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NSG2321 MENTAL HEALTH NURSING EXAM STUDY
GUIDE 2025|QUESTIONS AND ANSWERS|100% PASS
Mental Health A dynamic process of successful mental function resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity. The Mentally Healthy Adult Exhibits emotional resilience, capacity for self-reflection, adaptability to stress, and balanced interpersonal relationships. Do No Harm Rooted in legal/ethical principles: Nonmaleficence. Nurses must protect clients from physical, emotional, psychological harm. Accept the Client as a Whole Person Unconditional Positive Regard (Carl Rogers): Respect clients regardless of beliefs or behaviors, considering spiritual beliefs, lifestyle choices, cultural background, and environment.
Develop Mutual Trust Built over time with consistency, empathy (NOT sympathy), and advocacy; a trusting relationship is the foundation for therapeutic alliance. Explore Behaviors and Emotions Behaviors are expressions of internal thoughts and feelings; mental health assessment includes perceptions, thought processes, emotional responses, and verbal/nonverbal cues. Encourage Effective Adaptation Maladaptive behavior = signal of ineffective coping; nursing interventions include crisis stabilization, teaching coping skills, referrals for therapy/support, and psychosocial education. Encourage Responsibility Promotes self-esteem, accountability, dignity, and internal locus of control.
Professional Boundaries Red flags include over-involvement, gift acceptance, and touch without consent. Cognition Higher-level mental functions including memory, judgment, reasoning, learning, abstract thinking, and attention. Confusion Impairment in cognitive processing, memory, or awareness; may be acute (delirium) or chronic (dementia). Five 'Ds' of Confusion Damage, Delirium, Dementia, Depression, Deprivation. Damage Physical brain trauma (e.g., TBI, stroke).
Delirium Rapid-onset, reversible change in cognition. Dementia Gradual onset, irreversible, progressive decline. Depression Can present with cognitive impairment ('pseudo-dementia'). Deprivation Sensory or social isolation, especially in institutionalized elderly. Delirium Acute, sudden, reversible
Alzheimer's Disease (AD) Most common cause of dementia Alzheimer's Disease Pathophysiology Degeneration of neurons → plaques & tangles → brain atrophy Alzheimer's Disease Affects Memory (esp. recent), Judgment, Language, Behavior AD Stages - Early Short-term memory loss, subtle personality changes AD Stages - Intermediate Wandering, difficulty with ADLs, agnosia, aphasia AD Stages - Severe Incontinence, mutism, loss of ambulation
AD Stages - End Stage Nonresponsive, bedridden, death due to complications Sundown Syndrome Worsening of symptoms in the evening Sundown Syndrome Symptoms Agitation, Aggression, Confusion Causes of Sundown Syndrome Fatigue, melatonin changes, overstimulation Interventions for Sundown Syndrome Consistency and routine, Provide cues for orientation (clocks, calendars), Redirect instead of correcting, Maintain safety and dignity, Avoid overstimulation
Levels of Anxiety - Panic Terror, disconnection from reality Defense Mechanisms Unconscious ways to reduce anxiety Types of Anxiety Disorders GAD - Excessive worry >6 months, Panic Disorder - Recurrent panic attacks, Phobias - Irrational fear of object/situation, OCD - Obsessions
- compulsions, PTSD - Re-experiencing trauma; hyperarousal, Acute Stress Disorder - Symptoms <1 month post-trauma Pharmacological Management of Anxiety Benzodiazepines: Fast-acting, short-term only; Buspirone: No sedation; takes weeks; SSRIs/SNRIs: First-line for chronic anxiety Therapeutic Interventions for Anxiety CBT: Identify/modify irrational thoughts, Desensitization: Gradual exposure, Therapy animals, Mindfulness training
Mood Disorder Spectrum Mood is a sustained emotional state Mood Disorders Disorders occur when emotions interfere with daily life, relationships, and health Monoamine hypothesis Imbalance in serotonin, dopamine, norepinephrine Dysregulation of HPA axis ↑ cortisol Genetics Strong familial link
Irritability, somatic complaints, failure to thrive Adolescents' symptoms of depression Withdrawal, acting out, self-harm, risk-taking Adults' symptoms of depression Anhedonia, hopelessness, poor concentration Elderly symptoms of depression Often misdiagnosed; signs mistaken for dementia Major Depressive Disorder (MDD) Functional but 'always down' Persistent Depressive Disorder (Dysthymia) Chronic, milder symptoms >2 years
Premenstrual Dysphoric Disorder Mood lability prior to menstruation Postpartum Depression Onset within 4 weeks postpartum; suicidal ideation, bonding difficulties Seasonal Affective Disorder (SAD) Occurs in fall/winter due to less sunlight; treated with light therapy Substance-induced Depressive Disorder Triggered by medications/substances Mania Elevated, expansive, irritable mood >1 week
6-12 weeks: Reduce symptoms, prevent suicide. Continuation treatment phase 4-9 months: Prevent relapse, consolidate gains. Maintenance treatment phase Indefinite: Prevent recurrence. SSRIs Fluoxetine, Sertraline; 1st line, avoid St. John's Wort SNRIs Venlafaxine, Duloxetine; Useful for pain & depression TCAs Amitriptyline, Nortriptyline; Cardiotoxic in OD; anticholinergic effects
MAOIs Phenelzine, Tranylcypromine; Hypertensive crisis risk with tyramine Atypicals Bupropion (NDRI), Mirtazapine; Seizure risk (bupropion); sedation (mirtazapine) Lithium 0.6-1.2 mEq/L therapeutic range; toxic >1. Valproic Acid (Depakote) Monitor liver enzymes Lamotrigine (Lamictal) Risk of Stevens-Johnson Syndrome
Fear of serious illness despite medical reassurance Conversion Disorder Neurological symptoms (e.g., blindness, paralysis) without organic cause; Often precipitated by conflict/stress; la belle indifférence: lack of concern over symptoms Substance Any chemical that alters body function (legal or illegal) Use Any consumption Abuse Maladaptive pattern causing impairment Dependence
Physiological/psychological need Addiction Loss of control, compulsive use Alcohol Use Disorder CNS depressant; Withdrawal can occur within 4-12 hours of last drink Alcohol Withdrawal Symptoms Tremors, Anxiety, Tachycardia, Seizures, Hallucinations, Delirium Tremens (DTs): Medical emergency Opioid Use Includes heroin, morphine, oxycodone; Overdose = respiratory depression; Treated with Naloxone (Narcan) Withdrawal Symptoms
