NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
NU 160 / NUR 253
Final Practice Exam | 2026–2027
110 Multiple-Choice Questions • Answers • Detailed Rationales
Scope Original mental-health nursing learning resource. NU 160 and NUR 253 are user-supplied course labels; course
equivalence or school affiliation is not asserted. The 2026–2027 label indicates the study edition, not an official exam date.
How to study Attempt each item without looking at the green answer. Review the highlighted rationale and red distractor
explanations; revisit missed safety concepts. Questions are single-best-answer unless otherwise stated.
Safety note Medication orders, observation levels, restraints, emergency responses, and legal rules must follow the prescriber,
local policy, clinical circumstances, and jurisdiction. This resource does not substitute for patient care guidance.
High-yield review map
• Clinical priorities
• Disorder recognition
• Therapeutic responses
• Medication adverse effects
• Integrated scenarios
Original educational practice • Not a school-issued or official examination | Page 1
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Practice Questions with Rationales
Question 1. A distressed person is willing to speak but refuses to sit. What is the best response?
A. Offer a safe standing space and simple choices while maintaining calm communication.
B. Force the person into a chair.
C. Punish refusal to sit.
D. Turn the conversation into a power struggle.
Correct answer: A. Offer a safe standing space and simple choices while maintaining calm communication.
Detailed rationale: Offering safe choices preserves dignity and can reduce arousal.
Why the other options are incorrect:
B. This wording or action misses the therapeutic priority. Offering safe choices preserves dignity and can reduce
arousal.
C. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
D. This wording or action misses the therapeutic priority. Offering safe choices preserves dignity and can reduce
arousal.
Question 2. A psychiatric inpatient with antipsychotic exposure develops temperature 40°C, rigidity, and autonomic
instability. What is priority?
A. Offer vigorous exercise.
B. Wait until scheduled group therapy.
C. Treat as a medical emergency with possible neuroleptic malignant syndrome.
D. Provide routine reassurance only.
Correct answer: C. Treat as a medical emergency with possible neuroleptic malignant syndrome.
Detailed rationale: NMS can cause organ failure and death; immediate escalation is crucial.
Why the other options are incorrect:
A. This response fails to address the priority clinical concern and could worsen the patient’s condition.
B. This competing interpretation is not supported by the findings. NMS can cause organ failure and death; immediate
escalation is crucial.
D. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
Question 3. A stable client wants to discuss medication adverse effects and preferences. What should the nurse
prioritize?
A. Dismiss every adverse-effect concern.
B. Tell the patient preferences never matter.
C. Change prescriptions without authority.
D. Elicit goals and concerns and collaborate with the prescriber on options.
Correct answer: D. Elicit goals and concerns and collaborate with the prescriber on options.
Detailed rationale: Shared decision-making integrates evidence with patient values and informed choice.
Why the other options are incorrect:
A. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This wording or action misses the therapeutic priority. Shared decision-making integrates evidence with patient
values and informed choice.
Question 4. A patient exhibits new agitation and mutism with unusual postures. Which syndrome should be considered
and escalated for urgent assessment?
A. Catatonia.
B. A guaranteed voluntary protest.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
C. Expected side effect of supportive listening.
D. Routine boredom.
Correct answer: A. Catatonia.
Detailed rationale: Catatonia can be medically dangerous and requires urgent evaluation for psychiatric and medical
causes.
Why the other options are incorrect:
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This competing interpretation is not supported by the findings. Catatonia can be medically dangerous and requires
urgent evaluation for psychiatric and medical causes.
D. This competing interpretation is not supported by the findings. Catatonia can be medically dangerous and requires
urgent evaluation for psychiatric and medical causes.
Question 5. A patient says treatment has made them feel powerless. Which action supports a therapeutic alliance?
A. Issue new orders without discussion.
B. Tell the patient choice is inappropriate.
C. Ask about goals, preferences, and areas where meaningful choice can be restored.
D. Ignore the statement and change topic.
Correct answer: C. Ask about goals, preferences, and areas where meaningful choice can be restored.
Detailed rationale: Choice and collaboration help recovery-oriented mental-health care.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Choice and collaboration help recovery-oriented
mental-health care.
B. This competing interpretation is not supported by the findings. Choice and collaboration help recovery-oriented
mental-health care.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 6. A client’s facial expression remains fixed despite discussing a joyful event. Which term best describes
observed emotional expression?
A. Euthymic mood.
B. Compulsion.
C. Hyperreflexia.
D. Flat affect.
Correct answer: D. Flat affect.
