,NSG3450/NSG 3450 Exam 4 | Mental Health
Nursing | Galen College | 26/27 Updated
(PDF)
1. A patient is pacing rapidly, clenching fists, and speaking in a loud, threatening manner. The nurse
recognizes this behavioral presentation as which emotional state?
A) Aggression
B) Anger
C) Violence
D) Assertiveness
Correct Answer: Anger
Rationale: Anger is an emotional response to frustration or a perceived threat, often manifested by
pacing, clenched fists, and loud speech. Aggression is the behavioral action that results in verbal or
physical attack, violence is the actual act of physical force, and assertiveness is a healthy expression of
feelings without hostility—making the others incorrect.
2. Which part of the brain is primarily responsible for the regulation of aggression and emotional
responses?
A) Amygdala
B) Limbic system
C) Prefrontal cortex
D) Hippocampus
Correct Answer: Limbic system
Rationale: The limbic system, located beneath the cerebrum, integrates higher mental functions with
primitive emotions and is responsible for aggression. The amygdala is a component of the limbic
system involved in fear, the prefrontal cortex governs impulse control, and the hippocampus is
primarily involved in memory formation—making them incorrect for this specific role.
,3. A nurse is preparing to administer a B-52 injection for acute agitation. Which medications are
correctly included in this combination?
A) Benadryl 50 mg, Haldol 5 mg, Ativan 2 mg
B) Benadryl 25 mg, Haldol 10 mg, Valium 5 mg
C) Ativan 2 mg, Zyprexa 10 mg, Benadryl 50 mg
D) Haldol 5 mg, Ativan 2 mg, Zyprexa 10 mg
Correct Answer: Benadryl 50 mg, Haldol 5 mg, Ativan 2 mg
Rationale: The B-52 combination consists of Benadryl (diphenhydramine) 50 mg, Haldol (haloperidol)
5 mg, and Ativan (lorazepam) 2 mg for acute agitation management. The other options contain
incorrect dosages or substitute medications that are not part of this standard protocol.
4. A patient is placed in involuntary confinement alone in a room and physically prevented from
leaving. The nurse correctly documents this intervention as:
A) Restraint
B) Seclusion
C) Isolation
D) Time-out
Correct Answer: Seclusion
Rationale: Seclusion is the involuntary confinement of a patient alone in a room from which the
patient is physically prevented from leaving. Restraint refers to any manual method or device that
restricts freedom of movement, isolation is a general term for separation, and time-out is a behavioral
technique—all distinct from this specific intervention.
5. Which clinical scenario predicts the highest risk for directing violent behavior toward others?
A) Obsessive-compulsive disorder with performance of many rituals
B) Major depressive disorder with delusions of worthlessness
, C) Paranoid delusions of being followed by alien monsters
D) Completed alcohol withdrawal with beginning of a rehabilitation program
Correct Answer: Paranoid delusions of being followed by alien monsters
Rationale: Paranoid delusions create intense fear and suspicion, which can lead to defensive or
preemptive violence against perceived threats. OCD rituals, depressive worthlessness, and successful
withdrawal are not associated with the same level of imminent risk for externalized violence.
6. A new patient acts out so aggressively that seclusion is required before the admission assessment is
completed. Immediately after safely secluding the patient, what is the nurse's priority action?
A) Complete the physical assessment
B) Notify the healthcare provider to obtain a seclusion order
C) Document the incident objectively in the patient's medical record
D) Explain to the patient that seclusion will end when self-control is regained
Correct Answer: Notify the healthcare provider to obtain a seclusion order
Rationale: After initiating emergency seclusion, the nurse must promptly obtain a provider's order to
maintain legal and ethical compliance. Physical assessment, documentation, and patient education
are important but secondary to securing the required authorization.
7. Which medications from the medication administration record should a nurse administer to provide
immediate intervention for a psychotic patient whose aggressive behavior continues to escalate
despite verbal intervention?
