GALEN COLLEGE OF NURSING • NU 160 EXAM 4 COMPREHENSIVE
GALEN COLLEGE OF NURSING
NU 160: Lifespan Mental Health Concepts and Developmental Disorders
EXAM 4 COMPREHENSIVE EXAMINATION (50 QUESTIONS)
FALL 2026
STUDENT NAME: STUDENT ID: ___________________
___________________________
DATE: ___________________________________ SCORE: ________ / 50
EXAMINATION INSTRUCTIONS:
This official examination contains 50 NCLEX-style multiple-choice questions grounded strictly in course concepts
across Units 9, 10, and 11. Select the single best answer choice (A, B, C, or D) for each item. Answers are verified
with a green tick (✔) and rationale explanations are highlighted in yellow.
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Question 1. A nurse is completing an admission assessment on an adolescent client suspected of having
Anorexia Nervosa. According to diagnostic criteria, which constellation of findings must be present to
establish this diagnosis?
(A) Persistent ingestion of nonfood items for at least 1 month accompanied by severe gastrointestinal
obstruction.
(B) Delayed timing of food consumption resulting in eating large amounts of food exclusively during
nighttime waking hours.
(C) Binge eating episodes occurring at least twice weekly for 3 months followed by obligatory purging via
self-induced vomiting.
(D) Refusal to maintain adequate body weight, intense fear of gaining weight, distorted body perception,
and lack of recognition of the severity of low body weight.
✔ Correct Answer: Option (D) — Refusal to maintain adequate body weight, intense fear of gaining
weight, distorted body perception, and lack of recognition of the severity of low body weight.
Rationale: For Anorexia Nervosa to be diagnosed, four criteria must be met: refusal to eat leading to
significantly low body weight, intense fear of becoming fat despite being underweight, distorted perception of
body weight/shape, and an ongoing lack of recognition of the seriousness of the problem (Passage 70, 71).
Question 2. A severely underweight client with anorexia nervosa is admitted to the inpatient unit and
initiated on nutritional refeeding. The nurse prioritizes frequent monitoring for Refeeding Syndrome.
What is the primary clinical danger associated with refeeding syndrome?
(A) Severe fluid and electrolyte imbalances that can precipitate acute cellular dysfunctions.
(B) Acute muscular hypertrophy accompanied by severe malignant hyperthermia.
Page 1 of Exam Paper • Mental Health Concepts NU 160
, GALEN COLLEGE OF NURSING • NU 160 EXAM 4 COMPREHENSIVE
(C) Rapid, uncontrollable gain of visceral fat resulting in esophageal rupture.
(D) Sudden elevation of serum potassium levels leading to immediate metabolic alkalosis.
✔ Correct Answer: Option (A) — Severe fluid and electrolyte imbalances that can precipitate acute
cellular dysfunctions.
Rationale: Refeeding syndrome is an imbalance of fluids and electrolytes that occurs when severely anorexic
individuals resume eating after periods of starvation, leading to dangerous cellular dysfunctions (Passage 72).
Question 3. The healthcare provider considers prescribing an antidepressant medication for a client
diagnosed with anorexia nervosa and bulimia nervosa. Which laboratory assessment finding requires the
nurse to withhold the drug and immediately notify the physician?
(A) Serum potassium level falling below normal limits.
(B) Serum sodium level at the upper limit of normal.
(C) Blood glucose level of 92 mg/dL.
(D) Hemoglobin level of 13.5 g/dL.
✔ Correct Answer: Option (A) — Serum potassium level falling below normal limits.
Rationale: Drug Alert: Administering antidepressants to clients with anorexia nervosa and bulimia before they
regain weight may be hazardous if there is a history of cardiac problems. The nurse must withhold the
medication and notify the physician if potassium levels drop below normal limits (Passage 81).
Question 4. A college student is evaluated for bulimia nervosa. To meet the diagnostic threshold for
bulimia nervosa, what minimum frequency and duration of recurring binge eating episodes must be
documented?
(A) Once per week for at least 6 consecutive months.
(B) At least three times per week for at least 1 month.
(C) At least twice per week for at least 3 consecutive months.
(D) Once daily for at least 30 consecutive days.
✔ Correct Answer: Option (C) — At least twice per week for at least 3 consecutive months.
Rationale: For a diagnosis of bulimia nervosa to be established, recurring episodes of binge eating must occur
at least twice per week for at least three months (Passage 77).
Question 5. During a physical exam of a client with purging-type bulimia nervosa, which clinical
presentation should the nurse anticipate finding?
(A) Profound muscle wasting, stool retention, and diminished deep tendon reflexes.
(B) Hypertension, hyperreflexia, and dry brittle hair.
(C) Fine soft lanugo hair covering the trunk and severe hypothermia.
(D) Enamel erosion on teeth, salivary gland enlargement, and calloused fingertips.
✔ Correct Answer: Option (D) — Enamel erosion on teeth, salivary gland enlargement, and calloused
fingertips.
Rationale: Clinical signs of bulimia with frequent vomiting include dental enamel erosion, enlargement of the
salivary glands, callouses on the fingertips (Russell's sign), and ankle edema (Passage 28).
