NUR 253 Exam 3 Questions With Correct Answers Graded A+ For Mental Health (2026)

NUR 253 Exam 3 Questions With Correct Answers Graded A+ For Mental Health (2026) 1. Different ways to diagnose/treat people - ANSWER • Admit to hospital • Partially hospitalized • In day treatment settings 2. Milieu management is a significant part of treatment - ANSWER o Goal is to manage pt affect in group context 3. Community meetings 4. Coping skills group 5. Socialization groups • When behaviors emerge - ANSWER o Calmly review therapeutic goals • boundaries of treatment • avoid rejection and rescuing • Assess for suicide intentions 6. Dependent Personality Disorder - ANSWER thought to be a result of chronic physical illness, punishment, indecent behavior or independent behavior in childhood, inherited trait of submissiveness, 7. dependent personality disorder-• What is important when planning their care? - ANSWER o Empathy • Independence 8. dependent personality disorder-characteristics - ANSWER o Clingy • Submissive • Fear of separation • Difficulty making everyday decisions • Dependent on other people to do things for them • Need others to assume responsibility for the major areas in their life • Do not express any kind of disagreement • Difficulty in initiating projects or doing things on their own • Helpless or uncomfortable being alone 9. Due to fears of being unable to care for themselves 10. Borderline Personality Disorder- - ANSWER Thought to be a result of early abandonment which results in an unstable view of self and others 11. Borderline personality disorder-important in planning care - ANSWER • Importance of maintaining a calm and matter of fact response • Don't give in to the persuasion of these patients trying to manipulate • Give rules, don't sugar coat, and be consistent • Behavioral contracts • Goal is to get these patients to verbalize when they want to hurt either themselves or others. 12. Borderline personality disorder-characteristics - ANSWER o Dramatic • Instability in emotional regulation and interpersonal relationships • Impulsiveness 13. Spending money 14. Binge eating 15. Sex 16. Substance abuse 17. Reckless driving • Identity of self-image distortions • Unstable mood and affect 18. Borderline personality disorder-Ineffective and harming self-soothing habits - ANSWER Cutting 19. Promiscuous sexual behavior 20. Numbing with substance abuse (most common) 21. Splitting (primary defense mechanism coping style): cannot incorporate positive and negative aspects of one's self or others into one image. Idealize a person at start of a new relationship and hoping this person can meet all their expectations. With the first frustration comes immediate hatred of the same person. 22. Suicidal behaviors • Will make gestures and threats 23. Feelings of emptiness 24. Inappropriate and intense flashes of anger that are uncontrollable 25. Histrionic Personality Disorder- - ANSWER Earliest as 3-5 yrs of age with an overly intense attachment to parent of opposite sex parent which results in fear of retaliation of same sex parent 26. Histrionic Personality Disorder- Know characteristics one might exhibit - ANSWER o Uncomfortable in situations where self is not the center of attention • Interactions with others is often characterized by inappropriate sexual seductive and provocative behavior • Consistently using physical appearance to draw attention to self • Self-dramatic, theatrical 27. Exaggeration of expression and emotion • Think relationships are more intimate than they actually are • Excessive emotional and attention seeking 28. begins in early adulthood 29. Presents in variety of contexts 30. Narcissistic Personality Disorder - ANSWER result of childhood neglect and criticism. Did not learn that other people can be the source of comfort and support so as adults they hide their feelings of emptiness with exterior or invulnerability of self sufficiency 31. Narcissistic Personality Disorder-Know signs and symptoms of what a patient would appear like with this disorder - ANSWER o No sympathy for others • Excessive admiration of self • Thoughts of entitlement 32. Everything is mine 33. I am the best 34. You owe it to me 35. I'm perfect 36. Admire me 37. Its all about me • Obsessed with themselves • Will take advantage of others in order to achieve personal goals 38. Make themselves look the best regardless of the cost • No thought to the feelings of others • Not fun to be around 39. Obsessive Compulsive Disorder- - ANSWER