BIOS252 EXAM 3 Actual Exam 2026/2027
Complete Questions and Verified Answers
with Detailed Rationales Anatomy and
Physiology II Grade A 100% Correct Pass
SECTION 1: MOOD DISORDERS (Questions 1-15)
Q1: A client with major depressive disorder tells the nurse, "I'm a failure. Nothing I do ever
works out." Which response by the nurse is most therapeutic?
• A. "You shouldn't feel that way. You have many accomplishments."
• B. "I understand how you feel. I've felt that way before."
• C. "Tell me more about what makes you feel like a failure." [CORRECT]
• D. "Let's focus on the positive things in your life instead."
Correct Answer: C
Rationale: Encouraging the client to explore their feelings by asking for more information is
therapeutic (C). It validates the client's experience and opens communication without being
dismissive. Telling the client they shouldn't feel that way (A) dismisses their feelings and may
increase guilt. Sharing personal experiences (B) shifts focus to the nurse and is inappropriate.
Redirecting to positive things (D) may be perceived as minimizing their distress and lacks
empathy.
Q2: A client with bipolar I disorder is in an acute manic episode. Which behavior would the
nurse expect to observe?
• A. Psychomotor retardation and social withdrawal
• B. Increased need for sleep and low energy
• C. Pressured speech, flight of ideas, and hyperactivity [CORRECT]
• D. Anhedonia and poor concentration
Correct Answer: C
,Rationale: Acute mania is characterized by DIGFAST symptoms: Distractibility, Indiscretion,
Grandiosity, Flight of ideas, Activity increase, Sleep deficit, and Talkativeness (C). Pressured
speech and hyperactivity are hallmark signs. Psychomotor retardation (A), increased sleep (B),
and anhedonia (D) are symptoms of depression, not mania.
Q3: A client with major depressive disorder is prescribed fluoxetine (Prozac). Which teaching
point is most important for the nurse to include?
• A. "You may notice immediate improvement in your mood within 2-3 days."
• B. "Avoid foods high in tyramine such as aged cheese and wine."
• C. "It may take 2-4 weeks to notice the full therapeutic effects." [CORRECT]
• D. "Take the medication at bedtime to avoid daytime drowsiness."
Correct Answer: C
Rationale: SSRIs like fluoxetine require 2-4 weeks for full therapeutic effects (C), and clients
should be taught to continue taking the medication even if immediate results aren't apparent.
Tyramine restriction (B) applies to MAOIs, not SSRIs. Fluoxetine is typically activating and
taken in the morning (D), not bedtime. Immediate improvement (A) is unrealistic.
Q4: A client with bipolar disorder has a lithium level of 1.8 mEq/L. Which nursing action is the
priority?
• A. Encourage increased fluid intake
• B. Hold the next dose and notify the provider [CORRECT]
• C. Administer the next dose as scheduled
• D. Increase dietary sodium intake
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.6-1.2 mEq/L (up to 1.5 mEq/L for acute
mania). A level of 1.8 mEq/L indicates toxicity, requiring holding the dose and notifying the
provider immediately (B). Early signs of toxicity include coarse tremor, ataxia, and confusion.
Increasing fluids (A) or sodium (D) are maintenance measures, not appropriate for acute toxicity.
Administering the dose (C) would worsen toxicity.
,Q5: A client with depression asks the nurse, "Do you think I should kill myself?" What is the
nurse's best initial response?
• A. "Don't worry, things will get better soon."
• B. "Are you thinking about hurting yourself right now?" [CORRECT]
• C. "You have so much to live for."
• D. "Let's talk about something else."
Correct Answer: B
Rationale: When suicide is mentioned, the nurse must assess immediate risk by asking direct,
specific questions about current suicidal ideation, plan, means, and intent (B). Vague
reassurances (A, C) or changing the subject (D) fail to assess safety and may increase the client's
isolation. Direct assessment is essential for safety planning.
Q6: A client with persistent depressive disorder (dysthymia) is being discharged. Which outcome
indicates successful treatment?
• A. The client reports no depressive symptoms for the past 2 weeks
• B. The client reports improved mood and functioning for at least 2 months [CORRECT]
• C. The client has eliminated all negative thoughts permanently
• D. The client no longer requires any follow-up care
Correct Answer: B
Rationale: Dysthymia (persistent depressive disorder) requires symptoms for at least 2 years (1
year in children/adolescents) with no more than 2 months symptom-free. Successful treatment
shows sustained improvement in mood and functioning for at least 2 months (B). Two weeks (A)
is insufficient for this chronic condition. Eliminating all negative thoughts (C) is unrealistic, and
ongoing follow-up (D) is typically needed for chronic conditions.
