• NSG 526 Exam 09/01/2026
Wilkes NSG 526 Exam | Clinical
Modalities in Advanced Psych | Questions
& Correct Verified Answers with Rationales
| Latest 2026/2027 Update | Graded A+|
A 31-year-old patient admitted with acute mania tells the staff and the other patients that he
is on a secret mission for the President of the United States. He states, "I am the only one he
trusts, because I am the best!" What term will the nurse use when documenting this
behavior?
a. Unpredictability
b. Rapid cycling
c. Grandiosity
d. Flight of ideas –
P 1
, • NSG 526 Exam 09/01/2026
Correct Answer :c. Grandiosity
Grandiosity is inflated self-regard. People with mania may exaggerate their achievements or
importance, state that they know famous people, or believe they have great powers.
Although patients with mania are unpredictable, the scenario does not describe
unpredictability: rapid cycling is switching between mania and depression in a given time
period. The scenario does not describe flight of ideas, which means a continuous flow of
speech with abrupt topic changes.
Which of the following describe the symptoms of the manic phase of bipolar disorder?
Select all that apply.
a. Excessive energy
b. Fatigue and increased sleep
c. Low self-esteem
d. Pressured speech
e. Purposeless movement
f. Racing thoughts
g. Withdrawal from environment
h. Distractibility –
Correct Answer :a. Excessive energy
d. Pressured speech
e. Purposeless movement
f. Racing thoughts
h. Distractibility
P 2
, • NSG 526 Exam 09/01/2026
Which of the following is true of the relationship between bipolar disorder and suicide?
a. Patients need to be monitored only in the depressed phase because this is when suicides
occur.
b. Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit
suicide.
c. Patients with bipolar disorder are not considered high risk for suicide.
d. As long as patients with bipolar disorder adhere to their medication regimen, there is little
risk for suicide. –
Correct Answer :b. Suicide is a serious risk because nearly 20% of those diagnosed with
bipolar disorder commit suicide.
Mortality rates for bipolar disorder are severe because substantial numbers of individuals with
bipolar disorder will make a suicide attempt at least once in their lifetime. Suicides occur in
both the depressed and the manic phase. Bipolar patients are always considered high risk for
suicide because of impulsivity while in the manic phase and hopelessness when in the
depressed phase. Although staying on medications may decrease risk, there is no evidence to
suggest that only patients who stop medications commit suicide.
What is the major reason for the hospitalization of a depressed patient?
a. Inability to go to work
b. Suicidal ideation
c. Loss of appetite
d. Psychomotor agitation –
Correct Answer :b. Suicidal ideation
Suicidal thoughts are a major reason for hospitalization for patients with major depression. It
is imperative to intervene with such patients to keep them safe from self-harm. The other
P 3
, • NSG 526 Exam 09/01/2026
options describe symptoms of major depression but aren't by themselves the major reason
for hospitalization.
A client admitted with major depression and suicidal ideation with a plan to overdose is
preparing for discharge and asks you, "Why did I get a prescription for only 7 days of
amitriptyline?" The nurse's response is based on what fact?
a. Amitriptyline is very expensive, so the patient may have to buy fewer at a time.
b. The goal is to see how the client responds to the first week of medication to evaluate its
effectiveness.
c. The health care provider wants to see whether any side effects occur within the first week
of administration.
d. Amitriptyline is lethal in overdose. –
Correct Answer :d. Amitriptyline is lethal in overdose.
Amitriptyline is a tricyclic antidepressant (TCA); these drugs are known to be lethal in smaller
doses than other antidepressants. Because the patient had a plan of overdose, the best
course of action is to give a small prescription requiring her to visit her provider's office more
often for monitoring of suicidal ideation and plan. Tricyclics are not known to be expensive.
Antidepressant therapy usually takes several weeks to produce full results, so the patient
would not be evaluated after only 1 week. Side effects are always a consideration but not the
most important consideration with TCAs.
When the nurse asks whether a client is having any thoughts of suicide, the client becomes
angry and defensive, shouting, "I'm sick of you people! Are you ever do is ask me the same
question over and over. Get out of here!" The nurse's response is based on what fact
concerning hostility?
a. The client is getting better and is able to be assertive.
b. The client may be at high risk for self-harm.
c. The client is probably experiencing transference.