thought to be a result of excessive parental criticism, control and shame 40. Obsessive Compulsive Disorder- s/s that one might exhibit - ANSWER o Rigid • Stubborn • Do not fluctuate from a routine 41. Need to close the door a certain amount of times before leaving the house • Not flexible 42. Obsessive Compulsive Disorder-Important to them - ANSWER Detail 43. Rules 44. Schedules 45. Routines 46. Perfectionism 47. Work 48. Productivity 49. Reluctant to delegate tasks • They want it done their way 50. Antisocial Personality Disorder - ANSWER genetically linked 51. Antisocial Personality Disorder-s/s of disorder - ANSWER o No remorse • Do not care • Deceitful • Impulsive • Irritable • Aggressive • Reckless • Disregard to safety of self or others • Irresponsible • At least 18 years of age 52. In a child would be called conduct disorder 53. Anorexia Nervosa:Know what this person looks like (clinical manifestations - ANSWER 1. Underweight 54. 2. growth of fine, downy hair (lanugo) on the face and back 55. 3. mottled, cool skin on the extremities 56. 4. low blood pressure, pulse, and temperature. 57. 5. These patients are consistent with a malnourished, dehydrated state. 58. 6. Binge-purge type has similar characteristics but present with severe electrolyte imbalances due to purging. 59. low weight caused by - ANSWER calorie restriction 60. amenorrhea - ANSWER low weight 61. yellow skin - ANSWER hypercarotenemia 62. lanugo - ANSWER starvation 63. cold extremities - ANSWER starvation 64. peripheral edema - ANSWER hypoalbuminemia and refeeding 65. muscle weakening - ANSWER starvation, electrolyte imbalance 66. constipation - ANSWER starvation 67. abnormal lab values - ANSWER starvation 68. cardiovascular abnormalities - ANSWER starvation, dehydration, electrolyte imbalance 69. impaired renal function - ANSWER dehydration 70. hypokalemia - ANSWER starvation 71. anemic pancytopenia - ANSWER starvation 72. decreased bone density - ANSWER estrogen deficiency. low calcium intake 73. how patients with anorexia feel, who it may affect - ANSWER feel that they are fat, though they look skeletal. High achievers in school and may have many pressures on them. Food becomes the only thing that they can control. They don't want to maintain body weight. They are malnourished and do not eat. 74. goal for anorexic patient - ANSWER begin nutritional stabilization. When the patient is stabilized, the therapist will work with the patient on strengthening coping skills. They will work to change the patient's current body image. Exercise will be closely monitored 75. tx plan for anorexic patient may include - ANSWER • Eating plan • Gain small increments of weight back is more realistic • Weigh daily • Food journals 76. nursing diagnosis for anorexia - ANSWER 1. Imbalanced nutrition: less than body requirements 77. 2. Decreased cardiac output 78. 3. Risk for injury (electrolyte imbalance) 79. 4. Risk for imbalanced fluid volume 80. 5. Anxiety 81. 6. Chronic low self esteem 82. 7. Disturbed body image 83. 8. Deficient knowledge 84. 9. Ineffective coping 85. 10. Powerlessness 86. 11. Hopelessness 87. outcomes for anorexia - ANSWER weight gain, weight maintenance, anxiety that is self-controlled. 88. Short term indicators of anorexia - ANSWER caloric, fat, carbohydrate, and protein intake, sets to achievable healthy weight, selects a healthy target weight, commits to a healthy eating plan, monitors intensity of anxiety, plans coping strategies for stressful situations, verbalized self-acceptance, feelings of self-worth. 89. how patient with anorexia may act - ANSWER Refusal to maintain body weight at or above minimally normal weight for age and height or failure to make expected weight gain during period of growth, intense fear of gaining weight or becoming fat, even though underweight, disturbance in the way body weight or shape is experienced, denial of seriousness of current low body weight, amenorrhea. • Re-feeding syndrome - ANSWER complications that occur from having the patient eat regular portions. The electrolytes will shift because the body cannot accommodate the increased calories. This can cause cardiac collapse. 90. complications of refeeding syndrome - ANSWER • Important to monitor for electrolyte imbalances that can take place within the first week and delirium and other neurologic features afterward. 91. bulimia nervosa - ANSWER is a type of eating disorder. People with bulimia will eat a large amount of food in a short time (binge). Then they will do something to get rid of the food (purge). They may vomit, exercise too much, or use medicines like laxatives. 