RASMUSSEN MENTAL HEALTH FINAL EXAM
LATEST REAL EXAM ALL 75 QUESTIONS AND
CORRECT ANSWERS
Milieu ...ANSWER...the environment in which holistic treatment occurs and includes all
members of the treatment team
mental health ...ANSWER...balance of psychological and emotional well-being; ability to
adapt to life-changing events
mental illness ...ANSWER...medical conditions that cause dysfunction of the brain and
neurotransmitters that affect a person's thinking, feeling, mood, ability to relate to others
and daily functioning
Maslow's Hierarchy of Needs ...ANSWER...physiological, safety, love/belonging,
esteem, self-actualization; must start at bottom to work upwards
Erikson's Stages of Development ...ANSWER...1. Trust vs. mistrust (Birth to 12-18
months)
2. Autonomy vs. Shame and Doubt (12-18 months to 3 years)
3. Initiative vs. Guilt (3 years to 5-6 years)
4. Industry vs. Inferiority (5-6 years to adolescence; 6-12 yrs)
5. Identity vs. role diffusion (Adolescence; 12-20 yrs)
6. Intimacy vs. Isolation (Early adulthood; 20-30 yrs)
7. Generativity vs. Stagnation (Middle adulthood; 30-60 years)
8. Ego-Integrity vs. Despair (Late adulthood; 60+ yrs)
Freud ...ANSWER...1) Oral: birth-1.5yrs; pleasure-pain principle; Id: unconscious mind
2) Anal: 1.5-3yrs; reality principle
3) Phallic: 3-7yrs; reward and punishment principle (superego develops)
4) Latency: 7-12yrs; sexuality is repressed, form close bonds w/same sex
5) Genital phase (adolesence): 13-20yrs; relationships w/opposite sex
,Sullivan ...ANSWER...1) Infancy (birth-1.5yrs): mothering object relieves tension
through empathetic intervention/tenderness; goal: biological satisfaction & psychological
security
2) Childhood (1.5-6yrs): muscular maturation & learning to communicate verbally; task:
learn to delay satisfaction of wishes
3) Juvenile (6-9yrs): absorbed in learning to deal w/ever widening outside
world/peers/adults; task: develop interpersonal relationships
4) Preadolescence (9-12yrs): develop intimate relationships w/same sex; task: learn to
care for others of same sex outside of family; "normal homosexual phase"
Adolscence (12-20yrs): Early (12-14yrs) establishing satisfying relationships w/opposite
sex, Late (14-20yrs) interdependent and establishing durable sexual relations w/select
member of opposite sex
therapeutic communication ...ANSWER...Verbal and nonverbal communication
techniques that encourage patients to express their feelings and to achieve a positive
relationship (silence, accepting, giving recognition, offering self, offering general leads,
giving broad openings, making observations, encouraging description of percetion)
Phases of Nurse-Patient Relationship ...ANSWER...orientation: setting
boundaries/objectives, working towards a common goal, confidentiality established
working: symptoms/problem solving skill, challengig negative thoughts and behaviors
termination: can take a long amount of time, ending relationship, role has now ended
boundaries with patients ...ANSWER...do not overshare, focus is on the patient, do not
accept gifts, no special favors, blurring boundaries (overhelping, controlling, narcissism)
Negligence ...ANSWER...omission to act and can be charged if nurse does not report a
foreseeable harm to the pt
autonomy ...ANSWER...respecting the rights of others to make their own decisions
justice ...ANSWER...the duty to distribute resources or care equally, regardless of
personal attributes
benficence ...ANSWER...the duty to act so as to benefit or promote the good of others
Fidelity (nonmaleficence) ...ANSWER...maintaining loyalty and commitment to the
patient and doing no wrong to the patient
veracity ...ANSWER...one's duty to communicate truthfully
,Civil rights ...ANSWER...people with mental illness are guaranteed the same rights
under the federal and state laws as any other citizen
Civil Rights Examples ...ANSWER...right to refuse medications (unless court ordered),
right to informed consent, right to be involved in treatment, right to consult w/spiritual
advisors, right to visitors (unless needing restriction), right to request to leave (if
voluntary), right to make self-care decisions (shower, clothing, etc)
informed consent ...ANSWER...making sure the pts have everything they need to be
educated on any procedure, medications, or any treatment for them to be able to give
informed consent; pt must be competent
confidentiality/HIPPA ...ANSWER...right to receive psychiatric treatment and have
confidential medical recors legally protected
Psychiatric nursing assessment (priority interventions, nursing dx, etc.) ...ANSWER...1)
always safety first, pt specific
2) establish rapport
3) obtain an understanding of the current problem or chief complaint
4) review physical status and obtain baseline VS
5) assess for risk factors affecting safety of pt or others (suicide/homicide)
6) perform a mental status examination (MSE)
7) assess psychosocial status
8) identify mutual treatment goals
9) formulate POC prioritizing pts immediate condition/needs
10) document data
primary depression ...ANSWER...depression ALONE
