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MH FINAL (2025) Actual Exam Questions and Answers A+ Graded, Exams of Nutrition

Hampton University (HU)Nutrition

MH FINAL (2025) Actual Exam Questions and Answers A+ Graded

Typology: Exams

2024/2025

Available from 07/04/2025

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2023-2024 MH FINAL BLUEPRINT

STUDY GUIDE REVIEW

MODULE ONE

Chapter 1

Know definition of mental health – what constitutes mental wellness

Mental Health: a state of well-being in which each individual is able to realize his or her own

potential, cope with normal stresses of life, work productively, and make a contribution to the

community

Mental Illness: all psychiatric disorders that have definable diagnoses. These disorders are

manifested in significant dysfunctions that may be related to developmental, biological, or

psychological disturbances in mental functioning.

Mental Health is on a continuum from well-being to problems/concerns to mental illness

What external factors can influence mental health and wellness? Nature vs. nurture

Individual attributes and behaviors

•Individual attributes are characteristics that are both inborn and learned

•Biological and genetic factors – prenatal exposure to alcohol and O2 deprivation at birth

•Resiliency – the ability and capacity for people to secure the resources they need

to support their well-being. Resilient people are effective at regulating their

emotions

o Characterized by optimism, sense of mastery, competence

Social and economic circumstances

•Immediate social surroundings impact personal attributes (family and friends)

•Family sets the stage for promoting confidence and coping skills, or instilling anxiety

or feelings of inadequacy

•Socioeconomic status has an impact on the resources available to support mental

health and reduce concerns over food, clothing, and shelter

Environmental factors

•Access or lack thereof to basic needs and commodities such as healthcare, water,

safety services, and a highway system have a major impact on community mental health

•In US, there has been a shift towards access and reimbursement for mental

health services

•Mental health is culturally defined – beliefs, attitudes, and practices influence what

is considered mental illness (violates the norms of the society)

Know definition of resilience, what factors lead to increased resilience

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2023-2024 MH FINAL BLUEPRINT

STUDY GUIDE REVIEW

MODULE ONE

Chapter 1 Know definition of mental health – what constitutes mental wellness Mental Health : a state of well-being in which each individual is able to realize his or her own potential, cope with normal stresses of life, work productively, and make a contribution to the community Mental Illness : all psychiatric disorders that have definable diagnoses. These disorders are manifested in significant dysfunctions that may be related to developmental, biological, or psychological disturbances in mental functioning. Mental Health is on a continuum from well-being to problems/concerns to mental illness What external factors can influence mental health and wellness? Nature vs. nurture Individual attributes and behaviors

- Individual attributes are characteristics that are both inborn and learned

Biological and genetic factors – prenatal exposure to alcohol and O2 deprivation at birth
Resiliency – the ability and capacity for people to secure the resources they need to support their well-being. Resilient people are effective at regulating their emotions o Characterized by optimism, sense of mastery, competence Social and economic circumstances
Immediate social surroundings impact personal attributes (family and friends)
Family sets the stage for promoting confidence and coping skills, or instilling anxiety or feelings of inadequacy
Socioeconomic status has an impact on the resources available to support mental health and reduce concerns over food, clothing, and shelter Environmental factors
Access or lack thereof to basic needs and commodities such as healthcare, water, safety services, and a highway system have a major impact on community mental health
In US, there has been a shift towards access and reimbursement for mental health services
Mental health is culturally defined – beliefs, attitudes, and practices influence what is considered mental illness ( violates the norms of the society ) Know definition of resilience, what factors lead to increased resilience

Therapeutic milieu – how is it maintained – behavioral crisis, safety – measures to promote safety on nursing units, unit designs – know safety precautions regarding unit designs Resiliency – the ability and capacity for people to secure the resources they need to support their well-being. Resilient people are effective at regulating their emotions.

- Characterized by optimism, sense of mastery, competence DSM-5 definition/use Diagnostic and Statistical Manual, 5th Edition (DSM-V) – major classification system. Dominant method of categorizing and diagnosing mental illness in the US and is the framework for clinical disorders

Classifies disorders, NOT people – viewing the person as a person and not an illness
Based on specific criteria influenced by multi-professional clinical field trials - The official medical guideline for diagnosing psychiatric disorders Chapter 4 Box 4.2 – Sample of patient rights p 70 new p 75 old Client’s right in a psychiatric inpatient facility retain the same rights as any other citizen. Milieu , meaning middle, refers to surroundings and the physical environment. In a therapeutic context, it refers to the overall environment and interactions w/in that environment.
Recognizes that the people, the setting, the structure, and the emotional climate are important to healing. o Structure involves activities, rules, reality orientation, and environment
Offers pts a sense of security and promotes healing.

