NGN-Aligned Study Set Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
[SECTION 1: Mood Disorders (Questions 1-7)]
Q1: A patient with bipolar I disorder is experiencing a manic episode. Which clinical
manifestation distinguishes bipolar I from bipolar II disorder?
A. Presence of hypomanic episodes
B. History of major depressive episodes
C. Severe impairment requiring hospitalization
D. Duration of mood episodes exceeding 2 weeks
C. Severe impairment requiring hospitalization [CORRECT]
Correct Answer: C
Rationale: Bipolar I disorder requires at least one manic episode causing severe
impairment or requiring hospitalization (DSM-5-TR). Bipolar II involves hypomanic
episodes (A) without severe impairment. Major depressive episodes (B) occur in both
types. Duration (D) is not a distinguishing factor. This aligns with NGN clinical judgment for
prioritizing safety in severe mania.
Q2: A patient with major depressive disorder (MDD) reports anhedonia, insomnia, and
feelings of worthlessness. Which nursing intervention is most appropriate for initial
management?
,A. Encouraging participation in group therapy immediately
B. Administering a benzodiazepine for sleep
C. Establishing a structured daily routine with minimal demands
D. Confronting the patient about negative thought patterns
C. Establishing a structured daily routine with minimal demands [CORRECT]
Correct Answer: C
Rationale: Structured routines reduce overwhelm in MDD patients (ANA scope).
Benzodiazepines (B) risk dependence and are not first-line for depression. Group therapy
(A) may be too stimulating initially. Confrontation (D) can damage the therapeutic alliance.
This reflects NGN application of psychosocial interventions.
Q3: A patient with persistent depressive disorder (dysthymia) has a 3-year history of low
mood. Which DSM-5-TR criterion is essential for diagnosis?
A. Psychotic features present
B. Depressed mood most of the day, more days than not
C. At least one major depressive episode
D. Manic episode history
B. Depressed mood most of the day, more days than not [CORRECT]
Correct Answer: B
Rationale: Persistent depressive disorder requires depressed mood for ≥2 years
(DSM-5-TR). Psychotic features (A) are not required. Major depressive episodes (C) may
coexist but are not diagnostic. Manic episodes (D) exclude this diagnosis. This tests recall
of diagnostic criteria for NGN.
Q4: A bipolar patient on lithium therapy presents with tremors, nausea, and confusion.
What is the nurse’s priority action?
A. Administering an antiemetic
B. Checking serum lithium level
,C. Increasing fluid intake
D. Documenting symptoms as side effects
B. Checking serum lithium level [CORRECT]
Correct Answer: B
Rationale: Tremors, nausea, and confusion indicate lithium toxicity (therapeutic range:
0.6-1.2 mEq/L). Immediate level check is critical (APA guidelines). Anti emetics (A) or
fluids (C) are supportive but not priority. Documentation (D) delays intervention. This
applies pharmacology monitoring for NGN.
Q5: A patient with MDD refuses to eat, stating, “I deserve to starve.” Which nursing
diagnosis takes priority?
A. Risk for infection
B. Imbalanced nutrition: less than body requirements
C. Chronic low self-esteem
D. Social isolation
B. Imbalanced nutrition: less than body requirements [CORRECT]
Correct Answer: B
Rationale: Refusal to eat poses immediate physical risk (NCSBN CJMM). Self-esteem (C)
and isolation (D) are important but secondary. Infection risk (A) is less urgent. This
prioritizes physiological needs per Maslow’s hierarchy for NGN analysis.
Q6: A patient with bipolar disorder is nonadherent to valproate therapy. Which intervention
best promotes adherence?
A. Educating about long-term risks of nonadherence
B. Simplifying the dosing schedule
C. Threatening hospitalization for nonadherence
D. Encouraging family to supervise medication
B. Simplifying the dosing schedule [CORRECT]
, Correct Answer: B
Rationale: Simplified regimens improve adherence (APA practice guidelines). Education
(A) is important but less immediate.1. Threats (C) harm the alliance. Family supervision (D)
may infringe on autonomy. This applies behavioral strategies for NGN application.1.
Q7: A patient with seasonal affective disorder (SAD) asks about light therapy. What is the
correct instruction?
A. Use a 10,000-lux light box for 30 minutes daily
B. Avoid morning light to prevent mania
C. Use light therapy only in winter
D. Combine with benzodiazepines for best results
A. Use a 10,000-lux light box for 30 minutes daily [CORRECT]
Correct Answer: A
Rationale: 10,000-lux light boxes for 20-30 minutes daily are evidence-based for SAD
(DSM-5-TR). Morning use (B) is recommended, not avoided. Light therapy can be used
year-round (C). Benzodiazepines (D) are not indicated. This tests knowledge of
non-pharmacological interventions for NGN.
[SECTION 2: Anxiety Disorders (Questions 8-14)]
Q8: A patient with panic disorder experiences sudden palpitations and fear of dying. What
is the nurse’s first action?
A. Administering alprazolam
B. Teaching deep breathing exercises
C. Assessing for suicidal ideation
D. Leaving the patient alone to reduce stimulation
B. Teaching deep breathing exercises [CORRECT]