A) Valproic acid
B) Lithium
C) Trazodone
D) Olanzapine
Correct Answer: Olanzapine
Nursing | Galen College | 26/27 Updated
(PDF)
1. A patient is pacing rapidly, clenching fists, and speaking in a loud, threatening manner. The nurse
recognizes this behavioral presentation as which emotional state?
A) Aggression
B) Anger
C) Violence
D) Assertiveness
Correct Answer: Anger
Rationale: Anger is an emotional response to frustration or a perceived threat, often manifested by
pacing, clenched fists, and loud speech. Aggression is the behavioral action that results in verbal or
physical attack, violence is the actual act of physical force, and assertiveness is a healthy expression of
feelings without hostility—making the others incorrect.
2. Which part of the brain is primarily responsible for the regulation of aggression and emotional
responses?
A) Amygdala
B) Limbic system
C) Prefrontal cortex
D) Hippocampus
Correct Answer: Limbic system
Rationale: The limbic system, located beneath the cerebrum, integrates higher mental functions with
primitive emotions and is responsible for aggression. The amygdala is a component of the limbic
system involved in fear, the prefrontal cortex governs impulse control, and the hippocampus is
primarily involved in memory formation—making them incorrect for this specific role.
,3. A nurse is preparing to administer a B-52 injection for acute agitation. Which medications are
correctly included in this combination?
A) Benadryl 50 mg, Haldol 5 mg, Ativan 2 mg
B) Benadryl 25 mg, Haldol 10 mg, Valium 5 mg
C) Ativan 2 mg, Zyprexa 10 mg, Benadryl 50 mg
D) Haldol 5 mg, Ativan 2 mg, Zyprexa 10 mg
Correct Answer: Benadryl 50 mg, Haldol 5 mg, Ativan 2 mg
Rationale: The B-52 combination consists of Benadryl (diphenhydramine) 50 mg, Haldol (haloperidol)
5 mg, and Ativan (lorazepam) 2 mg for acute agitation management. The other options contain
incorrect dosages or substitute medications that are not part of this standard protocol.
4. A patient is placed in involuntary confinement alone in a room and physically prevented from
leaving. The nurse correctly documents this intervention as:
A) Restraint
B) Seclusion
C) Isolation
D) Time-out
Correct Answer: Seclusion
Rationale: Seclusion is the involuntary confinement of a patient alone in a room from which the
patient is physically prevented from leaving. Restraint refers to any manual method or device that
restricts freedom of movement, isolation is a general term for separation, and time-out is a behavioral
technique—all distinct from this specific intervention.
5. Which clinical scenario predicts the highest risk for directing violent behavior toward others?
A) Obsessive-compulsive disorder with performance of many rituals
B) Major depressive disorder with delusions of worthlessness
, C) Paranoid delusions of being followed by alien monsters
D) Completed alcohol withdrawal with beginning of a rehabilitation program
Correct Answer: Paranoid delusions of being followed by alien monsters
Rationale: Paranoid delusions create intense fear and suspicion, which can lead to defensive or
preemptive violence against perceived threats. OCD rituals, depressive worthlessness, and successful
withdrawal are not associated with the same level of imminent risk for externalized violence.
6. A new patient acts out so aggressively that seclusion is required before the admission assessment is
completed. Immediately after safely secluding the patient, what is the nurse's priority action?
A) Complete the physical assessment
B) Notify the healthcare provider to obtain a seclusion order
C) Document the incident objectively in the patient's medical record
D) Explain to the patient that seclusion will end when self-control is regained
Correct Answer: Notify the healthcare provider to obtain a seclusion order
Rationale: After initiating emergency seclusion, the nurse must promptly obtain a provider's order to
maintain legal and ethical compliance. Physical assessment, documentation, and patient education
are important but secondary to securing the required authorization.
7. Which medications from the medication administration record should a nurse administer to provide
immediate intervention for a psychotic patient whose aggressive behavior continues to escalate
despite verbal intervention?
A) Valproic acid
B) Lithium
C) Trazodone
D) Olanzapine
Correct Answer: Olanzapine
