NUR253 Exam 4 V1 | Mental Health
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is assessing a client with anorexia nervosa. Which physical finding should the nurse
expect to observe?
A. Tachycardia
B. Hypertension
C. Lanugo
D. Hyperthermia
Answer: C
Rationale: Lanugo is the growth of fine, downy hair on the face and back as the body
attempts to provide insulation due to the loss of subcutaneous fat. Clients with anorexia
nervosa typically exhibit bradycardia and hypotension rather than tachycardia and
hypertension. Hypothermia is also a common finding because the body’s metabolic rate
slows down significantly to conserve energy.
2. Which intervention is the priority for a nurse caring for a client with bulimia nervosa who
has just finished a meal?
A. Allowing the client to rest in their room privately
B. Monitoring the client for at least one hour after meals
,C. Encouraging the client to exercise to burn calories
D. Discussing the client’s feelings about body image immediately
Answer: B
Rationale: Monitoring the client for one hour after meals is essential to prevent purging
behaviors such as self-induced vomiting. This observation period ensures that the client
retains the nutrients consumed and helps break the binge-purge cycle. Private time
immediately after eating provides an opportunity for the client to engage in secretive
behaviors, which must be avoided during the stabilization phase.
3. A client is diagnosed with Somatic Symptom Disorder. What is the primary characteristic of
this condition?
A. Multiple physical symptoms that cannot be explained medically
B. Persistent preoccupation with having a serious undiagnosed illness
C. Intentional production of physical symptoms for gain
D. A sudden loss of sensory or motor function following a stressor
Answer: A
Rationale: Somatic Symptom Disorder involves physical symptoms that cause significant
distress or impairment, though no organic medical cause can be found. The client is not
consciously producing these symptoms, as seen in factitious disorders. Their distress is
genuine, and the focus of nursing care should be on coping mechanisms rather than
searching for physical causes.
,4. A child is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Which
medication is commonly prescribed as a first-line stimulant?
A. Methylphenidate
B. Atomoxetine
C. Guanfacine
D. Fluoxetine
Answer: A
Rationale: Methylphenidate is a central nervous system stimulant and is considered a
first-line pharmacological treatment for ADHD. It works by increasing levels of dopamine
and norepinephrine in the brain to improve focus and impulse control. Atomoxetine and
Guanfacine are non-stimulant options often used if stimulants are ineffective or
contraindicated.
5. Which behavior is most characteristic of a child with Conduct Disorder?
A. Persistent difficulty with reading and math skills
B. Frequent temper tantrums when told to do chores
C. Extreme shyness and avoidance of social interactions
D. Repetitive patterns of violating the basic rights of others
Answer: D
, Rationale: Conduct Disorder is characterized by a persistent pattern of behavior in which
the basic rights of others or major age-appropriate societal norms are violated. This often
includes aggression toward people or animals, destruction of property, and deceitfulness
or theft. While temper tantrums occur in Oppositional Defiant Disorder, Conduct Disorder
involves more severe, antisocial actions.
6. A nurse is caring for an older adult with Delirium. Which feature distinguishes delirium
from dementia?
A. Sudden change in level of consciousness and attention
B. Irreversible loss of memory functions
C. Gradual onset of cognitive decline
D. Stable symptoms that do not fluctuate during the day
Answer: A
Rationale: Delirium is characterized by an abrupt, rapid onset of symptoms and a
fluctuating level of consciousness. In contrast, dementia involves a slow, progressive
decline in cognitive function that is usually irreversible. Identifying the sudden change is
critical because delirium is often caused by an underlying medical condition that requires
immediate treatment.
7. Which nursing intervention is most appropriate for a client with Alzheimer’s disease who is
experiencing sundowning?
A. Turning on bright overhead lights in the evening
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is assessing a client with anorexia nervosa. Which physical finding should the nurse
expect to observe?
A. Tachycardia
B. Hypertension
C. Lanugo
D. Hyperthermia
Answer: C
Rationale: Lanugo is the growth of fine, downy hair on the face and back as the body
attempts to provide insulation due to the loss of subcutaneous fat. Clients with anorexia
nervosa typically exhibit bradycardia and hypotension rather than tachycardia and
hypertension. Hypothermia is also a common finding because the body’s metabolic rate
slows down significantly to conserve energy.
2. Which intervention is the priority for a nurse caring for a client with bulimia nervosa who
has just finished a meal?
A. Allowing the client to rest in their room privately
B. Monitoring the client for at least one hour after meals
,C. Encouraging the client to exercise to burn calories
D. Discussing the client’s feelings about body image immediately
Answer: B
Rationale: Monitoring the client for one hour after meals is essential to prevent purging
behaviors such as self-induced vomiting. This observation period ensures that the client
retains the nutrients consumed and helps break the binge-purge cycle. Private time
immediately after eating provides an opportunity for the client to engage in secretive
behaviors, which must be avoided during the stabilization phase.
3. A client is diagnosed with Somatic Symptom Disorder. What is the primary characteristic of
this condition?
A. Multiple physical symptoms that cannot be explained medically
B. Persistent preoccupation with having a serious undiagnosed illness
C. Intentional production of physical symptoms for gain
D. A sudden loss of sensory or motor function following a stressor
Answer: A
Rationale: Somatic Symptom Disorder involves physical symptoms that cause significant
distress or impairment, though no organic medical cause can be found. The client is not
consciously producing these symptoms, as seen in factitious disorders. Their distress is
genuine, and the focus of nursing care should be on coping mechanisms rather than
searching for physical causes.
,4. A child is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Which
medication is commonly prescribed as a first-line stimulant?
A. Methylphenidate
B. Atomoxetine
C. Guanfacine
D. Fluoxetine
Answer: A
Rationale: Methylphenidate is a central nervous system stimulant and is considered a
first-line pharmacological treatment for ADHD. It works by increasing levels of dopamine
and norepinephrine in the brain to improve focus and impulse control. Atomoxetine and
Guanfacine are non-stimulant options often used if stimulants are ineffective or
contraindicated.
5. Which behavior is most characteristic of a child with Conduct Disorder?
A. Persistent difficulty with reading and math skills
B. Frequent temper tantrums when told to do chores
C. Extreme shyness and avoidance of social interactions
D. Repetitive patterns of violating the basic rights of others
Answer: D
, Rationale: Conduct Disorder is characterized by a persistent pattern of behavior in which
the basic rights of others or major age-appropriate societal norms are violated. This often
includes aggression toward people or animals, destruction of property, and deceitfulness
or theft. While temper tantrums occur in Oppositional Defiant Disorder, Conduct Disorder
involves more severe, antisocial actions.
6. A nurse is caring for an older adult with Delirium. Which feature distinguishes delirium
from dementia?
A. Sudden change in level of consciousness and attention
B. Irreversible loss of memory functions
C. Gradual onset of cognitive decline
D. Stable symptoms that do not fluctuate during the day
Answer: A
Rationale: Delirium is characterized by an abrupt, rapid onset of symptoms and a
fluctuating level of consciousness. In contrast, dementia involves a slow, progressive
decline in cognitive function that is usually irreversible. Identifying the sudden change is
critical because delirium is often caused by an underlying medical condition that requires
immediate treatment.
7. Which nursing intervention is most appropriate for a client with Alzheimer’s disease who is
experiencing sundowning?
A. Turning on bright overhead lights in the evening