You may also agree upon a contract regarding boundaries where you and the patient agree that you will meet in certain places, you may decide where to sit and what type of personal space is needed to make you and the patient feel comfortable. Blurring of boundaries occur when the relationship moves from professional to the social context. This occurs when the nurse’s needs are met at the expense of the patient’s needs such as buying patient clothes because they do not have certain things so that the patient will like you and say you are their favorite nurse. Blurring of roles in nurse/patient relationship – transference – definition, how to identify statement of transference, countertransference – definition, how to identify statement of countertransference (table 8.2 p 129 new, p 135 old) Another means of blurring of boundaries is the method of transference where the patient unconsciously and inappropriately displaces onto the nurse feeling and behaviors related to significant figures in their past.
Transference can be positive or negative depending on the relationship with the significant figure from their past. o Positive does not need to be address, but negative does to prevent an impact on the nurse-patient relationship
Pt may say, “you remind me of my mother/sister, etc.” – Transference can occur in all relationships, but seems to be intensified in relationships where one person is in authority. Countertransference is transference in reverse. It occurs when the nurse unconsciously displaces feelings related to significant figures in the nurse’s past onto the patient.

Typically, intense transference from the patient will bring about countertransference in the nurse
Often results in overinvolvement and impairs the therapeutic relationship
A common sign is overidentification with the patient Know difference between empathy and sympathy and how to identify statement showing empathy/sympathy Empathy occurs when the helping person attempts to understand the world from the patient’s perspective. It means temporarily living in the other’s life, moving about in it delicately without making judgments. - Empathy is consistent with improved patient outcomes and increased patient satisfaction with care

Chapter 9 Identify nonverbal behaviors that can affect communication table 9.1 p 140 new, p 150 old Communication is an interactive process between two or more persons who send and receive messages to one another.

Stimulus —need for information, comfort, or advice
Sender —initiates contact
Message —sent or expressed
Channel —variety of media (hearing, visual, touch, smell)
Receiver —interprets and responds through feedback

o Feedback that validates the accuracy of the sender’s message is extremely important Verbal communication is more than just speaking if can relay beliefs or values of a person. It can allow the nurse to show interest or concern.

We too often can say one thing while we portray a different meaning.
Verbally we can appear honest in our comments, but if we are not sincere, our patients can sense this conflicting message. Nonverbal communication can almost be more powerful that verbal communication. Often our expressions and body language portray a very different message that what we say. It includes:
Tone of voice
Emphasis on certain words
Physical appearance
Facial expressions
Body posture
Amount of eye contact
Hand gestures Nonverbal cues are a better predictor of attitudes and feelings than are words.
Spoken words represent our public selves and can be straightforward or used to distort, conceal, deny, or disguise true feelings
Nonverbal behaviors include a wide range of human activities, from body movements to facial expressions to physical reactions to messages from others o Listening, silence, and touch can convey the private self o Must account for cultural norms (facial expressions are almost universal)
Verbal message can be called the content , while the nonverbal behavior is the process.
Double-bind messages : Mutually contradictory messages, usually given by a person in power

▪ Projective questions – “what if” statements that allow the pt to articulate, explore, and identify thoughts and feelings ▪ The “Miracle” question – goal-setting question that helps the pt to see what the future would look like without a certain problem.

- Should be asked deliberately and dramatically

“suppose a miracle happens. What will be different in your life to tell you that the miracle has happened?”
Helps to identify the goals a person might be motivated to pursue

Nontherapeutic communication techniques – table 9.3, p 146 new, p 156 old – know nontherapeutic technique and be able to identify an example of that technique, i.e. – falsely reassuring – “I wouldn’t worry about that”

Know how cultural considerations can play a part in communication We must be aware of cultural considerations when we communicate with our patients. It is important to understand their communication style use of expressions or lack of expressions, use of dramatic body language may be disturbing to some cultures.

