,NSG 3450 Exam 2 | Questions &
Verified Answers | 2026 Edition | Galen
College
1. Which of the following best describes the primary goal of cognitive behavioral therapy for
depression?
A) To identify and change distorted thinking patterns and maladaptive behaviors
B) To explore unconscious conflicts from childhood
C) To provide unconditional positive regard without challenging beliefs
D) To use free association to uncover repressed memories
Correct Answer: To identify and change distorted thinking patterns and maladaptive behaviors
Rationale: CBT focuses on the here and now, helping patients recognize automatic negative thoughts
and modify behaviors that maintain depression. It is structured, time-limited, and goal-oriented.
Psychodynamic therapy explores unconscious conflicts, while person-centered therapy emphasizes
unconditional acceptance.
2. The nurse is conducting a group therapy session. A patient with social anxiety remains silent. Which
intervention is most appropriate?
A) Demand that the patient participate immediately
B) Gently encourage the patient to share when ready and provide a supportive environment
C) Ask the patient to leave the group if they are not participating
D) Ignore the patient and focus on others
Correct Answer: Gently encourage the patient to share when ready and provide a supportive
environment
,Rationale: A supportive, non-pressuring approach builds trust and reduces anxiety. Forcing participation
or excluding the patient increases fear and is counter-therapeutic. The nurse should acknowledge the
patient’s presence and allow gradual engagement at their own pace.
3. According to the DSM-5 criteria for panic disorder, which feature is essential?
A) Panic attacks occur only in specific situations
B) Panic attacks are followed by persistent concern about additional attacks
C) Panic attacks are unexpected and followed by at least one month of worry about future attacks
D) Panic attacks are always triggered by a traumatic event
Correct Answer: Panic attacks are unexpected and followed by at least one month of worry about future
attacks
Rationale: Panic disorder requires recurrent, unexpected panic attacks and at least one month of
persistent concern about having more attacks or their consequences. Situationally bound attacks are
more characteristic of specific phobias; post-traumatic triggers suggest PTSD.
4. The nurse is caring for a patient with bipolar I disorder who is experiencing a manic episode. Which
nursing intervention is the priority?
A) Engage the patient in competitive sports to channel energy
B) Provide a high-stimulus environment to keep the patient engaged
C) Encourage the patient to participate in lengthy group discussions
D) Offer high-calorie finger foods and provide a low-stimulus environment
Correct Answer: Offer high-calorie finger foods and provide a low-stimulus environment
Rationale: Patients in mania are hyperactive and cannot sit still to eat. Providing portable, nutritious
snacks prevents weight loss and dehydration. A low-stimulus environment with reduced noise and
activity helps decrease agitation and prevent exhaustion.
5. The nurse is teaching a patient about the side effects of lithium. Which side effect is most concerning
and should be reported immediately?
, A) Coarse tremor, confusion, and nausea
B) Fine hand tremors
C) Polyuria
D) Metallic taste
Correct Answer: Coarse tremor, confusion, and nausea
Rationale: Coarse tremor, confusion, nausea, and vomiting are early signs of lithium toxicity, which can
progress to seizures, coma, and death. Fine tremors and polyuria are common side effects at therapeutic
levels, not emergent. Patients must report toxicity signs promptly.
6. Which of the following statements by a patient indicates an understanding of the use of disulfiram?
A) “I can drink alcohol in moderation while taking this.”
B) “I must avoid all alcohol, including that in mouthwash and cooking wine.”
C) “This medication will reduce my craving for alcohol.”
D) “I only need to take this when I feel like drinking.”
Correct Answer: “I must avoid all alcohol, including that in mouthwash and cooking wine.”
Rationale: Disulfiram inhibits aldehyde dehydrogenase, causing a toxic reaction if any alcohol is ingested.
Even small amounts in mouthwash or vanilla extract trigger severe illness. It does not reduce cravings
and must be taken daily, not PRN.
7. The nurse is assessing a patient with schizophrenia who exhibits a flat affect and social withdrawal.
These symptoms are classified as
A) positive symptoms
B) disorganized symptoms
C) negative symptoms
D) mood symptoms
Verified Answers | 2026 Edition | Galen
College
1. Which of the following best describes the primary goal of cognitive behavioral therapy for
depression?