Detailed rationale: Affect is outward emotional expression, which may be diminished or flat.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
B. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
C. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
Question 7. A patient after severe stress describes feeling detached from their own body. Which symptom is described?
A. Aphonia.
B. Ataxia.
C. Depersonalization.
D. Hyperphagia.
Correct answer: C. Depersonalization.
Detailed rationale: Depersonalization is a feeling of detachment from oneself.
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
B. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
D. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
Question 8. A trauma survivor has intrusive memories, avoidance, hypervigilance, and impaired functioning months after
an event. Which disorder is a key consideration?
A. Simple transient sadness with no need for assessment.
B. Substance intoxication in every case.
C. Posttraumatic stress disorder.
D. Alzheimer disease by definition.
Correct answer: C. Posttraumatic stress disorder.
Detailed rationale: PTSD can feature intrusion, avoidance, negative changes in cognition/mood, and arousal symptoms.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
B. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
D. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
Question 9. A person with schizophrenia says they want to return to part-time work. Which nursing goal supports recovery?
A. Discourage all employment solely because of diagnosis.
B. Focus only on symptom counts.
C. Impose goals the client does not share.
D. Explore strengths, rehabilitation supports, and personally meaningful goals.
Correct answer: D. Explore strengths, rehabilitation supports, and personally meaningful goals.
Detailed rationale: Recovery involves function, agency, participation, and personal meaning.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Recovery involves function, agency, participation, and
personal meaning.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This competing interpretation is not supported by the findings. Recovery involves function, agency, participation, and
personal meaning.
Question 10. A new parent reports persistent low mood, hopelessness, and loss of pleasure after delivery. Which
approach is appropriate?
A. Assume symptoms are always normal and untreatable.
B. Advise stopping infant feeding as the only treatment.
C. Screen for perinatal depression, functioning, and suicide risk and arrange care.
D. Discourage professional help.
Correct answer: C. Screen for perinatal depression, functioning, and suicide risk and arrange care.
Detailed rationale: Perinatal depression is treatable and warrants assessment, support, and safety screening.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Original educational practice • Not a school-issued or official examination | Page 4
NU 160 / NUR 253
Final Practice Exam | 2026–2027
110 Multiple-Choice Questions • Answers • Detailed Rationales
Scope Original mental-health nursing learning resource. NU 160 and NUR 253 are user-supplied course labels; course
equivalence or school affiliation is not asserted. The 2026–2027 label indicates the study edition, not an official exam date.
How to study Attempt each item without looking at the green answer. Review the highlighted rationale and red distractor
explanations; revisit missed safety concepts. Questions are single-best-answer unless otherwise stated.
Safety note Medication orders, observation levels, restraints, emergency responses, and legal rules must follow the prescriber,
local policy, clinical circumstances, and jurisdiction. This resource does not substitute for patient care guidance.
High-yield review map
• Clinical priorities
• Disorder recognition
• Therapeutic responses
• Medication adverse effects
• Integrated scenarios
Original educational practice • Not a school-issued or official examination | Page 1
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Practice Questions with Rationales
Question 1. A distressed person is willing to speak but refuses to sit. What is the best response?
A. Offer a safe standing space and simple choices while maintaining calm communication.
B. Force the person into a chair.
C. Punish refusal to sit.
D. Turn the conversation into a power struggle.
Correct answer: A. Offer a safe standing space and simple choices while maintaining calm communication.
Detailed rationale: Offering safe choices preserves dignity and can reduce arousal.
Why the other options are incorrect:
B. This wording or action misses the therapeutic priority. Offering safe choices preserves dignity and can reduce
arousal.
C. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
D. This wording or action misses the therapeutic priority. Offering safe choices preserves dignity and can reduce
arousal.
Question 2. A psychiatric inpatient with antipsychotic exposure develops temperature 40°C, rigidity, and autonomic
instability. What is priority?
A. Offer vigorous exercise.
B. Wait until scheduled group therapy.
C. Treat as a medical emergency with possible neuroleptic malignant syndrome.
D. Provide routine reassurance only.
Correct answer: C. Treat as a medical emergency with possible neuroleptic malignant syndrome.
Detailed rationale: NMS can cause organ failure and death; immediate escalation is crucial.
Why the other options are incorrect:
A. This response fails to address the priority clinical concern and could worsen the patient’s condition.
B. This competing interpretation is not supported by the findings. NMS can cause organ failure and death; immediate
escalation is crucial.
D. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
Question 3. A stable client wants to discuss medication adverse effects and preferences. What should the nurse
prioritize?
