NUR 208 / NUR208 Mental Health Nursing Exam 3
Review Actual 2025/2026 with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section 1: Mood Disorders (Depression & Bipolar) (12 Questions)
Q1: A patient with major depressive disorder reports feeling hopeless, has lost 15
pounds in one month, and sleeps 12–14 hours daily. Which symptom cluster is most
prominent?
A. Psychotic features
B. Atypical depression
C. Melancholic features [CORRECT]
D. Seasonal pattern
Correct Answer: C
Rationale: Correct because melancholic features include profound anhedonia,
significant weight loss, psychomotor changes, and excessive guilt, distinguishing it
from other depression subtypes.
Q2: A patient prescribed sertraline asks when they should expect to notice
improvement in mood. Which response by the nurse is most accurate?
A. "You will feel better within 24 to 48 hours."
B. "Most patients notice improvement within 1 to 2 weeks, with full therapeutic effect
in 4 to 6 weeks." [CORRECT]
C. "Antidepressants work immediately, so you should feel better right away."
D. "It may take 3 to 4 months before any improvement occurs."
Correct Answer: B
Rationale: Correct because SSRIs such as sertraline typically require 1–2 weeks for
initial symptom improvement and 4–6 weeks for full therapeutic antidepressant
effect due to adaptive neuroplastic changes.
Q3: A patient with bipolar I disorder is in a manic episode and has not slept in three
days. Which nursing intervention is the priority?
A. Encourage the patient to complete all pending tasks to reduce anxiety
B. Provide a stimulating environment to match the patient's energy level
,C. Implement a calm, low-stimulation environment and ensure safety [CORRECT]
D. Allow the patient unrestricted access to the phone and visitors
Correct Answer: C
Rationale: Correct because manic patients are at high risk for injury, exhaustion, and
poor judgment; a calm, structured environment with safety measures is the priority
nursing intervention.
Q4: Which medication is considered a first-line mood stabilizer for acute mania in
bipolar I disorder?
A. Fluoxetine
B. Lithium [CORRECT]
C. Lorazepam
D. Haloperidol
Correct Answer: B
Rationale: Correct because lithium is a first-line mood stabilizer that reduces the
severity and frequency of manic episodes and provides prophylaxis against
recurrence in bipolar disorder.
Q5: A patient with depression reports taking St. John's wort in addition to prescribed
fluoxetine. What is the nurse's primary concern?
A. The herbal supplement will reduce fluoxetine absorption
B. The combination increases the risk of serotonin syndrome [CORRECT]
C. St. John's wort causes dangerous hypotension with SSRIs
D. The supplement will block fluoxetine's therapeutic effect
Correct Answer: B
Rationale: Correct because St. John's wort has serotonergic activity and combined
use with SSRIs significantly increases the risk of serotonin syndrome, a potentially
life-threatening condition.
Q6: A patient with major depressive disorder is started on bupropion. Which side
effect should the nurse monitor for most closely?
A. Significant weight gain
B. Sedation and drowsiness
C. Increased seizure risk, especially at higher doses [CORRECT]
D. Severe orthostatic hypotension
Correct Answer: C
, Rationale: Correct because bupropion lowers the seizure threshold, with risk
increasing at doses above 450 mg/day; the nurse should assess for seizure history
and monitor for seizure activity.
Q7: Which symptom differentiates bipolar I disorder from bipolar II disorder?
A. Presence of depressive episodes
B. History of at least one manic episode [CORRECT]
C. Rapid cycling between mood states
D. Presence of psychotic features during depression
Correct Answer: B
Rationale: Correct because bipolar I disorder requires at least one full manic episode,
whereas bipolar II is characterized by hypomanic episodes and major depressive
episodes without full mania.
Q8: A patient with depression asks the nurse why cognitive behavioral therapy (CBT)
is recommended alongside medication. Which explanation is most accurate?
A. "CBT replaces medication entirely for most patients."
B. "CBT helps identify and modify negative thought patterns that perpetuate
depression." [CORRECT]
C. "CBT is only effective for patients with mild depression."
D. "CBT works by increasing serotonin levels directly."
Correct Answer: B
Rationale: Correct because CBT addresses maladaptive cognitive distortions and
behavioral patterns, providing skills that reduce relapse rates and enhance
medication response in major depressive disorder.
Q9: A patient on lithium therapy has a serum lithium level of 1.8 mEq/L. Which
clinical finding is most consistent with this result?
A. Mild tremor and mild gastrointestinal upset
B. Ataxia, confusion, and coarse tremor [CORRECT]
C. No symptoms, as this is within the therapeutic range
D. Bradycardia and hypotension only
Correct Answer: B
Rationale: Correct because lithium levels above 1.5 mEq/L indicate toxicity,
presenting with neurological symptoms including ataxia, confusion, slurred speech,
and coarse tremor requiring immediate intervention.