Utilization of eye contact is accepted in some cultures and is seen as disrespectful in others. o Direct eye contact may cause discomfort in some of your patients so it is important to be aware if it is causing distress.
The use of touch is part of the nurturing aspect of nursing, yet many cultures are not comfortable with the use of touch. o Many psychiatric facilities have a no touch policy , so it is important to be aware of this. o It may also be necessary for the nurse to instruct patients about inappropriate use of touch , and you may have to tell them that it is inappropriate.
If using a technique that is not appropriate for that patient’s culture, then it can cause the patient to shut down or go into distress
It is impossible to listen to people in an unbiased way. We develop cultural filters – a form a cultural bias or prejudice that determines what we pay attention to and what we ignore

Know how you prepare for a client interview – pace, setting, and seating, know appropriate introductions, know how to initiate an interview, Know tactics to avoid p 150 new, p 161 old, know how eye contact, body language and voice quality can affect an interview

Pace : it is important to allow the client to set the pace of the interview , this is often frustrating for nurses who have so many tasks to complete, but it is necessary to maintain stability in some patients
Setting : should be in an atmosphere where the patient and nurse feel safe. In a health care setting this can be done in a conference room or in a quiet place on the unit
Seating : where eye contact can be adjusted if needed. o You want to assume the same height as patient. If they are sitting down, so should you. o Avoid face to face. o Sit at 90-120- degree angle. So, if the nurse or patient needs to look away, it is permissible. o Be careful to not position the patient between the nurse and the door and be careful placing the patient so they don’t feel trapped in a room o As a student, do not place yourself alone with a patient. Always go with the other members of your group and stay within eyesight of the staff. Positive attending behaviors serve to open up communication and encourage free expression :
Eye Contact – varies by culture and individual

o The nature of the problem or condition o Nature and purpose of treatment o Risk and benefits of that treatment o Alternative treatment options o Probability that the proposed treatment will be successful o Risks of not consenting to treatment. Psychiatric advanced directives : Prepared when the individual is well and identifies his/her wishes and treatment choices:

Designate a preferred physician
Appoint someone to make medical decision
Preferences regarding medication to take or not to take
Consent for ECT
Consent for psychiatric admission
Preferred facilities or unacceptable facilities
Individuals who should not visit Rights regarding restrain and seclusion : these are done as a last resort.
The nurse should try other alternatives such as verbally intervening, reduction of stimulation, actively listening, providing diversion or offering PRN medication. - Restraints include any mechanical or physical device or equipment that prevents or reduces movement of the patient’s legs, arms, body or head.
In a psychiatric setting, therapeutic holds are considered a form of restraint.
Chemical restraints can also be utilized in the form of medication. - Seclusion consists of confining a patient alone in an area or room and preventing the patient from leaving. It is utilized when the patient is demonstrating violent or self- destructive behavior that puts clients or staff at risk. o A timeout is different from seclusion in that the patient chooses to spend time alone in a specific area or in their room and the patient can voluntarily leave.
Both restraints and seclusions require a doctor’s order and must be time limited. The nurse must document the restraint or seclusion. It should include the behavior that required the restraint or seclusion, the time the patient was placed in restraints and the time they were released. o The patient must be monitored continuously while in restraint or seclusion and must be reassessed at prescribed intervals and restrains must be released at prescribed intervals to allow for eating, toileting, and hygiene. o Documentation of observation must be completed every 15-30 minutes.
The patient has the right to be protected from harm while in restraints or seclusion. Rights regarding confidentiality – HIPAA, social media, confidentiality after death, professional communication. What are the exceptions to this rule?

HIPAA – know that this act protects healthcare information from being shared with persons who have NO right to patient’s information Social Media – the internet is not confidential and is open to legal subpoenas Confidentiality after death – states person’s reputation cannot be damaged after death. You may not share any information after death that you could not share while patient was living

Dead Man’s Statute – protects confidential information about individuals when they are not alive to speak for themselves Confidentially of professional communications – vary from state to state in regards as to information share between patient and healthcare professional, you must know law in your state regarding sharing nurse-patient communication. Exceptions to the Rule:
Duty to warn and protect third party – if a patient states they are going to kill their mother you have a duty to warn this third party and you are able to breech confidentiality o When a patient presents a serious danger of violence to another, the therapist’s duty is to protect the other person
Child and elder abuse reporting statutes – law vary between states and federal mandates regarding reporting of child abuse, but all 50 states have child abuse statues. You should be aware of your states reporting laws. If you have any questions in your professional capacity always contact your nursing supervisor for guidance and reporting assistance. o Sometimes there is conflict btw federal and state laws with child abuse reporting
cannot disclose drug/alcohol abuse treatment  must obtain a court order, no identify the abuser as a member of a treatment program, or report it anonymously. o Failure to report suspected abuse, neglect, or exploitation of a disabled adult may result in a misdemeanor. Know what it means to fail to protect a patient
Leaving a suicidal patient alone with the means of self-harm – nurse can be held responsible for any injuries
Miscommunication and med errors are common bc most psychiatric pts are ambulatory
always check ID before med admin
Abuse of the patient-therapist relationship – sexual misconduct and power differential
Precautions to prevent harm when a patient is restrained – strangulation risk
Protect patients from other patients – all should be monitored and supervised

