NU 160 Mental Health Concepts Exam 2 Prep Document |
2026/2027 Edition | 250 Verified Questions
NU 160 Mental Health Concepts Exam 2 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document contains 250 verified questions for NU 160 Mental
Health Concepts Exam 2, covering essential topics in psychiatric nursing. Each question includes
detailed rationales to reinforce understanding and ensure mastery of key concepts. Designed for the
2026/2027 academic year, this resource aligns with current NCLEX and ATI standards. With a pass
guarantee and A+ grading, it is the ultimate tool for nursing students seeking exam success.
Abstract:
This meticulously curated exam preparation document for NU 160 Mental Health Concepts Exam 2 features 250
verified questions with detailed rationales, designed to facilitate deep learning and retention. The content spans
core areas of psychiatric mental health nursing, including therapeutic communication, psychopharmacology, mood
disorders, anxiety disorders, psychotic disorders, and legal-ethical considerations. Each question is aligned with
the 2026/2027 academic year standards and reflects the latest DSM-5-TR diagnostic criteria and NCLEX test plan.
Rationales provide evidence-based explanations for correct and incorrect answer choices, promoting clinical
reasoning and application. The document is structured to support self-paced study, with content areas weighted to
mirror exam distribution. Updates include integration of telehealth practices, crisis intervention strategies, and
current pharmacological guidelines. This resource is guaranteed to prepare students for an A+ grade by
reinforcing essential concepts and test-taking strategies.
Content Area Overview:
Content Area Questions Key Topics Weight
Therapeutic Communication and 1-40 Active listening, empathy, boundaries, 16%
Nurse-Patient Relationship transference, countertransference
Psychopharmacology 41-80 Antidepressants, antipsychotics, mood 16%
stabilizers, anxiolytics, side effects
Mood Disorders and Suicide 81-120 Major depressive disorder, bipolar disorder, 16%
Prevention suicide assessment, safety planning
Anxiety, Trauma, and 121-160 GAD, panic disorder, PTSD, OCD, coping 16%
Stressor-Related Disorders mechanisms
Psychotic Disorders and 161-200 Positive/negative symptoms, delusions, 16%
Schizophrenia hallucinations, nursing interventions
Legal and Ethical Issues 201-250 Involuntary commitment, patient rights, 20%
confidentiality, HIPAA, informed consent
Page 1
,Q1. A patient with a history of bipolar I disorder is admitted in a manic episode. The provider
orders lithium 600 mg PO TID. The patient asks, 'Why do I need blood tests?' Which response by
the nurse best demonstrates therapeutic communication?
A. The blood tests check your kidney function and lithium level to prevent toxicity.
B. You need these tests because lithium can damage your kidneys if not monitored.
C. It is standard procedure for anyone taking lithium to have regular blood work.
D. The doctor ordered them to make sure the medication is safe for you.
Correct Answer: A. The blood tests check your kidney function and lithium level to prevent toxicity.
Rationale: Option A provides accurate, patient-centered information about the purpose of monitoring
(kidney function and lithium level) and the rationale (prevent toxicity), which is therapeutic. Option B,
while factual, uses alarming language ('damage your kidneys') that may increase anxiety. Option C
dismisses the patient's concern by calling it 'standard procedure.' Option D is vague and does not
empower the patient with understanding.
Why Wrong:
B - Uses fear-inducing language ('damage your kidneys') which may escalate anxiety and is not
therapeutic.
C - Dismisses the patient's question as routine, failing to provide meaningful education.
D - Vague and does not address the specific reason for monitoring, reducing patient understanding.
Reference: Varcarolis, E.M. & Fosbre, C.D. (2026). Essentials of Psychiatric Mental Health Nursing, 5th
Ed., Ch. 6
Q2. A patient with major depressive disorder has been taking fluoxetine 40 mg daily for 6 weeks
with minimal improvement. The provider considers augmentation. Which mechanism of action
supports adding aripiprazole to fluoxetine?
