STUVIA EXAM LIBRARY
EXAMINATION DOCUMENT • 2026/2027 A+
VERIFIED
NUR 253 Exam 4 Mental Health
2026/2027 – Questions and Answers |
Psychiatric Nursing | Clinical
Mood, Anxiety, Psychotic, Personality & Substance-Use Disorders —
ReasoningLevel
Application/Analysis – Pass Guaranteed – A+
Graded
50 5 100%
QUESTIONS SECTIONS R AT I O N A L E S
Application / Analysis level Domain-aligned distribution Every item includes a specific
MCQs with rationales across the blueprint explanatory rationale
W H AT T H I S C O V E R S
SECTION 01 SECTION 02
Mood Disorders and Suicide Risk Anxiety and Obsessive-Compulsive
Disorders
SECTION 03 SECTION 04
Schizophrenia and Psychotic Disorders Personality and Dissociative Disorders
A BSO UT THIS ASSESSMENT
ECTION 05
Substance Use and Eating Disorders
SCOPE & COGNITIVE DEMAND
This assessment evaluates the nursing student's ability to apply psychiatric-mental health concepts to clinical
scenarios spanning mood disorders and suicide risk, anxiety and obsessive-compulsive disorders,
schizophrenia and psychotic disorders, personality and dissociative disorders, and substance use with eating
disorders. Items target application and analysis cognitive levels: prioritizing nursing actions, interpreting
therapeutic communication, evaluating medication safety, recognizing acute decompensation, and tailoring
evidence-based interventions across the lifespan. Each question is paired with a specific rationale to support
formative review.
80% Intermediate MCQ A–D 2026/2027
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT CYCLE
S T U V I A A C T U A L E X A M
, NUR 253 Exam 4 Mental Health 50 Questions • Pass 80% • A+ Verified
NUR 253 Exam 4 Mental Health 2026/2027 – Questions and Answers | Psychiatric Nursing | Clinical
Reasoning – Pass Guaranteed – A+ Graded
Year Tag: 2026/2027 • Total Questions: 50 • Sections: 5 • Passing Score: 80% • Difficulty: Intermediate • Bloom's:
Application/Analysis
Section 1: Mood Disorders and Suicide Risk
Major depression, bipolar disorder, suicide assessment, and crisis intervention. Items in this section: 10.
CONCEPT: Suicide assessment — SAD PERSONS scale application
1. A 34-year-old veteran with major depressive disorder tells the nurse, 'I just want to go to sleep and not
wake up.' Which initial nursing action best addresses the immediate risk?
A. Document the statement and notify the provider at the next shift handoff
B. Encourage the patient to attend group therapy to reduce isolation
C. Place the patient on suicide precautions and remove all sharp objects
D. Ask directly if the patient has a specific plan, means, and timeline
Answer: D. Rationale: Directly assessing for plan, means, and timeline is the highest-priority intervention because it
quantifies lethality risk and drives the level of precaution. Precautions (C) follow only after risk is quantified;
documentation (A) and group referral (B) do not address immediate safety.
CONCEPT: Lithium toxicity — early signs
2. A patient on lithium 900 mg twice daily for bipolar I disorder presents with coarse hand tremor, nausea,
and mild confusion. Serum lithium is 1.8 mEq/L. Which nursing action is most appropriate?
A. Administer PRN lorazepam 1 mg to control the tremor
B. Reassure the patient that tremor is a common benign side effect
C. Administer the next scheduled dose with food to reduce GI upset
D. Hold the dose, force oral fluids, and notify the prescriber
Answer: D. Rationale: Serum lithium above 1.5 mEq/L with tremor, GI distress, and confusion signals toxicity. The dose
must be held, hydration promoted to enhance renal clearance, and the prescriber notified. Giving the next dose (C)
worsens toxicity; reassurance (B) ignores the dangerous level; lorazepam (A) does not lower lithium.
CONCEPT: ECT nursing care — post-anesthesia airway
3. A 68-year-old patient is recovering in the PACU after the sixth electroconvulsive therapy (ECT)
treatment for treatment-resistant depression. Which finding requires the most immediate intervention?
A. Oxygen saturation 90% on room air with sonorous respirations
B. Reports of muscle soreness in the jaw and neck
C. Disorientation to time and place lasting 20 minutes
D. Heart rate 88, blood pressure 110/68 with mild headache
Answer: A. Rationale: An SpO2 of 90% with sonorous respirations indicates airway obstruction from residual anesthesia
— an immediate ABC priority requiring jaw-thrust, suction, or airway adjunct. Disorientation (C), vital sign stability (D),
and muscle soreness (B) are expected post-ECT findings that require monitoring but not emergency intervention.
CONCEPT: Bipolar mania — milieu management priorities
4. A patient in acute mania is pacing the unit, talking rapidly, and interrupting peers. Which intervention
best protects the patient and milieu without escalating behavior?
