NUR 253 Exam 4
Mental Health Nursing
| Verified Answers
Galen College of Nursing | Comprehensive Preparation
Child/Adolescent • Neurocognitive • Geriatric • Eating Disorders
Personality Disorders • Recovery Model • Psychiatric Emergencies
110 Questions | 7 Sections | Current Mental Health Standards
Cognitive Distribution: 30% Recall | 50% Application | 20% Analysis
Format: 75% Scenario-Based | 25% Direct Recall
Aligned with 2026-2027 NUR 253 Mental Health Nursing Curriculum Standards
,NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
NUR 253 Exam 4 — Mental Health Nursing
| Verified Answers | Galen College of Nursing
Comprehensive Mental Health Nursing Exam Preparation
Section Topic Focus Question Range
1 Child and Adolescent Psychiatric Disorders Q1 – Q18
2 Neurocognitive Disorders Q19 – Q36
3 Older Adult Mental Health and Geriatric Considerations Q37 – Q50
4 Eating Disorders Q51 – Q64
5 Personality Disorders and Complex Presentations Q65 – Q80
6 Psychiatric Rehabilitation, Recovery, and Community Care Q81 – Q96
7 Integrative and Advanced Practice Concepts Q97 – Q110
Examination Instructions: This examination contains 110 multiple-choice items. Each item has four
options (A–D) with exactly one best answer. Select the option that best addresses each mental health
nursing scenario using current DSM-5-TR diagnostic criteria, psychiatric-mental health nursing
scope of practice, recovery-oriented principles, and trauma-informed care. Apply safety-first
prioritization for self-harm, suicide, and behavioral emergencies. Rationales reference current
mental health nursing standards and best-practice evidence (ANA, APNA, SAMHSA).
SECTION 1: Child and Adolescent Psychiatric Disorders
ADHD, Autism Spectrum, Disruptive Disorders (ODD, Conduct Disorder), & Pediatric
Psychopharmacology
Question Range: Q1 – Q18
Q1: A 7-year-old is prescribed methylphenidate for ADHD. The nurse should monitor for
which common side effect?
A. Weight gain and hypersomnia.
B. Decreased appetite, insomnia, and growth velocity suppression. [CORRECT]
C. Hypotension and bradycardia.
D. Increased seizure threshold.
Correct Answer: B
Rationale: Stimulants like methylphenidate commonly cause appetite suppression, insomnia,
and growth velocity suppression requiring monitoring of height and weight. Weight gain,
hypersomnia, hypotension/bradycardia, or increased seizure threshold are not typical stimulant
effects; cardiovascular monitoring includes heart rate and BP. The nurse also screens for cardiac
history before initiation.
Clinical Note: Stimulants: monitor weight, height, sleep, appetite, BP/HR; drug holidays may be considered
for growth.
Educational Use — Mental Health Nursing Certification Preparation Page 2
,NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
Q2: A parent of a 9-year-old with ADHD asks about non-stimulant medication options.
The nurse explains that atomoxetine is:
A. A stimulant with a higher abuse potential.
B. A selective norepinephrine reuptake inhibitor (NRI) with lower abuse potential,
often used when stimulants are ineffective or contraindicated. [CORRECT]
C. An antipsychotic used for aggression.
D. A benzodiazepine for anxiety.
Correct Answer: B
Rationale: Atomoxetine is a selective norepinephrine reuptake inhibitor (NRI) with lower abuse
potential than stimulants, often used when stimulants are ineffective, contraindicated, or there is
a substance abuse concern. It is not a stimulant, antipsychotic, or benzodiazepine. It may take 4-6
weeks for full effect and requires monitoring for suicidal ideation (FDA black box warning in
children).
Clinical Note: Atomoxetine = non-stimulant NRI; lower abuse potential; monitor for suicidal ideation in
children/adolescents.
Q3: A 6-year-old with Autism Spectrum Disorder repeatedly lines up toy cars and
becomes distressed when the arrangement is changed. The nurse recognizes this as:
A. A typical play behavior that requires no intervention.
B. A restricted, repetitive pattern of behavior characteristic of ASD. [CORRECT]
C. A sign of obsessive-compulsive disorder.
D. An early indicator of conduct disorder.
Correct Answer: B
Rationale: Lining up toys and distress at disruption are restricted, repetitive patterns of behavior
characteristic of ASD per DSM-5-TR. These differ from OCD compulsions (driven by anxiety) and
conduct disorder (violation of others' rights). Typical play involves varied, imaginative scenarios.
