NUR 256 Exam 2 – Concepts of Mental Health
Nursing – (2026) Actual Questions & Answers
(Galen College of Nursing)
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An adolescent diagnosed with a conduct disorder stole and wrecked a neighbor's motorcycle.
Afterward, the adolescent was confronted about the behavior but expressed no remorse. Which
variation in the central nervous system best explains the adolescent's reaction?
a. Serotonin dysregulation and increased testosterone activity impair one's capacity for remorse.
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b. Increased neuron destruction in the hippocampus results in decreased abilities to conform to social
rules.
c. Reduced gray matter in the cortex and dysfunction of the amygdala results in decreased feelings of
empathy.
d. Disturbances in the occipital lobe reduce sensations that help an individual clearly visualize the
consequences of behavior. –
Correct Answer :C
Adolescents with conduct disorder have been found to have significantly reduced gray matter
bilaterally in the anterior insulate cortex and the amygdala. This reduction may be related to
aggressive behavior and deficits of empathy. The less gray matter in these regions of the brain, the
less likely adolescents are to feel remorse for their actions or victims. People with intermittent
explosive disorder may have differences in serotonin regulation in the brain and higher levels of
testosterone. Neuron destruction in the hippocampus is associated with memory deficits. The
occipital lobe is involved with visual stimuli but not the processing of emotions.
Which assessment findings support a diagnosis of oppositional defiant disorder?
a. Negative, hostile, and spiteful toward parents. Blames others for misbehavior.
b. Exhibits involuntary facial twitching and blinking; makes barking sounds.
c. Violates others' rights; cruelty toward people or animals; steals; truancy.
d. Displays poor academic performance and reports frequent nightmares. –
Correct Answer :A
Oppositional defiant disorder is a repeated and persistent pattern of having an angry and irritable
mood in conjunction with demonstrating defiant and vindictive behavior. The distracters identify
findings associated with conduct disorder, anxiety disorder, and Tourette's syndrome.
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A nurse on an adolescent psychiatric unit assesses a newly admitted 14-year-old. An impulse control
disorder is suspected. Which aspects of the patient's history support the suspected diagnosis? Select
all that apply.
a. Family history of mental illness
b. Allergies to multiple antibiotics
c. Long history of severe facial acne
d. Father with history of alcohol abuse
e. History of an abusive relationship with one parent –
Correct Answer :A, D, E
Parents who are abusive, rejecting, or overly controlling cause a child to suffer detrimental effects.
Other stressors associated with impulse control disorders can include major disruptions such as
placement in foster care, severe marital discord, or a separation of parents. Substance abuse by a
parent is common. Acne and allergies are not aspects of the history that relate to the behavior.
What are the primary distinguishing factors between the behavior of persons diagnosed with
oppositional defiant disorder (ODD) and those with conduct disorder (CD)? Select all that apply. The
person diagnosed with:
a. ODD relives traumatic events by acting them out.
b. ODD tests limits and disobeys authority figures.
c. ODD has difficulty separating from loved ones.
d. CD uses stereotypical or repetitive language.
e. CD often violates the rights of others. –
Correct Answer :B, E
Persons diagnosed with ODD are negativistic, disobedient, and defiant toward authority figures
without seriously violating the basic rights of others, whereas persons with conduct disorder
frequently behave in ways that do violate the rights of others and age-appropriate societal norms.
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Reliving traumatic events occurs with posttraumatic stress disorder. Stereotypical language behaviors
are seen in persons with autism spectrum disorders.
A nurse works with an adolescent who was placed in a residential program after multiple episodes of
violence at school. Establishing rapport with this adolescent is a priority because: (select all that apply)
a. it is a vital component of implementing a behavior modification program.
b. a therapeutic alliance is the first step in a nurse's therapeutic use of self.
c. the adolescent has demonstrated resistance to other authority figures.
d. acceptance and trust convey feelings of security for the adolescent.
e. adolescents usually relate better to authority figures than peers. –
Correct Answer :B, D
Trust is frequently an issue because the adolescent may never have had a trusting relationship with an
adult. Trust promotes feelings of security and is the basis of the nurse's therapeutic use of self.
Adolescents value peer relationships over those related to authority. Rewards for appropriate
behavior are the main component of behavior modification programs.
Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. This
person wears layered loose clothing. Her current weight is 95 pounds, a loss of 35 pounds. Which
medical diagnosis is most likely?
a. Binge eating
b. Bulimia nervosa
c. Anorexia nervosa
d. Eating disorder not otherwise specified –
Correct Answer :ANS: C
Overly controlled eating behaviors, extreme weight loss, preoccupation with food, and wearing
several layers of loose clothing to appear larger are part of the clinical picture of an individual with
anorexia nervosa. The individual with bulimia usually is near normal weight. The binge eater is often
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