NUR256 EXAM 3 Actual Exam 2026/2027
Complete Questions and Verified Answers
with Detailed Rationales Concepts of Mental
Health Nursing Grade A 100% Correct Pass
Guaranteed - A+ Graded
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. Telling the client
they shouldn't feel that way (A) dismisses their feelings. Sharing personal experiences (B) shifts
focus to the nurse. Redirecting to positive things (D) may be perceived as minimizing their
distress.
Q2: A 28-year-old client with bipolar I disorder is admitted during a manic episode. The client is
pacing, speaking rapidly, and has not slept in 3 days. Which nursing intervention is the priority?
A. Encourage the client to participate in group therapy
B. Provide a quiet environment and decrease stimulation [CORRECT]
C. Engage the client in competitive activities to expend energy
D. Allow the client to stay up late to avoid conflict
Correct Answer: B
,Rationale: During mania, the priority is to reduce environmental stimulation to prevent
escalation and promote sleep (B). Group therapy (A) may be overstimulating. Competitive
activities (C) can increase agitation. Allowing sleep deprivation (D) worsens symptoms and
increases risk for psychosis.
Q3: A client with major depressive disorder is prescribed sertraline. Which statement by the
client indicates understanding of the medication teaching?
A. "I should expect to feel better within a few days."
B. "I can stop taking this medication once I feel better."
C. "I need to avoid foods high in tyramine while taking this medication."
D. "I should report any thoughts of self-harm immediately." [CORRECT]
Correct Answer: D
Rationale: SSRIs like sertraline can increase suicidal ideation, especially in young adults, and
this risk should be reported immediately (D). Therapeutic effects take 2-4 weeks (A is incorrect).
SSRIs should not be stopped abruptly (B is incorrect). Tyramine restriction applies to MAOIs,
not SSRIs (C is incorrect).
Q4: A client with bipolar disorder has a lithium level of 1.8 mEq/L. Which finding requires
immediate nursing intervention?
A. Mild hand tremor
B. Nausea and diarrhea
C. Ataxia and confusion [CORRECT]
D. Polyuria and thirst
Correct Answer: C
Rationale: Lithium toxicity occurs at levels above 1.5 mEq/L. Ataxia and confusion indicate
severe toxicity and require immediate intervention (C). Mild tremor, nausea, and polyuria (A, B,
D) are common side effects at therapeutic levels (0.6-1.2 mEq/L) but do not indicate toxicity.
Q5: A nurse is caring for a client with persistent depressive disorder (dysthymia). Which clinical
manifestation differentiates this from major depressive disorder?
A. Presence of suicidal ideation
B. Duration of symptoms for at least 2 years [CORRECT]
C. Presence of psychotic features
D. Significant weight loss
, Correct Answer: B
Rationale: Persistent depressive disorder requires depressed mood for most of the day, more days
than not, for at least 2 years (B). Suicidal ideation (A), psychotic features (C), and significant
weight changes (D) can occur in both disorders but do not differentiate them.
Q6: A client with bipolar II disorder asks the nurse to explain the difference between bipolar I
and bipolar II. Which response by the nurse is most accurate?
A. "Bipolar I involves hypomanic episodes, while bipolar II involves full manic episodes."
B. "Bipolar I involves full manic episodes, while bipolar II involves hypomanic and major
depressive episodes." [CORRECT]
C. "Bipolar I is less severe than bipolar II and does not require medication."
D. "Bipolar II includes psychotic features, while bipolar I does not."
Correct Answer: B
Rationale: Bipolar I is characterized by at least one full manic episode, while bipolar II involves
at least one hypomanic episode and at least one major depressive episode (B). Bipolar I is
typically more severe, and both require medication management.
Q7: A client receiving ECT for treatment-resistant depression asks the nurse about memory
effects. Which response is most accurate?
A. "You will likely experience permanent memory loss of your entire life."
B. "You may experience temporary memory loss for events around the time of treatment."
[CORRECT]
C. "Memory loss only occurs if the treatment is unsuccessful."
D. "ECT does not cause any memory problems."
Correct Answer: B
Rationale: ECT can cause temporary retrograde amnesia for events surrounding the treatment
period, which typically resolves within weeks to months (B). Permanent memory loss (A) is rare.
Memory effects are not related to treatment success (C), and ECT does carry memory risks (D).
Q8: A nurse is assessing a client for major depressive disorder using the SIGECAPS mnemonic.
Which finding supports this diagnosis?