The behavior is part of the ASD presentation and intervention should focus on functional support,
not suppression.
Clinical Note: ASD core features: social communication deficits + restricted/repetitive behaviors (lining up,
insistence on sameness).
Educational Use — Mental Health Nursing Certification Preparation Page 3
, NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
Q4: A nurse is assessing a 4-year-old for Autism Spectrum Disorder. Which finding is
MOST consistent with the social communication deficit domain?
A. The child points to objects of interest to share attention with the parent.
B. The child does not respond to their name by 12 months and lacks joint attention.
[CORRECT]
C. The child speaks in full sentences by 18 months.
D. The child engages in symbolic play with peers.
Correct Answer: B
Rationale: Lack of response to name by 12 months and absence of joint attention (sharing interest
with another) are core social communication deficits in ASD. Pointing to share, full sentences by
18 months, and symbolic play are typical or advanced development. Joint attention deficits are a
hallmark early marker of ASD and warrant further developmental evaluation.
Clinical Note: ASD early markers: no response to name, no joint attention, no pointing to share, no babbling
by 12 months.
Q5: An 8-year-old with Oppositional Defiant Disorder (ODD) frequently argues with
adults and refuses to follow rules. Which nursing intervention is MOST appropriate?
A. Use harsh punishment to enforce compliance.
B. Use consistent, calmly enforced boundaries with positive reinforcement for
appropriate behavior and parent training in behavioral management. [CORRECT]
C. Ignore all defiant behavior to avoid power struggles.
D. Recommend immediate psychiatric hospitalization.
Correct Answer: B
Rationale: ODD management uses consistent, calmly enforced boundaries with positive
reinforcement and parent training in behavioral management (e.g., Parent-Child Interaction
Therapy). Harsh punishment escalates defiance; ignoring reinforces behavior; hospitalization is
not indicated for ODD alone. ODD interventions focus on teaching the child and family adaptive
skills.
Clinical Note: ODD: consistent boundaries + positive reinforcement + parent training (PCIT); no harsh
punishment or hospitalization.
Educational Use — Mental Health Nursing Certification Preparation Page 4
Mental Health Nursing
| Verified Answers
Galen College of Nursing | Comprehensive Preparation
Child/Adolescent • Neurocognitive • Geriatric • Eating Disorders
Personality Disorders • Recovery Model • Psychiatric Emergencies
110 Questions | 7 Sections | Current Mental Health Standards
Cognitive Distribution: 30% Recall | 50% Application | 20% Analysis
Format: 75% Scenario-Based | 25% Direct Recall
Aligned with 2026-2027 NUR 253 Mental Health Nursing Curriculum Standards
,NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
NUR 253 Exam 4 — Mental Health Nursing
| Verified Answers | Galen College of Nursing
Comprehensive Mental Health Nursing Exam Preparation
Section Topic Focus Question Range
1 Child and Adolescent Psychiatric Disorders Q1 – Q18
2 Neurocognitive Disorders Q19 – Q36
3 Older Adult Mental Health and Geriatric Considerations Q37 – Q50
4 Eating Disorders Q51 – Q64
5 Personality Disorders and Complex Presentations Q65 – Q80
6 Psychiatric Rehabilitation, Recovery, and Community Care Q81 – Q96
7 Integrative and Advanced Practice Concepts Q97 – Q110
Examination Instructions: This examination contains 110 multiple-choice items. Each item has four
options (A–D) with exactly one best answer. Select the option that best addresses each mental health
nursing scenario using current DSM-5-TR diagnostic criteria, psychiatric-mental health nursing
scope of practice, recovery-oriented principles, and trauma-informed care. Apply safety-first
prioritization for self-harm, suicide, and behavioral emergencies. Rationales reference current
mental health nursing standards and best-practice evidence (ANA, APNA, SAMHSA).
SECTION 1: Child and Adolescent Psychiatric Disorders
ADHD, Autism Spectrum, Disruptive Disorders (ODD, Conduct Disorder), & Pediatric
Psychopharmacology
Question Range: Q1 – Q18
Q1: A 7-year-old is prescribed methylphenidate for ADHD. The nurse should monitor for
which common side effect?
