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NUR 253 Mental Health Exam 3 Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Mood Disorders & Suicide Prevention (Questions 1-20)
Q1: A patient diagnosed with Major Depressive Disorder (MDD) reports sleeping 14 hours a
night but still feels exhausted. The nurse documents this as which SIGECAPS symptom?
A. Interest loss
B. Guilt
C. Energy loss
D. Psychomotor retardation
Correct Answer: C
Rationale: SIGECAPS includes Sleep disturbance (hypersomnia or insomnia), Interest loss,
Guilt, Energy loss, Concentration problems, Appetite change, Psychomotor changes, and
Suicidality. Hypersomnia (excessive sleeping) leading to fatigue falls under both Sleep and
Energy loss, but the symptom of feeling exhausted is specifically "Energy loss." Psychomotor
retardation refers to slowed physical movement/speech.
Q2: A patient is exhibiting a pressured speech, grandiosity, decreased need for sleep, and
excessive involvement in high-risk business investments. The nurse recognizes these symptoms
as:
A. A depressive episode
B. A manic episode
C. A hypomanic episode
D. Schizophrenia
Correct Answer: B
Rationale: These symptoms correlate with the mnemonic DIGFAST (Depressed mood is not part
of it, but Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity increase, Sleep
,2
decreased, Talkativeness are). The severity (high-risk investments) suggests a full Manic Episode
rather than Hypomania.
Q3: A patient with Bipolar I Disorder is prescribed Lithium. Which instruction is most critical for
the nurse to teach the patient?
A. "Maintain a consistent intake of sodium and caffeine."
B. "Take this medication on an empty stomach."
C. "You may stop taking this medication when you feel better."
D. "Expect immediate results within 24 hours."
Correct Answer: A
Rationale: Lithium levels are affected by sodium balance. Low sodium intake can lead to lithium
retention and toxicity, while high sodium can lower levels, making the drug ineffective. Caffeine
can also affect levels. Lithium takes weeks to reach a steady state and should not be stopped
abruptly.
Q4: The nurse is assessing a patient for suicide risk. The patient states, "I wish I were dead," but
denies having a plan. The nurse should:
A. Place the patient on one-to-one observation immediately.
B. Ask the patient, "Do you have a specific plan to kill yourself?"
B. Dismiss the statement as attention-seeking.
D. Tell the patient's family to take them home immediately.
Correct Answer: B
Rationale: While the statement requires assessment, the nurse must first determine the specificity
and lethality of the plan. Directly asking about a plan does not increase the risk of suicide but is a
standard part of a risk assessment. One-to-one observation may be implemented depending on
the full assessment, but the immediate action is to clarify the risk.
Q5: Which medication requires a slow titration to prevent Stevens-Johnson Syndrome (SJS) or
Toxic Epidermal Necrolysis (TEN)?
A. Lithium
, 3
B. Valproate (Depakote)
C. Lamotrigine (Lamictal)
D. Olanzapine (Zyprexa)
Correct Answer: C
Rationale: Lamotrigine carries a risk of severe rash (SJS/TEN). To minimize this risk, the
medication must be titrated slowly over several weeks. Patients should report any rash
immediately.
Q6: A patient with Persistent Depressive Disorder (Dysthymia) differs from a patient with Major
Depressive Disorder primarily in terms of:
A. Severity of symptoms
B. Duration of symptoms
C. Presence of suicidal ideation
D. Response to antidepressants
Correct Answer: B
Rationale: While symptoms can be similar, Dysthymia (now Persistent Depressive Disorder) is
characterized by a chronic, milder depression lasting for at least 2 years (1 year in
children/adolescents), whereas MDD is more severe but episodic (≥2 weeks).
Q7: A patient with Bipolar II Disorder is experiencing a depressive episode. The nurse knows
that which class of medications is contraindicated as monotherapy because it may precipitate a
manic episode?
A. Mood Stabilizers
B. Antipsychotics
C. Antidepressants
D. Benzodiazepines
Correct Answer: C
Rationale: Antidepressants used as monotherapy in Bipolar Disorder can induce mania or rapid
cycling. They should typically be used in combination with a mood stabilizer.