A. Provide a low-stimulation single room and offer high-protein finger foods
B. Insist the patient sit through a 45-minute psychoeducation group
Page 1 STUVIA ACTUAL EXAM A+ Graded • Pass Guaranteed
EXAMINATION DOCUMENT • 2026/2027 A+
VERIFIED
NUR 253 Exam 4 Mental Health
2026/2027 – Questions and Answers |
Psychiatric Nursing | Clinical
Mood, Anxiety, Psychotic, Personality & Substance-Use Disorders —
ReasoningLevel
Application/Analysis – Pass Guaranteed – A+
Graded
50 5 100%
QUESTIONS SECTIONS R AT I O N A L E S
Application / Analysis level Domain-aligned distribution Every item includes a specific
MCQs with rationales across the blueprint explanatory rationale
W H AT T H I S C O V E R S
SECTION 01 SECTION 02
Mood Disorders and Suicide Risk Anxiety and Obsessive-Compulsive
Disorders
SECTION 03 SECTION 04
Schizophrenia and Psychotic Disorders Personality and Dissociative Disorders
A BSO UT THIS ASSESSMENT
ECTION 05
Substance Use and Eating Disorders
SCOPE & COGNITIVE DEMAND
This assessment evaluates the nursing student's ability to apply psychiatric-mental health concepts to clinical
scenarios spanning mood disorders and suicide risk, anxiety and obsessive-compulsive disorders,
schizophrenia and psychotic disorders, personality and dissociative disorders, and substance use with eating
disorders. Items target application and analysis cognitive levels: prioritizing nursing actions, interpreting
therapeutic communication, evaluating medication safety, recognizing acute decompensation, and tailoring
evidence-based interventions across the lifespan. Each question is paired with a specific rationale to support
formative review.
80% Intermediate MCQ A–D 2026/2027
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT CYCLE
S T U V I A A C T U A L E X A M
, NUR 253 Exam 4 Mental Health 50 Questions • Pass 80% • A+ Verified
NUR 253 Exam 4 Mental Health 2026/2027 – Questions and Answers | Psychiatric Nursing | Clinical
Reasoning – Pass Guaranteed – A+ Graded
Year Tag: 2026/2027 • Total Questions: 50 • Sections: 5 • Passing Score: 80% • Difficulty: Intermediate • Bloom's:
Application/Analysis
Section 1: Mood Disorders and Suicide Risk
Major depression, bipolar disorder, suicide assessment, and crisis intervention. Items in this section: 10.
CONCEPT: Suicide assessment — SAD PERSONS scale application
1. A 34-year-old veteran with major depressive disorder tells the nurse, 'I just want to go to sleep and not
wake up.' Which initial nursing action best addresses the immediate risk?
A. Document the statement and notify the provider at the next shift handoff
B. Encourage the patient to attend group therapy to reduce isolation
C. Place the patient on suicide precautions and remove all sharp objects
D. Ask directly if the patient has a specific plan, means, and timeline
Answer: D. Rationale: Directly assessing for plan, means, and timeline is the highest-priority intervention because it
quantifies lethality risk and drives the level of precaution. Precautions (C) follow only after risk is quantified;
documentation (A) and group referral (B) do not address immediate safety.
CONCEPT: Lithium toxicity — early signs
2. A patient on lithium 900 mg twice daily for bipolar I disorder presents with coarse hand tremor, nausea,
and mild confusion. Serum lithium is 1.8 mEq/L. Which nursing action is most appropriate?
A. Administer PRN lorazepam 1 mg to control the tremor
B. Reassure the patient that tremor is a common benign side effect
C. Administer the next scheduled dose with food to reduce GI upset
D. Hold the dose, force oral fluids, and notify the prescriber
Answer: D. Rationale: Serum lithium above 1.5 mEq/L with tremor, GI distress, and confusion signals toxicity. The dose
must be held, hydration promoted to enhance renal clearance, and the prescriber notified. Giving the next dose (C)
worsens toxicity; reassurance (B) ignores the dangerous level; lorazepam (A) does not lower lithium.
CONCEPT: ECT nursing care — post-anesthesia airway
3. A 68-year-old patient is recovering in the PACU after the sixth electroconvulsive therapy (ECT)
treatment for treatment-resistant depression. Which finding requires the most immediate intervention?
A. Oxygen saturation 90% on room air with sonorous respirations
B. Reports of muscle soreness in the jaw and neck
C. Disorientation to time and place lasting 20 minutes
D. Heart rate 88, blood pressure 110/68 with mild headache
Answer: A. Rationale: An SpO2 of 90% with sonorous respirations indicates airway obstruction from residual anesthesia
— an immediate ABC priority requiring jaw-thrust, suction, or airway adjunct. Disorientation (C), vital sign stability (D),
and muscle soreness (B) are expected post-ECT findings that require monitoring but not emergency intervention.
CONCEPT: Bipolar mania — milieu management priorities
4. A patient in acute mania is pacing the unit, talking rapidly, and interrupting peers. Which intervention
best protects the patient and milieu without escalating behavior?
A. Provide a low-stimulation single room and offer high-protein finger foods
B. Insist the patient sit through a 45-minute psychoeducation group
Page 1 STUVIA ACTUAL EXAM A+ Graded • Pass Guaranteed
