Exam 1- NUR 256 NUR 256 EXAM WITH COMPLETE SOLUTIONS
Chapters 1. 7. 8. 9
LATEST UPDATE FOR 2026
Chapters 2.3.4.5.6
Chapter 1
Stigma- the belief that the overall person is flawed, is characterized by social shunning, disgrace,
and shame.
QSEN- as a nurse you need to know what QSEN is and have these 6 memorized
1 . Patient-centered care: Care should be given in an atmosphere of respect and
responsiveness, and the patient’s values, preferences, and needs should guide care.
2 . Teamwork and collaboration: Nurses and interprofessional teams need to maintain open
communication, respect, and shared decision making.
3 . Evidence-based practice: Optimal healthcare is the result of integrating the best current
evidence while considering the patient/family values and preferences.
4 . Quality improvement: Nurses should be involved in monitoring the outcomes of the care
that they give. They should also be care designers and test changes that will result in quality
improvement.
5 . Safety: The care provided should not add further injury (e.g., nosocomial infections). Harm
to patients and providers are minimized through both system effectiveness and individual
performance.
6. Informatics: Information and technology are used to communicate, manage knowledge,
mitigate error, and support decision making.
Chapter 2
Two important concepts from classic psychoanalysis are transference and countertransference
(Freud, 1969). Transference refers to unconscious feelings that the patient has toward a healthcare
worker that were originally felt in childhood for a significant other. The patient may say something
like, “You remind me exactly of my sister.” The transference may be positive (affectionate) or negative
(hostile). Psychoanalysis actually encourages transference as a way to understand original
relationships. Such exploration helps the patient to better understand certain feelings and
behaviors.
Countertransference refers to unconscious feelings that the healthcare worker has toward the
patient. For instance, if the patient reminds you of someone you do not like, you may unconsciously
react as if the patient were that individual. Strong negative or positive feelings toward the patient
could be a red flag for countertransference. Such responses underscore the importance of
maintaining self-awareness and seeking supervisory guidance as therapeutic relationships progress.
Chapter 8 talks more about countertransference and the nurse-patient relationship.
Peplau was the first nurse to identify psychiatric-mental health nursing both as an essential
element of general nursing and as a specialty area that embraces specific governing principles.
Table 2.3- Common Cognitive Distortions
Hierarchy of Needs- enough said
Erikson’s Eight Stages of Development- Table 2.6- must know these, look at the examples
Chapter 3- I have already sent
Chapter 4
, Treatment options are presented in order of acuteness, beginning with those in the least restrictive
environment, which is the setting that provides the necessary care while allowing the greatest
personal freedom.
Page 68 prevention in outpatient care- primary, secondary, tertiary, think of it like in medical
areas, but mental health - Primary, secondary, and tertiary prevention are aimed at reducing the
effects of mental illness by preventing its occurrence, preventing its progression, or by restoring
functional ability.
Milieu (meel-yoo) is a word of French origin (mi “middle” + lieu “place”) and refers to surroundings
and physical environment. In a therapeutic context, it refers to the overall environment and
interactions within that environment
Safety
A safe environment is an essential component of any inpatient setting. Protecting the patient is
essential, but equally important is the safety of the staff and other patients. Safety needs are
identified, and individualized interventions begin on admission. Staff members check all personal
property and clothing to prevent any potentially harmful items (e.g., medication, alcohol, or sharp
objects) from being taken onto the unit or left in their immediate possession. Some patients are at
greater risk for suicide than others, and psychiatric-mental health nurses are skillful in evaluating
this risk through questions and observations.
Chapter 5- cultural, for the love of all that is holy get an interpreter and have them translate what
the nurse says as closely as possible.
Chapter 6- there are so many questions on legal and ethical
Ethical principles help practitioners to make decisions for care and also help to evaluate care that
has been given. Important ethical principles are:
1 . Autonomy: Respecting the rights of others to make their own decisions (e.g., acknowledging the
patient’s right to refuse medication supports autonomy).
2 . Beneficence: The duty to act to benefit or promote the health and well-being of others (e.g.,
spending extra time to help calm an anxious patient).
3. Nonmaleficence: Doing no harm to the patient (e.g., protecting confidential information about a
patient).
4 . Justice: The duty to distribute resources or care equally, regardless of personal attributes (e.g.,
an intensive care unit [ICU] nurse devotes equal attention to someone who has attempted suicide as
to someone who suffered a brain aneurysm).
5 . Fidelity: Maintaining loyalty and commitment to the patient and doing no wrong to the patient
(e.g., maintaining expertise in nursing skill through continuing nurse education).
6 . Veracity: The duty to communicate truthfully (e.g., describing the purpose and side effects of
psychotropic medications in a truthful and non-misleading way).
Voluntary Admissions
Voluntary admissions occur when patients apply in writing for admission to the facility. The person
should understand the need for treatment and be willing to be admitted. If the individual is under
1 6, the parent, legal guardian, custodian, or next of kin may have authority to apply on the person’s
behalf. Adolescents between 16 and 18 may seek admission independently or on the application by
an authorized individual or agency.
