NUR 3300 EXAM 4 – WPU NURSING PRACTICE II (2026) NEWEST
2026/2027 COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
|ALREADY GRADED A+||ALREADY GRADED A+
EXAM CONTENT DOMAINS
Domain 01: Psychiatric/Mental Health Nursing
Domain 02: Maternal-Newborn Nursing
Domain 03: Pediatric Nursing
Domain 04: Geriatric Nursing
Domain 05: Community & Public Health Nursing
Domain 06: Leadership, Management, & Professional Practice
SECTION 1: PSYCHIATRIC/MENTAL HEALTH NURSING (Questions 1–50)
Q1. A patient diagnosed with major depressive disorder is prescribed fluoxetine
(Prozac). The nurse should teach the patient that therapeutic effects may take:
A) 1–3 days
B) 1–2 weeks
C) 4–6 weeks
D) 8–12 weeks
Answer: C) 4–6 weeks
Rationale: SSRIs like fluoxetine typically take 4–6 weeks to achieve full
therapeutic effect for depression. While some improvement may be seen in
2–4 weeks, full benefit often requires 4–6 weeks. The patient should be
encouraged to continue the medication even if no immediate improvement is
noticed. Suicidal ideation may increase during the first few weeks of
treatment, so close monitoring is essential.
Q2. A patient with bipolar disorder is prescribed lithium. The nurse should
monitor which laboratory value most closely?
A) Serum lithium level
B) Serum sodium
C) Serum potassium
D) Serum calcium
Answer: A) Serum lithium level
1
,Rationale: Lithium has a narrow therapeutic range (0.6–1.2 mEq/L for
maintenance, 1.0–1.5 mEq/L for acute mania). Toxicity (> 1.5 mEq/L) can
cause nausea, vomiting, tremor, ataxia, confusion, seizures, and coma.
Sodium levels affect lithium excretion; hyponatremia increases lithium
levels and toxicity risk. Serum creatinine and BUN should also be monitored
for nephrotoxicity.
Q3. A patient is experiencing acute alcohol withdrawal. Which medication is
most commonly prescribed to prevent seizures and delirium tremens?
A) Lorazepam (Ativan)
B) Haloperidol (Haldol)
C) Naltrexone (ReVia)
D) Disulfiram (Antabuse)
Answer: A) Lorazepam (Ativan)
Rationale: Benzodiazepines (lorazepam, diazepam, chlordiazepoxide) are the
first-line treatment for alcohol withdrawal to prevent seizures and
delirium tremens. Lorazepam is preferred in patients with liver disease
due to its shorter half-life and lack of active metabolites. Haloperidol
may be used for agitation but does not prevent seizures. Naltrexone and
disulfiram are used for maintaining abstinence, not for acute withdrawal.
Q4. A patient with schizophrenia is prescribed haloperidol (Haldol). The nurse
should monitor for which adverse effect?
A) Extrapyramidal symptoms (EPS) including dystonia, akathisia, and tardive
dyskinesia
B) Hyperglycemia
C) Weight gain
D) Sedation only
Answer: A) Extrapyramidal symptoms (EPS)
Rationale: Haloperidol is a first-generation (typical) antipsychotic that
has a high risk of extrapyramidal symptoms, including acute dystonia,
parkinsonism, akathisia, and tardive dyskinesia (irreversible). Second-
generation (atypical) antipsychotics like olanzapine and clozapine have
lower EPS risk but higher metabolic side effects (weight gain, diabetes,
2
,hyperlipidemia).
Q5. A patient with generalized anxiety disorder is prescribed buspirone
(BuSpar). The nurse should teach the patient that:
A) The medication takes 2–4 weeks to become effective
B) The medication works immediately
C) The medication should be taken on an empty stomach
D) The medication is a benzodiazepine
Answer: A) The medication takes 2–4 weeks to become effective
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not cause
dependence or sedation. However, it takes 2–4 weeks to achieve therapeutic
effect, unlike benzodiazepines which work immediately. Patients should be
taught to take it consistently and not expect immediate relief. It can be
taken with or without food.
Q6. A patient with panic disorder is prescribed a benzodiazepine (alprazolam).
The nurse should include which teaching point?
A) Do not abruptly stop the medication to avoid withdrawal seizures
B) Take the medication on an empty stomach
C) The medication takes 4–6 weeks to work
D) Weight gain is a common side effect
Answer: A) Do not abruptly stop the medication to avoid withdrawal seizures
Rationale: Benzodiazepines cause physical dependence. Abrupt withdrawal can
cause rebound anxiety, tremors, seizures, and delirium. The medication
should be tapered gradually under a healthcare provider's supervision.