92. They are ashamed of their behaviors, but feel they have no control over them. They may be at a normal weight, underweight, or overweight because the body will hold up to 75% of calories. 93. bulimia nervosa hx - ANSWER anorexia, depressed, problems with relationships, possible chemical deficiency. throw up for the comfort 94. medical complications of bulimia - ANSWER • Sinus bradycardia • Orthostatic changes in BP and pulse • Cardiac arrhythmias • Cardiac arrest from electrolyte imbalances • Cardiac murmur • Elevated serum bicarb levels • Hypokalemia • Hypochloremia • Dehydration • Loss of dental arch • Diminished chewing ability • Parotid gland swelling • Esophageal tears • Severe abdominal pains • Russell's sign ( callus on knuckles from self-induced vomiting) 95. What is the nurses role when assisting a patient who is being monitored during meal times - ANSWER Observation during and after meals to prevent purging, promote normalization of eating patterns, and maintenance of appropriate exercise. 96. Know nursing diagnosis and assisting the patient with outcomes that deal with ineffective coping and or loneliness - ANSWER • Decreased cardiac output • Powerlessness • Chronic low self-esteem • Anxiety • Ineffective coping 97. outcomes of tx for bulimia - ANSWER • Ineffective coping= Patient will demonstrate at least 2 coping strategies that result in adhering to a structured meal schedule. • Loneliness= Patient will maintain at least one healthy relationship. 98. Substance abuse - ANSWER Maladaptive pattern of substance use leading to significant impairment or distress, manifested by one or more of the following: • Inability to fulfill a major role ( school, work, home) • Hazardous situations ( like driving intoxicated) • Recurrent legal or interpersonal problems • Continued use despite problems 99. Abuse= - ANSWER that's all they focus on, that drug will interfere in ability to maintain work, unable to fulfill major roles. 100. Substance dependence- - ANSWER 3 or more of the following in 12 months: - Presence of tolerance of drug - Presence of withdraw syndrome - Substance taken in larger amounts, a longer period than intended - Unsuccessful or persistent desire to cutdown or control use - Increase time in getting, taking, or recovering from substance - Absence from social, occupational, or recreational activities - Substance used despite knowing problem caused by substance 101. Dependence - ANSWER withdrawal symptoms. Larger amounts for longer time, does not want to cut down on substance • Alcohol - ANSWER CNS depressant ( acts on GABA receptors, increases availability of dopamine and norepinephrine) • Opiates/Herion - ANSWER action on opiod receptors, dopamine, catecholamine, GABA syst., and glutamate. • Cocaine and Amphetamines - ANSWER increases level of norepinepherine, serotonin, and dopamine. • Tolerance- - ANSWER person physical response, when body gets used to amount of the substance that is being ingested. Person requires more substance for same effect. • Withdraw - ANSWER Body's response to a sudden discontinuance of a substance- due to a blood and tissue concentration decreased levels. Psychological, and physical symptoms depending on substance. • Alcohol intoxication s/s - ANSWER - signs- slurred speech, incoordination, unsteady gait, decreased B/P, drowsiness, stupor, Nystagmus, impaired memory or attention, sexual, mood, and judgment prob. 102. overdose of alcohol - ANSWER coma, shock, convulsions, vomiting 103. tx of overdose of alcohol - ANSWER If awake- Activated charcoal, check vitals every 15 min. • If in a coma- IV fluids, clear airway, gastric levage, seizure precautions, Flumazenil (Benzo antagonist) 104. Alcohol withdrawal- - ANSWER • Cessation of alcohol with cause- n/v/anxiety, hallucinations (visual, auditory, and tactile), increased pulse (greater than 100), hand tremors, seizures (Grand Mal), sweating, psychomotor agitation, insomnia. With use that has been heavy or prolonged. 105. (2 or more of the side effects is considered alcohol withdrawal) 106. delirium w/ alcohol abuse - ANSWER after 5-15 years 107. alcohol and opiates equal - ANSWER synergistic effect-will have double the effect 108. (both are cns depressants) 109. can be lethal 110. alcohol and cocaine together - ANSWER can cause tachycardia. must not mix 111. benzos for alcohol withdrawal - ANSWER helps patient relax, decreases delirium, decrease s/s, help prevent seizures 112. when do alcohol withdrawal s/s peak - ANSWER 24-48 hours 113. may have seizures, delirium, tachycardia, disorientation, fevers visual or tactile hallucinations 114. Delirium from alcohol withdrawal - ANSWER medical emergency, peaks 2-3 Days after substation of alcohol. 