A. Aripiprazole is a dopamine D2 receptor antagonist that enhances serotonergic transmission.
B. Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, modulating dopamine and serotonin
activity.
C. Aripiprazole inhibits reuptake of norepinephrine and dopamine, complementing fluoxetine's effect.
D. Aripiprazole blocks NMDA receptors, reducing glutamate excitotoxicity in depression.
Correct Answer: B. Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, modulating
dopamine and serotonin activity.
Rationale: Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, which modulates both
dopamine and serotonin systems. This mechanism is thought to augment the effect of SSRIs like fluoxetine
in treatment-resistant depression. Option A is incorrect because aripiprazole is not a pure antagonist; it
is a partial agonist. Option C describes bupropion, not aripiprazole. Option D describes ketamine, not
aripiprazole.
Why Wrong:
C - Describes the mechanism of bupropion (NDRI), not aripiprazole.
D - Describes the mechanism of ketamine (NMDA antagonist), not aripiprazole.
Reference: Stahl, S.M. (2026). Essential Psychopharmacology, 5th Ed., Ch. 8
Page 2
,Q3. A patient diagnosed with borderline personality disorder frequently splits staff, idealizing one
nurse and devaluing another. Which nursing intervention is most appropriate to address this
behavior?
A. Assign the same primary nurse daily to provide consistency.
B. Confront the patient about the splitting behavior during group therapy.
C. Encourage the patient to express feelings in a journal rather than to staff.
D. Hold a team meeting to ensure consistent limit-setting and unified responses.
Correct Answer: D. Hold a team meeting to ensure consistent limit-setting and unified responses.
Rationale: Splitting is a defense mechanism common in BPD where the patient views people as all good
or all bad. A team approach with consistent limit-setting and unified responses prevents reinforcement of
splitting. Option A may intensify splitting as the patient idealizes one nurse. Option B may shame the
patient and damage trust. Option C avoids addressing the behavior directly and may not reduce splitting.
Why Wrong:
A - Assigning one primary nurse may intensify idealization and devaluation, reinforcing splitting.
B - Confrontation in group may be perceived as punitive and damage therapeutic alliance.
C - Journaling is helpful but does not directly address the interpersonal splitting behavior.
Reference: Townsend, M.C. & Morgan, K.I. (2026). Psychiatric Mental Health Nursing, 9th Ed., Ch. 22
Q4. A patient with schizophrenia is prescribed clozapine. The nurse is reviewing the patient's
history. Which finding would be an absolute contraindication to starting clozapine?
A. History of constipation managed with dietary fiber.
B. History of leukopenia due to chemotherapy 5 years ago.
C. Current white blood cell count of 4,500/mm³.
D. History of orthostatic hypotension with other antipsychotics.
Correct Answer: B. History of leukopenia due to chemotherapy 5 years ago.
Rationale: Clozapine can cause agranulocytosis, and a history of drug-induced leukopenia (e.g., from
chemotherapy) is an absolute contraindication because the bone marrow may be compromised. Option C
is a normal WBC count. Option A (constipation) is a common side effect but not a contraindication.
Option D (orthostatic hypotension) is a risk but not an absolute contraindication.
Why Wrong:
C - A WBC of 4,500/mm³ is within normal range and not a contraindication.
D - Orthostatic hypotension is a common side effect but not an absolute contraindication.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 16
Page 3
, Q5. A patient is admitted involuntarily under a civil commitment order for danger to self. After 72
hours, the patient demands to leave. Which legal principle applies?
A. The patient must be released immediately because the initial order has expired.
B. The patient can be held for an additional period if a second physician certifies continued danger.
C. The patient has the right to a court hearing within 24 hours of the request.
D. The patient can be held indefinitely until deemed no longer dangerous.
Correct Answer: B. The patient can be held for an additional period if a second physician certifies
continued danger.
Rationale: Civil commitment laws vary by state but generally allow an initial short-term hold (e.g., 72
hours) for evaluation. If the patient remains dangerous, a second certification by a physician can extend
the hold for a specified period (e.g., 14 days). Option A is incorrect because the hold can be extended.
