NSG 322 Behavioral Health Nursing Exam 3 |
Questions and Correct Answers plus Rationales |
Latest Update 2026-2027 | Graded A+
1. Which of the following best describes the primary purpose of the mental
status examination (MSE) in psychiatric nursing?
A) To provide a structured assessment of the client's current cognitive and
emotional functioning
B) To diagnose medical conditions that mimic psychiatric disorders
C) To prescribe psychotropic medications based on symptom severity
D) To evaluate the client's response to psychotherapy over time
Correct Answer: To provide a structured assessment of the client's current
cognitive and emotional functioning
Rationale: The mental status examination is a structured assessment tool used to
evaluate a client's appearance, behavior, mood, affect, thought process, thought
content, cognition, and insight. It provides a snapshot of the client's current
mental state and helps guide diagnosis and treatment planning. It is not used to
diagnose medical conditions, prescribe medications, or evaluate psychotherapy
response.
2. What is the primary function of the DIGFAST mnemonic in behavioral health
assessment?
A) To screen for substance use disorders
B) To assess for symptoms of mania
C) To evaluate cognitive decline in older adults
D) To determine suicide risk level
Correct Answer: To assess for symptoms of mania
,Rationale: DIGFAST is a mnemonic used to assess for symptoms of mania:
Distractibility, Insomnia (decreased need for sleep), Grandiosity, Flight of ideas,
Activity increase, Speech (pressured), and Thoughtlessness (impulsivity). It helps
clinicians systematically evaluate manic symptoms in clients with suspected
bipolar disorder.
3. According to the NSG-322 Exam 3 blueprint, which topic area carries the
highest percentage of exam questions?
A) Schizophrenia Spectrum Disorders, Part 2
B) Bipolar and Impulse-Control Disorders
C) Schizophrenia Spectrum Disorders, Part 1
D) Medication Math
Correct Answer: Bipolar and Impulse-Control Disorders
Rationale: The Exam 3 blueprint specifies that Topic 6: Bipolar and Impulse-
Control Disorders comprises 44% of the exam (22 questions). Topic 7:
Schizophrenia Spectrum Disorders, Part 1 accounts for 22% (11 questions), and
Topic 8: Schizophrenia Spectrum Disorders, Part 2 accounts for 28% (14
questions). Medication Math comprises 6% (3 questions).
4. Which finding is most consistent with a diagnosis of bipolar I disorder?
A) At least one manic episode lasting at least one week
B) Hypomanic episodes alternating with major depressive episodes
C) Persistent depressed mood for at least two years
D) Recurrent intrusive thoughts and compulsive rituals
Correct Answer: At least one manic episode lasting at least one week
Rationale: Bipolar I disorder is diagnosed when a client experiences at least one
manic episode lasting at least one week (or requiring hospitalization). Manic
episodes are characterized by elevated or irritable mood, decreased need for
sleep, grandiosity, and increased goal-directed activity. Bipolar II involves
hypomanic episodes and major depressive episodes.
, 5. What is the most likely outcome if a client with acute mania is placed in a
highly stimulating environment?
A) The client will experience rapid mood stabilization
B) The client's symptoms will escalate due to increased stimulation
C) The client will become more cooperative with treatment
D) The client will develop depressive symptoms
Correct Answer: The client's symptoms will escalate due to increased stimulation
Rationale: Clients experiencing acute mania are highly sensitive to environmental
stimuli. A stimulating environment can exacerbate symptoms such as agitation,
impulsivity, and hyperactivity. A low-stimulation environment with reduced noise,
minimal activity, and structured routines is essential for promoting calm and
safety.
6. Which medication is considered first-line for acute mania in bipolar
disorder?
A) Lithium
B) Fluoxetine
C) Lorazepam
D) Haloperidol
Correct Answer: Lithium
Rationale: Lithium is considered the gold standard and first-line medication for
acute mania and maintenance treatment in bipolar disorder. It stabilizes mood by
altering sodium transport and second messenger systems in neurons. Fluoxetine is
an SSRI for depression, lorazepam is a benzodiazepine for anxiety, and haloperidol
is an antipsychotic.
7. Which laboratory value should be monitored closely in a client taking
lithium?
A) Serum sodium
B) Serum lithium level
, C) Serum calcium
D) Serum chloride
Correct Answer: Serum lithium level
Rationale: Lithium has a narrow therapeutic index, with a therapeutic range of
0.6-1.2 mEq/L. Levels above 1.5 mEq/L can cause toxicity, including tremor,
confusion, ataxia, and seizures. Regular monitoring of serum lithium levels is
essential for safe administration. Sodium, calcium, and chloride are not the
primary monitoring parameters for lithium therapy.
8. Which finding indicates lithium toxicity?
A) Coarse hand tremor and confusion
B) Dry mouth and constipation
C) Increased appetite and weight gain
D) Improved mood and energy
Correct Answer: Coarse hand tremor and confusion
Rationale: Lithium toxicity is characterized by coarse hand tremor, confusion,
ataxia, vomiting, and seizures. It can occur with dehydration, NSAID use, or
excessive dosing. Serum lithium levels should be monitored, and immediate
medical attention is required for severe toxicity. Dry mouth and constipation are
common side effects but not indicative of toxicity.
9. What is the primary mechanism of action of valproic acid in treating bipolar
disorder?
