NUR2459 / NUR 2459
Mental and Behavioral Health Nursing
Exam 2
Comprehensive 120-Question Examination
LATEST EDITION
Rasmussen University
Total Questions: 120 Multiple Choice (4 options, 1 correct)
Sections: 8 (Anxiety/Trauma, Mood/Suicide, Psychotic, Personality,
Substance, Eating/Somatic, Lifespan, Psychopharmacology)
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis
Question Style: 75% Scenario-Based | 25% Direct Knowledge
Alignment: NCLEX-RN Test Plan, QSEN Competencies, DSM-5/5-TR,
ANA Psychiatric-Mental Health Nursing Standards
Special Inclusions: 20 clinical-reasoning scenarios, 15 psychopharmacology items,
10 suicide risk/crisis intervention items
This examination is designed for course assessment and NCLEX-RN preparation. Each item includes rationale
grounded in evidence-based psychiatric-mental health nursing practice.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
,NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 2
Examination Overview & Instructions
This comprehensive examination assesses mastery of NUR 2459 Mental and Behavioral Health Nursing content aligned
with the Rasmussen University course syllabus, the NCLEX-RN Test Plan, QSEN Competencies, and DSM-5/5-TR
diagnostic criteria. The examination consists of 120 multiple-choice questions distributed across eight content domains
reflective of the major diagnostic categories in psychiatric-mental health nursing. Each item is designed to evaluate
cognitive skills at the recall, application, and analysis levels, with emphasis on clinical reasoning, prioritization,
pharmacological safety, therapeutic communication, and evidence-based nursing interventions.
Examination Structure
Section Content Domain Questions
Section 1 Anxiety, Obsessive-Compulsive, & Trauma-Related Disorders Q1-Q18 (18)
Section 2 Mood Disorders & Suicide Q19-Q36 (18)
Section 3 Psychotic Disorders & Schizophrenia Q37-Q51 (15)
Section 4 Personality Disorders & Impulse Control Q52-Q63 (12)
Section 5 Substance Use & Addictive Disorders Q64-Q78 (15)
Section 6 Eating Disorders & Somatic Symptoms Q79-Q90 (12)
Section 7 Child, Adolescent, & Geriatric Mental Health Q91-Q105 (15)
Section 8 Psychopharmacology & Somatic Therapies Q106-Q120 (15)
TOTAL 120 Questions
Cognitive Level Distribution
Recall (knowledge/comprehension): 20% (24 items) | Application (clinical application): 50% (60 items) | Analysis (clinical
reasoning, prioritization, management): 30% (36 items).
Special Inclusions
20 scenario-based clinical reasoning questions; 15 psychopharmacology and medication management items; 10 suicide
risk assessment and crisis intervention items. Each question includes a rationale grounded in the NUR 2459 curriculum,
NCLEX-RN standards, and current evidence-based psychiatric-mental health nursing practice.
How to Use This Examination
Select the single best answer for each question. The correct option is marked *[CORRECT]*, followed by the "Correct
Answer" letter and a rationale explaining why the correct option is best and why the distractors are incorrect. Use this
document for course examination preparation, NCLEX-RN review, and remediation.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
,NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 3
Section 1: Anxiety, Obsessive-Compulsive, & Trauma-Related Disorders
Q1: A 32-year-old client presents with recurrent, unexpected panic attacks followed by 1 month of persistent
concern about having another attack and avoidance of driving on the highway. Which DSM-5 diagnosis is
most consistent with this presentation?
A. Generalized anxiety disorder (GAD)
B. Panic disorder *[CORRECT]*
C. Agoraphobia
D. Social anxiety disorder
Correct Answer: B
Rationale: Panic disorder requires recurrent, unexpected panic attacks followed by ≥1 month of persistent concern about
additional attacks, maladaptive behavior change, or avoidance. GAD involves excessive worry across multiple domains for
≥6 months; agoraphobia requires fear of ≥2 situations where escape might be difficult; social anxiety disorder centers on
social scrutiny. The NUR 2459 curriculum emphasizes differentiating unexpected (panic disorder) from expected
(phobia-triggered) attacks.