Review Actual 2025/2026 with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section 1: Mood Disorders (Depression & Bipolar) (12 Questions)
Q1: A patient with major depressive disorder reports feeling hopeless, has lost 15
pounds in one month, and sleeps 12–14 hours daily. Which symptom cluster is most
prominent?
A. Psychotic features
B. Atypical depression
C. Melancholic features [CORRECT]
D. Seasonal pattern
Correct Answer: C
Rationale: Correct because melancholic features include profound anhedonia,
significant weight loss, psychomotor changes, and excessive guilt, distinguishing it
from other depression subtypes.
Q2: A patient prescribed sertraline asks when they should expect to notice
improvement in mood. Which response by the nurse is most accurate?
A. "You will feel better within 24 to 48 hours."
B. "Most patients notice improvement within 1 to 2 weeks, with full therapeutic effect
in 4 to 6 weeks." [CORRECT]
C. "Antidepressants work immediately, so you should feel better right away."
D. "It may take 3 to 4 months before any improvement occurs."
Correct Answer: B
Rationale: Correct because SSRIs such as sertraline typically require 1–2 weeks for
initial symptom improvement and 4–6 weeks for full therapeutic antidepressant
effect due to adaptive neuroplastic changes.
Q3: A patient with bipolar I disorder is in a manic episode and has not slept in three
days. Which nursing intervention is the priority?
A. Encourage the patient to complete all pending tasks to reduce anxiety
B. Provide a stimulating environment to match the patient's energy level
,C. Implement a calm, low-stimulation environment and ensure safety [CORRECT]
D. Allow the patient unrestricted access to the phone and visitors
Correct Answer: C
Rationale: Correct because manic patients are at high risk for injury, exhaustion, and
poor judgment; a calm, structured environment with safety measures is the priority
nursing intervention.
Q4: Which medication is considered a first-line mood stabilizer for acute mania in
bipolar I disorder?
A. Fluoxetine
B. Lithium [CORRECT]
C. Lorazepam
D. Haloperidol
Correct Answer: B
Rationale: Correct because lithium is a first-line mood stabilizer that reduces the
severity and frequency of manic episodes and provides prophylaxis against
recurrence in bipolar disorder.
Q5: A patient with depression reports taking St. John's wort in addition to prescribed
fluoxetine. What is the nurse's primary concern?
A. The herbal supplement will reduce fluoxetine absorption
B. The combination increases the risk of serotonin syndrome [CORRECT]
C. St. John's wort causes dangerous hypotension with SSRIs
D. The supplement will block fluoxetine's therapeutic effect
Correct Answer: B
Rationale: Correct because St. John's wort has serotonergic activity and combined
use with SSRIs significantly increases the risk of serotonin syndrome, a potentially
life-threatening condition.
Q6: A patient with major depressive disorder is started on bupropion. Which side
effect should the nurse monitor for most closely?
A. Significant weight gain
B. Sedation and drowsiness
C. Increased seizure risk, especially at higher doses [CORRECT]
D. Severe orthostatic hypotension
Correct Answer: C
, Rationale: Correct because bupropion lowers the seizure threshold, with risk
increasing at doses above 450 mg/day; the nurse should assess for seizure history
and monitor for seizure activity.
Q7: Which symptom differentiates bipolar I disorder from bipolar II disorder?
A. Presence of depressive episodes
B. History of at least one manic episode [CORRECT]
C. Rapid cycling between mood states
D. Presence of psychotic features during depression
Correct Answer: B
Rationale: Correct because bipolar I disorder requires at least one full manic episode,
whereas bipolar II is characterized by hypomanic episodes and major depressive
episodes without full mania.
Q8: A patient with depression asks the nurse why cognitive behavioral therapy (CBT)
is recommended alongside medication. Which explanation is most accurate?
A. "CBT replaces medication entirely for most patients."
B. "CBT helps identify and modify negative thought patterns that perpetuate
depression." [CORRECT]
C. "CBT is only effective for patients with mild depression."
D. "CBT works by increasing serotonin levels directly."
Correct Answer: B
Rationale: Correct because CBT addresses maladaptive cognitive distortions and
behavioral patterns, providing skills that reduce relapse rates and enhance
medication response in major depressive disorder.
Q9: A patient on lithium therapy has a serum lithium level of 1.8 mEq/L. Which
clinical finding is most consistent with this result?
A. Mild tremor and mild gastrointestinal upset
B. Ataxia, confusion, and coarse tremor [CORRECT]
C. No symptoms, as this is within the therapeutic range
D. Bradycardia and hypotension only
Correct Answer: B
Rationale: Correct because lithium levels above 1.5 mEq/L indicate toxicity,
presenting with neurological symptoms including ataxia, confusion, slurred speech,
and coarse tremor requiring immediate intervention.
