NU 664C Family Psychiatric Mental
Health I Exam 1 Study Guide
Verified Questions and Rationales
GRADED A+
SECTION 1: FOUNDATIONAL & ETHICAL CONCEPTS
Ethical Principles in Psychiatric Practice
Q1: A PMHNP is treating a competent adult who refuses medication,
believing it is poison. The NP believes the medication is crucial. To
respect the patient's rights while ensuring safety, the NP should:
Answer: Respect the refusal, document it, and reassess regularly.
Rationale: Autonomy dictates that a competent individual has the absolute
right to refuse treatment, even if that decision seems unwise to the
provider. Forcing treatment constitutes battery, and deception violates
informed consent .
Q2: Which ethical principle refers to acting in the best interests of the
patient?
Answer: Beneficence
,Rationale: Beneficence is the duty to act in the patient's best interest.
Nonmaleficence means "do no harm," fidelity refers to keeping promises
and being loyal, and veracity refers to truth-telling .
Q3: What is paternalism in psychiatric practice?
Answer: Restricting freedom for "one's own good," often justified in cases
of mental illness, where the psychiatrist uses judgment about the best
course of action for a patient .
Rationale: Paternalism involves overriding a patient's autonomy based on
the provider's judgment of what is best for the patient. While sometimes
necessary in acute psychiatric emergencies, it must be carefully balanced
against the ethical principle of autonomy.
Q4: What is the difference between capacity and competency?
Capacity Competency
Decisional capacity determined by clinician Legal term determined by courts
Capacity is NOT a legal term Only a judge can determine competency
Can be evaluated for specific decisions Applies to all decisions
Rationale: Capacity is a clinical determination made by healthcare
providers regarding a patient's ability to make specific decisions.
Competency is a legal determination made exclusively by a judge .
,Q5: What is the legal basis for emergency detention of a patient who is
floridly psychotic and threatening staff?
Answer: Police powers (Police Power)
Rationale: The state has two powers: Police Power (to protect the public
from dangerous individuals) and Parens Patriae (to care for those who
cannot care for themselves). Emergency detention for danger to others falls
under Police Power .
Q6: A PMHNP is asked to testify regarding a patient's competency to
stand trial. This determination is made by:
Answer: A judge
Rationale: A PMHNP can provide an expert opinion regarding a patient's
mental state, but competency is a legal determination made exclusively by
a judge .
Q7: Which Massachusetts General Law section allows for the
involuntary hospitalization of a person with alcohol use disorder who
poses a danger due to intoxication?
Answer: Section 35
Rationale: Section 35 specifically allows for the civil commitment of
individuals with substance use disorders (alcohol or drugs) for up to 90
days .
, Q8: What is Professional Resilience?
Answer: The ability to adapt to stress, adversity, and challenging situations
in the workplace while maintaining effectiveness .
Rationale: Professional Resilience is essential for managing
countertransference and burnout, particularly in psychiatric-mental health
nursing where emotional demands are high.
SECTION 2: NEUROBIOLOGY &
PSYCHOPHARMACOLOGY
Key Neurotransmitters and Pathways
Q9: What is the main neurotransmitter implicated in ADHD?
Answer: Dopamine
Rationale: Dopamine dysregulation in the prefrontal cortex and locus
ceruleus is central to ADHD pathophysiology .
Q10: What brain regions are associated with ADHD?
Answer: Prefrontal cortex and locus ceruleus .
Rationale: These areas are responsible for attention, executive function,
and arousal regulation.
Health I Exam 1 Study Guide
Verified Questions and Rationales
GRADED A+
SECTION 1: FOUNDATIONAL & ETHICAL CONCEPTS
Ethical Principles in Psychiatric Practice
Q1: A PMHNP is treating a competent adult who refuses medication,
believing it is poison. The NP believes the medication is crucial. To
respect the patient's rights while ensuring safety, the NP should:
Answer: Respect the refusal, document it, and reassess regularly.
Rationale: Autonomy dictates that a competent individual has the absolute
right to refuse treatment, even if that decision seems unwise to the
provider. Forcing treatment constitutes battery, and deception violates
informed consent .
Q2: Which ethical principle refers to acting in the best interests of the
patient?
Answer: Beneficence
,Rationale: Beneficence is the duty to act in the patient's best interest.
Nonmaleficence means "do no harm," fidelity refers to keeping promises
and being loyal, and veracity refers to truth-telling .
Q3: What is paternalism in psychiatric practice?
Answer: Restricting freedom for "one's own good," often justified in cases
of mental illness, where the psychiatrist uses judgment about the best
course of action for a patient .
Rationale: Paternalism involves overriding a patient's autonomy based on
the provider's judgment of what is best for the patient. While sometimes
necessary in acute psychiatric emergencies, it must be carefully balanced
against the ethical principle of autonomy.
Q4: What is the difference between capacity and competency?
Capacity Competency
Decisional capacity determined by clinician Legal term determined by courts
Capacity is NOT a legal term Only a judge can determine competency
Can be evaluated for specific decisions Applies to all decisions
Rationale: Capacity is a clinical determination made by healthcare
providers regarding a patient's ability to make specific decisions.
Competency is a legal determination made exclusively by a judge .
,Q5: What is the legal basis for emergency detention of a patient who is
floridly psychotic and threatening staff?
Answer: Police powers (Police Power)
Rationale: The state has two powers: Police Power (to protect the public
from dangerous individuals) and Parens Patriae (to care for those who
cannot care for themselves). Emergency detention for danger to others falls
under Police Power .
Q6: A PMHNP is asked to testify regarding a patient's competency to
stand trial. This determination is made by:
Answer: A judge
Rationale: A PMHNP can provide an expert opinion regarding a patient's
mental state, but competency is a legal determination made exclusively by
a judge .
Q7: Which Massachusetts General Law section allows for the
involuntary hospitalization of a person with alcohol use disorder who
poses a danger due to intoxication?
Answer: Section 35
Rationale: Section 35 specifically allows for the civil commitment of
individuals with substance use disorders (alcohol or drugs) for up to 90
days .
, Q8: What is Professional Resilience?
Answer: The ability to adapt to stress, adversity, and challenging situations
in the workplace while maintaining effectiveness .
Rationale: Professional Resilience is essential for managing
countertransference and burnout, particularly in psychiatric-mental health
nursing where emotional demands are high.
SECTION 2: NEUROBIOLOGY &
PSYCHOPHARMACOLOGY
Key Neurotransmitters and Pathways
Q9: What is the main neurotransmitter implicated in ADHD?
Answer: Dopamine
Rationale: Dopamine dysregulation in the prefrontal cortex and locus
ceruleus is central to ADHD pathophysiology .
Q10: What brain regions are associated with ADHD?
Answer: Prefrontal cortex and locus ceruleus .
Rationale: These areas are responsible for attention, executive function,
and arousal regulation.
