1
MENTAL HEALTH NURSING FINAL EXAM STUDY
GUIDE FULL BLUEPRINT 2026 VERSION
UNIT 1
What are the obstacles of therapeutic communication?
a) Resistance- lack of awareness of problems in order to avoid anxiety
b) Transference- unconscious assoc. NS with someone significant in his/her life.
c) Countertransference- Ns emotional response to a specific client.
d) Boundary violations- occurs when Ns enters into a personal/social relationship
with client
What are the traits of therapeutic communication?
a) Genuineness- being consistent with both verbal and nonverbal behaviours
b) Positive Regard – respect and acceptance eg. addressing client by name they
prefer, sitting and listening,
c) Empathy – ability to see things from the clients viewpoint
d) Trustworthiness- being responsible and dependable ex. Keeping commitments and
promises
e) Clarity- be specific and clear
f) Responsibility- language involves the use of “I” statements when being assertive.
g) Assertiveness- the ability to express thoughts and feelings comfortably and
confidently in a positive, honest, and open manner.
Describe Mental Health:
MENTAL HEALTH consists of a person’s perceptions, thoughts, emotions, and behaviours
Discuss DSM-IV:
A. Clients diagnosis has 5 parts or AXIS:
1. AXIS I: Psychiatric Dx
2. AXIS II: Personality disorder or mental retardation
3. AXIS II: Medical dx
4. AXIS IV: Psychosocial stressors
5. AXIS V: Global Assessment of Fxning (GAF)- considered Psychologic,
social and occupational fxn on a hypothetical continuum of MENTAL
HEALTH-ILLNESS.
B. What does GAF Measure? The client’s functional state @ the time of admission and
within the last year
Safety is the top priority in mental health setting.
,2
Discuss Client rights:
I. RIGHT TO TREATMENT:
A. People w/ mental illness have a right to tx.
B. State cannot detain individuals who are non-dangerous without providing some
mode of tx.
C. MHN has professional obligations to help pts. Seek out and engage tx for mental
illness 2 the least restrictive level.
II. RIGHT TO REFUSE TX:
A. Voluntary and involuntary clients have the right to refuse medication.
B. During emergency situations, if there is potential danger, the client can be forcibly
medicated
C. Right to refuse medication is upheld if client is involuntary and competent
What are the types of COMMITMENTS?
A. Voluntary – Those who want to be discharged must give written notice of intent
to leave and must be discharged within 3 days.
B. Emergency
C. Civil/judicial commitment- Legal basis
<<LEAST RESTRICTIVE ALTERNATIVE means providing MH tx in the least restrictive
environment using the least restrictive tx. >>
What is Duty to warn? Establishes responsibility of a treating MPH to notify an intended,
identifiable victim.
Describe Neuroanatomy:
LOBE NORMAL FXN
FRONTAL ▪ execution of voluntary motor fxn
▪ thought processes ex. Planning, abstract thought, decision
making, critical thinking
, 3
▪ Intellectual insight, judgment
▪ Expression emotion
PARIETAL ▪ Sensory and motor
▪ Interprets sensory information
▪ Right and left orientation
TEMPORAL ▪ Hearing, connects with limbic system, allows connection of
emotions, responsible for language comprehension
OCCIPITAL ▪ vision
III. ANTIPSYCHOTIC MEDICATIONS:
A. Also called NEUROLEPTICS – used for tx psychosis, behavioural problems in
children, schizophrenia etc. Controls symptoms like delusions, hallucinations and
thought disorders Two types:
i. CONVENTIONAL or TYPICAL - block dopamine, acetylcholine and
epinephrine Phenothiazines (first generation) and non-phenothiazines ex.
Haldol, Thorazine, Stelazine
a. Side effects: extrapyramidal symptoms, dry mouth, orthostatic
hypotension
ii. UNCONVENTIONAL or ATYPICAL – blocks action of dopamine and serotonin.
Ex. Clozaril, Zyprexa, Risperdal, Abilify
1. Less side effects, few or no EPS
2. Work on negative and positive symptoms of schizophrenia
IV. ANTIDEPRESSANTS:
B. Partially block reuptake of norepinephrine and serotonin. 4 classes:
i. Selective Serotonin Reputake Inhibitors (SSRI’s)- work by inhibiting
reuptake of serotonin These treat major depressive disorder ex. Prozac,
Zoloft, Paxil
ii. Tricyclic Antidepressant (TCA)- act by blocking the reuptake of Serotonin
and norepinephrine. This increases serotonin and norepinephrine in the
nerve cell. These are used to treat major depression.
iii. Side effects: orthostatic hypotension, sedation,
iv. Monoamine Oxidase Inhibitors- MAOI’s inhibit Monoamine oxidase
enzyme----result=increased availability neurotransmitter Ex. Nardil, Parnate
1. Side effects: HYPERTENSIVE CRISIS
2. Avoid foods with Tyramine
v. Atypical Antidepressant- used tx major depression and anxiety. Effects one
or two of these neurotransmitters: serotonin, norepinephrine, and
dopamine. Ex. Wellbutrin, Cymbalta, Effexor
a. Side effects: Headache, dry mouth, Seizures, suppress appetite
MENTAL HEALTH NURSING FINAL EXAM STUDY
GUIDE FULL BLUEPRINT 2026 VERSION
UNIT 1
What are the obstacles of therapeutic communication?
