• NSG 526 Exam 09/01/2026
Advanced Psych Wilkes NSG 526 Exam |
Clinical Modalities in Advanced Psych |
Questions & Correct Verified Answers with
Rationales | Latest 2026/2027 Update |
Graded A+|
A patient diagnosed with borderline personality disorder has a history of self-mutilation and
suicide attempts. The patient reveals feelings of depression and anger with life. The
psychiatrist suggests the use of a medication. Which type of medication should the nurse
expect?
P 1
, • NSG 526 Exam 09/01/2026
a. Selective serotonin reuptake inhibitor (SSRI)
b. Monoamine oxidase inhibitor (MAOI)
c. Benzodiazepine
d. Antipsychotic –
Correct Answer :a. Selective serotonin reuptake inhibitor (SSRI)
SSRIs are used to treat depression. Many patients with borderline personality disorder are
fearful of taking something over which they have little control. Because SSRIs have a good
side effect profile, the patient is more likely to comply with the medication. Low-dose
antipsychotic or anxiolytic medications are not supported by the data given in this scenario.
MAOIs require great diligence in adherence to a restricted diet and are rarely used for patients
who are impulsive.
A patient diagnosed with borderline personality disorder and a history of self-mutilation has
now begun dialectical behavior therapy (DBT) on an outpatient basis. Counseling focuses on
self-harm behavior management. Today the patient telephones to say, "I'm feeling empty and
want to cut myself." The nurse should:
a. arrange for emergency inpatient hospitalization.
b. send the patient to the crisis intervention unit for 8 to 12 hours.
c. assist the patient to identify the trigger situation and choose a coping strategy.
d. advise the patient to take an antianxiety medication to decrease the anxiety level. –
Correct Answer :c. assist the patient to identify the trigger situation and choose a coping
strategy.
P 2
, • NSG 526 Exam 09/01/2026
The patient has responded appropriately to the urge for self-harm by calling a helping
individual. A component of dialectical behavior therapy is telephone access to the therapist
for "coaching" during crises. The nurse can assist the patient to choose an alternative to self-
mutilation. The need for a protective environment may not be necessary if the patient is able
to use cognitive strategies to determine a coping strategy that reduces the urge to mutilate.
A patient tells a nurse, "I sometimes get into trouble because I make quick decisions and act
on them." A therapeutic response would be:
a. "Let's consider the advantages of being able to stop and think before acting."
b. "It sounds as though you've developed some insight into your situation."
c. "I'll bet you have some interesting stories to share about overreacting."
d. "It's good that you're showing readiness for behavioral change." –
Correct Answer :a. "Let's consider the advantages of being able to stop and think before
acting."
The patient is showing openness to learning techniques for impulse control. One technique is
to teach the patient to stop and think before acting impulsively. The patient can then be
taught to evaluate the outcomes of possible actions and choose an effective action. The
incorrect responses shift the encounter to a social level or are judgmental.
Which statement made by a patient diagnosed with borderline personality disorder indicates
the treatment plan is effective?
a. "I think you are the best nurse on the unit."
b. "I'm never going to get high on drugs again."
P 3
, • NSG 526 Exam 09/01/2026
c. "I hate my doctor for not giving me what I ask for."
d. "I felt empty and wanted to cut myself, so I called you." –
Correct Answer :d. "I felt empty and wanted to cut myself, so I called you."
Seeking a staff member instead of impulsively self-mutilating shows an adaptive coping
strategy. The incorrect responses demonstrate idealization, devaluation, and wishful thinking.
When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse
can anticipate the assessment findings will include:
a. preoccupation with minute details; perfectionism.
b. charm, drama, seductiveness; seeking admiration.
c. difficulty being alone; indecisiveness, submissiveness.
d. grandiosity, attention seeking, and arrogance. –
Correct Answer :d. grandiosity, attention seeking, and arrogance.
