NUR 253 Exam 2 Actual Exam V1 | NUR 253 Mental Health Nursing
(NUR253 Exam 2) | Galen College of Nursing
1. A patient diagnosed with Major Depressive Disorder is prescribed Fluoxetine. Which
statement by the patient indicates the need for further teaching regarding this medication?
A. I should take this medication in the morning to avoid sleep disturbances.
B. It may take several weeks before I feel the full therapeutic effect.
C. I need to report any suicidal thoughts to my doctor immediately.
D. I can stop taking the medicine as soon as my mood feels better.
Answer: D
Rationale: Antidepressants like SSRIs must not be stopped abruptly to avoid
discontinuation syndrome. Patients should be taught that therapeutic effects take 2-4
weeks and that adherence is critical even when feeling better.
2. A patient with Bipolar I Disorder is being treated with Lithium carbonate. The nurse notes a
serum lithium level of 1.8 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose as ordered.
B. Encourage the patient to increase their fluid intake immediately.
C. Hold the dose and notify the healthcare provider of the toxic level.
D. Document the result as a therapeutic level for the manic phase.
Answer: C
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates toxicity, which requires holding the medication and notifying the provider to
prevent severe complications like seizures or coma.
3. A nurse is caring for a patient experiencing a panic attack. Which intervention is the most
appropriate during the peak of the panic episode?
A. Teach the patient deep breathing relaxation techniques.
B. Provide a quiet environment and use short, simple sentences.
C. Ask the patient to describe the triggers for their anxiety.
D. Leave the patient alone to allow them to calm down privately.
Answer: B
,Rationale: During a panic attack, the patient is unable to process complex information. The
nurse should stay with the patient, ensure safety, and use brief, clear communication in a
low-stimulus environment.
4. A patient with Schizophrenia is experiencing auditory hallucinations and appears
distracted. Which response by the nurse is therapeutic?
A. I don’t hear the voices, but I can see that you are upset.
B. Why do you think the voices are talking to you right now?
C. Please tell the voices to go away so we can finish our talk.
D. I hear the voices too, and they are telling us to be quiet.
Answer: A
Rationale: The nurse should present reality without arguing with the hallucination.
Acknowledging the patient’s feelings while stating that the nurse does not perceive the
stimulus is a key therapeutic technique.
5. The nurse is assessing a patient for Neuroleptic Malignant Syndrome (NMS). Which clinical
finding should the nurse prioritize?
A. Fine tremors and restlessness.
B. Orthostatic hypotension and diarrhea.
C. Dry mouth and blurred vision.
D. Muscle rigidity and hyperpyrexia.
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotic drugs characterized by
severe muscle rigidity, high fever (hyperpyrexia), tachycardia, and autonomic instability.
6. A patient is admitted with a diagnosis of Borderline Personality Disorder. The nurse
observes the patient praising one nurse while demeaning another. Which defense mechanism
is the patient using?
A. Projection
B. Splitting
C. Reaction Formation
D. Sublimation
Answer: B
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder
where individuals view others as either all good or all bad, often causing conflict among
staff members.
, 7. A patient is prescribed Clozapine for treatment-resistant Schizophrenia. Which laboratory
parameter must the nurse monitor weekly?
A. Serum potassium levels
B. Liver function tests (LFTs)
C. White blood cell (WBC) count
D. Blood urea nitrogen (BUN)
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis, a severe decrease in WBCs. Weekly
monitoring of the Absolute Neutrophil Count (ANC) and WBC is mandatory for patients on
this medication.
8. A nurse is conducting a suicide risk assessment. Which patient statement represents the
highest immediate risk?
A. I have a loaded gun in my garage and I plan to use it tonight.
B. I have been feeling very down lately and don’t enjoy my hobbies.
C. Sometimes I wish I could just sleep and never wake up again.
D. My family would be better off if I wasn’t around anymore.
Answer: A
Rationale: The highest risk is associated with a specific plan, a lethal method (gun), and
immediate intent (tonight). This requires immediate 1:1 observation.
9. A patient with Obsessive-Compulsive Disorder (OCD) spends two hours washing their
hands every morning. What is the initial nursing intervention?
A. Lock the bathroom door to prevent the patient from washing.
B. Explain the harmful effects of excessive washing on the skin.
C. Allow the patient enough time to perform the ritual initially.
D. Administer an anti-anxiety medication before the ritual starts.
Answer: C
Rationale: Initially, the nurse should allow the ritual to prevent overwhelming anxiety. As
treatment progresses, the nurse works with the patient to set limits and develop coping
mechanisms.
10. A patient is experiencing alcohol withdrawal. Which medication should the nurse expect
to administer to manage tremors and prevent seizures?