a) Resistance- lack of awareness of problems in order to avoid anxiety
b) Transference- unconscious assoc. NS with someone significant in his/her life.
c) Countertransference- Ns emotional response to a specific client.
d) Boundary violations- occurs when Ns enters into a personal/social relationship
with client
What are the traits of therapeutic communication?
a) Genuineness- being consistent with both verbal and nonverbal behaviours
b) Positive Regard – respect and acceptance eg. addressing client by name they
prefer, sitting and listening,
c) Empathy – ability to see things from the clients viewpoint
d) Trustworthiness- being responsible and dependable ex. Keeping commitments and
promises
e) Clarity- be specific and clear
f) Responsibility- language involves the use of “I” statements when being assertive.
g) Assertiveness- the ability to express thoughts and feelings comfortably and
confidently in a positive, honest, and open manner.
Describe Mental Health:
MENTAL HEALTH consists of a person’s perceptions, thoughts, emotions, and behaviours
Discuss DSM-IV:
A. Clients diagnosis has 5 parts or AXIS:
1. AXIS I: Psychiatric Dx
2. AXIS II: Personality disorder or mental retardation
3. AXIS II: Medical dx
4. AXIS IV: Psychosocial stressors
5. AXIS V: Global Assessment of Fxning (GAF)- considered Psychologic,
social and occupational fxn on a hypothetical continuum of MENTAL
HEALTH-ILLNESS.
B. What does GAF Measure? The client’s functional state @ the time of admission and
within the last year
Safety is the top priority in mental health setting.
,2
Discuss Client rights:
I. RIGHT TO TREATMENT:
A. People w/ mental illness have a right to tx.
B. State cannot detain individuals who are non-dangerous without providing some
mode of tx.
C. MHN has professional obligations to help pts. Seek out and engage tx for mental
illness 2 the least restrictive level.
II. RIGHT TO REFUSE TX:
A. Voluntary and involuntary clients have the right to refuse medication.
B. During emergency situations, if there is potential danger, the client can be forcibly
medicated
C. Right to refuse medication is upheld if client is involuntary and competent
What are the types of COMMITMENTS?
A. Voluntary – Those who want to be discharged must give written notice of intent
to leave and must be discharged within 3 days.
B. Emergency
C. Civil/judicial commitment- Legal basis
<<LEAST RESTRICTIVE ALTERNATIVE means providing MH tx in the least restrictive
environment using the least restrictive tx. >>
What is Duty to warn? Establishes responsibility of a treating MPH to notify an intended,
identifiable victim.
Describe Neuroanatomy:
LOBE NORMAL FXN
FRONTAL ▪ execution of voluntary motor fxn
▪ thought processes ex. Planning, abstract thought, decision
making, critical thinking
, 3
▪ Intellectual insight, judgment
▪ Expression emotion
PARIETAL ▪ Sensory and motor
▪ Interprets sensory information
▪ Right and left orientation
TEMPORAL ▪ Hearing, connects with limbic system, allows connection of
emotions, responsible for language comprehension
OCCIPITAL ▪ vision
III. ANTIPSYCHOTIC MEDICATIONS:
A. Also called NEUROLEPTICS – used for tx psychosis, behavioural problems in
children, schizophrenia etc. Controls symptoms like delusions, hallucinations and
thought disorders Two types:
i. CONVENTIONAL or TYPICAL - block dopamine, acetylcholine and
epinephrine Phenothiazines (first generation) and non-phenothiazines ex.
Haldol, Thorazine, Stelazine
a. Side effects: extrapyramidal symptoms, dry mouth, orthostatic
hypotension
ii. UNCONVENTIONAL or ATYPICAL – blocks action of dopamine and serotonin.
Ex. Clozaril, Zyprexa, Risperdal, Abilify
1. Less side effects, few or no EPS
2. Work on negative and positive symptoms of schizophrenia
IV. ANTIDEPRESSANTS:
B. Partially block reuptake of norepinephrine and serotonin. 4 classes:
i. Selective Serotonin Reputake Inhibitors (SSRI’s)- work by inhibiting
reuptake of serotonin These treat major depressive disorder ex. Prozac,
Zoloft, Paxil
ii. Tricyclic Antidepressant (TCA)- act by blocking the reuptake of Serotonin
and norepinephrine. This increases serotonin and norepinephrine in the
nerve cell. These are used to treat major depression.
iii. Side effects: orthostatic hypotension, sedation,
iv. Monoamine Oxidase Inhibitors- MAOI’s inhibit Monoamine oxidase
enzyme----result=increased availability neurotransmitter Ex. Nardil, Parnate
1. Side effects: HYPERTENSIVE CRISIS
2. Avoid foods with Tyramine
v. Atypical Antidepressant- used tx major depression and anxiety. Effects one
or two of these neurotransmitters: serotonin, norepinephrine, and
dopamine. Ex. Wellbutrin, Cymbalta, Effexor
a. Side effects: Headache, dry mouth, Seizures, suppress appetite