Q2: A nurse is caring for a client experiencing a panic attack. Which intervention is the PRIORITY during
the acute phase?
A. Teach deep-breathing exercises
B. Administer a PRN benzodiazepine
C. Stay with the client and remain calm *[CORRECT]*
D. Encourage the client to describe their fears
Correct Answer: C
Rationale: During an acute panic attack, the priority nursing intervention is to stay with the client and project calm,
reassuring presence — the client cannot process teaching or counseling during peak anxiety (Peplau's levels of anxiety:
panic = unable to learn). Medication may be administered after assessment, but presence reduces escalation. Teaching and
cognitive work wait until anxiety drops to mild/moderate levels.
Q3: A client with generalized anxiety disorder is started on buspirone (Buspar). Which statement by the client
indicates a need for further teaching?
A. I know this medication may take 2 to 4 weeks to work.
B. I should not drink grapefruit juice while taking this.
C. I can stop taking this if I feel better in a few days. *[CORRECT]*
D. This medicine will not make me feel drowsy like alprazolam did.
Correct Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic with delayed onset (1–4 weeks), no sedation, and no dependence
potential — it must NOT be abruptly stopped and is not abusable. Grapefruit juice can increase buspirone levels (CYP3A4
inhibition). NUR 2459 emphasizes contrasting buspirone with benzodiazepines: benzodiazepines are fast-acting but carry
dependence/withdrawal risks, while buspirone is safer but slower.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
, NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 4
Q4: A client with OCD spends 3 hours daily washing their hands until they "feel right." The nurse recognizes
the compulsive behavior primarily functions to:
A. Provide pleasure and gratification
B. Neutralize anxiety caused by obsessive thoughts *[CORRECT]*
C. Manipulate caregivers into giving attention
D. Communicate distress to family members
Correct Answer: B
Rationale: In OCD, compulsions are repetitive behaviors (handwashing, checking) the client feels driven to perform in
response to an obsession, aimed at reducing anxiety — not pleasure. The cycle is obsession → anxiety → compulsion →
temporary relief → reinforcement. NUR 2459 nursing priorities include reducing time spent in compulsive rituals gradually
(response prevention) while supporting the client through anxiety.
Q5: A veteran with PTSD reports nightmares that disrupt sleep 5 nights per week. Which medication is most
appropriate for PTSD-related nightmares?
A. Lorazepam (Ativan)
B. Prazosin (Minipress) *[CORRECT]*
C. Bupropion (Wellbutrin)
D. Trazodone (Desyrel)
Correct Answer: B
Rationale: Prazosin, an alpha-1 adrenergic antagonist, is used off-label to reduce PTSD-related nightmares and sleep
disturbance by blocking noradrenergic hyperactivity. SSRIs (sertraline, paroxetine) are FDA-approved for core PTSD
symptoms but are less effective for nightmares. Benzodiazepines are generally avoided in PTSD due to risk of dependence
and emotional blunting. NUR 2459 pharmacology emphasizes targeted symptom management in trauma disorders.
Q6: A client newly diagnosed with social anxiety disorder is prescribed paroxetine (Paxil). The nurse should
teach the client to expect which side effect during the first 2 weeks of therapy?