Q7: A client receiving ECT asks, "Will this treatment hurt my brain or change my personality?"
Which response by the nurse is most accurate?
• A. "ECT causes permanent brain damage, but it's worth the risk."
• B. "ECT is very dangerous and should be avoided if possible."
• C. "ECT is safe and effective; you may experience temporary memory problems that
typically resolve." [CORRECT]
, • D. "Your personality will definitely change after ECT."
Correct Answer: C
Rationale: ECT is a safe, effective treatment for severe depression, especially when medication-
resistant or when rapid response is needed. The most common side effect is temporary
anterograde and retrograde amnesia that typically resolves within weeks to months (C). ECT
does not cause permanent brain damage (A) or personality changes (D), nor is it extremely
dangerous (B) when properly administered with modern techniques including anesthesia and
muscle relaxants.
Q8: A client with bipolar disorder is prescribed lamotrigine. Which adverse effect requires
immediate medical attention?
• A. Mild headache
• B. Slight dizziness
• C. Rash, especially involving mucous membranes [CORRECT]
• D. Mild nausea
Correct Answer: C
Rationale: Lamotrigine carries a risk of serious rash including Stevens-Johnson syndrome and
toxic epidermal necrolysis, which can be life-threatening. Any rash, especially involving mucous
membranes (C), requires immediate medical attention and discontinuation of the drug. Mild
headaches (A), dizziness (B), and nausea (D) are common side effects that don't require
immediate intervention but should be monitored.
Q9: A nurse is caring for a client with major depressive disorder who has been taking sertraline
for 3 weeks. The client reports, "I have more energy and can concentrate better, but I still feel
sad." Which interpretation by the nurse is most accurate?
• A. The medication is not working and should be discontinued.
• B. This indicates early response to treatment; full mood improvement may take more
time [CORRECT]
• C. The client is experiencing a manic switch and needs different medication.
• D. The client needs immediate hospitalization.
Correct Answer: B
Complete Questions and Verified Answers
with Detailed Rationales Anatomy and
Physiology II Grade A 100% Correct Pass
SECTION 1: MOOD DISORDERS (Questions 1-15)
Q1: A client with major depressive disorder tells the nurse, "I'm a failure. Nothing I do ever
works out." Which response by the nurse is most therapeutic?
• A. "You shouldn't feel that way. You have many accomplishments."
• B. "I understand how you feel. I've felt that way before."
• C. "Tell me more about what makes you feel like a failure." [CORRECT]
• D. "Let's focus on the positive things in your life instead."
Correct Answer: C
Rationale: Encouraging the client to explore their feelings by asking for more information is
therapeutic (C). It validates the client's experience and opens communication without being
dismissive. Telling the client they shouldn't feel that way (A) dismisses their feelings and may
increase guilt. Sharing personal experiences (B) shifts focus to the nurse and is inappropriate.
Redirecting to positive things (D) may be perceived as minimizing their distress and lacks
empathy.
Q2: A client with bipolar I disorder is in an acute manic episode. Which behavior would the
nurse expect to observe?
• A. Psychomotor retardation and social withdrawal
• B. Increased need for sleep and low energy
• C. Pressured speech, flight of ideas, and hyperactivity [CORRECT]
• D. Anhedonia and poor concentration
Correct Answer: C
,Rationale: Acute mania is characterized by DIGFAST symptoms: Distractibility, Indiscretion,
Grandiosity, Flight of ideas, Activity increase, Sleep deficit, and Talkativeness (C). Pressured
speech and hyperactivity are hallmark signs. Psychomotor retardation (A), increased sleep (B),
and anhedonia (D) are symptoms of depression, not mania.
Q3: A client with major depressive disorder is prescribed fluoxetine (Prozac). Which teaching
point is most important for the nurse to include?
• A. "You may notice immediate improvement in your mood within 2-3 days."
• B. "Avoid foods high in tyramine such as aged cheese and wine."
• C. "It may take 2-4 weeks to notice the full therapeutic effects." [CORRECT]
• D. "Take the medication at bedtime to avoid daytime drowsiness."