A. Dismiss every adverse-effect concern.
B. Tell the patient preferences never matter.
C. Change prescriptions without authority.
D. Elicit goals and concerns and collaborate with the prescriber on options.
Correct answer: D. Elicit goals and concerns and collaborate with the prescriber on options.
Detailed rationale: Shared decision-making integrates evidence with patient values and informed choice.
Why the other options are incorrect:
A. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This wording or action misses the therapeutic priority. Shared decision-making integrates evidence with patient
values and informed choice.
Question 4. A patient exhibits new agitation and mutism with unusual postures. Which syndrome should be considered
and escalated for urgent assessment?
A. Catatonia.
B. A guaranteed voluntary protest.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
C. Expected side effect of supportive listening.
D. Routine boredom.
Correct answer: A. Catatonia.
Detailed rationale: Catatonia can be medically dangerous and requires urgent evaluation for psychiatric and medical
causes.
Why the other options are incorrect:
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This competing interpretation is not supported by the findings. Catatonia can be medically dangerous and requires
urgent evaluation for psychiatric and medical causes.
D. This competing interpretation is not supported by the findings. Catatonia can be medically dangerous and requires
urgent evaluation for psychiatric and medical causes.
Question 5. A patient says treatment has made them feel powerless. Which action supports a therapeutic alliance?
A. Issue new orders without discussion.
B. Tell the patient choice is inappropriate.
C. Ask about goals, preferences, and areas where meaningful choice can be restored.
D. Ignore the statement and change topic.
Correct answer: C. Ask about goals, preferences, and areas where meaningful choice can be restored.
Detailed rationale: Choice and collaboration help recovery-oriented mental-health care.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Choice and collaboration help recovery-oriented
mental-health care.
B. This competing interpretation is not supported by the findings. Choice and collaboration help recovery-oriented
mental-health care.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 6. A client’s facial expression remains fixed despite discussing a joyful event. Which term best describes
observed emotional expression?
A. Euthymic mood.
B. Compulsion.
C. Hyperreflexia.
D. Flat affect.
Correct answer: D. Flat affect.
Detailed rationale: Affect is outward emotional expression, which may be diminished or flat.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
B. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
C. This competing interpretation is not supported by the findings. Affect is outward emotional expression, which may be
diminished or flat.
Question 7. A patient after severe stress describes feeling detached from their own body. Which symptom is described?
A. Aphonia.
B. Ataxia.
C. Depersonalization.
D. Hyperphagia.
Correct answer: C. Depersonalization.
Detailed rationale: Depersonalization is a feeling of detachment from oneself.
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
B. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
D. This competing interpretation is not supported by the findings. Depersonalization is a feeling of detachment from
oneself.
Question 8. A trauma survivor has intrusive memories, avoidance, hypervigilance, and impaired functioning months after
an event. Which disorder is a key consideration?
A. Simple transient sadness with no need for assessment.
B. Substance intoxication in every case.
C. Posttraumatic stress disorder.
D. Alzheimer disease by definition.
Correct answer: C. Posttraumatic stress disorder.
Detailed rationale: PTSD can feature intrusion, avoidance, negative changes in cognition/mood, and arousal symptoms.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
B. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
D. This competing interpretation is not supported by the findings. PTSD can feature intrusion, avoidance, negative
changes in cognition/mood, and arousal symptoms.
Question 9. A person with schizophrenia says they want to return to part-time work. Which nursing goal supports recovery?
A. Discourage all employment solely because of diagnosis.
B. Focus only on symptom counts.
C. Impose goals the client does not share.
D. Explore strengths, rehabilitation supports, and personally meaningful goals.
Correct answer: D. Explore strengths, rehabilitation supports, and personally meaningful goals.
Detailed rationale: Recovery involves function, agency, participation, and personal meaning.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Recovery involves function, agency, participation, and
personal meaning.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. This competing interpretation is not supported by the findings. Recovery involves function, agency, participation, and
personal meaning.
Question 10. A new parent reports persistent low mood, hopelessness, and loss of pleasure after delivery. Which
approach is appropriate?
A. Assume symptoms are always normal and untreatable.
B. Advise stopping infant feeding as the only treatment.
C. Screen for perinatal depression, functioning, and suicide risk and arrange care.
D. Discourage professional help.
Correct answer: C. Screen for perinatal depression, functioning, and suicide risk and arrange care.
Detailed rationale: Perinatal depression is treatable and warrants assessment, support, and safety screening.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Original educational practice • Not a school-issued or official examination | Page 4
