
Impulsive or aggressive tendencies
Substance use
Current or prior history of adverse childhood experiences
Sense of hopelessness
Violence victimization and/or perpetration
Circumstances that increase suicide risk: Relationship Risk Factors
Bullying
Family/loved one's history of suicide
Loss of relationships
High conflict or violent relationships
Social isolation
Circumstances that increase suicide risk: Community Risk Factors
Lack of access to healthcare
Suicide cluster in the community
Stress of acculturation
Community violence
Historical trauma
Discrimination
Circumstances that increase suicide risk: Societal Risk Factors
Stigma associated with help-seeking and mental illness
Easy access to lethal means of suicide among people at risk
Unsafe media portrayals of suicide
Circumstances that protect against suicide risk: Individual Protective Factors
Effective coping and problem-solving skills
Reasons for living (for example, family, friends, pets, etc.)
Strong sense of cultural identity
Circumstances that protect against suicide risk: Relationship Protective Factors
Support from partners, friends, and family
Feeling connected to others
Circumstances that protect against suicide risk: Community Protective Factors
Feeling connected to school, community, and other social institutions
Availability of consistent and high quality physical and behavioral healthcare
Circumstances that protect against suicide risk: Societal Protective Factors
, Reduced access to lethal means of suicide among people at risk
Cultural, religious, or moral objections to suicide
warning signs for suicide:
Talking about being a burden
Being isolated
Increased anxiety
Talking about feeling trapped or in unbearable pain
Increased substance use
Looking for a way to access lethal means
Increased anger or rage
Extreme mood swings
Expressing hopelessness
Sleeping too little or too much
Talking or posting about wanting to die
Making plans for suicide
Holistic Paradigm of Healing
-holistic model of care with a focus on healing
-Holistic therapy respects the complexity of each unique individual
• appreciating the relationship between the client's mind, body, and spirit
• recognizing the interdependence of all parts of the human system
-Foundational to healing is the relationship between the client and therapist
• Emotional connection in the relationship is critical to the success of psychotherapy
• PMHNP approaches the nurse-client relationship with acceptance, empathy, patience,
and kindness to create a space for healing
-psychotherapy can help the individual accept dysregulation and disharmony in the
present moment
• achieves acceptance of the present, they may be able to let go of resistance, relax,
and release fears
Theoretical Models in Psychotherapy
Maslow's Hierarchy of Needs
Health Belief Model
Transtheoretical Model of Change
Maslow's Hierarchy of Needs
Diagnosis & Management In Psychiatric-
Mental Health Across The Lifespan
Questions With Correct Answers A+ Graded
Actual Exam Ohio State University
Disparities in Mental Health Services
Racial, ethnic, gender, and sexual minorities
-often experience poor mental health outcomes due to inaccessibility of quality mental
health services, discrimination, a cultural stigma surrounding mental health care, and
lack of knowledge about mental health
• To address disparities, the American Psychological Association (2022) advocates for
the expansion and use of culturally and linguistically competent psychological and
behavioral research and services
Legal & Ethical Considerations
Provider initiated termination for cause
Termination letters
Court mandated treatment
Process and progress notes
Code of Ethics for Nurses
Respect for the Individual
Commitment to the Healthcare Consumer
Advocacy for the Healthcare Consumer
Responsibility and Accountability for Practice
Duties to Self and Others
Contributions to Healthcare Environments
Advancement of the Nursing Profession
Collaboration to Meet Health Needs
Promotion of the Nursing Profession
A client who is alert and oriented declines the PMHNP's treatment recommendation for
an antipsychotic in a non-emergent situation.
Informed consent required
Exception to informed consent
,Informed consent required
Rationale: The client has the capacity to consent and the situation is not emergent. The
ethic of autonomy provides for the client to refuse treatment options.
An agitated, hallucinating client with a diagnosis of schizophrenia and no designated
decision-maker threatens to shoot his neighbors. The client acts out violently towards
the security guard in the emergency department. The PMHNP orders haloperidol and
lorazepam for the client.
Exception to informed consent
Informed consent required
Exception to informed consent
Rationale: The client does not have the capacity to provide consent.
A very anxious client is seeking treatment for anxiety symptoms. When the PMHNP
begins to explain the treatment options, the client says she is too anxious to hear them
and asks that the PMHNP select the best option.
Exception to informed consent
Informed consent required
Exception to informed consent
Rationale: Clients may choose to waive their right to informed consent.
A client with depression is unhappy about the performance of the anti-depressant that
has been prescribed and would like to discuss alternate treatment options with the
PMHNP.
Informed consent required
Exception to informed consent
Informed consent required
Rationale: Clients have a right to information about treatment options with associated
risks and benefits.
Circumstances that increase suicide risk: Individual Risk Factors
Previous suicide attempt
History of depression and other mental illnesses
Serious illness such as chronic pain
,Criminal/legal problems
Job/financial problems or loss
Impulsive or aggressive tendencies
Substance use
Current or prior history of adverse childhood experiences
Sense of hopelessness
Violence victimization and/or perpetration
Circumstances that increase suicide risk: Relationship Risk Factors
Bullying
Family/loved one's history of suicide
Loss of relationships
High conflict or violent relationships
Social isolation
Circumstances that increase suicide risk: Community Risk Factors
Lack of access to healthcare
Suicide cluster in the community
Stress of acculturation
Community violence
Historical trauma
Discrimination
Circumstances that increase suicide risk: Societal Risk Factors
Stigma associated with help-seeking and mental illness
Easy access to lethal means of suicide among people at risk
Unsafe media portrayals of suicide
Circumstances that protect against suicide risk: Individual Protective Factors
Effective coping and problem-solving skills
Reasons for living (for example, family, friends, pets, etc.)
Strong sense of cultural identity
Circumstances that protect against suicide risk: Relationship Protective Factors
Support from partners, friends, and family
Feeling connected to others
Circumstances that protect against suicide risk: Community Protective Factors
Feeling connected to school, community, and other social institutions
Availability of consistent and high quality physical and behavioral healthcare
Circumstances that protect against suicide risk: Societal Protective Factors
, Reduced access to lethal means of suicide among people at risk
Cultural, religious, or moral objections to suicide
warning signs for suicide:
Talking about being a burden
Being isolated
Increased anxiety
Talking about feeling trapped or in unbearable pain
Increased substance use
Looking for a way to access lethal means
Increased anger or rage
Extreme mood swings
Expressing hopelessness
Sleeping too little or too much
Talking or posting about wanting to die
Making plans for suicide
Holistic Paradigm of Healing
-holistic model of care with a focus on healing
-Holistic therapy respects the complexity of each unique individual
• appreciating the relationship between the client's mind, body, and spirit
• recognizing the interdependence of all parts of the human system
-Foundational to healing is the relationship between the client and therapist
• Emotional connection in the relationship is critical to the success of psychotherapy
• PMHNP approaches the nurse-client relationship with acceptance, empathy, patience,
and kindness to create a space for healing
-psychotherapy can help the individual accept dysregulation and disharmony in the
present moment
• achieves acceptance of the present, they may be able to let go of resistance, relax,
and release fears
Theoretical Models in Psychotherapy
Maslow's Hierarchy of Needs
Health Belief Model
Transtheoretical Model of Change
Maslow's Hierarchy of Needs