A. Weight gain and hypersomnia.
B. Decreased appetite, insomnia, and growth velocity suppression. [CORRECT]
C. Hypotension and bradycardia.
D. Increased seizure threshold.
Correct Answer: B
Rationale: Stimulants like methylphenidate commonly cause appetite suppression, insomnia,
and growth velocity suppression requiring monitoring of height and weight. Weight gain,
hypersomnia, hypotension/bradycardia, or increased seizure threshold are not typical stimulant
effects; cardiovascular monitoring includes heart rate and BP. The nurse also screens for cardiac
history before initiation.
Clinical Note: Stimulants: monitor weight, height, sleep, appetite, BP/HR; drug holidays may be considered
for growth.
Educational Use — Mental Health Nursing Certification Preparation Page 2
,NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
Q2: A parent of a 9-year-old with ADHD asks about non-stimulant medication options.
The nurse explains that atomoxetine is:
A. A stimulant with a higher abuse potential.
B. A selective norepinephrine reuptake inhibitor (NRI) with lower abuse potential,
often used when stimulants are ineffective or contraindicated. [CORRECT]
C. An antipsychotic used for aggression.
D. A benzodiazepine for anxiety.
Correct Answer: B
Rationale: Atomoxetine is a selective norepinephrine reuptake inhibitor (NRI) with lower abuse
potential than stimulants, often used when stimulants are ineffective, contraindicated, or there is
a substance abuse concern. It is not a stimulant, antipsychotic, or benzodiazepine. It may take 4-6
weeks for full effect and requires monitoring for suicidal ideation (FDA black box warning in
children).
Clinical Note: Atomoxetine = non-stimulant NRI; lower abuse potential; monitor for suicidal ideation in
children/adolescents.
Q3: A 6-year-old with Autism Spectrum Disorder repeatedly lines up toy cars and
becomes distressed when the arrangement is changed. The nurse recognizes this as:
A. A typical play behavior that requires no intervention.
B. A restricted, repetitive pattern of behavior characteristic of ASD. [CORRECT]
C. A sign of obsessive-compulsive disorder.
D. An early indicator of conduct disorder.
Correct Answer: B
Rationale: Lining up toys and distress at disruption are restricted, repetitive patterns of behavior
characteristic of ASD per DSM-5-TR. These differ from OCD compulsions (driven by anxiety) and
conduct disorder (violation of others' rights). Typical play involves varied, imaginative scenarios.
The behavior is part of the ASD presentation and intervention should focus on functional support,
not suppression.
Clinical Note: ASD core features: social communication deficits + restricted/repetitive behaviors (lining up,
insistence on sameness).
Educational Use — Mental Health Nursing Certification Preparation Page 3
, NUR 253 Exam 4 | Mental Health Nursing | Galen College of Nursing 2026/2027 | 110 Questions
Q4: A nurse is assessing a 4-year-old for Autism Spectrum Disorder. Which finding is
MOST consistent with the social communication deficit domain?
A. The child points to objects of interest to share attention with the parent.
B. The child does not respond to their name by 12 months and lacks joint attention.
[CORRECT]
C. The child speaks in full sentences by 18 months.
D. The child engages in symbolic play with peers.
Correct Answer: B
Rationale: Lack of response to name by 12 months and absence of joint attention (sharing interest
with another) are core social communication deficits in ASD. Pointing to share, full sentences by
18 months, and symbolic play are typical or advanced development. Joint attention deficits are a
hallmark early marker of ASD and warrant further developmental evaluation.
Clinical Note: ASD early markers: no response to name, no joint attention, no pointing to share, no babbling
by 12 months.
Q5: An 8-year-old with Oppositional Defiant Disorder (ODD) frequently argues with
adults and refuses to follow rules. Which nursing intervention is MOST appropriate?
A. Use harsh punishment to enforce compliance.
B. Use consistent, calmly enforced boundaries with positive reinforcement for
appropriate behavior and parent training in behavioral management. [CORRECT]
C. Ignore all defiant behavior to avoid power struggles.
D. Recommend immediate psychiatric hospitalization.
Correct Answer: B
Rationale: ODD management uses consistent, calmly enforced boundaries with positive
reinforcement and parent training in behavioral management (e.g., Parent-Child Interaction
Therapy). Harsh punishment escalates defiance; ignoring reinforces behavior; hospitalization is
not indicated for ODD alone. ODD interventions focus on teaching the child and family adaptive
skills.
Clinical Note: ODD: consistent boundaries + positive reinforcement + parent training (PCIT); no harsh
punishment or hospitalization.
Educational Use — Mental Health Nursing Certification Preparation Page 4
