NSG 3450 Exam 4 | Nursing Practice –
Mental Health
COMPREHENSIVE PSYCH NURSING REVIEW (2026/2027) - GALEN COLLEGE
(1) A client with Borderline Personality Disorder (BPD) tells a nurse, 'You are the only
nurse who actually cares. The day shift nurse is incompetent.' This behavior is an
example of:
A. Projection
B. Splitting
C. Displacement
D. Intellectualization
CORRECT ANSWER: B
Therapeutic Rationale: Splitting is a common defense mechanism in BPD where the individual
perceives people as 'all good' or 'all bad,' often pitting staff members against each other.
(2) Which personality disorder is characterized by a pervasive pattern of disregard for
and violation of the rights of others, often lacking remorse?
A. Narcissistic
B. Antisocial
C. Histrionic
D. Avoidant
CORRECT ANSWER: B
Therapeutic Rationale: Antisocial Personality Disorder is characterized by deceitfulness,
impulsivity, irritability, and a profound lack of empathy or remorse for harming others.
,(3) A client is admitted for alcohol detoxification. Which medication should the nurse
anticipate administering to prevent or manage alcohol withdrawal seizures?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Bupropion
CORRECT ANSWER: B
Therapeutic Rationale: Benzodiazepines like Lorazepam or Chlordiazepoxide are the gold
standard for managing alcohol withdrawal symptoms and preventing life-threatening seizures and
delirium tremens.
(4) A client is brought to the ER with pinpoint pupils, respiratory depression, and
extreme somnolence. The nurse should prepare to administer which medication?
A. Flumazenil
B. Naloxone
C. Atropine
D. N-acetylcysteine
CORRECT ANSWER: B
Therapeutic Rationale: These symptoms are the classic triad of opioid overdose. Naloxone is a
fast-acting opioid antagonist used to reverse respiratory depression.
,(5) Which clinical finding is a common physical manifestation of Anorexia Nervosa as
the body tries to conserve heat?
A. Hypertension
B. Lanugo
C. Tachycardia
D. Hyperthermia
CORRECT ANSWER: B
Therapeutic Rationale: Lanugo is the growth of fine, downy hair on the face and back, which
occurs in severe malnutrition (Anorexia) as a physiological adaptation to maintain body
temperature.
(6) A client with Bulimia Nervosa is admitted. Which electrolyte imbalance is the
priority for the nurse to monitor?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
CORRECT ANSWER: B
Therapeutic Rationale: Self-induced vomiting leads to a significant loss of potassium, putting the
client at high risk for cardiac arrhythmias and sudden death.
, (7) A nurse is assisting a client who has just experienced a sexual assault. What is the
priority nursing goal during the 'acute phase' of the crisis?
A. Helping the client identify long-term goals.
B. Providing a safe environment and emotional support.
C. Confronting the client's denial.
D. Referring the client to a support group immediately.
CORRECT ANSWER: B
Therapeutic Rationale: During the acute phase of a crisis, the priority is safety, stabilization, and
establishing a supportive, non-judgmental environment.
(8) A child is diagnosed with Oppositional Defiant Disorder (ODD). Which behavior is
characteristic of this diagnosis?
A. Cruelty to animals and fire-setting.
B. Difficulty paying attention in school.
C. Persistent pattern of irritability, defiance, and vindictiveness.
D. Social withdrawal and lack of eye contact.
CORRECT ANSWER: C
Therapeutic Rationale: ODD is characterized by a pattern of angry/irritable mood and defiant
behavior towards authority figures. Cruelty to animals is more associated with Conduct Disorder.
Mental Health
COMPREHENSIVE PSYCH NURSING REVIEW (2026/2027) - GALEN COLLEGE
(1) A client with Borderline Personality Disorder (BPD) tells a nurse, 'You are the only
nurse who actually cares. The day shift nurse is incompetent.' This behavior is an
example of:
A. Projection
B. Splitting
C. Displacement
D. Intellectualization
CORRECT ANSWER: B
Therapeutic Rationale: Splitting is a common defense mechanism in BPD where the individual
perceives people as 'all good' or 'all bad,' often pitting staff members against each other.
(2) Which personality disorder is characterized by a pervasive pattern of disregard for
and violation of the rights of others, often lacking remorse?
A. Narcissistic
B. Antisocial
C. Histrionic
D. Avoidant
CORRECT ANSWER: B
Therapeutic Rationale: Antisocial Personality Disorder is characterized by deceitfulness,
impulsivity, irritability, and a profound lack of empathy or remorse for harming others.
,(3) A client is admitted for alcohol detoxification. Which medication should the nurse
anticipate administering to prevent or manage alcohol withdrawal seizures?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Bupropion
CORRECT ANSWER: B
Therapeutic Rationale: Benzodiazepines like Lorazepam or Chlordiazepoxide are the gold
standard for managing alcohol withdrawal symptoms and preventing life-threatening seizures and
delirium tremens.
(4) A client is brought to the ER with pinpoint pupils, respiratory depression, and
extreme somnolence. The nurse should prepare to administer which medication?
A. Flumazenil
B. Naloxone
C. Atropine
D. N-acetylcysteine
CORRECT ANSWER: B
Therapeutic Rationale: These symptoms are the classic triad of opioid overdose. Naloxone is a
fast-acting opioid antagonist used to reverse respiratory depression.
,(5) Which clinical finding is a common physical manifestation of Anorexia Nervosa as
the body tries to conserve heat?
A. Hypertension
B. Lanugo
C. Tachycardia
D. Hyperthermia
CORRECT ANSWER: B
Therapeutic Rationale: Lanugo is the growth of fine, downy hair on the face and back, which
occurs in severe malnutrition (Anorexia) as a physiological adaptation to maintain body
temperature.
(6) A client with Bulimia Nervosa is admitted. Which electrolyte imbalance is the
priority for the nurse to monitor?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
CORRECT ANSWER: B
Therapeutic Rationale: Self-induced vomiting leads to a significant loss of potassium, putting the
client at high risk for cardiac arrhythmias and sudden death.
, (7) A nurse is assisting a client who has just experienced a sexual assault. What is the
priority nursing goal during the 'acute phase' of the crisis?
A. Helping the client identify long-term goals.
B. Providing a safe environment and emotional support.
C. Confronting the client's denial.
D. Referring the client to a support group immediately.
CORRECT ANSWER: B
Therapeutic Rationale: During the acute phase of a crisis, the priority is safety, stabilization, and
establishing a supportive, non-judgmental environment.
(8) A child is diagnosed with Oppositional Defiant Disorder (ODD). Which behavior is
characteristic of this diagnosis?
A. Cruelty to animals and fire-setting.
B. Difficulty paying attention in school.
C. Persistent pattern of irritability, defiance, and vindictiveness.
D. Social withdrawal and lack of eye contact.
CORRECT ANSWER: C
Therapeutic Rationale: ODD is characterized by a pattern of angry/irritable mood and defiant
behavior towards authority figures. Cruelty to animals is more associated with Conduct Disorder.