Correct Answer: C
Rationale: SSRIs like fluoxetine require 2-4 weeks for full therapeutic effects (C), and clients
should be taught to continue taking the medication even if immediate results aren't apparent.
Tyramine restriction (B) applies to MAOIs, not SSRIs. Fluoxetine is typically activating and
taken in the morning (D), not bedtime. Immediate improvement (A) is unrealistic.
Q4: A client with bipolar disorder has a lithium level of 1.8 mEq/L. Which nursing action is the
priority?
• A. Encourage increased fluid intake
• B. Hold the next dose and notify the provider [CORRECT]
• C. Administer the next dose as scheduled
• D. Increase dietary sodium intake
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.6-1.2 mEq/L (up to 1.5 mEq/L for acute
mania). A level of 1.8 mEq/L indicates toxicity, requiring holding the dose and notifying the
provider immediately (B). Early signs of toxicity include coarse tremor, ataxia, and confusion.
Increasing fluids (A) or sodium (D) are maintenance measures, not appropriate for acute toxicity.
Administering the dose (C) would worsen toxicity.
,Q5: A client with depression asks the nurse, "Do you think I should kill myself?" What is the
nurse's best initial response?
• A. "Don't worry, things will get better soon."
• B. "Are you thinking about hurting yourself right now?" [CORRECT]
• C. "You have so much to live for."
• D. "Let's talk about something else."
Correct Answer: B
Rationale: When suicide is mentioned, the nurse must assess immediate risk by asking direct,
specific questions about current suicidal ideation, plan, means, and intent (B). Vague
reassurances (A, C) or changing the subject (D) fail to assess safety and may increase the client's
isolation. Direct assessment is essential for safety planning.
Q6: A client with persistent depressive disorder (dysthymia) is being discharged. Which outcome
indicates successful treatment?
• A. The client reports no depressive symptoms for the past 2 weeks
• B. The client reports improved mood and functioning for at least 2 months [CORRECT]
• C. The client has eliminated all negative thoughts permanently
• D. The client no longer requires any follow-up care
Correct Answer: B
Rationale: Dysthymia (persistent depressive disorder) requires symptoms for at least 2 years (1
year in children/adolescents) with no more than 2 months symptom-free. Successful treatment
shows sustained improvement in mood and functioning for at least 2 months (B). Two weeks (A)
is insufficient for this chronic condition. Eliminating all negative thoughts (C) is unrealistic, and
ongoing follow-up (D) is typically needed for chronic conditions.
Q7: A client receiving ECT asks, "Will this treatment hurt my brain or change my personality?"
Which response by the nurse is most accurate?
• A. "ECT causes permanent brain damage, but it's worth the risk."
• B. "ECT is very dangerous and should be avoided if possible."
• C. "ECT is safe and effective; you may experience temporary memory problems that
typically resolve." [CORRECT]
, • D. "Your personality will definitely change after ECT."
Correct Answer: C
Rationale: ECT is a safe, effective treatment for severe depression, especially when medication-
resistant or when rapid response is needed. The most common side effect is temporary
anterograde and retrograde amnesia that typically resolves within weeks to months (C). ECT
does not cause permanent brain damage (A) or personality changes (D), nor is it extremely
dangerous (B) when properly administered with modern techniques including anesthesia and
muscle relaxants.
Q8: A client with bipolar disorder is prescribed lamotrigine. Which adverse effect requires
immediate medical attention?
• A. Mild headache
• B. Slight dizziness
• C. Rash, especially involving mucous membranes [CORRECT]
• D. Mild nausea
Correct Answer: C
Rationale: Lamotrigine carries a risk of serious rash including Stevens-Johnson syndrome and
toxic epidermal necrolysis, which can be life-threatening. Any rash, especially involving mucous
membranes (C), requires immediate medical attention and discontinuation of the drug. Mild
headaches (A), dizziness (B), and nausea (D) are common side effects that don't require
immediate intervention but should be monitored.
Q9: A nurse is caring for a client with major depressive disorder who has been taking sertraline
for 3 weeks. The client reports, "I have more energy and can concentrate better, but I still feel
sad." Which interpretation by the nurse is most accurate?
• A. The medication is not working and should be discontinued.
• B. This indicates early response to treatment; full mood improvement may take more
time [CORRECT]
• C. The client is experiencing a manic switch and needs different medication.
• D. The client needs immediate hospitalization.
Correct Answer: B
