NSG 526-- Exam One
,The exam will consist of 50 multiple choice questions. The following are items that should be
studied as part of your review and will be on the quiz:
1- DSM 5-TR classification of Psychiatric illness:
o The DSM-5 is a diagnostic manual. It does not provide theories of cause, management, or
treatment options. It lists 22 major categories of mental disorders with more than 150
individual illnesses. The DSM-5 is organized in an attempt to follow the lifespan with
neurodevelopmental disorders that occur early in life listed first and neurocognitive
disorders that occur at the end of life listed last. It is organized this way to assist the
diagnostic decision-making process. o Depression and other mood disorders (major
depression, bipolar disorder, dysthymia) Personality disorders (primarily borderline
personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obsessive-compulsive disorder)
Somatization disorder, eating disorders (these two disorders are combined because both
involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis accompanying
depression, substance abuse or dementia)
Mnemonic:
"Depressed Patients Seem Anxious, So Claim Psychiatrists"
2- Diagnosis of Psychiatric Disorders:
o When working with the DSM-5 the PMH-APRN must remember that normal reactions to
stressful events are not considered mental disorders. The DSM-5 conceptualizes each of
the mental disorders as a clinically significant behavioral or psychological syndrome or
pattern that occurs in an individual and is associated with present distress (e.g., a painful
symptom), disability (i.e., impairment in one or more important areas of functioning), or
with a significantly increased risk of suffering death, pain, disability, or an important loss
of freedom (APA, 2013). This syndrome or pattern must not be merely an expected and
transient response to a particular event, such as the death of a loved one. Whatever its
original causes, the behavior must currently be considered a manifestation of a
behavioral, psychological, or biological dysfunction to be classified as a mental disorder.
Deviant behaviors (e.g., political, religious, or sexual) and conflicts between the individual
and society are not considered mental orders per se, but if the deviance or conflict is a
symptom of dysfunction in the individual, then it may be considered a symptom of the
illness.
3- Scope and standards of Practice:
, o Scope of Practice defines the boundaries of the practitioner’s license. While Standards
are authoritative statements that describe the level of care or performance common to
the profession of nursing and are used to judge the quality of nursing practice. Scope and
standards guide our actions and help us manage our practice along with the challenges
we face in nursing.
o Scope and Standards of Practice provides definitions and descriptions of basic and
advanced psychiatric-mental health clinical nursing practice. It delineates the scope,
functions, and roles of the clinical practice of psychiatric-mental health nurses as well as
the diverse settings in which they practice. In addition, it establishes the clinical practice
standards for the specialty.
4- Neurobiology and brain regions involved in pathology.
Structure Function Impairment
Brainstem (Pons, Regulates BP, respirations, level of PTSD, paralysis, psychosis,
Medulla oblongata, arousal and digestion coma, death
Midbrain)
Cerebellum “motor Coordinates balance, posture, Ataxia, tremors, emotional
brain” movement, memory, impulse control, blunting and lack of inhibition
cognition, language
Structure Function Impairment
Amygdala Regulates powerful emotions (fear, Irritability, anger, aggression
rage, sexual desires”
Hippocampu Memory, converting STM to LTM, Impaired memory and
s learning attention
Thalamus Relay station for sensory information, Sensory processing issues
Hypothalam Essential for maintaining homeostasis; Disturbed sleep, eating,
u controls basic needs (eating, drinking, changes in body
s temperature regulation, sleep-wake temperature, emotional
, cycles instability.
Structure Function Impairment
Frontal lobe Executive functioning Expressive aphasia
“prefrontal cortex” and personality Lack of inhibition, promiscuous, poor Higher order
planning, judgement, defects in executive
speech, motivation. functioning
Houses Broca’s area
Parietal lobe Receives and evaluates Dementia (trouble recognizing familiar
sensory information people, objects or surroundings
Occipital lobe Vision and visual Vision loss. VH memory
Temporal lobe Receives and processes AH in depression, mania and auditory
informationschizophrenia
5- Purpose of the Psychiatric Interview:
o The purpose of the psychiatric interview is to gather information necessary to
understand, diagnose, and treat the client.
o The content of the psychiatric interview focuses on the client’s biopsychosocial history
and current mental status. The Biopsychosocial history is a comprehensive assessment of
the client’s lifetime biologic, psychological, and social functioning.
6- Therapeutic alliance/communication techniques:
o A cooperative working relationship between client and therapist, considered by many to
be an essential aspect of successful therapy. Derived from the concept of the
psychoanalytic working alliance, the therapeutic alliance comprises bonds, goals, and
tasks. Bonds are constituted by the core conditions of therapy, the client’s attitude
toward the therapist, and the therapist’s style of relating to the client; goals are the
mutually negotiated, understood, agreed upon, and regularly reviewed aims of the
therapy; and tasks are the activities carried out by both client and therapist.
