NRSG263 / NRSG 263 TASK 2: CASE
STUDY TWO – TREVOR | MAJOR
DEPRESSIVE DISORDER, MSE & RISK
ASSESSMENT | 2026/2027 UPDATED |
AUSTRALIAN CATHOLIC UNIVERSITY
Original practice question bank aligned with the case-study themes of Major
Depressive Disorder (MDD), Mental Status Examination (MSE), suicide/self-harm
risk assessment, clinical reasoning, therapeutic communication, and nursing
management. These are practice questions, not proprietary or leaked Australian
Catholic University examination questions, and they are not a guarantee of
assessment results.
INTRODUCTION
This practice bank is designed to support preparation for NRSG263 / NRSG 263
Task 2: Case Study Two – Trevor, with emphasis on the clinical reasoning expected
when assessing a person experiencing depressive symptoms. Questions focus on
interpretation rather than simple recall, requiring the learner to integrate presenting
symptoms, Mental Status Examination findings, psychosocial history, suicide and
self-harm risk, protective factors, therapeutic communication, nursing priorities, and
evidence-informed care.
The scenarios emphasize the distinction between depressive symptoms and immediate
safety concerns. Particular attention is given to identifying clinically significant
changes in mood, affect, cognition, thought content, perception, behaviour, insight,
judgment, functioning, and risk. Several questions require prioritisation of nursing
actions, appropriate escalation, documentation, and communication with the
multidisciplinary team.
The questions are written as original study material and should be used alongside
ACU course materials, prescribed readings, Australian clinical guidance, and the
specific requirements of the Trevor case study.
CORE DOMAINS
1.
Major Depressive Disorder
2.
3.
1
, Mental Status Examination
4.
5.
Suicide and Self-Harm Risk Assessment
6.
7.
Therapeutic Communication
8.
9.
Risk Management and Safety Planning
10.
11.
Mental Health Nursing Assessment
12.
13.
Clinical Reasoning and Prioritisation
14.
15.
Psychosocial Assessment
16.
17.
Documentation and Handover
18.
19.
Recovery-Oriented Nursing Care
20.
QUESTIONS 1–100
2
,QUESTION 1
Trevor reports feeling “empty and hopeless” nearly every day and states that activities
he previously enjoyed no longer interest him. Which combination of findings most
strongly supports a depressive syndrome?
A. Elevated mood, increased energy, reduced need for sleep
B. Persistent low mood, anhedonia, reduced energy, and impaired concentration
C. Suspiciousness, pressured speech, and grandiosity
D. Increased goal-directed activity and excessive confidence
ANSWER: B
Rationale: B is correct because persistent depressed mood, anhedonia, low energy,
and impaired concentration are characteristic features of a depressive syndrome. A
and D are more consistent with manic or hypomanic presentations. C describes
features more suggestive of psychosis or mania rather than uncomplicated depression.
QUESTION 2
During Trevor's assessment, the nurse notices that he speaks very slowly, provides
brief answers, and requires additional time to respond. Which MSE domain is
primarily being described?
A. Speech
B. Perception
C. Insight
D. Thought content
ANSWER: A
Rationale: A is correct because rate, volume, quantity, and spontaneity of speech are
assessed under the speech component of the MSE. B concerns hallucinations and
other perceptual disturbances. C concerns awareness of illness and circumstances. D
concerns the themes and content of the person's thoughts.
QUESTION 3
Trevor states, “Nothing is going to improve, and there is no point trying anymore.”
What should the nurse do first?
A. Reassure Trevor that everything will improve
B. Change the subject to a less distressing topic
C. Explore the statement further, including suicidal thoughts and intent
D. Tell Trevor to focus on positive aspects of his life
3
, ANSWER: C
Rationale: C is correct because hopelessness can be associated with suicide risk and
requires direct, therapeutic exploration. A, B, and D may prematurely minimise
Trevor's experience and can prevent accurate risk assessment.
QUESTION 4
Which nursing question is most appropriate when assessing Trevor for suicidal
ideation?
A. “You aren't thinking about suicide, are you?”
B. “You wouldn't hurt yourself because of your family, would you?”
C. “Have you been having thoughts about killing yourself?”
D. “Why would you want to do something like that?”
ANSWER: C
Rationale: C is correct because it is direct, nonjudgmental, and clearly assesses
suicidal ideation. Directly asking about suicide does not cause suicidal behaviour. A
and B are leading questions, while D may sound judgmental and discourage
disclosure.
QUESTION 5
Trevor acknowledges suicidal thoughts but denies having a current plan. What is the
nurse's most appropriate interpretation?
A. Trevor has no suicide risk because there is no plan
B. The absence of a plan eliminates the need for further assessment
C. Suicidal ideation remains clinically significant and requires further risk assessment
D. Trevor should automatically be discharged because he denies intent
ANSWER: C
Rationale: C is correct because suicidal ideation remains significant even when a
person denies a current plan. Risk assessment should consider intent, access to means,
previous attempts, substance use, psychiatric symptoms, protective factors, supports,
and changes in circumstances. A, B, and D incorrectly equate absence of a plan with
absence of risk.
