NURS 222 Final Exam Study Guide Psychiatric-Mental Health
Nursing West Coast University Actual Exam 2026/2027 –
Complete Assessment with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Foundations of Psychiatric-Mental Health Nursing (Questions
1–10)
Q1: According to Freudian theory, which structure of the personality operates on the
"pleasure principle" and seeks immediate gratification of basic drives?
A. Ego
B. Superego
C. Id [CORRECT]
D. Preconscious mind
Correct Answer: C
Rationale: The id operates on the pleasure principle, demanding immediate gratification.
The ego follows the reality principle, the superego the moral principle, and the
preconscious is a level of awareness, not a personality structure.
Q2: A 15-year-old tells the school nurse, "I don't know who I am or what I want to be."
According to Erikson, this patient is struggling with which developmental stage?
A. Trust versus mistrust
B. Identity versus role confusion [CORRECT]
C. Intimacy versus isolation
D. Generativity versus stagnation
Correct Answer: B
Rationale: Adolescence is the stage of identity versus role confusion, in which the
developmental task is forming a coherent sense of self. The other stages belong to
infancy, young adulthood, and middle adulthood respectively.
Q3: A nurse begins working with a new patient by introducing herself, establishing the
purpose and parameters of the relationship, and building initial trust. According to
Peplau, which phase is this?
A. Orientation phase [CORRECT]
B. Working phase
,C. Termination phase
D. Exploitation phase
Correct Answer: A
Rationale: Peplau's orientation phase focuses on introductions, contracting, and trust
building. The working phase addresses problems, termination reviews gains and
separation, and "exploitation" is Sullivan's terminology.
Q4: Which theorist emphasized interpersonal relationships as the foundation of
personality development?
A. Freud
B. Sullivan [CORRECT]
C. Erikson
D. Maslow
Correct Answer: B
Rationale: Harry Stack Sullivan developed interpersonal theory, viewing relationships
and social interactions as central to personality. Freud emphasized unconscious drives,
Erikson psychosocial stages, and Maslow a hierarchy of needs.
Q5: Which components are included in the mental status examination?
A. Serum electrolytes and liver enzymes
B. Family genogram and insurance status
C. Appearance, behavior, mood and affect, speech, thought process and content, and
cognition [CORRECT]
D. Blood pressure, pulse, and height
Correct Answer: C
Rationale: The MSE systematically assesses appearance, behavior, mood/affect,
speech, thought process/content, perceptual disturbances, and cognition. Laboratory
values and biometric data are physical, not mental status, assessments.
Q6: A patient sits slumped, speaks slowly in a monotone, and shows no facial
expression while describing a recent loss. How should the nurse document this
presentation?
A. "Elevated mood with expansive affect"
B. "Depressed mood with flat affect" [CORRECT]
C. "Euphoric mood with grandiose affect"
D. "Euthymic mood with appropriate affect"
Correct Answer: B
Rationale: Slumped posture, slowed monotone speech, and absent facial expression
describe depressed mood with flat affect. Euphoric/expansive presentations
accompany mania, and euthymic with appropriate affect would be a normal finding.
, Q7: Which statement best reflects the concept of mental health?
A. The absence of any stressful life events
B. Experiencing only positive emotions at all times
C. Never requiring support from other people
D. The ability to cope with stress, realize one's potential, work productively, and
contribute to the community [CORRECT]
Correct Answer: D
Rationale: Mental health is a state of well-being in which people cope with normal
stresses, work productively, and contribute to community. Stress-free living, constant
positivity, and total independence are unrealistic and are not defining criteria.
Q8: A nurse realizes she feels unusually irritable and overprotective with a patient who
strongly resembles her younger brother. This nurse response is best described as:
A. Countertransference [CORRECT]
B. Transference
C. Empathy
D. Advocacy
Correct Answer: A
Rationale: Countertransference is the nurse's emotional reaction to a patient based on
the nurse's own past relationships. Transference is the same phenomenon directed by
the patient toward the nurse.
Q9: A nurse finds herself repeatedly avoiding a patient who reminds her of an abusive
ex-partner and shortening their sessions. What is the nurse's best action?
A. Recognize the countertransference, reflect on it, and seek supervision to maintain a
therapeutic relationship [CORRECT]
B. Continue avoiding the patient to prevent conflict
C. Share her personal abuse history with the patient
D. Request a permanent transfer with no further reflection
Correct Answer: A
Rationale: The therapeutic response to countertransference is self-awareness,
reflection, and supervision so care stays patient-centered. Avoidance, self-disclosure of
personal trauma, or unexamined transfers compromise the relationship.
Q10: A homeless patient with schizophrenia is hungry, has not slept in two nights, and
reports hearing voices. Using Maslow's hierarchy, which needs does the nurse address
first?
