MENTAL HEALTH FINAL EXAM SPRING 2026/2027 | PSYCHIATRIC
NURSING STUDY GUIDE & PRACTICE QUESTIONS
Transference - correct answer ✔✔A patient's transference of emotions to a caregiver/nurse to that of a
family member or intimate or past for
Countertransference - correct answer ✔✔- A caregiver/nurse transfers personal emotions onto a patient
- Peplau's model of three phases specific to mental health - WORKING section
See table 5.2
Congruency - correct answer ✔✔In agreement, in harmony
Reflect - correct answer ✔✔Directing client actions, thoughts, and feelings back to client
Restate - correct answer ✔✔Repeating the main idea expressed
Present Reality - correct answer ✔✔Offering for consideration that which is real
Summarizing - correct answer ✔✔Organizing and summing up that which has gone before
Assertive Communication - correct answer ✔✔- Tone of voice, cadence
- Can be difficult when the nurse doesn't speak the same language
- Nonverbal communication has different meaning in various cultures
Physical Distance or Space - correct answer ✔✔The nurse should be conscious of these cultural
differences in space and should allow enough room for clients to be comfortable
Social Organization - correct answer ✔✔- Refers to family structure and organization
- Which affect a person's role and therefore his or her health and illness behavior
Time Orientation - correct answer ✔✔On whether one view time is precise or approximate differs
among cultures
Environmental Control - correct answer ✔✔Refers to the client's ability to control the surroundings or
direct factors in the environment
Biological Variations - correct answer ✔✔- Differences related to ethnicity/cultural origins cause
variation in response to some psychotropic drugs
- Biological variations based on physical makeup are said to arise from one's race, while other cultural
variations arise from ethnicity
- Sickle cell anemia is found almost exclusively in African Americans, and Tay-Sachs disease is most
prevalent in the JEWISH community
Socioeconomic status, social class - correct answer ✔✔- Refers to one's income, education, and
occupation
, - Strongly influences a person's health, including whether or not the person has insurance and adequate
access to health care or can afford prescribed treatment
- Natural View: such as cold, heat, wind or dampness as responsible for illness
- Lack of belief of patient's behavior (smoking, high fat foods) being part of illness
- Stigma of mental illness is cause for guilt or shame but is also still true in the US
- Suicide ideation is also still an issue as failure
Client is the best resource
Open-ended questions identify and compare to closed and why? - correct answer ✔✔- Open-ended
questions to initiate assessment, focused closed questions only if client cannot organize thoughts or has
difficulty answering open-ended questions
- EX. of open-ended: what brings you here today? How can we help you?
- Open-ended gives the nurse an idea about the client's perception of his or her situation
Thought Blocking/loose association - correct answer ✔✔- Thought blocking: stopping abruptly in he
middle of a sentence or train of thought; sometimes unable to continue the idea
- Loose association: disorganized thinking that jumps from one idea to another with little or no evident
relation between the thoughts
Least restrictive environment - correct answer ✔✔- Clients have the right to treatment in the least
restrictive environment appropriate to meet their needs
- Concept comes from the deinstitutionalization movement
- It means that clients do not have to be hospitalized if they can be treated outpatient setting or in a
group home
- It also means that the client should be free from restraint or seclusion unless it is necessary
Duty to Warn - correct answer ✔✔- Duty to warn stems from the decision of the California Supreme
Court in Tarasoff v Regents of the University of California
- As a result of this, mental health clinicians now have a. duty to warn identifiable third parties of threats
made by clients, even if the threats were discovered during therapy sessions otherwise protected by
privilege
- Since this decision, many state now have laws that make it required to warn, while other states say the
clinician "may" warn
3 Criteria for involuntary admission - correct answer ✔✔- Patient must be at risk of harm to self
- Patient must be at risk of harm to others
- Patient wishes to not be treated unless they are a danger to self or others. They are committed until
they are no longer a danger
- Patient can be detained in psych facility for 48 to 72 hours on an emergency basis
- Client can still remain the right to refuse medication and treatment
5 types of loss: Physiologic - correct answer ✔✔Ex. include amputation of a limb, a mastectomy or
hysterectomy, or loss of mobility
5 types of loss: Safety - correct answer ✔✔Loss of a safe environment is evident in domestic, child
abuse, or public violence. Some public institutions, such as schools and churches, are often associated
with safety as well. That feeling of safety is shattered as when violence occurs on campus or in a holy