Option C is incorrect because the right to a hearing usually occurs within a few days but not necessarily
within 24 hours. Option D is incorrect because holds are time-limited.
Why Wrong:
A - The initial hold can be extended if the patient continues to meet criteria for involuntary
commitment.
C - The patient has a right to a hearing, but the timeline is typically longer than 24 hours.
D - Involuntary commitment is not indefinite; it requires periodic review and justification.
Reference: American Nurses Association. (2025). Psychiatric-Mental Health Nursing: Scope and
Standards of Practice, 3rd Ed.
Q6. A patient with generalized anxiety disorder has been on buspirone 15 mg BID for 4 weeks with
no improvement. The patient asks, 'Can I take this with an alcoholic drink?' Which response is most
accurate?
A. Buspirone does not interact with alcohol, so moderate consumption is safe.
B. Alcohol may increase the sedative effect of buspirone; it is best to avoid alcohol.
C. Buspirone can cause a disulfiram-like reaction if combined with alcohol.
D. Alcohol may reduce the effectiveness of buspirone, so avoid alcohol during treatment.
Correct Answer: B. Alcohol may increase the sedative effect of buspirone; it is best to avoid alcohol.
Rationale: Buspirone has minimal sedative effect, but alcohol can enhance CNS depression. While the
interaction is not as severe as with benzodiazepines, it is still advisable to avoid alcohol. Option A is
incorrect because there is some additive sedation. Option C is incorrect; disulfiram-like reactions occur
with certain antibiotics and alcohol, not buspirone. Option D is incorrect; alcohol does not directly
reduce buspirone's effectiveness but may worsen anxiety long-term.
Why Wrong:
A - Buspirone can cause additive sedation with alcohol, so avoidance is recommended.
C - Disulfiram-like reactions are not associated with buspirone.
D - Alcohol does not directly reduce buspirone's efficacy, but it can impair judgment and worsen
anxiety.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 18
Page 4
2026/2027 Edition | 250 Verified Questions
NU 160 Mental Health Concepts Exam 2 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document contains 250 verified questions for NU 160 Mental
Health Concepts Exam 2, covering essential topics in psychiatric nursing. Each question includes
detailed rationales to reinforce understanding and ensure mastery of key concepts. Designed for the
2026/2027 academic year, this resource aligns with current NCLEX and ATI standards. With a pass
guarantee and A+ grading, it is the ultimate tool for nursing students seeking exam success.
Abstract:
This meticulously curated exam preparation document for NU 160 Mental Health Concepts Exam 2 features 250
verified questions with detailed rationales, designed to facilitate deep learning and retention. The content spans
core areas of psychiatric mental health nursing, including therapeutic communication, psychopharmacology, mood
disorders, anxiety disorders, psychotic disorders, and legal-ethical considerations. Each question is aligned with
the 2026/2027 academic year standards and reflects the latest DSM-5-TR diagnostic criteria and NCLEX test plan.
Rationales provide evidence-based explanations for correct and incorrect answer choices, promoting clinical
reasoning and application. The document is structured to support self-paced study, with content areas weighted to
mirror exam distribution. Updates include integration of telehealth practices, crisis intervention strategies, and
current pharmacological guidelines. This resource is guaranteed to prepare students for an A+ grade by
reinforcing essential concepts and test-taking strategies.
Content Area Overview:
Content Area Questions Key Topics Weight
Therapeutic Communication and 1-40 Active listening, empathy, boundaries, 16%
Nurse-Patient Relationship transference, countertransference
Psychopharmacology 41-80 Antidepressants, antipsychotics, mood 16%
stabilizers, anxiolytics, side effects
Mood Disorders and Suicide 81-120 Major depressive disorder, bipolar disorder, 16%
Prevention suicide assessment, safety planning
Anxiety, Trauma, and 121-160 GAD, panic disorder, PTSD, OCD, coping 16%
Stressor-Related Disorders mechanisms
Psychotic Disorders and 161-200 Positive/negative symptoms, delusions, 16%
Schizophrenia hallucinations, nursing interventions
Legal and Ethical Issues 201-250 Involuntary commitment, patient rights, 20%
confidentiality, HIPAA, informed consent
Page 1
,Q1. A patient with a history of bipolar I disorder is admitted in a manic episode. The provider
orders lithium 600 mg PO TID. The patient asks, 'Why do I need blood tests?' Which response by
the nurse best demonstrates therapeutic communication?
