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Psychiatric/Mental Health Nursing 1521 C
HESI/Final Exam Review Fall 2012
This is a comprehensive exam (psychiatric nursing content only) taken online on campus.
Dosage Calculations may also be included.
Note: This review may be of help in understanding terms and concepts that help you
answer critical thinking questions.
Begin:
Know Psychobiology of Brain and Lobes
Frontal- responsible for voluntary motor movement, thinking, motivation, emotional
experiences
And
Has connection to:
Limbic system (emotional brain)
Parietal – responsible for sensory input – pain, taste, touch, temperature, body position,
language interpretation
What is the Limbic system?
Emotional brain associated with joy, rage, fear, hope, aggression, sexuality, social
behaviors. If a client is depressed, the limbic system plays a role.
THE BRAIN: 3 MAJOR DIVISIONS, SUBDIVIDED INTO 6 MAJOR PARTS
1. Forebrain
▪ cerebrum – composed of 2 hemispheres, separated by a deep groove called
the corpus callosum. The outer shell is called the cortex. It is extensively
folded. The left hemisphere appears to be dominant in most people.
▪ controls speech, comprehension, rationality, and logic. The right
hemisphere is nondominant in most people. It may be called the
“creative” brain and is associated with affect, behavior, and special-
perceptual functions.
▪ diencephalon – includes the thalamus, hypothalamus and limbic system
2. Midbrain
▪ Mesencephalon – it contains the nuclei and fiber tracts. Responsible for
visual, auditory, and balance (righting) reflexes (ex. automatically turning
away from a dangerous object when it comes into view)
3. Hindbrain
, 2
▪ Pons – regulation of respiration and skeletal muscle tone; ascending and
descending tracts connect brain stem with cerebellum and cortex.
▪ Medulla – Pathway for all ascending and descending fiber tracts; contains
vital centers that regulate HR, BP, and respiration; reflex centers for
swallowing, sneezing, coughing, and vomiting.
▪ Cerebellum – regulates muscle tone and coordination and maintains posture
and equilibrium
What are the functions the frontal lobe?
- voluntary body movement
- movements that permit speaking; thinking & judgement; expression of feelings: aggressiveness,
fear, depression, rage, euphoria, apathy
What are the functions of the temporal lobes?
- hearing, smell, short term memory
- expression of emotions through connection w/limbic system
What are the functions of the Parietal lobes?
- perception & interpretation of most sensory into (including touch, pain, taste, and body position
What functions occur through the Limbic System?
-major components include medially placed cortical & subcortical structures & fiber tracts
connecting to one another & hypothalamus
- composed of amygdala (social behavior) mammary body, olfactory tract, hypothalamus
(sensory to memory), thalamus, cingulate gyrus, septum pelliudum, hippocampus, neuronal
connecting pathyways (ex. fornix)
- called “emotional brain” and is associated with feelings of fear & anxiety; anger, rage, and
aggression, love, joy, hope; and with sexuality and social behavior
Hypothalmus
- regulation of pituitary gland (posterior and anterior lobes)
- posterior lobe stores antidiuretic hormone (which helps regulate BP thru regulation of water
retention
- Oxytocin – hormone responsible for stimulation of uterus during labor; release of milk from
mammary gland
- both these hormones (above) are produced in the hypothalamus
- anterior lobe – glandular tissue that produces number of hormones used by body
- hormone regulated by “releasing factors” from hypothalamus
- Direct Neural Control over actions of ANS – appropriate visceral responses
- Regulation of Appetite – regulated in response to blood nutrient levels
- Regulation of Temperature – senses internal changes in blood that flows thru brain.
Hypothalmus promotes certain responses sweating, shrivering to maintain body temp.
What are neurotransmitters and what are their functions?
, 3
Chemical messengers to the brain.
What are some of the specific neurotransmitters?
Acetylcholine- coordinates movement and assists with learning and affects pain
perception.
Norepinephrine- regulates mood, cognition and perception
Dopamine – found in basal ganglia, regulates movement, integration of thoughts and
emotions, assists in decision making.
Serotonin – plays a role in appetite, mood, and ability to pursue goal directed behavior.
(“feel good” neurotransmitter.)
Indications:
Decreased acetylcholine = Alzheimer’s disease
Decreased norepinephrine = Depression
Increased dopamine = Schizophrenia
Decreased serotonin = Depression
What are the characteristics of mental health?
– Successful adaptation to stressors. Best adjustment a person can make at a given time.
Functioning appropriately in one’s given role.
Characteristics of good mental health
Positive attitude toward self
Appropriate growth and development
Ability to integrate and synthesize life events
Ability to perceive reality without distortions
Autonomy
Able to develop meaningful relationships
Environmental mastery (able to live in own world)
What is the purpose of the Mental Status Exam?
Remember, a Mental Status Assessment takes place in the “here and now.”
Review parts of mental status assessment. Ex. Thought processes, thought content. Etc.
General description –
Age, gender
Appearance - Grooming and dress, hygiene, level of eye contact, scars and tattoos only
if extreme, appearance based on chronological age
Motor activity - extreme -tremors, hyperactivity, gait patterns. Note restlessness or
agitation, aggressiveness, echopraxia (mirroring movements)
Psychiatric/Mental Health Nursing 1521 C
HESI/Final Exam Review Fall 2012
This is a comprehensive exam (psychiatric nursing content only) taken online on campus.