A) Blocking dopamine receptors
B) Increasing GABA levels and blocking sodium channels
C) Inhibiting serotonin reuptake
D) Blocking calcium channels
Correct Answer: Increasing GABA levels and blocking sodium channels
Questions and Correct Answers plus Rationales |
Latest Update 2026-2027 | Graded A+
1. Which of the following best describes the primary purpose of the mental
status examination (MSE) in psychiatric nursing?
A) To provide a structured assessment of the client's current cognitive and
emotional functioning
B) To diagnose medical conditions that mimic psychiatric disorders
C) To prescribe psychotropic medications based on symptom severity
D) To evaluate the client's response to psychotherapy over time
Correct Answer: To provide a structured assessment of the client's current
cognitive and emotional functioning
Rationale: The mental status examination is a structured assessment tool used to
evaluate a client's appearance, behavior, mood, affect, thought process, thought
content, cognition, and insight. It provides a snapshot of the client's current
mental state and helps guide diagnosis and treatment planning. It is not used to
diagnose medical conditions, prescribe medications, or evaluate psychotherapy
response.
2. What is the primary function of the DIGFAST mnemonic in behavioral health
assessment?
A) To screen for substance use disorders
B) To assess for symptoms of mania
C) To evaluate cognitive decline in older adults
D) To determine suicide risk level
Correct Answer: To assess for symptoms of mania
,Rationale: DIGFAST is a mnemonic used to assess for symptoms of mania:
Distractibility, Insomnia (decreased need for sleep), Grandiosity, Flight of ideas,
Activity increase, Speech (pressured), and Thoughtlessness (impulsivity). It helps
clinicians systematically evaluate manic symptoms in clients with suspected
bipolar disorder.
3. According to the NSG-322 Exam 3 blueprint, which topic area carries the
highest percentage of exam questions?
A) Schizophrenia Spectrum Disorders, Part 2
B) Bipolar and Impulse-Control Disorders
C) Schizophrenia Spectrum Disorders, Part 1
D) Medication Math
Correct Answer: Bipolar and Impulse-Control Disorders
Rationale: The Exam 3 blueprint specifies that Topic 6: Bipolar and Impulse-
Control Disorders comprises 44% of the exam (22 questions). Topic 7:
Schizophrenia Spectrum Disorders, Part 1 accounts for 22% (11 questions), and
Topic 8: Schizophrenia Spectrum Disorders, Part 2 accounts for 28% (14
questions). Medication Math comprises 6% (3 questions).
4. Which finding is most consistent with a diagnosis of bipolar I disorder?
A) At least one manic episode lasting at least one week
B) Hypomanic episodes alternating with major depressive episodes
C) Persistent depressed mood for at least two years
D) Recurrent intrusive thoughts and compulsive rituals
Correct Answer: At least one manic episode lasting at least one week
Rationale: Bipolar I disorder is diagnosed when a client experiences at least one
manic episode lasting at least one week (or requiring hospitalization). Manic
episodes are characterized by elevated or irritable mood, decreased need for
sleep, grandiosity, and increased goal-directed activity. Bipolar II involves
hypomanic episodes and major depressive episodes.
, 5. What is the most likely outcome if a client with acute mania is placed in a
highly stimulating environment?
A) The client will experience rapid mood stabilization
B) The client's symptoms will escalate due to increased stimulation
C) The client will become more cooperative with treatment
D) The client will develop depressive symptoms
Correct Answer: The client's symptoms will escalate due to increased stimulation
Rationale: Clients experiencing acute mania are highly sensitive to environmental
stimuli. A stimulating environment can exacerbate symptoms such as agitation,
impulsivity, and hyperactivity. A low-stimulation environment with reduced noise,
minimal activity, and structured routines is essential for promoting calm and
safety.
6. Which medication is considered first-line for acute mania in bipolar
disorder?
A) Lithium
B) Fluoxetine
C) Lorazepam
D) Haloperidol
Correct Answer: Lithium
Rationale: Lithium is considered the gold standard and first-line medication for
acute mania and maintenance treatment in bipolar disorder. It stabilizes mood by
altering sodium transport and second messenger systems in neurons. Fluoxetine is
an SSRI for depression, lorazepam is a benzodiazepine for anxiety, and haloperidol
is an antipsychotic.
7. Which laboratory value should be monitored closely in a client taking
lithium?
A) Serum sodium
B) Serum lithium level
, C) Serum calcium
D) Serum chloride
Correct Answer: Serum lithium level
Rationale: Lithium has a narrow therapeutic index, with a therapeutic range of
0.6-1.2 mEq/L. Levels above 1.5 mEq/L can cause toxicity, including tremor,
confusion, ataxia, and seizures. Regular monitoring of serum lithium levels is
essential for safe administration. Sodium, calcium, and chloride are not the
primary monitoring parameters for lithium therapy.
8. Which finding indicates lithium toxicity?
A) Coarse hand tremor and confusion
B) Dry mouth and constipation
C) Increased appetite and weight gain
D) Improved mood and energy
Correct Answer: Coarse hand tremor and confusion
Rationale: Lithium toxicity is characterized by coarse hand tremor, confusion,
ataxia, vomiting, and seizures. It can occur with dehydration, NSAID use, or
excessive dosing. Serum lithium levels should be monitored, and immediate
medical attention is required for severe toxicity. Dry mouth and constipation are
common side effects but not indicative of toxicity.
9. What is the primary mechanism of action of valproic acid in treating bipolar
disorder?
A) Blocking dopamine receptors
B) Increasing GABA levels and blocking sodium channels
C) Inhibiting serotonin reuptake
D) Blocking calcium channels
Correct Answer: Increasing GABA levels and blocking sodium channels