A. The blood tests check your kidney function and lithium level to prevent toxicity.
B. You need these tests because lithium can damage your kidneys if not monitored.
C. It is standard procedure for anyone taking lithium to have regular blood work.
D. The doctor ordered them to make sure the medication is safe for you.
Correct Answer: A. The blood tests check your kidney function and lithium level to prevent toxicity.
Rationale: Option A provides accurate, patient-centered information about the purpose of monitoring
(kidney function and lithium level) and the rationale (prevent toxicity), which is therapeutic. Option B,
while factual, uses alarming language ('damage your kidneys') that may increase anxiety. Option C
dismisses the patient's concern by calling it 'standard procedure.' Option D is vague and does not
empower the patient with understanding.
Why Wrong:
B - Uses fear-inducing language ('damage your kidneys') which may escalate anxiety and is not
therapeutic.
C - Dismisses the patient's question as routine, failing to provide meaningful education.
D - Vague and does not address the specific reason for monitoring, reducing patient understanding.
Reference: Varcarolis, E.M. & Fosbre, C.D. (2026). Essentials of Psychiatric Mental Health Nursing, 5th
Ed., Ch. 6
Q2. A patient with major depressive disorder has been taking fluoxetine 40 mg daily for 6 weeks
with minimal improvement. The provider considers augmentation. Which mechanism of action
supports adding aripiprazole to fluoxetine?
A. Aripiprazole is a dopamine D2 receptor antagonist that enhances serotonergic transmission.
B. Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, modulating dopamine and serotonin
activity.
C. Aripiprazole inhibits reuptake of norepinephrine and dopamine, complementing fluoxetine's effect.
D. Aripiprazole blocks NMDA receptors, reducing glutamate excitotoxicity in depression.
Correct Answer: B. Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, modulating
dopamine and serotonin activity.
Rationale: Aripiprazole is a partial agonist at D2 and 5-HT1A receptors, which modulates both
dopamine and serotonin systems. This mechanism is thought to augment the effect of SSRIs like fluoxetine
in treatment-resistant depression. Option A is incorrect because aripiprazole is not a pure antagonist; it
is a partial agonist. Option C describes bupropion, not aripiprazole. Option D describes ketamine, not
aripiprazole.
Why Wrong:
C - Describes the mechanism of bupropion (NDRI), not aripiprazole.
D - Describes the mechanism of ketamine (NMDA antagonist), not aripiprazole.
Reference: Stahl, S.M. (2026). Essential Psychopharmacology, 5th Ed., Ch. 8
Page 2
,Q3. A patient diagnosed with borderline personality disorder frequently splits staff, idealizing one
nurse and devaluing another. Which nursing intervention is most appropriate to address this
behavior?
A. Assign the same primary nurse daily to provide consistency.
B. Confront the patient about the splitting behavior during group therapy.
C. Encourage the patient to express feelings in a journal rather than to staff.
D. Hold a team meeting to ensure consistent limit-setting and unified responses.
Correct Answer: D. Hold a team meeting to ensure consistent limit-setting and unified responses.
Rationale: Splitting is a defense mechanism common in BPD where the patient views people as all good
or all bad. A team approach with consistent limit-setting and unified responses prevents reinforcement of
splitting. Option A may intensify splitting as the patient idealizes one nurse. Option B may shame the
patient and damage trust. Option C avoids addressing the behavior directly and may not reduce splitting.
Why Wrong:
A - Assigning one primary nurse may intensify idealization and devaluation, reinforcing splitting.