P 4
Wilkes NSG 526 Exam | Clinical
Modalities in Advanced Psych | Questions
& Correct Verified Answers with Rationales
| Latest 2026/2027 Update | Graded A+|
A 31-year-old patient admitted with acute mania tells the staff and the other patients that he
is on a secret mission for the President of the United States. He states, "I am the only one he
trusts, because I am the best!" What term will the nurse use when documenting this
behavior?
a. Unpredictability
b. Rapid cycling
c. Grandiosity
d. Flight of ideas –
P 1
, • NSG 526 Exam 09/01/2026
Correct Answer :c. Grandiosity
Grandiosity is inflated self-regard. People with mania may exaggerate their achievements or
importance, state that they know famous people, or believe they have great powers.
Although patients with mania are unpredictable, the scenario does not describe
unpredictability: rapid cycling is switching between mania and depression in a given time
period. The scenario does not describe flight of ideas, which means a continuous flow of
speech with abrupt topic changes.
Which of the following describe the symptoms of the manic phase of bipolar disorder?
Select all that apply.
a. Excessive energy
b. Fatigue and increased sleep
c. Low self-esteem
d. Pressured speech
e. Purposeless movement
f. Racing thoughts
g. Withdrawal from environment
h. Distractibility –
Correct Answer :a. Excessive energy
d. Pressured speech
e. Purposeless movement
f. Racing thoughts
h. Distractibility
P 2
, • NSG 526 Exam 09/01/2026
Which of the following is true of the relationship between bipolar disorder and suicide?
a. Patients need to be monitored only in the depressed phase because this is when suicides
occur.
b. Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit
suicide.
c. Patients with bipolar disorder are not considered high risk for suicide.
d. As long as patients with bipolar disorder adhere to their medication regimen, there is little
risk for suicide. –
Correct Answer :b. Suicide is a serious risk because nearly 20% of those diagnosed with
bipolar disorder commit suicide.
Mortality rates for bipolar disorder are severe because substantial numbers of individuals with
bipolar disorder will make a suicide attempt at least once in their lifetime. Suicides occur in
both the depressed and the manic phase. Bipolar patients are always considered high risk for
suicide because of impulsivity while in the manic phase and hopelessness when in the
depressed phase. Although staying on medications may decrease risk, there is no evidence to
suggest that only patients who stop medications commit suicide.
What is the major reason for the hospitalization of a depressed patient?
a. Inability to go to work
b. Suicidal ideation
c. Loss of appetite
d. Psychomotor agitation –
Correct Answer :b. Suicidal ideation
Suicidal thoughts are a major reason for hospitalization for patients with major depression. It
is imperative to intervene with such patients to keep them safe from self-harm. The other
P 3
, • NSG 526 Exam 09/01/2026
options describe symptoms of major depression but aren't by themselves the major reason
for hospitalization.
A client admitted with major depression and suicidal ideation with a plan to overdose is
preparing for discharge and asks you, "Why did I get a prescription for only 7 days of
amitriptyline?" The nurse's response is based on what fact?
a. Amitriptyline is very expensive, so the patient may have to buy fewer at a time.
b. The goal is to see how the client responds to the first week of medication to evaluate its
effectiveness.
c. The health care provider wants to see whether any side effects occur within the first week
of administration.
d. Amitriptyline is lethal in overdose. –
Correct Answer :d. Amitriptyline is lethal in overdose.
Amitriptyline is a tricyclic antidepressant (TCA); these drugs are known to be lethal in smaller
doses than other antidepressants. Because the patient had a plan of overdose, the best
course of action is to give a small prescription requiring her to visit her provider's office more
often for monitoring of suicidal ideation and plan. Tricyclics are not known to be expensive.
Antidepressant therapy usually takes several weeks to produce full results, so the patient
would not be evaluated after only 1 week. Side effects are always a consideration but not the
most important consideration with TCAs.
When the nurse asks whether a client is having any thoughts of suicide, the client becomes
angry and defensive, shouting, "I'm sick of you people! Are you ever do is ask me the same
question over and over. Get out of here!" The nurse's response is based on what fact
concerning hostility?
a. The client is getting better and is able to be assertive.
b. The client may be at high risk for self-harm.
c. The client is probably experiencing transference.
P 4