secondary depression ...ANSWER...depression secondary to another dx or reason
seasonal affective disorder treatment options ...ANSWER...light therapy
First-line treatment for depression ...ANSWER...SSRIs (block the neuronal uptake of
serotonin, leaving more available at the synaptic site)
Examples: citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Sertraline
(Zoloft)
Take 5-6 weeks to fully work; take in AM
, SSRI side effects ...ANSWER...GI upset, sexual dysfunction, nervousness, headaches,
dry mouth; suicidal idealation is major concern first few weeks
TCAs ("start low go slow") ...ANSWER...inhibit the reuptake of neurotransmitters,
norepinephrine, and serotonin by the presynaptic neurons in CNS; receptors:
norepinephrine, serotonin, acetylcholine, histamine
Ex: amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan); 6-8 weeks to
work
TCA side effects ...ANSWER...Sedation, anticholinergic, orthostatic hypotension,
decreased libido, cardiac dysrhythmias
MAOIs ...ANSWER...second-line medications, prevent breakdown of norepinephrine,
serotonin, and dopamine in brain, increasing levels of these amines = elevated mood;
receptors: norepinephrine, serotonin, dopamine; examples: isocarboxazid (Marplan),
phenelzine (Nardil), tranylcypromine (Parnate)
MAOIs side effects ...ANSWER...hypertensive crisis when taken with tyramine
caution when taking with SSRIs, meperidine, decongestants, TCAs, antipsychotics, st
johns wort, tryptophan, ritalin, asthma meds
other side effects include insomnia, wgt gain, anticholinergic effects, lightheadedness or
dizziness, sexual dysfunction; avoid foods containing tyramine
risk factors for suicide ...ANSWER...depression/mental disorders; family hx of abuse,
violence, suicide; substance abuse; exposure to suicidal behavior; firearms in the home;
previous attempt; hopelessness; isolation; recent unemployment; loss of relationships;
separate/divorced/widowed; 4x more likely in males; age (elderly men more common,
then adolscents, then college students)
Suicidal idealation interventions ...ANSWER...follow institutional protocol;
accurate/thorough records of pt behavior; one-on-one monitoring, q15min visual check;
encourage expression of feelings
lithium levels & toxicity
(bipolar disorder treatment) ...ANSWER...therapeutic level: 0.8-1.4 mEq/L
maintenance level: 0.4-1.3 mEq/L
toxic level: 1.5-2.0 mEq/L
Lithium toxicity s/sx ...ANSWER...tremors, N/V/D, lethargy, slurred speech, muscle
weakness, ataxia, confusion, seizures, edema, hypotension, circulatory collapse; do not
restrict sodium!
LATEST REAL EXAM ALL 75 QUESTIONS AND
CORRECT ANSWERS
Milieu ...ANSWER...the environment in which holistic treatment occurs and includes all
members of the treatment team
mental health ...ANSWER...balance of psychological and emotional well-being; ability to
adapt to life-changing events
mental illness ...ANSWER...medical conditions that cause dysfunction of the brain and
neurotransmitters that affect a person's thinking, feeling, mood, ability to relate to others
and daily functioning
Maslow's Hierarchy of Needs ...ANSWER...physiological, safety, love/belonging,
esteem, self-actualization; must start at bottom to work upwards
Erikson's Stages of Development ...ANSWER...1. Trust vs. mistrust (Birth to 12-18
months)
2. Autonomy vs. Shame and Doubt (12-18 months to 3 years)
3. Initiative vs. Guilt (3 years to 5-6 years)
4. Industry vs. Inferiority (5-6 years to adolescence; 6-12 yrs)
5. Identity vs. role diffusion (Adolescence; 12-20 yrs)
6. Intimacy vs. Isolation (Early adulthood; 20-30 yrs)
7. Generativity vs. Stagnation (Middle adulthood; 30-60 years)
8. Ego-Integrity vs. Despair (Late adulthood; 60+ yrs)
Freud ...ANSWER...1) Oral: birth-1.5yrs; pleasure-pain principle; Id: unconscious mind
2) Anal: 1.5-3yrs; reality principle
3) Phallic: 3-7yrs; reward and punishment principle (superego develops)
4) Latency: 7-12yrs; sexuality is repressed, form close bonds w/same sex
5) Genital phase (adolesence): 13-20yrs; relationships w/opposite sex
,Sullivan ...ANSWER...1) Infancy (birth-1.5yrs): mothering object relieves tension
through empathetic intervention/tenderness; goal: biological satisfaction & psychological
security
2) Childhood (1.5-6yrs): muscular maturation & learning to communicate verbally; task:
learn to delay satisfaction of wishes
3) Juvenile (6-9yrs): absorbed in learning to deal w/ever widening outside
world/peers/adults; task: develop interpersonal relationships
4) Preadolescence (9-12yrs): develop intimate relationships w/same sex; task: learn to
care for others of same sex outside of family; "normal homosexual phase"
Adolscence (12-20yrs): Early (12-14yrs) establishing satisfying relationships w/opposite
sex, Late (14-20yrs) interdependent and establishing durable sexual relations w/select
member of opposite sex
therapeutic communication ...ANSWER...Verbal and nonverbal communication
techniques that encourage patients to express their feelings and to achieve a positive
relationship (silence, accepting, giving recognition, offering self, offering general leads,