QUESTION 6
4
STUDY TWO – TREVOR | MAJOR
DEPRESSIVE DISORDER, MSE & RISK
ASSESSMENT | 2026/2027 UPDATED |
AUSTRALIAN CATHOLIC UNIVERSITY
Original practice question bank aligned with the case-study themes of Major
Depressive Disorder (MDD), Mental Status Examination (MSE), suicide/self-harm
risk assessment, clinical reasoning, therapeutic communication, and nursing
management. These are practice questions, not proprietary or leaked Australian
Catholic University examination questions, and they are not a guarantee of
assessment results.
INTRODUCTION
This practice bank is designed to support preparation for NRSG263 / NRSG 263
Task 2: Case Study Two – Trevor, with emphasis on the clinical reasoning expected
when assessing a person experiencing depressive symptoms. Questions focus on
interpretation rather than simple recall, requiring the learner to integrate presenting
symptoms, Mental Status Examination findings, psychosocial history, suicide and
self-harm risk, protective factors, therapeutic communication, nursing priorities, and
evidence-informed care.
The scenarios emphasize the distinction between depressive symptoms and immediate
safety concerns. Particular attention is given to identifying clinically significant
changes in mood, affect, cognition, thought content, perception, behaviour, insight,
judgment, functioning, and risk. Several questions require prioritisation of nursing
actions, appropriate escalation, documentation, and communication with the
multidisciplinary team.
The questions are written as original study material and should be used alongside
ACU course materials, prescribed readings, Australian clinical guidance, and the
specific requirements of the Trevor case study.
CORE DOMAINS
1.
Major Depressive Disorder
2.
3.
1
, Mental Status Examination
4.
5.
Suicide and Self-Harm Risk Assessment
6.
7.
Therapeutic Communication
8.
9.
Risk Management and Safety Planning
10.
11.
Mental Health Nursing Assessment
12.
13.
Clinical Reasoning and Prioritisation
14.
15.
Psychosocial Assessment
16.
17.
Documentation and Handover
18.
19.
Recovery-Oriented Nursing Care
20.
QUESTIONS 1–100
2
,QUESTION 1
Trevor reports feeling “empty and hopeless” nearly every day and states that activities
he previously enjoyed no longer interest him. Which combination of findings most
strongly supports a depressive syndrome?
A. Elevated mood, increased energy, reduced need for sleep
B. Persistent low mood, anhedonia, reduced energy, and impaired concentration
C. Suspiciousness, pressured speech, and grandiosity
D. Increased goal-directed activity and excessive confidence
ANSWER: B
Rationale: B is correct because persistent depressed mood, anhedonia, low energy,
and impaired concentration are characteristic features of a depressive syndrome. A
and D are more consistent with manic or hypomanic presentations. C describes
features more suggestive of psychosis or mania rather than uncomplicated depression.
QUESTION 2
During Trevor's assessment, the nurse notices that he speaks very slowly, provides
brief answers, and requires additional time to respond. Which MSE domain is
primarily being described?
A. Speech
B. Perception
C. Insight
D. Thought content
ANSWER: A
Rationale: A is correct because rate, volume, quantity, and spontaneity of speech are
assessed under the speech component of the MSE. B concerns hallucinations and
other perceptual disturbances. C concerns awareness of illness and circumstances. D
concerns the themes and content of the person's thoughts.
QUESTION 3
Trevor states, “Nothing is going to improve, and there is no point trying anymore.”
What should the nurse do first?
A. Reassure Trevor that everything will improve
B. Change the subject to a less distressing topic
C. Explore the statement further, including suicidal thoughts and intent
D. Tell Trevor to focus on positive aspects of his life
3
, ANSWER: C
Rationale: C is correct because hopelessness can be associated with suicide risk and
requires direct, therapeutic exploration. A, B, and D may prematurely minimise
Trevor's experience and can prevent accurate risk assessment.
QUESTION 4
Which nursing question is most appropriate when assessing Trevor for suicidal
ideation?
A. “You aren't thinking about suicide, are you?”
B. “You wouldn't hurt yourself because of your family, would you?”
C. “Have you been having thoughts about killing yourself?”
D. “Why would you want to do something like that?”
ANSWER: C
Rationale: C is correct because it is direct, nonjudgmental, and clearly assesses
suicidal ideation. Directly asking about suicide does not cause suicidal behaviour. A
and B are leading questions, while D may sound judgmental and discourage
disclosure.
QUESTION 5
Trevor acknowledges suicidal thoughts but denies having a current plan. What is the
nurse's most appropriate interpretation?
A. Trevor has no suicide risk because there is no plan
B. The absence of a plan eliminates the need for further assessment
C. Suicidal ideation remains clinically significant and requires further risk assessment
D. Trevor should automatically be discharged because he denies intent
ANSWER: C
Rationale: C is correct because suicidal ideation remains significant even when a
person denies a current plan. Risk assessment should consider intent, access to means,
previous attempts, substance use, psychiatric symptoms, protective factors, supports,
and changes in circumstances. A, B, and D incorrectly equate absence of a plan with
absence of risk.
QUESTION 6
4
