NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
NU 160 / NUR 253
Exam 3 Practice Questions | 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
• Substance use
• Eating disorders
• Personality disorders
• Psychiatric emergencies
• Recovery and transition care
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 grieving patient starts crying after discussing a loss. Which nursing response is most therapeutic?
A. Say the patient must stop crying.
B. Remain present and allow supportive silence.
C. Tell a joke to distract from grief.
D. Immediately change the topic.
Correct answer: B. Remain present and allow supportive silence.
Detailed rationale: Therapeutic silence permits expression and communicates presence.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
C. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
D. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
Question 2. An underweight patient taking mirtazapine asks about common adverse effects. Which counseling point is
most relevant?
A. Increased appetite, weight gain, and sedation can occur.
B. The medication has no effect on sleep.
C. Severe dehydration always occurs.
D. It routinely causes hyperthyroidism.
Correct answer: A. Increased appetite, weight gain, and sedation can occur.
Detailed rationale: Mirtazapine commonly causes sedation and increased appetite, which influence treatment selection.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described mirtazapine issue. Mirtazapine commonly causes
sedation and increased appetite, which influence treatment selection.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. This alternative is not the relevant response to the described mirtazapine issue. Mirtazapine commonly causes
sedation and increased appetite, which influence treatment selection.
Question 3. A patient starting atomoxetine asks about onset and monitoring. Which answer is most accurate?
A. It always works within minutes.
B. Atomoxetine is the standard antidote for opioid overdose.
C. Benefit can build over weeks; monitor mood and cardiovascular status.
D. Monitoring is never needed.
Correct answer: C. Benefit can build over weeks; monitor mood and cardiovascular status.
Detailed rationale: Atomoxetine is a nonstimulant ADHD medication requiring follow-up for efficacy and adverse effects.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. Adding or relying on these substances does not address the problem and may introduce new safety risks.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 4. A client asks about zolpidem and night-time behaviors not remembered the next day. What is the correct
safety message?
A. Combine the medicine with alcohol to sleep more deeply.
B. Complex sleep behaviors require immediate medication review and avoidance of further doses until evaluated.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
C. Sleep-driving is a harmless intended effect.
D. Take extra medication after unexplained activities.
Correct answer: B. Complex sleep behaviors require immediate medication review and avoidance of further doses until
evaluated.
Detailed rationale: Z-drugs carry serious warnings for complex sleep behaviors and impairment.
Why the other options are incorrect:
A. Adding or relying on these substances does not address the problem and may introduce new safety risks.
C. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
D. This alternative is not the relevant response to the described sleep issue. Z-drugs carry serious warnings for complex
sleep behaviors and impairment.
Question 5. A client’s agitation has sharply worsened over the last hour. Which handoff format can clarify urgent
communication?
A. Delay telling the team until morning.
B. