NSG 3450 Exam 4 V3 | NSG 3450 Mental
Health Guide | Actual Q&A with Rationale
(NSG3450 Exam 4) | Galen College of
Nursing
1. A client is admitted to the psychiatric unit exhibiting a sudden onset of confusion,
disorientation, and fluctuating levels of consciousness. Which condition should the nurse
suspect?
A. Alzheimer’s disease
B. Depression
C. Vascular dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and a disturbance in consciousness
that fluctuates throughout the day. This condition is often secondary to an underlying
medical cause like infection or electrolyte imbalance. Unlike dementia, delirium is typically
reversible once the primary cause is addressed.
2. A nurse is assessing a client for alcohol withdrawal. Which clinical manifestation should the
nurse prioritize as a sign of autonomic hyperactivity?
A. Bradycardia
,B. Hypotension
C. Constricted pupils
D. Diaphoresis and tachycardia
Answer: D
Rationale: Alcohol withdrawal causes central nervous system irritability and autonomic
hyperactivity. Manifestations include tachycardia, diaphoresis, hypertension, and tremors.
Monitoring these vital signs is crucial to prevent progression to delirium tremens.
3. Which medication is considered the gold standard for the treatment of alcohol withdrawal
symptoms and seizure prevention?
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Fluoxetine
Answer: C
Rationale: Benzodiazepines like lorazepam are the primary treatment for managing
alcohol withdrawal. They provide cross-tolerance to alcohol and help stabilize vital signs
while preventing seizures. Medications like disulfiram are used for maintenance of sobriety
rather than acute withdrawal.
, 4. A client with Alzheimer’s disease is prescribed Donepezil. What should the nurse include in
the teaching regarding this medication?
A. It helps improve cognitive function by increasing acetylcholine levels.
B. It will cure the cognitive decline.
C. It is an antipsychotic medication.
D. It should be taken only when the client feels confused.
Answer: A
Rationale: Donepezil is a cholinesterase inhibitor that slows the breakdown of
acetylcholine in the brain. While it does not cure Alzheimer’s, it can temporarily improve or
stabilize cognitive symptoms. Patients and families should be educated that the effects are
modest and the disease will still progress.
5. A nurse is caring for a client with Borderline Personality Disorder. The client is praiseful of
the nurse one moment and extremely hostile the next. This behavior is known as:
A. Projection
B. Undoing
C. Rationalization
D. Splitting
Answer: D
Health Guide | Actual Q&A with Rationale
(NSG3450 Exam 4) | Galen College of
Nursing
1. A client is admitted to the psychiatric unit exhibiting a sudden onset of confusion,
disorientation, and fluctuating levels of consciousness. Which condition should the nurse
suspect?
A. Alzheimer’s disease
B. Depression
C. Vascular dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and a disturbance in consciousness
that fluctuates throughout the day. This condition is often secondary to an underlying
medical cause like infection or electrolyte imbalance. Unlike dementia, delirium is typically
reversible once the primary cause is addressed.
2. A nurse is assessing a client for alcohol withdrawal. Which clinical manifestation should the
nurse prioritize as a sign of autonomic hyperactivity?
A. Bradycardia
,B. Hypotension
C. Constricted pupils
D. Diaphoresis and tachycardia
Answer: D
Rationale: Alcohol withdrawal causes central nervous system irritability and autonomic
hyperactivity. Manifestations include tachycardia, diaphoresis, hypertension, and tremors.
Monitoring these vital signs is crucial to prevent progression to delirium tremens.
3. Which medication is considered the gold standard for the treatment of alcohol withdrawal
symptoms and seizure prevention?
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Fluoxetine
Answer: C
Rationale: Benzodiazepines like lorazepam are the primary treatment for managing
alcohol withdrawal. They provide cross-tolerance to alcohol and help stabilize vital signs
while preventing seizures. Medications like disulfiram are used for maintenance of sobriety
rather than acute withdrawal.
, 4. A client with Alzheimer’s disease is prescribed Donepezil. What should the nurse include in
the teaching regarding this medication?
A. It helps improve cognitive function by increasing acetylcholine levels.
B. It will cure the cognitive decline.
C. It is an antipsychotic medication.
D. It should be taken only when the client feels confused.
Answer: A
Rationale: Donepezil is a cholinesterase inhibitor that slows the breakdown of
acetylcholine in the brain. While it does not cure Alzheimer’s, it can temporarily improve or
stabilize cognitive symptoms. Patients and families should be educated that the effects are
modest and the disease will still progress.
5. A nurse is caring for a client with Borderline Personality Disorder. The client is praiseful of
the nurse one moment and extremely hostile the next. This behavior is known as:
A. Projection
B. Undoing
C. Rationalization
D. Splitting
Answer: D
