NURS 222 Mental Health Nursing Week 11 Advanced Assessment
2026 |WCU
1. A patient with Borderline Personality Disorder (BPD) attempts to convince a
night-shift nurse that the day-shift nurse is ‘incompetent’ and ‘cruel’ compared
to them. Which defense mechanism is this patient utilizing?
A. Sublimation
B. Splitting
C. Reaction Formation
D. Projective Identification
Answer: B
Rationale: Splitting is a common defense mechanism in BPD where individuals view
others as all good or all bad, often attempting to pit staff members against one another.
2. During the treatment of a patient with severe Anorexia Nervosa, the nurse
identifies a rapid drop in serum phosphorus and magnesium after the patient
starts eating again. What is the priority concern?
A. Refeeding Syndrome
B. Malabsorption Syndrome
C. Metabolic Alkalosis
D. Bulimia Transition
Answer: A
Rationale: Refeeding syndrome is a potentially fatal shift in fluids and electrolytes
(especially phosphorus) that occurs when malnourished patients are rehydrated or fed too
quickly.
,3. A nurse is caring for a client with Antisocial Personality Disorder. Which
nursing intervention is the highest priority for maintaining the milieu?
A. Encouraging the client to express feelings of guilt
B. Implementing isolation if the client lies
C. Providing a flexible schedule to reduce frustration
D. Setting clear, consistent limits on manipulative behavior
Answer: D
Rationale: Clients with Antisocial Personality Disorder often test boundaries and
manipulate others; consistent limit-setting by all staff is crucial for safety and structure.
4. Which clinical finding would most likely indicate a diagnosis of Bulimia
Nervosa rather than Anorexia Nervosa?
A. Presence of Lanugo
B. Extreme bradycardia and hypotension
C. Amenorrhea for three consecutive months
D. Body weight within or slightly above normal range
Answer: D
Rationale: While anorexic patients are severely underweight, bulimic patients often
maintain a weight that is near or slightly above normal despite purging behaviors.
5. A client presents with a sudden loss of vision after witnessing a traumatic
event, but neurological exams show no physical cause. The client seems
surprisingly unconcerned about the blindness. This lack of concern is known as:
A. Malingering
B. La belle indifférence
C. Somatization
D. Dissociative Fugue
Answer: B
, Rationale: La belle indifférence is a classic sign of Conversion Disorder where the patient
displays a lack of emotional concern regarding a significant physical symptom.
6. Which medication is specifically FDA-approved for the treatment of Bulimia
Nervosa to help reduce binge-purge cycles?
A. Risperidone (Risperdal)
B. Lithium Carbonate
C. Fluoxetine (Prozac)
D. Bupropion (Wellbutrin)
Answer: C
Rationale: Fluoxetine, an SSRI, is the only medication with specific FDA approval for
treating Bulimia Nervosa at higher doses (60mg/day).
7. In the context of legal and ethical issues, the ‘Duty to Warn’ (Tarasoff Rule)
requires the mental health professional to:
A. Notify the intended victim and/or authorities if a client makes a specific threat
B. Report any suspicion of child abuse to the police immediately
C. Always provide the client’s family with a diagnosis
D. Break confidentiality whenever a client mentions a past crime
Answer: A
Rationale: The Tarasoff Rule establishes that clinicians have a legal obligation to protect
third parties from a client’s credible and specific threats of violence.
8. A patient with Schizotypal Personality Disorder is most likely to exhibit which
of the following behaviors?
A. Magical thinking and odd, eccentric speech
B. Extreme need for admiration and grandiosity
C. Aggressive outbursts and lack of remorse
D. Excessive emotionality and attention-seeking
Answer: A
2026 |WCU
1. A patient with Borderline Personality Disorder (BPD) attempts to convince a
night-shift nurse that the day-shift nurse is ‘incompetent’ and ‘cruel’ compared
to them. Which defense mechanism is this patient utilizing?
A. Sublimation
B. Splitting
C. Reaction Formation
D. Projective Identification
Answer: B
Rationale: Splitting is a common defense mechanism in BPD where individuals view
others as all good or all bad, often attempting to pit staff members against one another.
2. During the treatment of a patient with severe Anorexia Nervosa, the nurse
identifies a rapid drop in serum phosphorus and magnesium after the patient
starts eating again. What is the priority concern?
A. Refeeding Syndrome
B. Malabsorption Syndrome
C. Metabolic Alkalosis
D. Bulimia Transition
Answer: A
Rationale: Refeeding syndrome is a potentially fatal shift in fluids and electrolytes
(especially phosphorus) that occurs when malnourished patients are rehydrated or fed too
quickly.
,3. A nurse is caring for a client with Antisocial Personality Disorder. Which
nursing intervention is the highest priority for maintaining the milieu?
A. Encouraging the client to express feelings of guilt
B. Implementing isolation if the client lies
C. Providing a flexible schedule to reduce frustration
D. Setting clear, consistent limits on manipulative behavior
Answer: D
Rationale: Clients with Antisocial Personality Disorder often test boundaries and
manipulate others; consistent limit-setting by all staff is crucial for safety and structure.
4. Which clinical finding would most likely indicate a diagnosis of Bulimia
Nervosa rather than Anorexia Nervosa?
A. Presence of Lanugo
B. Extreme bradycardia and hypotension
C. Amenorrhea for three consecutive months
D. Body weight within or slightly above normal range
Answer: D
Rationale: While anorexic patients are severely underweight, bulimic patients often
maintain a weight that is near or slightly above normal despite purging behaviors.
5. A client presents with a sudden loss of vision after witnessing a traumatic
event, but neurological exams show no physical cause. The client seems
surprisingly unconcerned about the blindness. This lack of concern is known as:
A. Malingering
B. La belle indifférence
C. Somatization
D. Dissociative Fugue
Answer: B
, Rationale: La belle indifférence is a classic sign of Conversion Disorder where the patient
displays a lack of emotional concern regarding a significant physical symptom.
6. Which medication is specifically FDA-approved for the treatment of Bulimia
Nervosa to help reduce binge-purge cycles?
A. Risperidone (Risperdal)
B. Lithium Carbonate
C. Fluoxetine (Prozac)
D. Bupropion (Wellbutrin)
Answer: C
Rationale: Fluoxetine, an SSRI, is the only medication with specific FDA approval for
treating Bulimia Nervosa at higher doses (60mg/day).
7. In the context of legal and ethical issues, the ‘Duty to Warn’ (Tarasoff Rule)
requires the mental health professional to:
A. Notify the intended victim and/or authorities if a client makes a specific threat
B. Report any suspicion of child abuse to the police immediately
C. Always provide the client’s family with a diagnosis
D. Break confidentiality whenever a client mentions a past crime
Answer: A
Rationale: The Tarasoff Rule establishes that clinicians have a legal obligation to protect
third parties from a client’s credible and specific threats of violence.
8. A patient with Schizotypal Personality Disorder is most likely to exhibit which
of the following behaviors?
A. Magical thinking and odd, eccentric speech
B. Extreme need for admiration and grandiosity
C. Aggressive outbursts and lack of remorse
D. Excessive emotionality and attention-seeking
Answer: A