B - Confrontation in group may be perceived as punitive and damage therapeutic alliance.
C - Journaling is helpful but does not directly address the interpersonal splitting behavior.
Reference: Townsend, M.C. & Morgan, K.I. (2026). Psychiatric Mental Health Nursing, 9th Ed., Ch. 22
Q4. A patient with schizophrenia is prescribed clozapine. The nurse is reviewing the patient's
history. Which finding would be an absolute contraindication to starting clozapine?
A. History of constipation managed with dietary fiber.
B. History of leukopenia due to chemotherapy 5 years ago.
C. Current white blood cell count of 4,500/mm³.
D. History of orthostatic hypotension with other antipsychotics.
Correct Answer: B. History of leukopenia due to chemotherapy 5 years ago.
Rationale: Clozapine can cause agranulocytosis, and a history of drug-induced leukopenia (e.g., from
chemotherapy) is an absolute contraindication because the bone marrow may be compromised. Option C
is a normal WBC count. Option A (constipation) is a common side effect but not a contraindication.
Option D (orthostatic hypotension) is a risk but not an absolute contraindication.
Why Wrong:
C - A WBC of 4,500/mm³ is within normal range and not a contraindication.
D - Orthostatic hypotension is a common side effect but not an absolute contraindication.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 16
Page 3
, Q5. A patient is admitted involuntarily under a civil commitment order for danger to self. After 72
hours, the patient demands to leave. Which legal principle applies?
A. The patient must be released immediately because the initial order has expired.
B. The patient can be held for an additional period if a second physician certifies continued danger.
C. The patient has the right to a court hearing within 24 hours of the request.
D. The patient can be held indefinitely until deemed no longer dangerous.
Correct Answer: B. The patient can be held for an additional period if a second physician certifies
continued danger.
Rationale: Civil commitment laws vary by state but generally allow an initial short-term hold (e.g., 72
hours) for evaluation. If the patient remains dangerous, a second certification by a physician can extend
the hold for a specified period (e.g., 14 days). Option A is incorrect because the hold can be extended.
Option C is incorrect because the right to a hearing usually occurs within a few days but not necessarily
within 24 hours. Option D is incorrect because holds are time-limited.
Why Wrong:
A - The initial hold can be extended if the patient continues to meet criteria for involuntary
commitment.
C - The patient has a right to a hearing, but the timeline is typically longer than 24 hours.
D - Involuntary commitment is not indefinite; it requires periodic review and justification.
Reference: American Nurses Association. (2025). Psychiatric-Mental Health Nursing: Scope and
Standards of Practice, 3rd Ed.
Q6. A patient with generalized anxiety disorder has been on buspirone 15 mg BID for 4 weeks with
no improvement. The patient asks, 'Can I take this with an alcoholic drink?' Which response is most
accurate?
A. Buspirone does not interact with alcohol, so moderate consumption is safe.
B. Alcohol may increase the sedative effect of buspirone; it is best to avoid alcohol.
C. Buspirone can cause a disulfiram-like reaction if combined with alcohol.
D. Alcohol may reduce the effectiveness of buspirone, so avoid alcohol during treatment.
Correct Answer: B. Alcohol may increase the sedative effect of buspirone; it is best to avoid alcohol.
Rationale: Buspirone has minimal sedative effect, but alcohol can enhance CNS depression. While the
interaction is not as severe as with benzodiazepines, it is still advisable to avoid alcohol. Option A is
incorrect because there is some additive sedation. Option C is incorrect; disulfiram-like reactions occur
with certain antibiotics and alcohol, not buspirone. Option D is incorrect; alcohol does not directly
reduce buspirone's effectiveness but may worsen anxiety long-term.
Why Wrong:
A - Buspirone can cause additive sedation with alcohol, so avoidance is recommended.
C - Disulfiram-like reactions are not associated with buspirone.
D - Alcohol does not directly reduce buspirone's efficacy, but it can impair judgment and worsen
anxiety.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 18
Page 4