A. Weight loss and insomnia
B. Nausea, headache, and increased anxiety *[CORRECT]*
C. Hypertensive crisis if cheese is consumed
D. Tardive dyskinesia after long-term use
Correct Answer: B
Rationale: SSRIs like paroxetine commonly cause transient nausea, headache, and a paradoxical increase in anxiety during
the first 1–2 weeks before therapeutic benefit. Clients should be reassured these usually resolve. Hypertensive crisis is
associated with MAOIs (tyramine interaction); tardive dyskinesia is associated with antipsychotics, not SSRIs. Weight gain
(not loss) and sexual dysfunction are common long-term SSRI effects.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
Mental and Behavioral Health Nursing
Exam 2
Comprehensive 120-Question Examination
LATEST EDITION
Rasmussen University
Total Questions: 120 Multiple Choice (4 options, 1 correct)
Sections: 8 (Anxiety/Trauma, Mood/Suicide, Psychotic, Personality,
Substance, Eating/Somatic, Lifespan, Psychopharmacology)
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis
Question Style: 75% Scenario-Based | 25% Direct Knowledge
Alignment: NCLEX-RN Test Plan, QSEN Competencies, DSM-5/5-TR,
ANA Psychiatric-Mental Health Nursing Standards
Special Inclusions: 20 clinical-reasoning scenarios, 15 psychopharmacology items,
10 suicide risk/crisis intervention items
This examination is designed for course assessment and NCLEX-RN preparation. Each item includes rationale
grounded in evidence-based psychiatric-mental health nursing practice.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
,NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 2
Examination Overview & Instructions
This comprehensive examination assesses mastery of NUR 2459 Mental and Behavioral Health Nursing content aligned
with the Rasmussen University course syllabus, the NCLEX-RN Test Plan, QSEN Competencies, and DSM-5/5-TR
diagnostic criteria. The examination consists of 120 multiple-choice questions distributed across eight content domains
reflective of the major diagnostic categories in psychiatric-mental health nursing. Each item is designed to evaluate
cognitive skills at the recall, application, and analysis levels, with emphasis on clinical reasoning, prioritization,
pharmacological safety, therapeutic communication, and evidence-based nursing interventions.
Examination Structure
Section Content Domain Questions
Section 1 Anxiety, Obsessive-Compulsive, & Trauma-Related Disorders Q1-Q18 (18)
Section 2 Mood Disorders & Suicide Q19-Q36 (18)
Section 3 Psychotic Disorders & Schizophrenia Q37-Q51 (15)
Section 4 Personality Disorders & Impulse Control Q52-Q63 (12)
Section 5 Substance Use & Addictive Disorders Q64-Q78 (15)
Section 6 Eating Disorders & Somatic Symptoms Q79-Q90 (12)
Section 7 Child, Adolescent, & Geriatric Mental Health Q91-Q105 (15)
Section 8 Psychopharmacology & Somatic Therapies Q106-Q120 (15)
TOTAL 120 Questions
Cognitive Level Distribution
Recall (knowledge/comprehension): 20% (24 items) | Application (clinical application): 50% (60 items) | Analysis (clinical
reasoning, prioritization, management): 30% (36 items).
Special Inclusions
20 scenario-based clinical reasoning questions; 15 psychopharmacology and medication management items; 10 suicide
risk assessment and crisis intervention items. Each question includes a rationale grounded in the NUR 2459 curriculum,
NCLEX-RN standards, and current evidence-based psychiatric-mental health nursing practice.
How to Use This Examination
Select the single best answer for each question. The correct option is marked *[CORRECT]*, followed by the "Correct
Answer" letter and a rationale explaining why the correct option is best and why the distractors are incorrect. Use this
document for course examination preparation, NCLEX-RN review, and remediation.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
,NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 3
Section 1: Anxiety, Obsessive-Compulsive, & Trauma-Related Disorders
Q1: A 32-year-old client presents with recurrent, unexpected panic attacks followed by 1 month of persistent
concern about having another attack and avoidance of driving on the highway. Which DSM-5 diagnosis is
most consistent with this presentation?
A. Generalized anxiety disorder (GAD)
B. Panic disorder *[CORRECT]*
C. Agoraphobia
D. Social anxiety disorder
Correct Answer: B
Rationale: Panic disorder requires recurrent, unexpected panic attacks followed by ≥1 month of persistent concern about
additional attacks, maladaptive behavior change, or avoidance. GAD involves excessive worry across multiple domains for
≥6 months; agoraphobia requires fear of ≥2 situations where escape might be difficult; social anxiety disorder centers on
social scrutiny. The NUR 2459 curriculum emphasizes differentiating unexpected (panic disorder) from expected
(phobia-triggered) attacks.
Q2: A nurse is caring for a client experiencing a panic attack. Which intervention is the PRIORITY during
the acute phase?
