NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain
control?
o Frontal Lobe: Thought Processes & Voluntary Movement
(decision making)
o Temporal Lobe: Auditory Processes (language, speech,
connects to Limbic system)
o Occipital Lobe: Vision (interprets visual images)
o Parietal Lobe: Sensory & Motor (L/R orientation, reading, math,
proprioception)
o Hypothalamus: maintains homeostasis, regulates BP, Temp,
libido, hunger, thirst, and sleep/wake cycles.
o Cerebellum: Balance, Skeletal Muscle Coordination
o Neurons: Nerves that translate electrical impulses into chemical
signals released at the synapse
Synapse- (pg. 51)- The space between neurons in which
neurotransmitters are released and either inhibit/excite the
adjacent neuron. The 4 NT’s are dopamine, norepinephrine,
serotonin and acetylcholine.
Milieu Therapy: Creating a SAFE, structured inpatient/outpatient
setting where the mentally ill can test new behaviors and coping
mechanisms with others.
o Creating a SAFE, structured inpatient/outpatient setting where
patients with mental illness can test new behaviors and
interactions.
o Climate is essential to healing: paint color, relaxed environments
are conducive to the healing process.
o Florence Nightingale believed that the environment helps heal
Maslow’s Hierarchy of needs
o Basic Needs: food, oxygen, water, sleep, sex, and a constant
body temperature. If all the needs were deprived, this level
would take priority.
o Safety Needs: Security, protection, freedom from
fear/anxiety/chaos, and the need for law, order, and limits.
o Belonging and Love Needs: intimate relationship, love,
affection, and belonging, having a family and a home and being
part of identifiable groups.
o Esteem Needs: If self-esteem needs are met, we feel confident,
valued, and valuable. When self-esteem is compromised, we feel
inferior, worthless, and helpless.
o Self-actualization: Reaching our full potential to feel inner
peace and fulfillment.
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Peplau’s Theory of Interpersonal Relations
o Created the Nurse-Patient Partnership increasing individual and
family roles in recovery. (Based off of Sullivan’s Interpersonal
Theory). Relationships greatly influence recovery
Freud- what did he contribute to psychiatric setting?
(Unconscious thoughts)
o Id – unconscious mind, instincts (this is dominant)
o Ego – sense of self, use of defense mechanisms
o Superego – our conscious and is greatly influenced by our
parents morals and ethical stances
o Erickson’s
Trust vs. Mistrust (infant 0- 1 ½) trust developed if
caregivers give affection, love, care, attention, and
reliability. (Feeding)
Autonomy vs. Shame (toddlers 1 ½ - 3) kids need to
develop a sense of personal control. (Toilet Training)
Initiative vs. Guilt (children 3-6) children need to have
power to explore their environment and not receive
disapproval from parents. (Exploration)
Industry vs. Inferiority: (school aged kids 6-12) Kids
dealing with new social and academic demands. Success
leads to a sense of competence. (School)
Identity vs. Role Confusion (teens 12-20) Teens need
to develop self-identity and personal identity to stay true to
themselves. (Social Relationships)
Intimacy & Solidarity vs. Isolation (young adults 20-
30) Young Adults need to form intimate, loving
relationships. (Relationships)
Generativity vs. Self-Absorption: (adults 30-65) Need
to create/nurture things by having children. (Work &
Parenthood)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Integrity vs. Despair (elderly 65+) Need to look back
and feel fulfilled by accomplishments; have wisdom and no
regrets (Reflection on Life)
o Sullivan
Personalities are influenced during childhood and mostly by
the MOTHER. (Page 31 in book for more information)
Therapeutic Communication
Therapeutic Communication: goal directed, professional,
scientifically based. Goal is to get information so that you can plan care
for the patient.
o Active Listening
Clarifying: promotes understanding of the patient’s
statement
Restating: repeating the same key words the patient has
just spoken to echo their feelings. (Ex: If a patient remarks,
“My life is empty…it has no meaning,” additional
information may be gained by restating, “Your life has no
meaning?”)
Reflecting: helps people understand their own thoughts
better; summarizes (Ex: For example, to reflect a patient's
feelings about his or her life, a good beginning might be,
“You sound as if you have had many disappointments.”)
Exploring: use of open-ended questions or statements to
allow the patient to express thoughts/feelings. (Ex: “Tell me
more…”, “Give me an example of…”)
Communication Technique Examples in Different Scenarios
o For Suicidal Patients: “These thoughts are very serious Mr.
Adams. I do not want any harm to come to you. Can you tell me
what you were feeling and if there were any circumstances that
led you to this decision?”
o For Patients who start Crying: Stay with your patient and
reinforce that it is all right to cry & offer tissues. “You seem
upset, what are you thinking right now?”
o For Patients who say they “don’t want to talk”: “Its alright.