A nurse in the emergency department tells an adult, "Your mother had a severe stroke." The
adult tearfully says, "Who will take care of me now? My mother always told me what to do,
what to wear, and what to eat. I need someone to reassure me when I get anxious." Which
term best describes this behavior?
a. Histrionic
b. Dependent
c. Narcissistic
P 4
Advanced Psych Wilkes NSG 526 Exam |
Clinical Modalities in Advanced Psych |
Questions & Correct Verified Answers with
Rationales | Latest 2026/2027 Update |
Graded A+|
A patient diagnosed with borderline personality disorder has a history of self-mutilation and
suicide attempts. The patient reveals feelings of depression and anger with life. The
psychiatrist suggests the use of a medication. Which type of medication should the nurse
expect?
P 1
, • NSG 526 Exam 09/01/2026
a. Selective serotonin reuptake inhibitor (SSRI)
b. Monoamine oxidase inhibitor (MAOI)
c. Benzodiazepine
d. Antipsychotic –
Correct Answer :a. Selective serotonin reuptake inhibitor (SSRI)
SSRIs are used to treat depression. Many patients with borderline personality disorder are
fearful of taking something over which they have little control. Because SSRIs have a good
side effect profile, the patient is more likely to comply with the medication. Low-dose
antipsychotic or anxiolytic medications are not supported by the data given in this scenario.
MAOIs require great diligence in adherence to a restricted diet and are rarely used for patients
who are impulsive.
A patient diagnosed with borderline personality disorder and a history of self-mutilation has
now begun dialectical behavior therapy (DBT) on an outpatient basis. Counseling focuses on
self-harm behavior management. Today the patient telephones to say, "I'm feeling empty and
want to cut myself." The nurse should:
a. arrange for emergency inpatient hospitalization.
b. send the patient to the crisis intervention unit for 8 to 12 hours.
c. assist the patient to identify the trigger situation and choose a coping strategy.
d. advise the patient to take an antianxiety medication to decrease the anxiety level. –
Correct Answer :c. assist the patient to identify the trigger situation and choose a coping
strategy.
P 2
, • NSG 526 Exam 09/01/2026
The patient has responded appropriately to the urge for self-harm by calling a helping
individual. A component of dialectical behavior therapy is telephone access to the therapist
for "coaching" during crises. The nurse can assist the patient to choose an alternative to self-
mutilation. The need for a protective environment may not be necessary if the patient is able
to use cognitive strategies to determine a coping strategy that reduces the urge to mutilate.
A patient tells a nurse, "I sometimes get into trouble because I make quick decisions and act
on them." A therapeutic response would be:
a. "Let's consider the advantages of being able to stop and think before acting."
b. "It sounds as though you've developed some insight into your situation."
c. "I'll bet you have some interesting stories to share about overreacting."
d. "It's good that you're showing readiness for behavioral change." –
Correct Answer :a. "Let's consider the advantages of being able to stop and think before
acting."
The patient is showing openness to learning techniques for impulse control. One technique is
to teach the patient to stop and think before acting impulsively. The patient can then be
taught to evaluate the outcomes of possible actions and choose an effective action. The
incorrect responses shift the encounter to a social level or are judgmental.
Which statement made by a patient diagnosed with borderline personality disorder indicates
the treatment plan is effective?
a. "I think you are the best nurse on the unit."
b. "I'm never going to get high on drugs again."
P 3
, • NSG 526 Exam 09/01/2026
c. "I hate my doctor for not giving me what I ask for."
d. "I felt empty and wanted to cut myself, so I called you." –
Correct Answer :d. "I felt empty and wanted to cut myself, so I called you."
Seeking a staff member instead of impulsively self-mutilating shows an adaptive coping
strategy. The incorrect responses demonstrate idealization, devaluation, and wishful thinking.
When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse
can anticipate the assessment findings will include:
a. preoccupation with minute details; perfectionism.
b. charm, drama, seductiveness; seeking admiration.
c. difficulty being alone; indecisiveness, submissiveness.
d. grandiosity, attention seeking, and arrogance. –
Correct Answer :d. grandiosity, attention seeking, and arrogance.
A nurse in the emergency department tells an adult, "Your mother had a severe stroke." The
adult tearfully says, "Who will take care of me now? My mother always told me what to do,
what to wear, and what to eat. I need someone to reassure me when I get anxious." Which
term best describes this behavior?
a. Histrionic
b. Dependent
c. Narcissistic
P 4