A. Teach deep-breathing exercises
B. Administer a PRN benzodiazepine
C. Stay with the client and remain calm *[CORRECT]*
D. Encourage the client to describe their fears
Correct Answer: C
Rationale: During an acute panic attack, the priority nursing intervention is to stay with the client and project calm,
reassuring presence — the client cannot process teaching or counseling during peak anxiety (Peplau's levels of anxiety:
panic = unable to learn). Medication may be administered after assessment, but presence reduces escalation. Teaching and
cognitive work wait until anxiety drops to mild/moderate levels.
Q3: A client with generalized anxiety disorder is started on buspirone (Buspar). Which statement by the client
indicates a need for further teaching?
A. I know this medication may take 2 to 4 weeks to work.
B. I should not drink grapefruit juice while taking this.
C. I can stop taking this if I feel better in a few days. *[CORRECT]*
D. This medicine will not make me feel drowsy like alprazolam did.
Correct Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic with delayed onset (1–4 weeks), no sedation, and no dependence
potential — it must NOT be abruptly stopped and is not abusable. Grapefruit juice can increase buspirone levels (CYP3A4
inhibition). NUR 2459 emphasizes contrasting buspirone with benzodiazepines: benzodiazepines are fast-acting but carry
dependence/withdrawal risks, while buspirone is safer but slower.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
, NUR2459 / NUR 2459: Mental and Behavioral Health Nursing Exam 2 (2026/2027) - Rasmussen Page 4
Q4: A client with OCD spends 3 hours daily washing their hands until they "feel right." The nurse recognizes
the compulsive behavior primarily functions to:
A. Provide pleasure and gratification
B. Neutralize anxiety caused by obsessive thoughts *[CORRECT]*
C. Manipulate caregivers into giving attention
D. Communicate distress to family members
Correct Answer: B
Rationale: In OCD, compulsions are repetitive behaviors (handwashing, checking) the client feels driven to perform in
response to an obsession, aimed at reducing anxiety — not pleasure. The cycle is obsession → anxiety → compulsion →
temporary relief → reinforcement. NUR 2459 nursing priorities include reducing time spent in compulsive rituals gradually
(response prevention) while supporting the client through anxiety.
Q5: A veteran with PTSD reports nightmares that disrupt sleep 5 nights per week. Which medication is most
appropriate for PTSD-related nightmares?
A. Lorazepam (Ativan)
B. Prazosin (Minipress) *[CORRECT]*
C. Bupropion (Wellbutrin)
D. Trazodone (Desyrel)
Correct Answer: B
Rationale: Prazosin, an alpha-1 adrenergic antagonist, is used off-label to reduce PTSD-related nightmares and sleep
disturbance by blocking noradrenergic hyperactivity. SSRIs (sertraline, paroxetine) are FDA-approved for core PTSD
symptoms but are less effective for nightmares. Benzodiazepines are generally avoided in PTSD due to risk of dependence
and emotional blunting. NUR 2459 pharmacology emphasizes targeted symptom management in trauma disorders.
Q6: A client newly diagnosed with social anxiety disorder is prescribed paroxetine (Paxil). The nurse should
teach the client to expect which side effect during the first 2 weeks of therapy?
A. Weight loss and insomnia
B. Nausea, headache, and increased anxiety *[CORRECT]*
C. Hypertensive crisis if cheese is consumed
D. Tardive dyskinesia after long-term use
Correct Answer: B
Rationale: SSRIs like paroxetine commonly cause transient nausea, headache, and a paradoxical increase in anxiety during
the first 1–2 weeks before therapeutic benefit. Clients should be reassured these usually resolve. Hypertensive crisis is
associated with MAOIs (tyramine interaction); tardive dyskinesia is associated with antipsychotics, not SSRIs. Weight gain
(not loss) and sexual dysfunction are common long-term SSRI effects.
Comprehensive Examination - 120 Questions | Aligned with NCLEX-RN Test Plan, QSEN Competencies, & DSM-5/5-TR Standards