Page 1 of Exam Paper • Mental Health Concepts NU 160
GALEN COLLEGE OF NURSING
NU 160: Lifespan Mental Health Concepts and Developmental Disorders
EXAM 4 COMPREHENSIVE EXAMINATION (50 QUESTIONS)
FALL 2026
STUDENT NAME: STUDENT ID: ___________________
___________________________
DATE: ___________________________________ SCORE: ________ / 50
EXAMINATION INSTRUCTIONS:
This official examination contains 50 NCLEX-style multiple-choice questions grounded strictly in course concepts
across Units 9, 10, and 11. Select the single best answer choice (A, B, C, or D) for each item. Answers are verified
with a green tick (✔) and rationale explanations are highlighted in yellow.
――――――――――――――――――――――――――――――――――――――――――――――
―――――――――
Question 1. A nurse is completing an admission assessment on an adolescent client suspected of having
Anorexia Nervosa. According to diagnostic criteria, which constellation of findings must be present to
establish this diagnosis?
(A) Persistent ingestion of nonfood items for at least 1 month accompanied by severe gastrointestinal
obstruction.
(B) Delayed timing of food consumption resulting in eating large amounts of food exclusively during
nighttime waking hours.
(C) Binge eating episodes occurring at least twice weekly for 3 months followed by obligatory purging via
self-induced vomiting.
(D) Refusal to maintain adequate body weight, intense fear of gaining weight, distorted body perception,
and lack of recognition of the severity of low body weight.
✔ Correct Answer: Option (D) — Refusal to maintain adequate body weight, intense fear of gaining
weight, distorted body perception, and lack of recognition of the severity of low body weight.
Rationale: For Anorexia Nervosa to be diagnosed, four criteria must be met: refusal to eat leading to
significantly low body weight, intense fear of becoming fat despite being underweight, distorted perception of
body weight/shape, and an ongoing lack of recognition of the seriousness of the problem (Passage 70, 71).
Question 2. A severely underweight client with anorexia nervosa is admitted to the inpatient unit and
initiated on nutritional refeeding. The nurse prioritizes frequent monitoring for Refeeding Syndrome.
What is the primary clinical danger associated with refeeding syndrome?
(A) Severe fluid and electrolyte imbalances that can precipitate acute cellular dysfunctions.
(B) Acute muscular hypertrophy accompanied by severe malignant hyperthermia.
Page 1 of Exam Paper • Mental Health Concepts NU 160
, GALEN COLLEGE OF NURSING • NU 160 EXAM 4 COMPREHENSIVE
(C) Rapid, uncontrollable gain of visceral fat resulting in esophageal rupture.
(D) Sudden elevation of serum potassium levels leading to immediate metabolic alkalosis.
✔ Correct Answer: Option (A) — Severe fluid and electrolyte imbalances that can precipitate acute
cellular dysfunctions.
Rationale: Refeeding syndrome is an imbalance of fluids and electrolytes that occurs when severely anorexic
individuals resume eating after periods of starvation, leading to dangerous cellular dysfunctions (Passage 72).
Question 3. The healthcare provider considers prescribing an antidepressant medication for a client
diagnosed with anorexia nervosa and bulimia nervosa. Which laboratory assessment finding requires the
nurse to withhold the drug and immediately notify the physician?
(A) Serum potassium level falling below normal limits.
(B) Serum sodium level at the upper limit of normal.
(C) Blood glucose level of 92 mg/dL.
(D) Hemoglobin level of 13.5 g/dL.
✔ Correct Answer: Option (A) — Serum potassium level falling below normal limits.
Rationale: Drug Alert: Administering antidepressants to clients with anorexia nervosa and bulimia before they
regain weight may be hazardous if there is a history of cardiac problems. The nurse must withhold the
medication and notify the physician if potassium levels drop below normal limits (Passage 81).
Question 4. A college student is evaluated for bulimia nervosa. To meet the diagnostic threshold for
bulimia nervosa, what minimum frequency and duration of recurring binge eating episodes must be
documented?
(A) Once per week for at least 6 consecutive months.
(B) At least three times per week for at least 1 month.
(C) At least twice per week for at least 3 consecutive months.
(D) Once daily for at least 30 consecutive days.
✔ Correct Answer: Option (C) — At least twice per week for at least 3 consecutive months.
Rationale: For a diagnosis of bulimia nervosa to be established, recurring episodes of binge eating must occur
at least twice per week for at least three months (Passage 77).
Question 5. During a physical exam of a client with purging-type bulimia nervosa, which clinical
presentation should the nurse anticipate finding?
(A) Profound muscle wasting, stool retention, and diminished deep tendon reflexes.
(B) Hypertension, hyperreflexia, and dry brittle hair.
(C) Fine soft lanugo hair covering the trunk and severe hypothermia.
(D) Enamel erosion on teeth, salivary gland enlargement, and calloused fingertips.
✔ Correct Answer: Option (D) — Enamel erosion on teeth, salivary gland enlargement, and calloused
fingertips.
Rationale: Clinical signs of bulimia with frequent vomiting include dental enamel erosion, enlargement of the
salivary glands, callouses on the fingertips (Russell's sign), and ankle edema (Passage 28).
Page 1 of Exam Paper • Mental Health Concepts NU 160
