NUR2459/NUR 2459 Exam 4 V1 | Mental
and Behavioral Health Nursing Q&A with
Rationale | Rasmussen University
1. A patient diagnosed with Borderline Personality Disorder (BPD) is observed trying to pit the
day shift nurse against the night shift nurse. Which defense mechanism is this patient using?
A. Splitting
B. Projection
C. Reaction Formation
D. Intellectualization
Answer: A
Rationale: Splitting is a hallmark characteristic of Borderline Personality Disorder where
individuals view things and people as all good or all bad. This behavior often manifests as
an attempt to manipulate staff members by playing them against each other. Nurses must
maintain clear boundaries and consistent communication to manage this behavior
effectively.
2. When assessing a patient with Anorexia Nervosa, which physical finding should the nurse
prioritize as a sign of medical instability?
A. Lanugo on the back
B. Yellowish skin tone
,C. Bradycardia and hypotension
D. Amenorrhea
Answer: C
Rationale: Physiological stability is the primary concern in patients with severe eating
disorders. Bradycardia and hypotension indicate that the body’s compensatory
mechanisms are failing due to starvation and electrolyte imbalances. While lanugo and
amenorrhea are common signs, they are not immediately life-threatening compared to
cardiac compromise.
3. At what point after the last drink do symptoms of alcohol withdrawal typically peak?
A. 24 to 48 hours
B. 6 to 12 hours
C. 72 to 96 hours
D. 1 to 2 weeks
Answer: A
Rationale: Alcohol withdrawal symptoms usually begin within hours of cessation but
typically reach their peak intensity between 24 and 48 hours. During this time, the risk for
seizures and significant autonomic hyperactivity is highest. Monitoring and early
intervention with benzodiazepines are critical during this window to prevent progression
to delirium tremens.
, 4. A nurse is caring for a patient with Bulimia Nervosa. Which physical assessment finding is
most indicative of frequent self-induced vomiting?
A. Hair loss
B. Low body mass index
C. Parotid gland swelling
D. Brittle nails
Answer: C
Rationale: Frequent purging via vomiting can cause hypertrophy of the parotid glands,
often referred to as ‘chipmunk cheeks.’ This occurs due to the constant stimulation of the
salivary glands by stomach acid. Other signs might include Russell’s sign on the knuckles
and dental enamel erosion.
5. Which behavior is most characteristic of a patient diagnosed with Antisocial Personality
Disorder?
A. Excessive need to be taken care of by others
B. Extreme shyness and fear of rejection
C. Frequent legal issues and disregard for the rights of others
D. Dramatic and attention-seeking behavior
Answer: C
and Behavioral Health Nursing Q&A with
Rationale | Rasmussen University
1. A patient diagnosed with Borderline Personality Disorder (BPD) is observed trying to pit the
day shift nurse against the night shift nurse. Which defense mechanism is this patient using?
A. Splitting
B. Projection
C. Reaction Formation
D. Intellectualization
Answer: A
Rationale: Splitting is a hallmark characteristic of Borderline Personality Disorder where
individuals view things and people as all good or all bad. This behavior often manifests as
an attempt to manipulate staff members by playing them against each other. Nurses must
maintain clear boundaries and consistent communication to manage this behavior
effectively.
2. When assessing a patient with Anorexia Nervosa, which physical finding should the nurse
prioritize as a sign of medical instability?
A. Lanugo on the back
B. Yellowish skin tone
,C. Bradycardia and hypotension
D. Amenorrhea
Answer: C
Rationale: Physiological stability is the primary concern in patients with severe eating
disorders. Bradycardia and hypotension indicate that the body’s compensatory
mechanisms are failing due to starvation and electrolyte imbalances. While lanugo and
amenorrhea are common signs, they are not immediately life-threatening compared to
cardiac compromise.
3. At what point after the last drink do symptoms of alcohol withdrawal typically peak?
A. 24 to 48 hours
B. 6 to 12 hours
C. 72 to 96 hours
D. 1 to 2 weeks
Answer: A
Rationale: Alcohol withdrawal symptoms usually begin within hours of cessation but
typically reach their peak intensity between 24 and 48 hours. During this time, the risk for
seizures and significant autonomic hyperactivity is highest. Monitoring and early
intervention with benzodiazepines are critical during this window to prevent progression
to delirium tremens.
, 4. A nurse is caring for a patient with Bulimia Nervosa. Which physical assessment finding is
most indicative of frequent self-induced vomiting?
A. Hair loss
B. Low body mass index
C. Parotid gland swelling
D. Brittle nails
Answer: C
Rationale: Frequent purging via vomiting can cause hypertrophy of the parotid glands,
often referred to as ‘chipmunk cheeks.’ This occurs due to the constant stimulation of the
salivary glands by stomach acid. Other signs might include Russell’s sign on the knuckles
and dental enamel erosion.
5. Which behavior is most characteristic of a patient diagnosed with Antisocial Personality
Disorder?
A. Excessive need to be taken care of by others
B. Extreme shyness and fear of rejection
C. Frequent legal issues and disregard for the rights of others
D. Dramatic and attention-seeking behavior
Answer: C
