NSG 322/NSG322 Exam 4 V2 | Behavioral
Health Nursing Q&A with Rationale |
Grand Canyon University
1. A patient with Borderline Personality Disorder (BPD) is praised by the night shift nurse but
complains to the day shift nurse that the night staff is ‘incompetent and cruel.’ What defense
mechanism is the patient using?
A. Projection
B. Reaction Formation
C. Splitting
D. Sublimation
Answer: C
Rationale: Splitting is a primary defense mechanism in Borderline Personality Disorder
where the patient views individuals as all good or all bad. This behavior is used to manage
anxiety and can cause significant conflict among the nursing staff. Nurses must use
consistent communication and staff meetings to maintain a unified treatment approach.
2. Which clinical manifestation is most indicative of a diagnosis of Anorexia Nervosa rather
than Bulimia Nervosa?
A. Excessive exercise
B. Parotid gland swelling
,C. Loss of tooth enamel
D. BMI significantly below 18.5
Answer: D
Rationale: Significant weight loss resulting in a very low body mass index is the hallmark
of Anorexia Nervosa. While both disorders may involve purging, Bulimia Nervosa patients
typically maintain a normal or slightly overweight BMI. Anorexia involves an intense fear of
gaining weight and a distorted body image regardless of actual thinness.
3. An elderly patient is admitted with sudden confusion, visual hallucinations, and a
fluctuating level of consciousness. The nurse suspects which condition?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Depression
Answer: A
Rationale: Delirium is characterized by an acute onset of confusion and fluctuations in
consciousness, often caused by an underlying medical condition like a UTI. Unlike
dementia, delirium is typically reversible once the physiological cause is addressed. The
nurse’s priority is to identify and treat the source of the cognitive impairment while
ensuring patient safety.
,4. A patient with Antisocial Personality Disorder is caught breaking a unit rule and responds,
‘It’s not my fault, the rules here are stupid anyway.’ What is the nurse’s best response?
A. Why do you think the rules don’t apply to you?
B. The rule exists for everyone’s safety, and there is a consequence for breaking it.
C. I understand you’re frustrated, but let’s talk about your feelings.
D. I’ll let it slide this time if you promise to follow the rules tomorrow.
Answer: B
Rationale: Patients with Antisocial Personality Disorder require firm, consistent
boundaries and clear consequences for their actions. Empathetic exploration of feelings is
often ineffective because these patients tend to manipulate emotions to avoid
accountability. The nurse must remain objective and avoid engaging in power struggles or
negotiations over established unit protocols.
5. Which medication is most commonly prescribed to help a patient maintain sobriety from
alcohol by causing a severe physical reaction if alcohol is consumed?
A. Naltrexone
B. Acamprosate
C. Disulfiram
D. Chlordiazepoxide
Answer: C
, Rationale: Disulfiram (Antabuse) is an aversion therapy agent that inhibits the breakdown
of acetaldehyde, causing nausea, vomiting, and tachycardia if the patient drinks alcohol.
Patient teaching must include avoiding all sources of alcohol, including mouthwash, vanilla
extract, and hand sanitizers. This medication is only effective for patients who are highly
motivated and committed to total abstinence.
6. A nurse is caring for a patient with Anorexia Nervosa who has a BMI of 14. What is the
priority nursing intervention during the first week of treatment?
A. Encouraging the patient to express feelings about body image
B. Developing a high-intensity exercise plan
C. Assisting the patient in choosing low-calorie meals
D. Monitoring for peripheral edema and electrolyte shifts
Answer: D
Rationale: Monitoring for refeeding syndrome is the physiological priority in severely
malnourished patients during initial nutritional rehabilitation. Refeding syndrome can
cause fatal electrolyte imbalances, particularly hypophosphatemia, as the body shifts from
a catabolic to an anabolic state. Nursing care must focus on slow weight gain and frequent
cardiovascular and metabolic monitoring.
Health Nursing Q&A with Rationale |
Grand Canyon University
1. A patient with Borderline Personality Disorder (BPD) is praised by the night shift nurse but
complains to the day shift nurse that the night staff is ‘incompetent and cruel.’ What defense
mechanism is the patient using?
A. Projection
B. Reaction Formation
C. Splitting
D. Sublimation
Answer: C
Rationale: Splitting is a primary defense mechanism in Borderline Personality Disorder
where the patient views individuals as all good or all bad. This behavior is used to manage
anxiety and can cause significant conflict among the nursing staff. Nurses must use
consistent communication and staff meetings to maintain a unified treatment approach.
2. Which clinical manifestation is most indicative of a diagnosis of Anorexia Nervosa rather
than Bulimia Nervosa?
A. Excessive exercise
B. Parotid gland swelling
,C. Loss of tooth enamel
D. BMI significantly below 18.5
Answer: D
Rationale: Significant weight loss resulting in a very low body mass index is the hallmark
of Anorexia Nervosa. While both disorders may involve purging, Bulimia Nervosa patients
typically maintain a normal or slightly overweight BMI. Anorexia involves an intense fear of
gaining weight and a distorted body image regardless of actual thinness.
3. An elderly patient is admitted with sudden confusion, visual hallucinations, and a
fluctuating level of consciousness. The nurse suspects which condition?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Depression
Answer: A
Rationale: Delirium is characterized by an acute onset of confusion and fluctuations in
consciousness, often caused by an underlying medical condition like a UTI. Unlike
dementia, delirium is typically reversible once the physiological cause is addressed. The
nurse’s priority is to identify and treat the source of the cognitive impairment while
ensuring patient safety.
,4. A patient with Antisocial Personality Disorder is caught breaking a unit rule and responds,
‘It’s not my fault, the rules here are stupid anyway.’ What is the nurse’s best response?
A. Why do you think the rules don’t apply to you?
B. The rule exists for everyone’s safety, and there is a consequence for breaking it.
C. I understand you’re frustrated, but let’s talk about your feelings.
D. I’ll let it slide this time if you promise to follow the rules tomorrow.
Answer: B
Rationale: Patients with Antisocial Personality Disorder require firm, consistent
boundaries and clear consequences for their actions. Empathetic exploration of feelings is
often ineffective because these patients tend to manipulate emotions to avoid
accountability. The nurse must remain objective and avoid engaging in power struggles or
negotiations over established unit protocols.
5. Which medication is most commonly prescribed to help a patient maintain sobriety from
alcohol by causing a severe physical reaction if alcohol is consumed?
A. Naltrexone
B. Acamprosate
C. Disulfiram
D. Chlordiazepoxide
Answer: C
, Rationale: Disulfiram (Antabuse) is an aversion therapy agent that inhibits the breakdown
of acetaldehyde, causing nausea, vomiting, and tachycardia if the patient drinks alcohol.
Patient teaching must include avoiding all sources of alcohol, including mouthwash, vanilla
extract, and hand sanitizers. This medication is only effective for patients who are highly
motivated and committed to total abstinence.
6. A nurse is caring for a patient with Anorexia Nervosa who has a BMI of 14. What is the
priority nursing intervention during the first week of treatment?
A. Encouraging the patient to express feelings about body image
B. Developing a high-intensity exercise plan
C. Assisting the patient in choosing low-calorie meals
D. Monitoring for peripheral edema and electrolyte shifts
Answer: D
Rationale: Monitoring for refeeding syndrome is the physiological priority in severely
malnourished patients during initial nutritional rehabilitation. Refeding syndrome can
cause fatal electrolyte imbalances, particularly hypophosphatemia, as the body shifts from
a catabolic to an anabolic state. Nursing care must focus on slow weight gain and frequent
cardiovascular and metabolic monitoring.