Least restrictive alternative doctrine – mandates that care providers must take the least drastic action to achieve a specific purpose

If a patient can be treated on an outpatient basis then in-patient hospitalization would be consider too restrictive MODULE 2 Chapter 2 Behavioral theory – felt that if we could control the environment that we can mold the behaviors or clients and began training methods to control behavior. A) Operant conditioning – utilized either positive or negative reinforcement to elicit the appropriate behavior. B) Modeling – where the therapist often provides a role model for specific behaviors.
Felt that if we could control the environment that we can mold the behaviors or clients and began training methods to control behavior.
Personality traits and responses are socially learned through classical conditioning
Operant conditioning – utilized either positive or negative reinforcement to elicit the appropriate behavior. o Behaviors are voluntary o Positive Reinforcement – press a lever and get a treat o Negative Reinforcement – press a lever and the pain stops – removal of adverse stimuli o Punishment – unpleasant consequence. Causes behaviors to occur less freq. o Extinction – absence of reinforcement. Decreased behaviors by withholding rewards that have become habitual. o OC has been very useful in improving the verbal behaviors of mute, autistic, and developmentally disabled children.
Modeling – where the therapist often provides a role model for specific behaviors , and the patient learns through imitation. o Therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose ▪ Fear of snakes example – video of positive interactions first, then saw live demonstration o Role playing – demonstrate patterns of behaviors that might prove more effective than those usually engaged in and then have the patients practice these new behaviors. Humanistic theory – Maslow – felt we are motivated by our unmet needs. Make sure to understand Maslow’s hierarchy of needs and understand what needs must be met first before the patient can progress. Understand how nursing uses Maslow’s theory to prioritize our nursing care. Fig 2.5 p 28 new and p 32 old

- Maslow is considered the father of humanistic psychology. Felt we are motivated by our unmet needs.

Categorized human needs into six incremental stages : o Physiological needs – food, oxygen, water, sleep, sex, constant body temp o Safety needs – security, protection, freedom from fear/anxiety/chaos, need for law and order, need for limits o Belonging and Love needs – need for intimate relationships, love, affection, and belonging. Seek to overcome loneliness and alienation. Stresses importance of family and a home o Esteem needs – need to have a high self-regard and have it reflected to them from others. Want to feel confident and valued. o Self-Actualization – strive to be everything you are capable of being. “What a man can be, he must be.” Highly individual o Self-Transcendence
The value of Maslow’s model in nursing practice is two-fold: o An emphasis on human potential and the patient’s strengths is key to successful nurse-patient relationships o The model helps establish what is most important in the sequencing of nursing actions – helps w/ prioritization ▪ Nurse meets the pts physiological need for stable vital signs and pain relief before collecting general information for a nursing database Chapter 3 Remember how brain is linked to autonomic nervous system. The ANS and the endocrine system serve as links between the brain and the cardiac muscle, smooth muscle, and glands of which the internal organs are composed. - The homeostatic link btw the brain and the internal organs is why mental disturbances such as anxiety alter internal function
The brain also influences the internal organs by regulating hormonal secretions of the pituitary gland, which in turn regulates other glands o May explain why anxiety or depression in women is sometimes associated with the menstrual cycle
The hypothalamic-pituitary-adrenal axis (HPTA) influences the functions of the nerve cells in the brain. This system influences most psychiatric disturbances Issues with neurotransmitters either arise from deficiency in transmission from deficiency in amount of neurotransmitter or reduction in the amount of receptors. When we review medications you will see how psychiatric medication act on usually one of these two things. Once an electrical impulse reaches the end of a neuron, an NT is released. An NT is a chemical substance that functions as a neuromessenger. NTs are released from the axon terminal at the

MH FINAL (2025) Actual Exam Questions and Answers A+ Graded, Exams of Nutrition

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Partial preview of the text

Download MH FINAL (2025) Actual Exam Questions and Answers A+ Graded and more Exams Nutrition in PDF only on Docsity!

2023-2024 MH FINAL BLUEPRINT

STUDY GUIDE REVIEW

MODULE ONE