Dosage Calculations may also be included.
Note: This review may be of help in understanding terms and concepts that help you
answer critical thinking questions.
Begin:
Know Psychobiology of Brain and Lobes
Frontal- responsible for voluntary motor movement, thinking, motivation, emotional
experiences
And
Has connection to:
Limbic system (emotional brain)
Parietal – responsible for sensory input – pain, taste, touch, temperature, body position,
language interpretation
What is the Limbic system?
Emotional brain associated with joy, rage, fear, hope, aggression, sexuality, social
behaviors. If a client is depressed, the limbic system plays a role.
THE BRAIN: 3 MAJOR DIVISIONS, SUBDIVIDED INTO 6 MAJOR PARTS
1. Forebrain
▪ cerebrum – composed of 2 hemispheres, separated by a deep groove called
the corpus callosum. The outer shell is called the cortex. It is extensively
folded. The left hemisphere appears to be dominant in most people.
▪ controls speech, comprehension, rationality, and logic. The right
hemisphere is nondominant in most people. It may be called the
“creative” brain and is associated with affect, behavior, and special-
perceptual functions.
▪ diencephalon – includes the thalamus, hypothalamus and limbic system
2. Midbrain
▪ Mesencephalon – it contains the nuclei and fiber tracts. Responsible for
visual, auditory, and balance (righting) reflexes (ex. automatically turning
away from a dangerous object when it comes into view)
3. Hindbrain
, 2
▪ Pons – regulation of respiration and skeletal muscle tone; ascending and
descending tracts connect brain stem with cerebellum and cortex.
▪ Medulla – Pathway for all ascending and descending fiber tracts; contains
vital centers that regulate HR, BP, and respiration; reflex centers for
swallowing, sneezing, coughing, and vomiting.
▪ Cerebellum – regulates muscle tone and coordination and maintains posture
and equilibrium
What are the functions the frontal lobe?
- voluntary body movement
- movements that permit speaking; thinking & judgement; expression of feelings: aggressiveness,
fear, depression, rage, euphoria, apathy
What are the functions of the temporal lobes?
- hearing, smell, short term memory
- expression of emotions through connection w/limbic system
What are the functions of the Parietal lobes?
- perception & interpretation of most sensory into (including touch, pain, taste, and body position
What functions occur through the Limbic System?
-major components include medially placed cortical & subcortical structures & fiber tracts
connecting to one another & hypothalamus
- composed of amygdala (social behavior) mammary body, olfactory tract, hypothalamus
(sensory to memory), thalamus, cingulate gyrus, septum pelliudum, hippocampus, neuronal
connecting pathyways (ex. fornix)
- called “emotional brain” and is associated with feelings of fear & anxiety; anger, rage, and
aggression, love, joy, hope; and with sexuality and social behavior
Hypothalmus
- regulation of pituitary gland (posterior and anterior lobes)
- posterior lobe stores antidiuretic hormone (which helps regulate BP thru regulation of water
retention
- Oxytocin – hormone responsible for stimulation of uterus during labor; release of milk from
mammary gland
- both these hormones (above) are produced in the hypothalamus
- anterior lobe – glandular tissue that produces number of hormones used by body
- hormone regulated by “releasing factors” from hypothalamus
- Direct Neural Control over actions of ANS – appropriate visceral responses
- Regulation of Appetite – regulated in response to blood nutrient levels
- Regulation of Temperature – senses internal changes in blood that flows thru brain.
Hypothalmus promotes certain responses sweating, shrivering to maintain body temp.
What are neurotransmitters and what are their functions?
, 3
Chemical messengers to the brain.
What are some of the specific neurotransmitters?
Acetylcholine- coordinates movement and assists with learning and affects pain
perception.
Norepinephrine- regulates mood, cognition and perception
Dopamine – found in basal ganglia, regulates movement, integration of thoughts and
emotions, assists in decision making.
Serotonin – plays a role in appetite, mood, and ability to pursue goal directed behavior.
(“feel good” neurotransmitter.)
Indications:
Decreased acetylcholine = Alzheimer’s disease
Decreased norepinephrine = Depression
Increased dopamine = Schizophrenia
Decreased serotonin = Depression
What are the characteristics of mental health?
– Successful adaptation to stressors. Best adjustment a person can make at a given time.
Functioning appropriately in one’s given role.
Characteristics of good mental health
Positive attitude toward self
Appropriate growth and development
Ability to integrate and synthesize life events
Ability to perceive reality without distortions
Autonomy
Able to develop meaningful relationships
Environmental mastery (able to live in own world)
What is the purpose of the Mental Status Exam?
Remember, a Mental Status Assessment takes place in the “here and now.”
Review parts of mental status assessment. Ex. Thought processes, thought content. Etc.
General description –
Age, gender
Appearance - Grooming and dress, hygiene, level of eye contact, scars and tattoos only
if extreme, appearance based on chronological age
Motor activity - extreme -tremors, hyperactivity, gait patterns. Note restlessness or
agitation, aggressiveness, echopraxia (mirroring movements)
