NUR 253 EXAM 3 – 350 UNIQUE MULTIPLE-
CHOICE QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES LATEST UPDATE
2026
SECTION 1: TRAUMA, STRESSOR-RELATED, AND DISSOCIATIVE
DISORDERS (Questions 1–90)
Post-Traumatic Stress Disorder (PTSD)
Question 1
A patient who survived a mass shooting reports recurrent nightmares, flashbacks,
hypervigilance, and avoidance of crowds. These symptoms have persisted for 4
months. Which diagnosis is most likely?
A) Acute stress disorder
B) Post-traumatic stress disorder (PTSD)
C) Generalized anxiety disorder
D) Adjustment disorder
Answer: B) Post-traumatic stress disorder (PTSD)
Rationale: PTSD requires symptom duration greater than 1 month following a
traumatic event. Acute stress disorder is diagnosed when symptoms persist for less
than 1 month. The combination of re-experiencing (flashbacks/nightmares),
avoidance, and hyperarousal (hypervigilance) are hallmark symptoms of PTSD.
1
,Generalized anxiety disorder involves excessive worry without a specific traumatic
trigger, and adjustment disorder occurs in response to an identifiable stressor but
lacks the trauma re-experiencing characteristic of PTSD.
---
Question 2
A patient reports severe anxiety, insomnia, and difficulty concentrating that began
2 weeks after losing their job. There is no history of trauma. What is the most
likely diagnosis?
A) PTSD
B) Acute stress disorder
C) Adjustment disorder
D) Major depressive disorder
Answer: C) Adjustment disorder
Rationale: Adjustment disorder occurs within 3 months of an identifiable stressor
(in this case, job loss) and causes emotional and behavioral symptoms. It lacks the
trauma re-experiencing seen in PTSD. Acute stress disorder requires exposure to a
traumatic event, which is absent here. Major depressive disorder would require
additional criteria including depressed mood or anhedonia lasting at least 2 weeks.
---
Question 3
2
,The nurse is caring for a 6-year-old child with PTSD. Which manifestation is most
characteristic of PTSD in children?
A) Flashbacks described in vivid detail
B) Reduced play and acting out trauma during play
C) Hypervigilance toward adult caregivers
D) Excessive verbal expression of emotions
Answer: B) Reduced play and acting out trauma during play
Rationale: Children with PTSD may have reduced play and may act out trauma
during play. Unlike adults, children often do not describe flashbacks verbally but
instead demonstrate trauma through play activities. Nightmares are also common
in children with PTSD.
---
Question 4
A patient with PTSD states, "I can't go to the mall anymore. It's too crowded and I
feel like something bad will happen." This statement reflects which cluster of
PTSD symptoms?
A) Re-experiencing
B) Avoidance
C) Negative alterations in cognition and mood
D) Alterations in arousal and reactivity
3
, Answer: B) Avoidance
Rationale: Avoidance involves efforts to avoid distressing memories, thoughts,
feelings, or external reminders associated with the traumatic event. The patient's
avoidance of crowded places (the mall) represents avoidance of stimuli associated
with the trauma. Re-experiencing involves intrusive memories or flashbacks.
Negative alterations in cognition/mood include distorted blame or persistent
negative emotional states. Alterations in arousal include hypervigilance and
exaggerated startle response.
---
Question 5
The nurse is providing psychoeducation to a patient with PTSD. Which medication
is commonly prescribed for hyperarousal symptoms in PTSD?
A) Clonidine
B) Bupropion
C) Lorazepam
D) Quetiapine
Answer: A) Clonidine
Rationale: Clonidine is given for hyperarousal symptoms in PTSD.
Antidepressants and antianxiety medications are also used. Clonidine, an alpha-2
adrenergic agonist, helps reduce sympathetic nervous system overactivity
associated with hyperarousal. Bupropion is an antidepressant primarily used for
depression and smoking cessation. Lorazepam is a benzodiazepine used for acute
anxiety but has addiction potential. Quetiapine is an atypical antipsychotic.