A. Sleeping more than usual, increased interest in activities, weight gain
B. Insomnia, anhedonia, feelings of worthlessness, fatigue [CORRECT]
C. Hyperactivity, pressured speech, grandiosity, decreased need for sleep
Complete Questions and Verified Answers
with Detailed Rationales Concepts of Mental
Health Nursing Grade A 100% Correct Pass
Guaranteed - A+ Graded
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. Telling the client
they shouldn't feel that way (A) dismisses their feelings. Sharing personal experiences (B) shifts
focus to the nurse. Redirecting to positive things (D) may be perceived as minimizing their
distress.
Q2: A 28-year-old client with bipolar I disorder is admitted during a manic episode. The client is
pacing, speaking rapidly, and has not slept in 3 days. Which nursing intervention is the priority?
A. Encourage the client to participate in group therapy
B. Provide a quiet environment and decrease stimulation [CORRECT]
C. Engage the client in competitive activities to expend energy
D. Allow the client to stay up late to avoid conflict
Correct Answer: B
,Rationale: During mania, the priority is to reduce environmental stimulation to prevent
escalation and promote sleep (B). Group therapy (A) may be overstimulating. Competitive
activities (C) can increase agitation. Allowing sleep deprivation (D) worsens symptoms and
increases risk for psychosis.
Q3: A client with major depressive disorder is prescribed sertraline. Which statement by the
client indicates understanding of the medication teaching?
A. "I should expect to feel better within a few days."
B. "I can stop taking this medication once I feel better."
C. "I need to avoid foods high in tyramine while taking this medication."
D. "I should report any thoughts of self-harm immediately." [CORRECT]
Correct Answer: D
Rationale: SSRIs like sertraline can increase suicidal ideation, especially in young adults, and
this risk should be reported immediately (D). Therapeutic effects take 2-4 weeks (A is incorrect).
SSRIs should not be stopped abruptly (B is incorrect). Tyramine restriction applies to MAOIs,
not SSRIs (C is incorrect).
Q4: A client with bipolar disorder has a lithium level of 1.8 mEq/L. Which finding requires
immediate nursing intervention?
A. Mild hand tremor
B. Nausea and diarrhea
C. Ataxia and confusion [CORRECT]
D. Polyuria and thirst
Correct Answer: C
Rationale: Lithium toxicity occurs at levels above 1.5 mEq/L. Ataxia and confusion indicate
severe toxicity and require immediate intervention (C). Mild tremor, nausea, and polyuria (A, B,
D) are common side effects at therapeutic levels (0.6-1.2 mEq/L) but do not indicate toxicity.
Q5: A nurse is caring for a client with persistent depressive disorder (dysthymia). Which clinical
manifestation differentiates this from major depressive disorder?
A. Presence of suicidal ideation
B. Duration of symptoms for at least 2 years [CORRECT]
C. Presence of psychotic features
D. Significant weight loss
, Correct Answer: B
Rationale: Persistent depressive disorder requires depressed mood for most of the day, more days
than not, for at least 2 years (B). Suicidal ideation (A), psychotic features (C), and significant
weight changes (D) can occur in both disorders but do not differentiate them.
Q6: A client with bipolar II disorder asks the nurse to explain the difference between bipolar I
and bipolar II. Which response by the nurse is most accurate?
A. "Bipolar I involves hypomanic episodes, while bipolar II involves full manic episodes."
B. "Bipolar I involves full manic episodes, while bipolar II involves hypomanic and major
depressive episodes." [CORRECT]
C. "Bipolar I is less severe than bipolar II and does not require medication."
D. "Bipolar II includes psychotic features, while bipolar I does not."
Correct Answer: B
Rationale: Bipolar I is characterized by at least one full manic episode, while bipolar II involves
at least one hypomanic episode and at least one major depressive episode (B). Bipolar I is
typically more severe, and both require medication management.
Q7: A client receiving ECT for treatment-resistant depression asks the nurse about memory
effects. Which response is most accurate?
A. "You will likely experience permanent memory loss of your entire life."
B. "You may experience temporary memory loss for events around the time of treatment."
[CORRECT]
C. "Memory loss only occurs if the treatment is unsuccessful."
D. "ECT does not cause any memory problems."
Correct Answer: B
Rationale: ECT can cause temporary retrograde amnesia for events surrounding the treatment
period, which typically resolves within weeks to months (B). Permanent memory loss (A) is rare.
Memory effects are not related to treatment success (C), and ECT does carry memory risks (D).
Q8: A nurse is assessing a client for major depressive disorder using the SIGECAPS mnemonic.
Which finding supports this diagnosis?
A. Sleeping more than usual, increased interest in activities, weight gain
B. Insomnia, anhedonia, feelings of worthlessness, fatigue [CORRECT]
C. Hyperactivity, pressured speech, grandiosity, decreased need for sleep
