NUR2459 Exam 4 Actual Exam Style V1 |
NUR 2459 Mental and Behavioral Health
Nursing | Rasmussen
1. A patient with Borderline Personality Disorder (BPD) tells a nurse, ‘You are the only one
who cares about me; all the other nurses are mean and incompetent.’ The nurse recognizes
this as which defense mechanism?
A. Rationalization
B. Splitting
C. Reaction Formation
D. Projection
Answer: B
Rationale: Splitting is a hallmark characteristic of Borderline Personality Disorder where
individuals view others as either all good or all bad. This mechanism prevents the person
from integrating the positive and negative qualities of others into a cohesive image. The
nursing priority is to maintain consistent communication among the treatment team to
prevent staff splitting.
2. Which assessment finding is most characteristic of a patient with Anorexia Nervosa rather
than Bulimia Nervosa?
A. Normal or slightly above-average weight
,B. Compensatory purging behaviors
C. Dental erosion and parotid gland swelling
D. Body weight less than 85% of expected weight
Answer: D
Rationale: Anorexia Nervosa is primarily characterized by a significantly low body weight
and a refusal to maintain a minimally normal weight for age and height. While both
disorders involve body image distortion, Bulimia patients are typically within or slightly
above their normal weight range. Nurses should prioritize monitoring electrolyte levels
and cardiac status in severely underweight patients.
3. A child is diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Which
medication side effect should the nurse instruct the parents to monitor most closely?
A. Increased appetite and weight gain
B. Insomnia and decreased appetite
C. Somnolence and lethargy
D. Bradycardia and hypotension
Answer: B
Rationale: Stimulant medications used to treat ADHD, such as methylphenidate, frequently
cause insomnia and a reduction in appetite. Parents should be advised to administer the
, medication early in the day and monitor the child’s growth and weight regularly. If weight
loss becomes significant, the healthcare provider may need to adjust the dose or timing.
4. An elderly patient is admitted with sudden confusion, fluctuating levels of consciousness,
and visual hallucinations. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Depression
Answer: B
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and
disturbances in consciousness and cognition. Unlike dementia, which is progressive and
stable, delirium is often secondary to an underlying medical condition like an infection or
medication toxicity. The nurse must identify and treat the underlying cause to resolve the
symptoms.
5. A 10-year-old child exhibits persistent defiance, argues with authority figures, and blames
others for his mistakes but does not violate the rights of others. This behavior is consistent
with:
A. Conduct Disorder
B. Autism Spectrum Disorder
C. Oppositional Defiant Disorder (ODD)
NUR 2459 Mental and Behavioral Health
Nursing | Rasmussen
1. A patient with Borderline Personality Disorder (BPD) tells a nurse, ‘You are the only one
who cares about me; all the other nurses are mean and incompetent.’ The nurse recognizes
this as which defense mechanism?
A. Rationalization
B. Splitting
C. Reaction Formation
D. Projection
Answer: B
Rationale: Splitting is a hallmark characteristic of Borderline Personality Disorder where
individuals view others as either all good or all bad. This mechanism prevents the person
from integrating the positive and negative qualities of others into a cohesive image. The
nursing priority is to maintain consistent communication among the treatment team to
prevent staff splitting.
2. Which assessment finding is most characteristic of a patient with Anorexia Nervosa rather
than Bulimia Nervosa?
A. Normal or slightly above-average weight
,B. Compensatory purging behaviors
C. Dental erosion and parotid gland swelling
D. Body weight less than 85% of expected weight
Answer: D
Rationale: Anorexia Nervosa is primarily characterized by a significantly low body weight
and a refusal to maintain a minimally normal weight for age and height. While both
disorders involve body image distortion, Bulimia patients are typically within or slightly
above their normal weight range. Nurses should prioritize monitoring electrolyte levels
and cardiac status in severely underweight patients.
3. A child is diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Which
medication side effect should the nurse instruct the parents to monitor most closely?
A. Increased appetite and weight gain
B. Insomnia and decreased appetite
C. Somnolence and lethargy
D. Bradycardia and hypotension
Answer: B
Rationale: Stimulant medications used to treat ADHD, such as methylphenidate, frequently
cause insomnia and a reduction in appetite. Parents should be advised to administer the
, medication early in the day and monitor the child’s growth and weight regularly. If weight
loss becomes significant, the healthcare provider may need to adjust the dose or timing.
4. An elderly patient is admitted with sudden confusion, fluctuating levels of consciousness,
and visual hallucinations. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Depression
Answer: B
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and
disturbances in consciousness and cognition. Unlike dementia, which is progressive and
stable, delirium is often secondary to an underlying medical condition like an infection or
medication toxicity. The nurse must identify and treat the underlying cause to resolve the
symptoms.
5. A 10-year-old child exhibits persistent defiance, argues with authority figures, and blames
others for his mistakes but does not violate the rights of others. This behavior is consistent
with:
A. Conduct Disorder
B. Autism Spectrum Disorder
C. Oppositional Defiant Disorder (ODD)
