NUR256 EXAM 3 Actual Exam 2026/2027
Complete Questions and Verified Answers
with Detailed Rationales Concepts of Mental
Health Nursing Grade A 100% Correct Pass
Guaranteed - A+ Graded
SECTION 1: MOOD DISORDERS (Questions 1-15)
Q1: A client with major depressive disorder has been taking sertraline for 6 weeks and reports
improved sleep and appetite but persistent sad mood. Which interpretation by the nurse is most
accurate?
• A. The medication has failed and should be discontinued immediately
• B. This represents a partial response; full mood improvement may require 8-12 weeks
[CORRECT]
• C. The dose should be doubled immediately
• D. These improvements indicate the depression is cured
Correct Answer: B
Rationale: Antidepressant response often follows a pattern where physical symptoms (sleep,
appetite, energy) improve before mood lifts completely. This partial response at 6 weeks (B)
suggests continued treatment may yield further improvement, typically evaluated at 8-12 weeks
before considering changes. Premature discontinuation (A) or dose increases (C) are
inappropriate. "Cured" (D) is incorrect as this is a chronic condition requiring ongoing
management.
Q2: A client with bipolar disorder is prescribed lithium carbonate. Which laboratory monitoring
is essential before starting treatment?
• A. Liver function tests only
• B. Thyroid function, renal function, and electrolytes [CORRECT]
• C. Cardiac enzymes only
, • D. Pulmonary function tests
Correct Answer: B
Rationale: Baseline and ongoing monitoring of thyroid function (lithium can cause
hypothyroidism), renal function (lithium is renally excreted and can affect kidneys), and
electrolytes (sodium affects lithium levels) is essential (B). Lithium does not typically affect liver
(A) or lungs (D). Cardiac enzymes (C) are not routinely monitored unless cardiac symptoms
present.
Q3: A nurse is assessing a client using the SIGECAPS mnemonic for depression. Which
symptom is being assessed when the client reports "I just can't seem to make decisions
anymore"?
• A. Sleep changes
• B. Interest loss
• C. Concentration problems [CORRECT]
• D. Psychomotor changes
Correct Answer: C
Rationale: The "C" in SIGECAPS stands for Concentration problems (C), which includes
difficulty making decisions, slowed thinking, and distractibility. Sleep (A) refers to insomnia or
hypersomnia. Interest (B) refers to anhedonia. Psychomotor (D) refers to agitation or retardation.
Q4: A client with severe depression is being evaluated for electroconvulsive therapy (ECT).
Which condition is an indication for ECT?
• A. Mild depression responsive to medication
• B. Severe depression with psychotic features or treatment resistance [CORRECT]
• C. Adjustment disorder with depressed mood
• D. Dysthymia
Correct Answer: B
Rationale: ECT is indicated for severe major depression, particularly with psychotic features,
catatonia, treatment resistance, or when rapid response is needed (suicide risk, refusal to eat) (B).
Mild depression (A), adjustment disorder (C), and dysthymia (D) are not typical indications for
ECT.
, Q5: A client with bipolar I disorder is in a manic episode and has been awake for 72 hours.
Which nursing diagnosis is the priority?
• A. Disturbed body image
• B. Risk for injury related to exhaustion and poor judgment [CORRECT]
• C. Social isolation
• D. Chronic confusion
Correct Answer: B
Rationale: 72 hours without sleep in mania causes severe exhaustion, impaired judgment, and
risk of physical collapse or dangerous behavior (B). While other diagnoses may apply,
physiological safety from exhaustion and poor judgment is the immediate priority. Body image
(A), isolation (C), and chronic confusion (D) are not the primary concerns in acute mania.
Q6: A client taking phenelzine (Nardil) reports eating pepperoni pizza and drinking red wine.
Which symptom indicates a hypertensive crisis?
• A. Blood pressure 90/60 mmHg with dizziness
• B. Severe headache, stiff neck, and blood pressure 200/120 mmHg [CORRECT]
• C. Blood pressure 110/70 mmHg with mild headache
• D. Bradycardia and hypotension
Correct Answer: B
Rationale: MAOI + tyramine-rich foods cause hypertensive crisis characterized by severe
occipital headache, stiff neck, palpitations, sweating, and markedly elevated BP (B) that can lead
to stroke or death. Hypotension (A, D) or normal BP (C) do not indicate crisis.
Q7: A nurse is teaching a client about bupropion (Wellbutrin). Which side effect should the nurse
emphasize?