A) To identify and change distorted thinking patterns and maladaptive behaviors
B) To explore unconscious conflicts from childhood
C) To provide unconditional positive regard without challenging beliefs
D) To use free association to uncover repressed memories
Correct Answer: To identify and change distorted thinking patterns and maladaptive behaviors
Rationale: CBT focuses on the here and now, helping patients recognize automatic negative thoughts
and modify behaviors that maintain depression. It is structured, time-limited, and goal-oriented.
Psychodynamic therapy explores unconscious conflicts, while person-centered therapy emphasizes
unconditional acceptance.
2. The nurse is conducting a group therapy session. A patient with social anxiety remains silent. Which
intervention is most appropriate?
A) Demand that the patient participate immediately
B) Gently encourage the patient to share when ready and provide a supportive environment
C) Ask the patient to leave the group if they are not participating
D) Ignore the patient and focus on others
Correct Answer: Gently encourage the patient to share when ready and provide a supportive
environment
,Rationale: A supportive, non-pressuring approach builds trust and reduces anxiety. Forcing participation
or excluding the patient increases fear and is counter-therapeutic. The nurse should acknowledge the
patient’s presence and allow gradual engagement at their own pace.
3. According to the DSM-5 criteria for panic disorder, which feature is essential?
A) Panic attacks occur only in specific situations
B) Panic attacks are followed by persistent concern about additional attacks
C) Panic attacks are unexpected and followed by at least one month of worry about future attacks
D) Panic attacks are always triggered by a traumatic event
Correct Answer: Panic attacks are unexpected and followed by at least one month of worry about future
attacks
Rationale: Panic disorder requires recurrent, unexpected panic attacks and at least one month of
persistent concern about having more attacks or their consequences. Situationally bound attacks are
more characteristic of specific phobias; post-traumatic triggers suggest PTSD.
4. The nurse is caring for a patient with bipolar I disorder who is experiencing a manic episode. Which
nursing intervention is the priority?
A) Engage the patient in competitive sports to channel energy
B) Provide a high-stimulus environment to keep the patient engaged
C) Encourage the patient to participate in lengthy group discussions
D) Offer high-calorie finger foods and provide a low-stimulus environment
Correct Answer: Offer high-calorie finger foods and provide a low-stimulus environment
Rationale: Patients in mania are hyperactive and cannot sit still to eat. Providing portable, nutritious
snacks prevents weight loss and dehydration. A low-stimulus environment with reduced noise and
activity helps decrease agitation and prevent exhaustion.
5. The nurse is teaching a patient about the side effects of lithium. Which side effect is most concerning
and should be reported immediately?
, A) Coarse tremor, confusion, and nausea
B) Fine hand tremors
C) Polyuria
D) Metallic taste
Correct Answer: Coarse tremor, confusion, and nausea
Rationale: Coarse tremor, confusion, nausea, and vomiting are early signs of lithium toxicity, which can
progress to seizures, coma, and death. Fine tremors and polyuria are common side effects at therapeutic
levels, not emergent. Patients must report toxicity signs promptly.
6. Which of the following statements by a patient indicates an understanding of the use of disulfiram?
A) “I can drink alcohol in moderation while taking this.”
B) “I must avoid all alcohol, including that in mouthwash and cooking wine.”
C) “This medication will reduce my craving for alcohol.”
D) “I only need to take this when I feel like drinking.”
Correct Answer: “I must avoid all alcohol, including that in mouthwash and cooking wine.”
Rationale: Disulfiram inhibits aldehyde dehydrogenase, causing a toxic reaction if any alcohol is ingested.
Even small amounts in mouthwash or vanilla extract trigger severe illness. It does not reduce cravings
and must be taken daily, not PRN.
7. The nurse is assessing a patient with schizophrenia who exhibits a flat affect and social withdrawal.
These symptoms are classified as
A) positive symptoms
B) disorganized symptoms
C) negative symptoms
D) mood symptoms