A. Self-actualization needs
B. Belonging and intimacy needs
C. Physiological and safety needs [CORRECT]
Nursing West Coast University Actual Exam 2026/2027 –
Complete Assessment with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Foundations of Psychiatric-Mental Health Nursing (Questions
1–10)
Q1: According to Freudian theory, which structure of the personality operates on the
"pleasure principle" and seeks immediate gratification of basic drives?
A. Ego
B. Superego
C. Id [CORRECT]
D. Preconscious mind
Correct Answer: C
Rationale: The id operates on the pleasure principle, demanding immediate gratification.
The ego follows the reality principle, the superego the moral principle, and the
preconscious is a level of awareness, not a personality structure.
Q2: A 15-year-old tells the school nurse, "I don't know who I am or what I want to be."
According to Erikson, this patient is struggling with which developmental stage?
A. Trust versus mistrust
B. Identity versus role confusion [CORRECT]
C. Intimacy versus isolation
D. Generativity versus stagnation
Correct Answer: B
Rationale: Adolescence is the stage of identity versus role confusion, in which the
developmental task is forming a coherent sense of self. The other stages belong to
infancy, young adulthood, and middle adulthood respectively.
Q3: A nurse begins working with a new patient by introducing herself, establishing the
purpose and parameters of the relationship, and building initial trust. According to
Peplau, which phase is this?
A. Orientation phase [CORRECT]
B. Working phase
,C. Termination phase
D. Exploitation phase
Correct Answer: A
Rationale: Peplau's orientation phase focuses on introductions, contracting, and trust
building. The working phase addresses problems, termination reviews gains and
separation, and "exploitation" is Sullivan's terminology.
Q4: Which theorist emphasized interpersonal relationships as the foundation of
personality development?
A. Freud
B. Sullivan [CORRECT]
C. Erikson
D. Maslow
Correct Answer: B
Rationale: Harry Stack Sullivan developed interpersonal theory, viewing relationships
and social interactions as central to personality. Freud emphasized unconscious drives,
Erikson psychosocial stages, and Maslow a hierarchy of needs.
Q5: Which components are included in the mental status examination?
A. Serum electrolytes and liver enzymes
B. Family genogram and insurance status
C. Appearance, behavior, mood and affect, speech, thought process and content, and
cognition [CORRECT]
D. Blood pressure, pulse, and height
Correct Answer: C
Rationale: The MSE systematically assesses appearance, behavior, mood/affect,
speech, thought process/content, perceptual disturbances, and cognition. Laboratory
values and biometric data are physical, not mental status, assessments.
Q6: A patient sits slumped, speaks slowly in a monotone, and shows no facial
expression while describing a recent loss. How should the nurse document this
presentation?
A. "Elevated mood with expansive affect"
B. "Depressed mood with flat affect" [CORRECT]
C. "Euphoric mood with grandiose affect"
D. "Euthymic mood with appropriate affect"
Correct Answer: B
Rationale: Slumped posture, slowed monotone speech, and absent facial expression
describe depressed mood with flat affect. Euphoric/expansive presentations
accompany mania, and euthymic with appropriate affect would be a normal finding.
, Q7: Which statement best reflects the concept of mental health?
A. The absence of any stressful life events
B. Experiencing only positive emotions at all times
C. Never requiring support from other people
D. The ability to cope with stress, realize one's potential, work productively, and
contribute to the community [CORRECT]
Correct Answer: D
Rationale: Mental health is a state of well-being in which people cope with normal
stresses, work productively, and contribute to community. Stress-free living, constant
positivity, and total independence are unrealistic and are not defining criteria.
Q8: A nurse realizes she feels unusually irritable and overprotective with a patient who
strongly resembles her younger brother. This nurse response is best described as:
A. Countertransference [CORRECT]
B. Transference
C. Empathy
D. Advocacy
Correct Answer: A
Rationale: Countertransference is the nurse's emotional reaction to a patient based on
the nurse's own past relationships. Transference is the same phenomenon directed by
the patient toward the nurse.
Q9: A nurse finds herself repeatedly avoiding a patient who reminds her of an abusive
ex-partner and shortening their sessions. What is the nurse's best action?
A. Recognize the countertransference, reflect on it, and seek supervision to maintain a
therapeutic relationship [CORRECT]
B. Continue avoiding the patient to prevent conflict
C. Share her personal abuse history with the patient
D. Request a permanent transfer with no further reflection
Correct Answer: A
Rationale: The therapeutic response to countertransference is self-awareness,
reflection, and supervision so care stays patient-centered. Avoidance, self-disclosure of
personal trauma, or unexamined transfers compromise the relationship.
Q10: A homeless patient with schizophrenia is hungry, has not slept in two nights, and
reports hearing voices. Using Maslow's hierarchy, which needs does the nurse address
first?
A. Self-actualization needs
B. Belonging and intimacy needs
C. Physiological and safety needs [CORRECT]