NUR 253 Mental Health Exam 3 Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Mood Disorders & Suicide Prevention (Questions 1-20)
Q1: A patient diagnosed with Major Depressive Disorder (MDD) reports sleeping 14 hours a
night but still feels exhausted. The nurse documents this as which SIGECAPS symptom?
A. Interest loss
B. Guilt
C. Energy loss
D. Psychomotor retardation
Correct Answer: C
Rationale: SIGECAPS includes Sleep disturbance (hypersomnia or insomnia), Interest loss,
Guilt, Energy loss, Concentration problems, Appetite change, Psychomotor changes, and
Suicidality. Hypersomnia (excessive sleeping) leading to fatigue falls under both Sleep and
Energy loss, but the symptom of feeling exhausted is specifically "Energy loss." Psychomotor
retardation refers to slowed physical movement/speech.
Q2: A patient is exhibiting a pressured speech, grandiosity, decreased need for sleep, and
excessive involvement in high-risk business investments. The nurse recognizes these symptoms
as:
A. A depressive episode
B. A manic episode
C. A hypomanic episode
D. Schizophrenia
Correct Answer: B
Rationale: These symptoms correlate with the mnemonic DIGFAST (Depressed mood is not part
of it, but Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity increase, Sleep
,2
decreased, Talkativeness are). The severity (high-risk investments) suggests a full Manic Episode
rather than Hypomania.
Q3: A patient with Bipolar I Disorder is prescribed Lithium. Which instruction is most critical for
the nurse to teach the patient?
A. "Maintain a consistent intake of sodium and caffeine."
B. "Take this medication on an empty stomach."
C. "You may stop taking this medication when you feel better."
D. "Expect immediate results within 24 hours."
Correct Answer: A
Rationale: Lithium levels are affected by sodium balance. Low sodium intake can lead to lithium
retention and toxicity, while high sodium can lower levels, making the drug ineffective. Caffeine
can also affect levels. Lithium takes weeks to reach a steady state and should not be stopped
abruptly.
Q4: The nurse is assessing a patient for suicide risk. The patient states, "I wish I were dead," but
denies having a plan. The nurse should:
A. Place the patient on one-to-one observation immediately.
B. Ask the patient, "Do you have a specific plan to kill yourself?"
B. Dismiss the statement as attention-seeking.
D. Tell the patient's family to take them home immediately.
Correct Answer: B
Rationale: While the statement requires assessment, the nurse must first determine the specificity
and lethality of the plan. Directly asking about a plan does not increase the risk of suicide but is a
standard part of a risk assessment. One-to-one observation may be implemented depending on
the full assessment, but the immediate action is to clarify the risk.
Q5: Which medication requires a slow titration to prevent Stevens-Johnson Syndrome (SJS) or
Toxic Epidermal Necrolysis (TEN)?
A. Lithium
, 3
B. Valproate (Depakote)
C. Lamotrigine (Lamictal)
D. Olanzapine (Zyprexa)
Correct Answer: C
Rationale: Lamotrigine carries a risk of severe rash (SJS/TEN). To minimize this risk, the
medication must be titrated slowly over several weeks. Patients should report any rash
immediately.
Q6: A patient with Persistent Depressive Disorder (Dysthymia) differs from a patient with Major
Depressive Disorder primarily in terms of:
A. Severity of symptoms
B. Duration of symptoms
C. Presence of suicidal ideation
D. Response to antidepressants
Correct Answer: B
Rationale: While symptoms can be similar, Dysthymia (now Persistent Depressive Disorder) is
characterized by a chronic, milder depression lasting for at least 2 years (1 year in
children/adolescents), whereas MDD is more severe but episodic (≥2 weeks).
Q7: A patient with Bipolar II Disorder is experiencing a depressive episode. The nurse knows
that which class of medications is contraindicated as monotherapy because it may precipitate a
manic episode?
A. Mood Stabilizers
B. Antipsychotics
C. Antidepressants
D. Benzodiazepines
Correct Answer: C
Rationale: Antidepressants used as monotherapy in Bipolar Disorder can induce mania or rapid
cycling. They should typically be used in combination with a mood stabilizer.