115. *** Immediate medical attention**** 116. Physical complications with drug abuse- Ingest cocaine - ANSWER nasal defect, ulcers, tachycardia, respiratory arrest, arrhythmias 117. IV physical complications with drug abuse - ANSWER AID's, hepatitis, bacterial endocarditis, renal failure, cardiac arrest, coma, seizure, resp arrest, dermatitis, pulmonary embolism, abscesses, septicemia, tetanus. 118. Mood disorders, also called affective disorders, are: - ANSWER pervasive alterations in emotions that are *manifested by depression, mania, or both* 119. -interfere with life; drastic & long term sadness, agitation, or elation 120. -accompanying self-doubt, guilt, & anger alter life activities, especially those that involve self-esteem, occupation, & relationships 121. ________ are the most common psychiatric diagnoses associated with suicide - ANSWER Mood disorders 122. -*depression is one of the most important risk factors for suicide* 123. The primary mood disorders are: (2) - ANSWER 1. major depressive disorder 124. 2. bipolar disorder 125. A major depressive episode lasts how long? - ANSWER At least *2 weeks, during which the person experiences a depressed mood or loss of pleasure* in nearly all activities 126. -twice as common in women 127. -1.5 to 3 times greater incidence in first-degree relatives 128. -Decreases with age in women; increases with age in men; *highest in single, divorced people* 129. -50% to 60% will suffer recurrence 130. -Approximately 20% will develop a chronic form of depression 131. -Symptoms range from mild to severe 132. Major depressive 7 symptoms - ANSWER 1. changes in eating habits, resulting in unplanned weight gain or loss 133. 2. hypersomnia (excessive sleepiness) or insomnia 134. 3. impaired concentration, decision making, or problem solving abilities 135. 4. inability to cope with daily life 136. 5. feelings of worthlessness, hopelessness, guilt, or despair 137. 6. thoughts of death/suicide 138. 7. pessimistic thinking with no hope of improvement 139. Selective serotonin reuptake inhibitors (SSRI) - ANSWER *Newest category; has the fewest side effects* making them safer for older adults 140. -more compliant to treatment regimen 141. -insomnia decreases in 3-4 days 142. -appetite returns to normal in 5-7 days 143. -energy returns in 4-7 days 144. -mood, concentration, & interest in life improve in 7-10 days 145. 5 SSRI antidepressants names & nursing considerations - ANSWER 1. fluoxetine (prozac) 146. -HA, nervousness, anxiety, sedation, tremor, sexual dysfunction, anorexia, constipation, nausea, diarrhea, weight loss 147. -*administer in AM if nervous; PM if drowsy* 148. -*monitor for hyponatremia* 149. -encourage fluids 150. -report sexual difficulties 151. 2. sertraline (zoloft) 152. -dizziness, sedation, HA, insomnia, tremor, sexual dysfunction, diarrhea, dry mouth/throat, NV, sweating 153. -*admin in PM if drowsy* 154. -sugar free beverages & hard candy; drink adequate fluids 155. -*monitor for hyponatremia* 156. -report sexual difficulties 157. 3. paroxetine (paxil) 158. -dizziness, sedation, HA, insomnia, weakness, fatigue, constipation, dry mouth/throat, NVD, sweating 159. -*admin with food* 160. -*admin in PM if drowsy* 161. -encourage sugar free hard candy or beverages 162. -adequate fluids 163. 4. Citalopram (celexa) 164. -drowsiness, sedation, insomnia, nausea, vomiting, weight gain, constipation, diarrhea 165. -*monitor for hyponatremia* 166. -*admin with food at 6 PM or later* 167. -promote nutrition & exercise 168. 5. escitalopram (lexapro) 169. -drowsiness, dizziness, weight gain, sexual dysfunction, restlessness, dry mouth, HA, nausea, diarrhea 170. -*check orthostatic BP* 171. -assist to rise slowly 172. -sugar free beverages & hard candy 173. -*admin with food* 174. Cyclic antidepressants - ANSWER *Oldest antidepressants* 175. -takes *6 weeks to reach full effect* 176. -lag period of 1-4 weeks before steady plasma levels are reached & symptoms begin to decrease 177. -*cost less* bc they have been around longer 178. -contraindicated in severe impairment of liver function & in myocardial infarction 179. -*cannot be given with MAOIs* 180. -bc of anticholinergic side effects, must be used in caution in clients with glaucoma, BPH, urinary retention/obstruction, DM, CV disease, resp. disease, or renal impairment 181. -overdosage occurs over several days & results in confusion, agitation, hallucinations, hyperpyrexia, & increased reflexes 182. -*seizures, coma, & CV toxicity can occur* with ensuing tachycardia, decreased output, decreased contractility, & AV block 183. -*used less often in geriatric population* 184. 