A. Disulfiram
(NUR253 Exam 2) | Galen College of Nursing
1. A patient diagnosed with Major Depressive Disorder is prescribed Fluoxetine. Which
statement by the patient indicates the need for further teaching regarding this medication?
A. I should take this medication in the morning to avoid sleep disturbances.
B. It may take several weeks before I feel the full therapeutic effect.
C. I need to report any suicidal thoughts to my doctor immediately.
D. I can stop taking the medicine as soon as my mood feels better.
Answer: D
Rationale: Antidepressants like SSRIs must not be stopped abruptly to avoid
discontinuation syndrome. Patients should be taught that therapeutic effects take 2-4
weeks and that adherence is critical even when feeling better.
2. A patient with Bipolar I Disorder is being treated with Lithium carbonate. The nurse notes a
serum lithium level of 1.8 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose as ordered.
B. Encourage the patient to increase their fluid intake immediately.
C. Hold the dose and notify the healthcare provider of the toxic level.
D. Document the result as a therapeutic level for the manic phase.
Answer: C
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates toxicity, which requires holding the medication and notifying the provider to
prevent severe complications like seizures or coma.
3. A nurse is caring for a patient experiencing a panic attack. Which intervention is the most
appropriate during the peak of the panic episode?
A. Teach the patient deep breathing relaxation techniques.
B. Provide a quiet environment and use short, simple sentences.
C. Ask the patient to describe the triggers for their anxiety.
D. Leave the patient alone to allow them to calm down privately.
Answer: B
,Rationale: During a panic attack, the patient is unable to process complex information. The
nurse should stay with the patient, ensure safety, and use brief, clear communication in a
low-stimulus environment.
4. A patient with Schizophrenia is experiencing auditory hallucinations and appears
distracted. Which response by the nurse is therapeutic?
A. I don’t hear the voices, but I can see that you are upset.
B. Why do you think the voices are talking to you right now?
C. Please tell the voices to go away so we can finish our talk.
D. I hear the voices too, and they are telling us to be quiet.
Answer: A
Rationale: The nurse should present reality without arguing with the hallucination.
Acknowledging the patient’s feelings while stating that the nurse does not perceive the
stimulus is a key therapeutic technique.
5. The nurse is assessing a patient for Neuroleptic Malignant Syndrome (NMS). Which clinical
finding should the nurse prioritize?
A. Fine tremors and restlessness.
B. Orthostatic hypotension and diarrhea.
C. Dry mouth and blurred vision.
D. Muscle rigidity and hyperpyrexia.
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotic drugs characterized by
severe muscle rigidity, high fever (hyperpyrexia), tachycardia, and autonomic instability.
6. A patient is admitted with a diagnosis of Borderline Personality Disorder. The nurse
observes the patient praising one nurse while demeaning another. Which defense mechanism
is the patient using?
A. Projection
B. Splitting
C. Reaction Formation
D. Sublimation
Answer: B
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder
where individuals view others as either all good or all bad, often causing conflict among
staff members.
, 7. A patient is prescribed Clozapine for treatment-resistant Schizophrenia. Which laboratory
parameter must the nurse monitor weekly?
A. Serum potassium levels
B. Liver function tests (LFTs)
C. White blood cell (WBC) count
D. Blood urea nitrogen (BUN)
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis, a severe decrease in WBCs. Weekly
monitoring of the Absolute Neutrophil Count (ANC) and WBC is mandatory for patients on
this medication.
8. A nurse is conducting a suicide risk assessment. Which patient statement represents the
highest immediate risk?
A. I have a loaded gun in my garage and I plan to use it tonight.
B. I have been feeling very down lately and don’t enjoy my hobbies.
C. Sometimes I wish I could just sleep and never wake up again.
D. My family would be better off if I wasn’t around anymore.
Answer: A
Rationale: The highest risk is associated with a specific plan, a lethal method (gun), and
immediate intent (tonight). This requires immediate 1:1 observation.
9. A patient with Obsessive-Compulsive Disorder (OCD) spends two hours washing their
hands every morning. What is the initial nursing intervention?
A. Lock the bathroom door to prevent the patient from washing.
B. Explain the harmful effects of excessive washing on the skin.
C. Allow the patient enough time to perform the ritual initially.
D. Administer an anti-anxiety medication before the ritual starts.
Answer: C
Rationale: Initially, the nurse should allow the ritual to prevent overwhelming anxiety. As
treatment progresses, the nurse works with the patient to set limits and develop coping
mechanisms.
10. A patient is experiencing alcohol withdrawal. Which medication should the nurse expect
to administer to manage tremors and prevent seizures?
A. Disulfiram
