NUR 253 EXAM 4 MENTAL HEALTH
NURSING QUESTION MEGA TEST
BANK (GALEN COLLEGE)
This high-yield, comprehensive practice exam is meticulously aligned with
the NUR 253 curriculum to guarantee mastery of complex mental health
nursing concepts. It features realistic multiple-choice questions complete
with italicized answers and detailed bold-italic rationales that clarify tricky
topics like psychopharmacology toxicities, neurocognitive disorders, and
legal/ethical boundary constraints. Perfect for self-study or rapid test
preparation, this premium bank is designed to build clinical judgment, boost
confidence, and secure top marks on your final assessment.
Question 1
A nurse is assessing an 83-year-old client who
became acutely confused, agitated, and visually
hallucinated within the past 24 hours. The family
reports the client was completely functional
yesterday. Which condition should the nurse
suspect?
A) Dementia
B) Delirium
C) Depression
D) Late-onset Schizophrenia
Rationale: Delirium is characterized by an
acute, abrupt onset and a fluctuating course,
usually triggered by an underlying medical
condition (such as a UTI or electrolyte
, imbalance). Dementia has a slow,
progressive, and insidious onset.
Question 2
A client diagnosed with Alzheimer’s disease
becomes increasingly restless, agitated, and
disoriented in the late afternoon and evening. Which
phenomenon is this client experiencing?
A) Sundowning
B) Confabulation
C) Preservation
D) Apraxia
Rationale: Sundowning refers to the
exacerbation of behavioral symptoms,
confusion, and agitation during late
afternoon or evening hours in clients with
neurocognitive disorders.
Question 3
Which environmental intervention should the nurse
implement to manage sundowning in a client with
advanced dementia?
A) Turn off all the lights in the room by 4:00 PM
B) Keep the environment well-lit in the evening and
maintain a calm, quiet routine
C) Place a television on a loud volume to distract the
,client
D) Move the client to a new room every evening for
a change of scenery
Rationale: Providing adequate ambient
lighting in the evening helps minimize
shadows and optical illusions that cause fear
and confusion, while a predictable routine
lowers anxiety.
Question 4
A client with severe dementia makes up stories to fill
in memory gaps about what they did over the
weekend. The nurse recognizes this protective
defense mechanism as which of the following?
A) Aphasia
B) Agnosia
C) Confabulation
D) Delusion
Rationale: Confabulation is the unconscious
creation of stories or answers to fill in
memory gaps. It is a defense mechanism
used to maintain self-esteem and decrease
anxiety over cognitive decline, not an
intentional lie.
Question 5
, A client taking lithium carbonate for bipolar disorder
presents with coarse hand tremors, severe diarrhea,
vomiting, and an unsteady gait. The nurse should
anticipate which lithium level and immediate action?
A) 0.8 mEq/L; administer the next dose
B) 1.2 mEq/L; encourage increased fluid intake
C) 2.1 mEq/L; hold the medication and notify the
healthcare provider immediately
D) 0.4 mEq/L; prepare to increase the dosage
Rationale: Coarse hand tremors, severe
gastrointestinal symptoms, and ataxia
(unsteady gait) are signs of severe lithium
toxicity, occurring at serum levels above 1.5
to 2.0 mEq/L. The drug must be held
immediately.
Question 6
A client prescribed sertraline (an SSRI) for
depression admits to also taking over-the-counter
St. John’s wort. The client presents with
hyperpyrexia, muscle rigidity, tachycardia, and
shivering. What condition should the nurse suspect?
A) Neuroleptic Malignant Syndrome (NMS)
B) Serotonin Syndrome
C) Anticholinergic Toxicity
D) Hypertensive Crisis
NURSING QUESTION MEGA TEST
BANK (GALEN COLLEGE)
This high-yield, comprehensive practice exam is meticulously aligned with
the NUR 253 curriculum to guarantee mastery of complex mental health
nursing concepts. It features realistic multiple-choice questions complete
with italicized answers and detailed bold-italic rationales that clarify tricky
topics like psychopharmacology toxicities, neurocognitive disorders, and
legal/ethical boundary constraints. Perfect for self-study or rapid test
preparation, this premium bank is designed to build clinical judgment, boost
confidence, and secure top marks on your final assessment.
Question 1
A nurse is assessing an 83-year-old client who
became acutely confused, agitated, and visually
hallucinated within the past 24 hours. The family
reports the client was completely functional
yesterday. Which condition should the nurse
suspect?
A) Dementia
B) Delirium
C) Depression
D) Late-onset Schizophrenia
Rationale: Delirium is characterized by an
acute, abrupt onset and a fluctuating course,
usually triggered by an underlying medical
condition (such as a UTI or electrolyte
, imbalance). Dementia has a slow,
progressive, and insidious onset.
Question 2
A client diagnosed with Alzheimer’s disease
becomes increasingly restless, agitated, and
disoriented in the late afternoon and evening. Which
phenomenon is this client experiencing?
A) Sundowning
B) Confabulation
C) Preservation
D) Apraxia
Rationale: Sundowning refers to the
exacerbation of behavioral symptoms,
confusion, and agitation during late
afternoon or evening hours in clients with
neurocognitive disorders.
Question 3
Which environmental intervention should the nurse
implement to manage sundowning in a client with
advanced dementia?
A) Turn off all the lights in the room by 4:00 PM
B) Keep the environment well-lit in the evening and
maintain a calm, quiet routine
C) Place a television on a loud volume to distract the
,client
D) Move the client to a new room every evening for
a change of scenery
Rationale: Providing adequate ambient
lighting in the evening helps minimize
shadows and optical illusions that cause fear
and confusion, while a predictable routine
lowers anxiety.
Question 4
A client with severe dementia makes up stories to fill
in memory gaps about what they did over the
weekend. The nurse recognizes this protective
defense mechanism as which of the following?
A) Aphasia
B) Agnosia
C) Confabulation
D) Delusion
Rationale: Confabulation is the unconscious
creation of stories or answers to fill in
memory gaps. It is a defense mechanism
used to maintain self-esteem and decrease
anxiety over cognitive decline, not an
intentional lie.
Question 5
, A client taking lithium carbonate for bipolar disorder
presents with coarse hand tremors, severe diarrhea,
vomiting, and an unsteady gait. The nurse should
anticipate which lithium level and immediate action?
A) 0.8 mEq/L; administer the next dose
B) 1.2 mEq/L; encourage increased fluid intake
C) 2.1 mEq/L; hold the medication and notify the
healthcare provider immediately
D) 0.4 mEq/L; prepare to increase the dosage
Rationale: Coarse hand tremors, severe
gastrointestinal symptoms, and ataxia
(unsteady gait) are signs of severe lithium
toxicity, occurring at serum levels above 1.5
to 2.0 mEq/L. The drug must be held
immediately.
Question 6
A client prescribed sertraline (an SSRI) for
depression admits to also taking over-the-counter
St. John’s wort. The client presents with
hyperpyrexia, muscle rigidity, tachycardia, and
shivering. What condition should the nurse suspect?
A) Neuroleptic Malignant Syndrome (NMS)
B) Serotonin Syndrome
C) Anticholinergic Toxicity
D) Hypertensive Crisis