2 Cyclic antidepressants names & nursing considerations - ANSWER 1. amitriptyline (elavil) 185. -dizziness, orthostatic hypotension, tachycardia, sedation, HA, tremor, blurred vision, constipation, dry mouth/throat, weight gain, urinary hesitancy, sweating 186. -assist client to rise slowly 187. -administer at bedtime 188. -encourage sugar free beverages & hard candy 189. -ensure adequate fluids & balanced nutrition 190. -encourage exercise 191. -*monitor cardiac function* 192. 2. imipramine (tofranil) 193. -dizziness, orthostatic hypotension, weakness, fatigue, blurred vision, constipation, dry mouth/throat, weight gain 194. -assist client to rise slowly 195. -ensure adequate fluids & balanced nutrition 196. -sugar free beverages & hard candy 197. -encourage exercise 198. Atypical antidepressants - ANSWER Used when the client has an *inadequate response to or side effects from SSRIs* 199. 4 Atypical antidepressants names & nursing considerations - ANSWER 1. venlafaxine (effexor) 200. -increased BP & pulse, NV, HA, dizziness, dry mouth, sweating 201. -*can alter lab tests: AST, ALT, alkaline phosphatase, creatinine, glucose & electrolytes* 202. -*administer with food in PM* 203. -ensure adequate fluids 204. -use of sugar free beverages & hard candy 205. 2. duloxetine (cymbalta) 206. -increased BP & pulse, NV, drowsiness/insomnia, HA, dry mouth, constipation, *lowered seizure threshold*, sexual dysfunction 207. -*admin with food* 208. -ensure adequate fluids 209. -use of sugar beverages & hard candy 210. 3. bupropion (wellbutrin) 211. -NV, *lowered seizure threshold*, agitation, restlessness, insomnia, *may alter taste*, *blurred vision*, weight gain, HA 212. -*admin in AM* 213. -ensure balanced nutrition & exercise 214. 4. mirtazapine (remeron) 215. -sedation, dizziness, dry mouth/throat, weight gain, sexual dysfunction, & constipation 216. -*admin in PM* 217. -sugar free beverages & hard candy 218. -ensure adequate fluids & balanced nutrition 219. -*report sexual difficulties to HCP* 220. Monoamine oxidase inhibitors (MAOI) - ANSWER *Used LEAST bc of fatal side effects & interactions with numerous drugs*, both prescription & OTC 221. -clients are *at risk for hypertensive crisis if they ingest tyramine-rich foods & fluids* 222. -also have a lag period before reaching adequate serum levels 223. MAOI names & nursing considerations - ANSWER 1. Isocarboxazid (marplan) 224. 2. phenelzine (nardil) 225. 3. tranylcypromine (parnate) 226. -assist client to rise slowly: most common side effect is orthostatic hypotension 227. -*administer in AM with food* 228. -ensure adequate fluids 229. -*perform essential teaching on importance of low tyramine diet* 230. Serotonin syndrome - ANSWER Occurs when there is an *inadequate washout period between taking MAOIs & SSRIs or when MAOIs are combined with meperidine* 231. Symptoms: 232. *change in mental state*: confusion & agitation 233. *neuromuscular excitement*: muscle rigidity, weakness, sluggish pupils, shivering, tremors, myoclonic jerks, collapse, & muscle paralysis 234. *autonomic abnormalities*: hyperthermia, tachycardia, tachypnea, hypersalivation, & diaphoresis 235. Overdose of MAOI & cyclic antidepressants - ANSWER Both the cyclic compounds & MAOIs are *potentially lethal when taken in overdose.* To decrease this risk, depressed or impulsive clients may need to have *prescriptions & refills in limited amounts* 236. 6 Anticonvulsants names & nursing considerations - ANSWER 1. carbamazepine (tegretol) 237. -*causes agranulocytosis* (failure of the bone marrow to produce adequate WBCs) 238. -dizziness, hypotension, ataxia, sedation, blurred vision, *leukopenia*, rashes 239. -*need levels checked regularly to monitor for toxicity* 240. -*monitor gait & assist* 241. -report rashes 242. 2. divalproex (depakote) 243. -ataxia, drowsiness, weakness, fatigue, *menstrual changes*, *dyspepsia (indigestion)*, NV, weight gain, *hair loss* 244. -*provide rest periods* 245. -*monitor gait & assist*