NUR 256 Mental Health Nursing – Exam 1 Study Guide | Practice Questions with Correct Answers | 2026–2027 Updated Edition | Galen College

This comprehensive NUR 256 Exam 1 Study Guide contains practice questions with verified correct answers — fully updated for the 2026–2027 academic year. Perfect for nursing students (ADN, BSN, or pre‑licensure programs) preparing for their first mental health nursing examination at Galen College or any nursing program. Content covers all major exam topics including: Neurotransmitters & Psychiatric Disorders – dopamine (excess: schizophrenia/mania; deficiency: Parkinson’s, depression), norepinephrine (excess: anxiety/schizophrenia/mania; deficiency: depression), serotonin (deficiency: depression, 90% in gut → GI side effects), GABA (deficiency: anxiety disorders, schizophrenia, mania, Huntington’s), glutamate (excess: Alzheimer’s; deficiency: psychosis), acetylcholine (deficiency: Alzheimer’s, Huntington’s, Parkinson’s) Psychopharmacology – benzodiazepines (promote GABA, risk for abuse/dependence, combined with CNS depressants → life‑threatening depression), buspirone (serotonergic, no addiction, not a CNS depressant, scheduled not PRN), SSRIs (fluoxetine, sertraline, paroxetine, citalopram, escitalopram – first‑line, side effects: low libido, GI upset; paroxetine most anticholinergic), SNRIs (venlafaxine, desvenlafaxine – monitor BP), mirtazapine (norepinephrine/serotonin specific antidepressant – sedation, appetite stimulation, weight gain), bupropion (NDRI – smoking cessation, no sexual side effects, contraindicated in seizure disorders, bulimia/anorexia), TCAs (older, more side effects, lethal in overdose, anticholinergic, cardiotoxic), MAOIs (dietary tyramine restriction – aged cheeses, smoked fish, wine; hypertensive crisis), lithium (mood stabilizer, narrow therapeutic range 0.5–1.5 mEq/L, monitor for toxicity – confusion, blurred vision, diarrhea, tinnitus, slurred speech, convulsions; maintain hydration, avoid hyponatremia), anticonvulsants (valproate – pancreatitis, hepatic failure, birth defects; carbamazepine – Stevens‑Johnson syndrome, genetic testing for Asian descent; lamotrigine – start low, slow to prevent SJS), typical antipsychotics (haloperidol, chlorpromazine – block dopamine, extrapyramidal symptoms EPS, tardive dyskinesia, neuroleptic malignant syndrome, monitor with AIMS), Alzheimer’s medications (cholinesterase inhibitors for acetylcholine deficiency) Therapeutic Communication & Nurse‑Patient Relationship – Peplau’s 4 phases (preorientation, orientation, working, termination), therapeutic techniques (silence, active listening, clarifying, paraphrasing, restating, reflecting, exploring), nontherapeutic techniques (excessive questioning, giving approval/disapproval, giving advice, asking “why” questions), transference vs. countertransference, boundaries, process recording Mental Status Exam (MSE) – appearance, behavior, speech, mood, thought process disorders, perceptual disturbances, cognition, ideas of harming self or others Ethics & Legal Issues – five bioethical principles (beneficence, autonomy, justice, fidelity, veracity), confidentiality exceptions (duty to warn), informed consent, advance directives, voluntary vs. involuntary admission, conditional/unconditional release, patient rights (right to treatment, right to refuse treatment, restraint and seclusion only as last resort – least restrictive first), intentional torts (assault, battery, false imprisonment), unintentional torts (negligence – duty, breach, cause in fact, proximate cause, damages), professional negligence QSEN Competencies – patient‑centered care, quality improvement, safety, informatics, teamwork/collaboration, evidence‑based practice Nursing Process & Documentation – ADPIE, SOAPIE documentation, legal considerations (timely, factual, no blanks, never chart “incident report filed”) Care Settings & Levels of Prevention – outpatient (primary, secondary, tertiary prevention), inpatient (crisis stabilization, general/private hospitals, state hospitals), specialty treatment centers (pediatric, geriatric, VA, forensic, substance abuse), intensive outpatient (IOP), partial hospitalization Developmental & Psychological Theories – Freud’s psychoanalytic theory (id, ego, superego; levels of consciousness – conscious, preconscious, unconscious; defense mechanisms), Erikson’s psychosocial stages (trust vs. mistrust to integrity vs. despair), Maslow’s hierarchy of needs, Peplau’s interpersonal theory, diathesis‑stress model Cultural Considerations – Eastern (family identity, balance, circular time), Western (self identity, scientific cause‑effect, linear time), Indigenous (community identity, harmony with nature, mind‑body‑spirit unity), populations at risk (immigrants, refugees, minorities) Pharmacodynamics & Pharmacokinetics – agonist vs. antagonist, pharmacogenetics (carbamazepine and Asian descent – Stevens‑Johnson syndrome) Serotonin Syndrome & Neuroleptic Malignant Syndrome (NMS) – recognition and emergency management National Patient Safety Goals – identify patients correctly (2 identifiers), use medicines safely, prevent infection, identify patient safety risk (suicide) All answers are verified and tested — ideal for exam 1 review, clinical rotation preparation, and NCLEX‑RN success.