Benzodiazepines work immediately (not 4–6 weeks). Weight gain is not a
common side effect.
Q7. A patient with post-traumatic stress disorder (PTSD) is experiencing
flashbacks. The nurse should:
A) Ground the patient to the present using sensory techniques
B) Encourage the patient to explore the flashback in detail
C) Leave the patient alone to process the flashback
D) Administer an antipsychotic immediately
3
, Answer: A) Ground the patient to the present using sensory techniques
Rationale: Grounding techniques (e.g., identifying objects in the room,
feeling textures, deep breathing, stating the date and location) help
bring the patient back to the present and reduce the intensity of
flashbacks. Encouraging detailed exploration can be re-traumatizing.
Leaving the patient alone is not supportive. Antipsychotics are not the
first-line treatment.
Q8. A patient with obsessive-compulsive disorder (OCD) is prescribed an SSRI
(sertraline). The nurse understands that the therapeutic effect for OCD:
A) May require higher doses than for depression
B) Is achieved at the same dose as for depression
C) Is achieved within 24 hours
D) Requires only behavioral therapy, not medication
Answer: A) May require higher doses than for depression
Rationale: SSRIs are first-line treatment for OCD, but they often require
higher doses than for depression (e.g., sertraline 50–200 mg/day for
depression vs. 200 mg/day for OCD). Therapeutic effect may take 8–12
weeks. SSRIs are often combined with cognitive-behavioral therapy (CBT)
including exposure and response prevention (ERP).
Q9. A patient is diagnosed with borderline personality disorder (BPD). Which
therapy is considered the gold standard?
A) Dialectical behavior therapy (DBT)
B) Cognitive-behavioral therapy (CBT)
C) Psychodynamic therapy
D) Electroconvulsive therapy (ECT)
Answer: A) Dialectical behavior therapy (DBT)
Rationale: DBT, developed by Marsha Linehan, is the gold standard treatment
for borderline personality disorder. It focuses on mindfulness, distress
tolerance, emotion regulation, and interpersonal effectiveness. CBT is
also used but is not as specifically targeted for BPD. ECT is used for
4
2026/2027 COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
|ALREADY GRADED A+||ALREADY GRADED A+
EXAM CONTENT DOMAINS
Domain 01: Psychiatric/Mental Health Nursing
Domain 02: Maternal-Newborn Nursing
Domain 03: Pediatric Nursing
Domain 04: Geriatric Nursing
Domain 05: Community & Public Health Nursing
Domain 06: Leadership, Management, & Professional Practice
SECTION 1: PSYCHIATRIC/MENTAL HEALTH NURSING (Questions 1–50)
Q1. A patient diagnosed with major depressive disorder is prescribed fluoxetine
(Prozac). The nurse should teach the patient that therapeutic effects may take:
A) 1–3 days
B) 1–2 weeks
C) 4–6 weeks
D) 8–12 weeks
Answer: C) 4–6 weeks
Rationale: SSRIs like fluoxetine typically take 4–6 weeks to achieve full
therapeutic effect for depression. While some improvement may be seen in
2–4 weeks, full benefit often requires 4–6 weeks. The patient should be
encouraged to continue the medication even if no immediate improvement is
noticed. Suicidal ideation may increase during the first few weeks of
treatment, so close monitoring is essential.
Q2. A patient with bipolar disorder is prescribed lithium. The nurse should
monitor which laboratory value most closely?
A) Serum lithium level
B) Serum sodium
C) Serum potassium
D) Serum calcium
Answer: A) Serum lithium level
1
,Rationale: Lithium has a narrow therapeutic range (0.6–1.2 mEq/L for
maintenance, 1.0–1.5 mEq/L for acute mania). Toxicity (> 1.5 mEq/L) can
cause nausea, vomiting, tremor, ataxia, confusion, seizures, and coma.
Sodium levels affect lithium excretion; hyponatremia increases lithium
levels and toxicity risk. Serum creatinine and BUN should also be monitored
for nephrotoxicity.
Q3. A patient is experiencing acute alcohol withdrawal. Which medication is
most commonly prescribed to prevent seizures and delirium tremens?