7- Legal and Ethical considerations (Beneficence, duty, malfeasance, fiduciary duty,
Autonomy)
,The exam will consist of 50 multiple choice questions. The following are items that should be
studied as part of your review and will be on the quiz:
1- DSM 5-TR classification of Psychiatric illness:
o The DSM-5 is a diagnostic manual. It does not provide theories of cause, management, or
treatment options. It lists 22 major categories of mental disorders with more than 150
individual illnesses. The DSM-5 is organized in an attempt to follow the lifespan with
neurodevelopmental disorders that occur early in life listed first and neurocognitive
disorders that occur at the end of life listed last. It is organized this way to assist the
diagnostic decision-making process. o Depression and other mood disorders (major
depression, bipolar disorder, dysthymia) Personality disorders (primarily borderline
personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obsessive-compulsive disorder)
Somatization disorder, eating disorders (these two disorders are combined because both
involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis accompanying
depression, substance abuse or dementia)
Mnemonic:
"Depressed Patients Seem Anxious, So Claim Psychiatrists"
2- Diagnosis of Psychiatric Disorders:
o When working with the DSM-5 the PMH-APRN must remember that normal reactions to
stressful events are not considered mental disorders. The DSM-5 conceptualizes each of
the mental disorders as a clinically significant behavioral or psychological syndrome or
pattern that occurs in an individual and is associated with present distress (e.g., a painful
symptom), disability (i.e., impairment in one or more important areas of functioning), or
with a significantly increased risk of suffering death, pain, disability, or an important loss
of freedom (APA, 2013). This syndrome or pattern must not be merely an expected and
transient response to a particular event, such as the death of a loved one. Whatever its
original causes, the behavior must currently be considered a manifestation of a
behavioral, psychological, or biological dysfunction to be classified as a mental disorder.
Deviant behaviors (e.g., political, religious, or sexual) and conflicts between the individual
and society are not considered mental orders per se, but if the deviance or conflict is a
symptom of dysfunction in the individual, then it may be considered a symptom of the
illness.
3- Scope and standards of Practice:
, o Scope of Practice defines the boundaries of the practitioner’s license. While Standards
are authoritative statements that describe the level of care or performance common to
the profession of nursing and are used to judge the quality of nursing practice. Scope and
standards guide our actions and help us manage our practice along with the challenges
we face in nursing.
o Scope and Standards of Practice provides definitions and descriptions of basic and
advanced psychiatric-mental health clinical nursing practice. It delineates the scope,
functions, and roles of the clinical practice of psychiatric-mental health nurses as well as
the diverse settings in which they practice. In addition, it establishes the clinical practice
standards for the specialty.
4- Neurobiology and brain regions involved in pathology.
Structure Function Impairment
Brainstem (Pons, Regulates BP, respirations, level of PTSD, paralysis, psychosis,
Medulla oblongata, arousal and digestion coma, death
Midbrain)
Cerebellum “motor Coordinates balance, posture, Ataxia, tremors, emotional
brain” movement, memory, impulse control, blunting and lack of inhibition
cognition, language
Structure Function Impairment
Amygdala Regulates powerful emotions (fear, Irritability, anger, aggression
rage, sexual desires”
Hippocampu Memory, converting STM to LTM, Impaired memory and
s learning attention
Thalamus Relay station for sensory information, Sensory processing issues
Hypothalam Essential for maintaining homeostasis; Disturbed sleep, eating,
u controls basic needs (eating, drinking, changes in body
s temperature regulation, sleep-wake temperature, emotional
, cycles instability.
Structure Function Impairment
Frontal lobe Executive functioning Expressive aphasia
“prefrontal cortex” and personality Lack of inhibition, promiscuous, poor Higher order
planning, judgement, defects in executive
speech, motivation. functioning
Houses Broca’s area
Parietal lobe Receives and evaluates Dementia (trouble recognizing familiar
sensory information people, objects or surroundings
Occipital lobe Vision and visual Vision loss. VH memory
Temporal lobe Receives and processes AH in depression, mania and auditory
informationschizophrenia
5- Purpose of the Psychiatric Interview:
o The purpose of the psychiatric interview is to gather information necessary to
understand, diagnose, and treat the client.
o The content of the psychiatric interview focuses on the client’s biopsychosocial history
and current mental status. The Biopsychosocial history is a comprehensive assessment of
the client’s lifetime biologic, psychological, and social functioning.
6- Therapeutic alliance/communication techniques:
o A cooperative working relationship between client and therapist, considered by many to
be an essential aspect of successful therapy. Derived from the concept of the
psychoanalytic working alliance, the therapeutic alliance comprises bonds, goals, and
tasks. Bonds are constituted by the core conditions of therapy, the client’s attitude
toward the therapist, and the therapist’s style of relating to the client; goals are the
mutually negotiated, understood, agreed upon, and regularly reviewed aims of the
therapy; and tasks are the activities carried out by both client and therapist.
7- Legal and Ethical considerations (Beneficence, duty, malfeasance, fiduciary duty,
Autonomy)