place
NURSING STUDY GUIDE & PRACTICE QUESTIONS
Transference - correct answer ✔✔A patient's transference of emotions to a caregiver/nurse to that of a
family member or intimate or past for
Countertransference - correct answer ✔✔- A caregiver/nurse transfers personal emotions onto a patient
- Peplau's model of three phases specific to mental health - WORKING section
See table 5.2
Congruency - correct answer ✔✔In agreement, in harmony
Reflect - correct answer ✔✔Directing client actions, thoughts, and feelings back to client
Restate - correct answer ✔✔Repeating the main idea expressed
Present Reality - correct answer ✔✔Offering for consideration that which is real
Summarizing - correct answer ✔✔Organizing and summing up that which has gone before
Assertive Communication - correct answer ✔✔- Tone of voice, cadence
- Can be difficult when the nurse doesn't speak the same language
- Nonverbal communication has different meaning in various cultures
Physical Distance or Space - correct answer ✔✔The nurse should be conscious of these cultural
differences in space and should allow enough room for clients to be comfortable
Social Organization - correct answer ✔✔- Refers to family structure and organization
- Which affect a person's role and therefore his or her health and illness behavior
Time Orientation - correct answer ✔✔On whether one view time is precise or approximate differs
among cultures
Environmental Control - correct answer ✔✔Refers to the client's ability to control the surroundings or
direct factors in the environment
Biological Variations - correct answer ✔✔- Differences related to ethnicity/cultural origins cause
variation in response to some psychotropic drugs
- Biological variations based on physical makeup are said to arise from one's race, while other cultural
variations arise from ethnicity
- Sickle cell anemia is found almost exclusively in African Americans, and Tay-Sachs disease is most
prevalent in the JEWISH community
Socioeconomic status, social class - correct answer ✔✔- Refers to one's income, education, and
occupation
, - Strongly influences a person's health, including whether or not the person has insurance and adequate
access to health care or can afford prescribed treatment
- Natural View: such as cold, heat, wind or dampness as responsible for illness
- Lack of belief of patient's behavior (smoking, high fat foods) being part of illness
- Stigma of mental illness is cause for guilt or shame but is also still true in the US
- Suicide ideation is also still an issue as failure
Client is the best resource
Open-ended questions identify and compare to closed and why? - correct answer ✔✔- Open-ended
questions to initiate assessment, focused closed questions only if client cannot organize thoughts or has
difficulty answering open-ended questions
- EX. of open-ended: what brings you here today? How can we help you?
- Open-ended gives the nurse an idea about the client's perception of his or her situation
Thought Blocking/loose association - correct answer ✔✔- Thought blocking: stopping abruptly in he
middle of a sentence or train of thought; sometimes unable to continue the idea
- Loose association: disorganized thinking that jumps from one idea to another with little or no evident
relation between the thoughts
Least restrictive environment - correct answer ✔✔- Clients have the right to treatment in the least
restrictive environment appropriate to meet their needs
- Concept comes from the deinstitutionalization movement
- It means that clients do not have to be hospitalized if they can be treated outpatient setting or in a
group home
- It also means that the client should be free from restraint or seclusion unless it is necessary
Duty to Warn - correct answer ✔✔- Duty to warn stems from the decision of the California Supreme
Court in Tarasoff v Regents of the University of California
- As a result of this, mental health clinicians now have a. duty to warn identifiable third parties of threats
made by clients, even if the threats were discovered during therapy sessions otherwise protected by
privilege
- Since this decision, many state now have laws that make it required to warn, while other states say the
clinician "may" warn
3 Criteria for involuntary admission - correct answer ✔✔- Patient must be at risk of harm to self
- Patient must be at risk of harm to others
- Patient wishes to not be treated unless they are a danger to self or others. They are committed until
they are no longer a danger
- Patient can be detained in psych facility for 48 to 72 hours on an emergency basis
- Client can still remain the right to refuse medication and treatment
5 types of loss: Physiologic - correct answer ✔✔Ex. include amputation of a limb, a mastectomy or
hysterectomy, or loss of mobility
5 types of loss: Safety - correct answer ✔✔Loss of a safe environment is evident in domestic, child
abuse, or public violence. Some public institutions, such as schools and churches, are often associated
with safety as well. That feeling of safety is shattered as when violence occurs on campus or in a holy
place