giving broad openings, making observations, encouraging description of percetion)
Phases of Nurse-Patient Relationship ...ANSWER...orientation: setting
boundaries/objectives, working towards a common goal, confidentiality established
working: symptoms/problem solving skill, challengig negative thoughts and behaviors
termination: can take a long amount of time, ending relationship, role has now ended
boundaries with patients ...ANSWER...do not overshare, focus is on the patient, do not
accept gifts, no special favors, blurring boundaries (overhelping, controlling, narcissism)
Negligence ...ANSWER...omission to act and can be charged if nurse does not report a
foreseeable harm to the pt
autonomy ...ANSWER...respecting the rights of others to make their own decisions
justice ...ANSWER...the duty to distribute resources or care equally, regardless of
personal attributes
benficence ...ANSWER...the duty to act so as to benefit or promote the good of others
Fidelity (nonmaleficence) ...ANSWER...maintaining loyalty and commitment to the
patient and doing no wrong to the patient
veracity ...ANSWER...one's duty to communicate truthfully
,Civil rights ...ANSWER...people with mental illness are guaranteed the same rights
under the federal and state laws as any other citizen
Civil Rights Examples ...ANSWER...right to refuse medications (unless court ordered),
right to informed consent, right to be involved in treatment, right to consult w/spiritual
advisors, right to visitors (unless needing restriction), right to request to leave (if
voluntary), right to make self-care decisions (shower, clothing, etc)
informed consent ...ANSWER...making sure the pts have everything they need to be
educated on any procedure, medications, or any treatment for them to be able to give
informed consent; pt must be competent
confidentiality/HIPPA ...ANSWER...right to receive psychiatric treatment and have
confidential medical recors legally protected
Psychiatric nursing assessment (priority interventions, nursing dx, etc.) ...ANSWER...1)
always safety first, pt specific
2) establish rapport
3) obtain an understanding of the current problem or chief complaint
4) review physical status and obtain baseline VS
5) assess for risk factors affecting safety of pt or others (suicide/homicide)
6) perform a mental status examination (MSE)
7) assess psychosocial status
8) identify mutual treatment goals
9) formulate POC prioritizing pts immediate condition/needs
10) document data
primary depression ...ANSWER...depression ALONE
secondary depression ...ANSWER...depression secondary to another dx or reason
seasonal affective disorder treatment options ...ANSWER...light therapy
First-line treatment for depression ...ANSWER...SSRIs (block the neuronal uptake of
serotonin, leaving more available at the synaptic site)
Examples: citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Sertraline
(Zoloft)
Take 5-6 weeks to fully work; take in AM
, SSRI side effects ...ANSWER...GI upset, sexual dysfunction, nervousness, headaches,
dry mouth; suicidal idealation is major concern first few weeks
TCAs ("start low go slow") ...ANSWER...inhibit the reuptake of neurotransmitters,
norepinephrine, and serotonin by the presynaptic neurons in CNS; receptors:
norepinephrine, serotonin, acetylcholine, histamine
Ex: amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan); 6-8 weeks to
work
TCA side effects ...ANSWER...Sedation, anticholinergic, orthostatic hypotension,
decreased libido, cardiac dysrhythmias
MAOIs ...ANSWER...second-line medications, prevent breakdown of norepinephrine,
serotonin, and dopamine in brain, increasing levels of these amines = elevated mood;
receptors: norepinephrine, serotonin, dopamine; examples: isocarboxazid (Marplan),
phenelzine (Nardil), tranylcypromine (Parnate)
MAOIs side effects ...ANSWER...hypertensive crisis when taken with tyramine
caution when taking with SSRIs, meperidine, decongestants, TCAs, antipsychotics, st
johns wort, tryptophan, ritalin, asthma meds
other side effects include insomnia, wgt gain, anticholinergic effects, lightheadedness or
dizziness, sexual dysfunction; avoid foods containing tyramine
risk factors for suicide ...ANSWER...depression/mental disorders; family hx of abuse,
violence, suicide; substance abuse; exposure to suicidal behavior; firearms in the home;
previous attempt; hopelessness; isolation; recent unemployment; loss of relationships;
separate/divorced/widowed; 4x more likely in males; age (elderly men more common,
then adolscents, then college students)
Suicidal idealation interventions ...ANSWER...follow institutional protocol;
accurate/thorough records of pt behavior; one-on-one monitoring, q15min visual check;
encourage expression of feelings
lithium levels & toxicity
(bipolar disorder treatment) ...ANSWER...therapeutic level: 0.8-1.4 mEq/L
maintenance level: 0.4-1.3 mEq/L
toxic level: 1.5-2.0 mEq/L
Lithium toxicity s/sx ...ANSWER...tremors, N/V/D, lethargy, slurred speech, muscle
weakness, ataxia, confusion, seizures, edema, hypotension, circulatory collapse; do not
restrict sodium!