Chapters 1. 7. 8. 9
LATEST UPDATE FOR 2026
Chapters 2.3.4.5.6
Chapter 1
Stigma- the belief that the overall person is flawed, is characterized by social shunning, disgrace,
and shame.
QSEN- as a nurse you need to know what QSEN is and have these 6 memorized
1 . Patient-centered care: Care should be given in an atmosphere of respect and
responsiveness, and the patient’s values, preferences, and needs should guide care.
2 . Teamwork and collaboration: Nurses and interprofessional teams need to maintain open
communication, respect, and shared decision making.
3 . Evidence-based practice: Optimal healthcare is the result of integrating the best current
evidence while considering the patient/family values and preferences.
4 . Quality improvement: Nurses should be involved in monitoring the outcomes of the care
that they give. They should also be care designers and test changes that will result in quality
improvement.
5 . Safety: The care provided should not add further injury (e.g., nosocomial infections). Harm
to patients and providers are minimized through both system effectiveness and individual
performance.
6. Informatics: Information and technology are used to communicate, manage knowledge,
mitigate error, and support decision making.
Chapter 2
Two important concepts from classic psychoanalysis are transference and countertransference
(Freud, 1969). Transference refers to unconscious feelings that the patient has toward a healthcare
worker that were originally felt in childhood for a significant other. The patient may say something
like, “You remind me exactly of my sister.” The transference may be positive (affectionate) or negative
(hostile). Psychoanalysis actually encourages transference as a way to understand original
relationships. Such exploration helps the patient to better understand certain feelings and
behaviors.
Countertransference refers to unconscious feelings that the healthcare worker has toward the
patient. For instance, if the patient reminds you of someone you do not like, you may unconsciously
react as if the patient were that individual. Strong negative or positive feelings toward the patient
could be a red flag for countertransference. Such responses underscore the importance of
maintaining self-awareness and seeking supervisory guidance as therapeutic relationships progress.
Chapter 8 talks more about countertransference and the nurse-patient relationship.
Peplau was the first nurse to identify psychiatric-mental health nursing both as an essential
element of general nursing and as a specialty area that embraces specific governing principles.
Table 2.3- Common Cognitive Distortions
Hierarchy of Needs- enough said
Erikson’s Eight Stages of Development- Table 2.6- must know these, look at the examples
Chapter 3- I have already sent
Chapter 4
, Treatment options are presented in order of acuteness, beginning with those in the least restrictive
environment, which is the setting that provides the necessary care while allowing the greatest
personal freedom.
Page 68 prevention in outpatient care- primary, secondary, tertiary, think of it like in medical
areas, but mental health - Primary, secondary, and tertiary prevention are aimed at reducing the
effects of mental illness by preventing its occurrence, preventing its progression, or by restoring
functional ability.
Milieu (meel-yoo) is a word of French origin (mi “middle” + lieu “place”) and refers to surroundings
and physical environment. In a therapeutic context, it refers to the overall environment and
interactions within that environment
Safety
A safe environment is an essential component of any inpatient setting. Protecting the patient is
essential, but equally important is the safety of the staff and other patients. Safety needs are
identified, and individualized interventions begin on admission. Staff members check all personal
property and clothing to prevent any potentially harmful items (e.g., medication, alcohol, or sharp
objects) from being taken onto the unit or left in their immediate possession. Some patients are at
greater risk for suicide than others, and psychiatric-mental health nurses are skillful in evaluating
this risk through questions and observations.
Chapter 5- cultural, for the love of all that is holy get an interpreter and have them translate what
the nurse says as closely as possible.
Chapter 6- there are so many questions on legal and ethical
Ethical principles help practitioners to make decisions for care and also help to evaluate care that
has been given. Important ethical principles are:
1 . Autonomy: Respecting the rights of others to make their own decisions (e.g., acknowledging the
patient’s right to refuse medication supports autonomy).
2 . Beneficence: The duty to act to benefit or promote the health and well-being of others (e.g.,
spending extra time to help calm an anxious patient).
3. Nonmaleficence: Doing no harm to the patient (e.g., protecting confidential information about a
patient).
4 . Justice: The duty to distribute resources or care equally, regardless of personal attributes (e.g.,
an intensive care unit [ICU] nurse devotes equal attention to someone who has attempted suicide as
to someone who suffered a brain aneurysm).
5 . Fidelity: Maintaining loyalty and commitment to the patient and doing no wrong to the patient
(e.g., maintaining expertise in nursing skill through continuing nurse education).
6 . Veracity: The duty to communicate truthfully (e.g., describing the purpose and side effects of
psychotropic medications in a truthful and non-misleading way).
Voluntary Admissions
Voluntary admissions occur when patients apply in writing for admission to the facility. The person
should understand the need for treatment and be willing to be admitted. If the individual is under
1 6, the parent, legal guardian, custodian, or next of kin may have authority to apply on the person’s
behalf. Adolescents between 16 and 18 may seek admission independently or on the application by
an authorized individual or agency.