4
CHOICE QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES LATEST UPDATE
2026
SECTION 1: TRAUMA, STRESSOR-RELATED, AND DISSOCIATIVE
DISORDERS (Questions 1–90)
Post-Traumatic Stress Disorder (PTSD)
Question 1
A patient who survived a mass shooting reports recurrent nightmares, flashbacks,
hypervigilance, and avoidance of crowds. These symptoms have persisted for 4
months. Which diagnosis is most likely?
A) Acute stress disorder
B) Post-traumatic stress disorder (PTSD)
C) Generalized anxiety disorder
D) Adjustment disorder
Answer: B) Post-traumatic stress disorder (PTSD)
Rationale: PTSD requires symptom duration greater than 1 month following a
traumatic event. Acute stress disorder is diagnosed when symptoms persist for less
than 1 month. The combination of re-experiencing (flashbacks/nightmares),
avoidance, and hyperarousal (hypervigilance) are hallmark symptoms of PTSD.
1
,Generalized anxiety disorder involves excessive worry without a specific traumatic
trigger, and adjustment disorder occurs in response to an identifiable stressor but
lacks the trauma re-experiencing characteristic of PTSD.
---
Question 2
A patient reports severe anxiety, insomnia, and difficulty concentrating that began
2 weeks after losing their job. There is no history of trauma. What is the most
likely diagnosis?
A) PTSD
B) Acute stress disorder
C) Adjustment disorder
D) Major depressive disorder
Answer: C) Adjustment disorder
Rationale: Adjustment disorder occurs within 3 months of an identifiable stressor
(in this case, job loss) and causes emotional and behavioral symptoms. It lacks the
trauma re-experiencing seen in PTSD. Acute stress disorder requires exposure to a
traumatic event, which is absent here. Major depressive disorder would require
additional criteria including depressed mood or anhedonia lasting at least 2 weeks.
---
Question 3
2
,The nurse is caring for a 6-year-old child with PTSD. Which manifestation is most
characteristic of PTSD in children?
A) Flashbacks described in vivid detail
B) Reduced play and acting out trauma during play
C) Hypervigilance toward adult caregivers
D) Excessive verbal expression of emotions
Answer: B) Reduced play and acting out trauma during play
Rationale: Children with PTSD may have reduced play and may act out trauma
during play. Unlike adults, children often do not describe flashbacks verbally but
instead demonstrate trauma through play activities. Nightmares are also common
in children with PTSD.
---
Question 4
A patient with PTSD states, "I can't go to the mall anymore. It's too crowded and I
feel like something bad will happen." This statement reflects which cluster of
PTSD symptoms?
A) Re-experiencing
B) Avoidance
C) Negative alterations in cognition and mood
D) Alterations in arousal and reactivity
3
, Answer: B) Avoidance
Rationale: Avoidance involves efforts to avoid distressing memories, thoughts,
feelings, or external reminders associated with the traumatic event. The patient's
avoidance of crowded places (the mall) represents avoidance of stimuli associated
with the trauma. Re-experiencing involves intrusive memories or flashbacks.
Negative alterations in cognition/mood include distorted blame or persistent
negative emotional states. Alterations in arousal include hypervigilance and
exaggerated startle response.
---
Question 5
The nurse is providing psychoeducation to a patient with PTSD. Which medication
is commonly prescribed for hyperarousal symptoms in PTSD?
A) Clonidine
B) Bupropion
C) Lorazepam
D) Quetiapine
Answer: A) Clonidine
Rationale: Clonidine is given for hyperarousal symptoms in PTSD.
Antidepressants and antianxiety medications are also used. Clonidine, an alpha-2
adrenergic agonist, helps reduce sympathetic nervous system overactivity
associated with hyperarousal. Bupropion is an antidepressant primarily used for
depression and smoking cessation. Lorazepam is a benzodiazepine used for acute
anxiety but has addiction potential. Quetiapine is an atypical antipsychotic.
4