• A. Sedation and weight gain
• B. Risk of seizures, especially at higher doses [CORRECT]
• C. Severe orthostatic hypotension
• D. Anticholinergic effects like dry mouth and constipation
Complete Questions and Verified Answers
with Detailed Rationales Concepts of Mental
Health Nursing Grade A 100% Correct Pass
Guaranteed - A+ Graded
SECTION 1: MOOD DISORDERS (Questions 1-15)
Q1: A client with major depressive disorder has been taking sertraline for 6 weeks and reports
improved sleep and appetite but persistent sad mood. Which interpretation by the nurse is most
accurate?
• A. The medication has failed and should be discontinued immediately
• B. This represents a partial response; full mood improvement may require 8-12 weeks
[CORRECT]
• C. The dose should be doubled immediately
• D. These improvements indicate the depression is cured
Correct Answer: B
Rationale: Antidepressant response often follows a pattern where physical symptoms (sleep,
appetite, energy) improve before mood lifts completely. This partial response at 6 weeks (B)
suggests continued treatment may yield further improvement, typically evaluated at 8-12 weeks
before considering changes. Premature discontinuation (A) or dose increases (C) are
inappropriate. "Cured" (D) is incorrect as this is a chronic condition requiring ongoing
management.
Q2: A client with bipolar disorder is prescribed lithium carbonate. Which laboratory monitoring
is essential before starting treatment?
• A. Liver function tests only
• B. Thyroid function, renal function, and electrolytes [CORRECT]
• C. Cardiac enzymes only
, • D. Pulmonary function tests
Correct Answer: B
Rationale: Baseline and ongoing monitoring of thyroid function (lithium can cause
hypothyroidism), renal function (lithium is renally excreted and can affect kidneys), and
electrolytes (sodium affects lithium levels) is essential (B). Lithium does not typically affect liver
(A) or lungs (D). Cardiac enzymes (C) are not routinely monitored unless cardiac symptoms
present.
Q3: A nurse is assessing a client using the SIGECAPS mnemonic for depression. Which
symptom is being assessed when the client reports "I just can't seem to make decisions
anymore"?
• A. Sleep changes
• B. Interest loss
• C. Concentration problems [CORRECT]
• D. Psychomotor changes
Correct Answer: C
Rationale: The "C" in SIGECAPS stands for Concentration problems (C), which includes
difficulty making decisions, slowed thinking, and distractibility. Sleep (A) refers to insomnia or
hypersomnia. Interest (B) refers to anhedonia. Psychomotor (D) refers to agitation or retardation.
Q4: A client with severe depression is being evaluated for electroconvulsive therapy (ECT).
Which condition is an indication for ECT?
• A. Mild depression responsive to medication
• B. Severe depression with psychotic features or treatment resistance [CORRECT]
• C. Adjustment disorder with depressed mood
• D. Dysthymia
Correct Answer: B
Rationale: ECT is indicated for severe major depression, particularly with psychotic features,
catatonia, treatment resistance, or when rapid response is needed (suicide risk, refusal to eat) (B).
Mild depression (A), adjustment disorder (C), and dysthymia (D) are not typical indications for
ECT.
, Q5: A client with bipolar I disorder is in a manic episode and has been awake for 72 hours.
Which nursing diagnosis is the priority?
• A. Disturbed body image
• B. Risk for injury related to exhaustion and poor judgment [CORRECT]
• C. Social isolation
• D. Chronic confusion
Correct Answer: B
Rationale: 72 hours without sleep in mania causes severe exhaustion, impaired judgment, and
risk of physical collapse or dangerous behavior (B). While other diagnoses may apply,
physiological safety from exhaustion and poor judgment is the immediate priority. Body image
(A), isolation (C), and chronic confusion (D) are not the primary concerns in acute mania.
Q6: A client taking phenelzine (Nardil) reports eating pepperoni pizza and drinking red wine.
Which symptom indicates a hypertensive crisis?
• A. Blood pressure 90/60 mmHg with dizziness
• B. Severe headache, stiff neck, and blood pressure 200/120 mmHg [CORRECT]
• C. Blood pressure 110/70 mmHg with mild headache
• D. Bradycardia and hypotension
Correct Answer: B
Rationale: MAOI + tyramine-rich foods cause hypertensive crisis characterized by severe
occipital headache, stiff neck, palpitations, sweating, and markedly elevated BP (B) that can lead
to stroke or death. Hypotension (A, D) or normal BP (C) do not indicate crisis.
Q7: A nurse is teaching a client about bupropion (Wellbutrin). Which side effect should the nurse
emphasize?
• A. Sedation and weight gain
• B. Risk of seizures, especially at higher doses [CORRECT]
• C. Severe orthostatic hypotension
• D. Anticholinergic effects like dry mouth and constipation