I would like to spend time with you. We don’t have to talk.” Or
reapproach at a later time, “Our 5 minutes is up. I will be back at
10am and spend another 5 minutes with you.”
o For Patients who ask the nurse to keep a secret: Nurses
cannot make such promises, as it may be important to share that
information with other staff for safety reasons. “I cannot make
Final Exam
Key Concepts
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain
control?
o Frontal Lobe: Thought Processes & Voluntary Movement
(decision making)
o Temporal Lobe: Auditory Processes (language, speech,
connects to Limbic system)
o Occipital Lobe: Vision (interprets visual images)
o Parietal Lobe: Sensory & Motor (L/R orientation, reading, math,
proprioception)
o Hypothalamus: maintains homeostasis, regulates BP, Temp,
libido, hunger, thirst, and sleep/wake cycles.
o Cerebellum: Balance, Skeletal Muscle Coordination
o Neurons: Nerves that translate electrical impulses into chemical
signals released at the synapse
Synapse- (pg. 51)- The space between neurons in which
neurotransmitters are released and either inhibit/excite the
adjacent neuron. The 4 NT’s are dopamine, norepinephrine,
serotonin and acetylcholine.
Milieu Therapy: Creating a SAFE, structured inpatient/outpatient
setting where the mentally ill can test new behaviors and coping
mechanisms with others.
o Creating a SAFE, structured inpatient/outpatient setting where
patients with mental illness can test new behaviors and
interactions.
o Climate is essential to healing: paint color, relaxed environments
are conducive to the healing process.
o Florence Nightingale believed that the environment helps heal
Maslow’s Hierarchy of needs
o Basic Needs: food, oxygen, water, sleep, sex, and a constant
body temperature. If all the needs were deprived, this level
would take priority.
o Safety Needs: Security, protection, freedom from
fear/anxiety/chaos, and the need for law, order, and limits.
o Belonging and Love Needs: intimate relationship, love,
affection, and belonging, having a family and a home and being
part of identifiable groups.
o Esteem Needs: If self-esteem needs are met, we feel confident,
valued, and valuable. When self-esteem is compromised, we feel
inferior, worthless, and helpless.
o Self-actualization: Reaching our full potential to feel inner
peace and fulfillment.
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Peplau’s Theory of Interpersonal Relations
o Created the Nurse-Patient Partnership increasing individual and
family roles in recovery. (Based off of Sullivan’s Interpersonal
Theory). Relationships greatly influence recovery
Freud- what did he contribute to psychiatric setting?
(Unconscious thoughts)
o Id – unconscious mind, instincts (this is dominant)
o Ego – sense of self, use of defense mechanisms
o Superego – our conscious and is greatly influenced by our
parents morals and ethical stances
o Erickson’s
Trust vs. Mistrust (infant 0- 1 ½) trust developed if
caregivers give affection, love, care, attention, and
reliability. (Feeding)
Autonomy vs. Shame (toddlers 1 ½ - 3) kids need to
develop a sense of personal control. (Toilet Training)
Initiative vs. Guilt (children 3-6) children need to have
power to explore their environment and not receive
disapproval from parents. (Exploration)
Industry vs. Inferiority: (school aged kids 6-12) Kids
dealing with new social and academic demands. Success
leads to a sense of competence. (School)
Identity vs. Role Confusion (teens 12-20) Teens need
to develop self-identity and personal identity to stay true to
themselves. (Social Relationships)
Intimacy & Solidarity vs. Isolation (young adults 20-
30) Young Adults need to form intimate, loving
relationships. (Relationships)
Generativity vs. Self-Absorption: (adults 30-65) Need
to create/nurture things by having children. (Work &
Parenthood)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Integrity vs. Despair (elderly 65+) Need to look back
and feel fulfilled by accomplishments; have wisdom and no
regrets (Reflection on Life)
o Sullivan
Personalities are influenced during childhood and mostly by
the MOTHER. (Page 31 in book for more information)
Therapeutic Communication
Therapeutic Communication: goal directed, professional,
scientifically based. Goal is to get information so that you can plan care
for the patient.
o Active Listening
Clarifying: promotes understanding of the patient’s
statement
Restating: repeating the same key words the patient has
just spoken to echo their feelings. (Ex: If a patient remarks,
“My life is empty…it has no meaning,” additional
information may be gained by restating, “Your life has no
meaning?”)
Reflecting: helps people understand their own thoughts
better; summarizes (Ex: For example, to reflect a patient's
feelings about his or her life, a good beginning might be,
“You sound as if you have had many disappointments.”)
Exploring: use of open-ended questions or statements to
allow the patient to express thoughts/feelings. (Ex: “Tell me
more…”, “Give me an example of…”)
Communication Technique Examples in Different Scenarios
o For Suicidal Patients: “These thoughts are very serious Mr.
Adams. I do not want any harm to come to you. Can you tell me
what you were feeling and if there were any circumstances that
led you to this decision?”
o For Patients who start Crying: Stay with your patient and
reinforce that it is all right to cry & offer tissues. “You seem
upset, what are you thinking right now?”
o For Patients who say they “don’t want to talk”: “Its alright.
I would like to spend time with you. We don’t have to talk.” Or
reapproach at a later time, “Our 5 minutes is up. I will be back at
10am and spend another 5 minutes with you.”
o For Patients who ask the nurse to keep a secret: Nurses
cannot make such promises, as it may be important to share that
information with other staff for safety reasons. “I cannot make