A) Lorazepam (Ativan)
B) Haloperidol (Haldol)
C) Naltrexone (ReVia)
D) Disulfiram (Antabuse)
Answer: A) Lorazepam (Ativan)
Rationale: Benzodiazepines (lorazepam, diazepam, chlordiazepoxide) are the
first-line treatment for alcohol withdrawal to prevent seizures and
delirium tremens. Lorazepam is preferred in patients with liver disease
due to its shorter half-life and lack of active metabolites. Haloperidol
may be used for agitation but does not prevent seizures. Naltrexone and
disulfiram are used for maintaining abstinence, not for acute withdrawal.
Q4. A patient with schizophrenia is prescribed haloperidol (Haldol). The nurse
should monitor for which adverse effect?
A) Extrapyramidal symptoms (EPS) including dystonia, akathisia, and tardive
dyskinesia
B) Hyperglycemia
C) Weight gain
D) Sedation only
Answer: A) Extrapyramidal symptoms (EPS)
Rationale: Haloperidol is a first-generation (typical) antipsychotic that
has a high risk of extrapyramidal symptoms, including acute dystonia,
parkinsonism, akathisia, and tardive dyskinesia (irreversible). Second-
generation (atypical) antipsychotics like olanzapine and clozapine have
lower EPS risk but higher metabolic side effects (weight gain, diabetes,
2
,hyperlipidemia).
Q5. A patient with generalized anxiety disorder is prescribed buspirone
(BuSpar). The nurse should teach the patient that:
A) The medication takes 2–4 weeks to become effective
B) The medication works immediately
C) The medication should be taken on an empty stomach
D) The medication is a benzodiazepine
Answer: A) The medication takes 2–4 weeks to become effective
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not cause
dependence or sedation. However, it takes 2–4 weeks to achieve therapeutic
effect, unlike benzodiazepines which work immediately. Patients should be
taught to take it consistently and not expect immediate relief. It can be
taken with or without food.
Q6. A patient with panic disorder is prescribed a benzodiazepine (alprazolam).
The nurse should include which teaching point?
A) Do not abruptly stop the medication to avoid withdrawal seizures
B) Take the medication on an empty stomach
C) The medication takes 4–6 weeks to work
D) Weight gain is a common side effect
Answer: A) Do not abruptly stop the medication to avoid withdrawal seizures
Rationale: Benzodiazepines cause physical dependence. Abrupt withdrawal can
cause rebound anxiety, tremors, seizures, and delirium. The medication
should be tapered gradually under a healthcare provider's supervision.
Benzodiazepines work immediately (not 4–6 weeks). Weight gain is not a
common side effect.
Q7. A patient with post-traumatic stress disorder (PTSD) is experiencing
flashbacks. The nurse should:
A) Ground the patient to the present using sensory techniques
B) Encourage the patient to explore the flashback in detail
C) Leave the patient alone to process the flashback
D) Administer an antipsychotic immediately
3
, Answer: A) Ground the patient to the present using sensory techniques
Rationale: Grounding techniques (e.g., identifying objects in the room,
feeling textures, deep breathing, stating the date and location) help
bring the patient back to the present and reduce the intensity of
flashbacks. Encouraging detailed exploration can be re-traumatizing.
Leaving the patient alone is not supportive. Antipsychotics are not the
first-line treatment.
Q8. A patient with obsessive-compulsive disorder (OCD) is prescribed an SSRI
(sertraline). The nurse understands that the therapeutic effect for OCD:
A) May require higher doses than for depression
B) Is achieved at the same dose as for depression
C) Is achieved within 24 hours
D) Requires only behavioral therapy, not medication
Answer: A) May require higher doses than for depression
Rationale: SSRIs are first-line treatment for OCD, but they often require
higher doses than for depression (e.g., sertraline 50–200 mg/day for
depression vs. 200 mg/day for OCD). Therapeutic effect may take 8–12
weeks. SSRIs are often combined with cognitive-behavioral therapy (CBT)
including exposure and response prevention (ERP).
Q9. A patient is diagnosed with borderline personality disorder (BPD). Which
therapy is considered the gold standard?
A) Dialectical behavior therapy (DBT)
B) Cognitive-behavioral therapy (CBT)
C) Psychodynamic therapy
D) Electroconvulsive therapy (ECT)
Answer: A) Dialectical behavior therapy (DBT)
Rationale: DBT, developed by Marsha Linehan, is the gold standard treatment
for borderline personality disorder. It focuses on mindfulness, distress
tolerance, emotion regulation, and interpersonal effectiveness. CBT is
also used but is not as specifically targeted for BPD. ECT is used for
4
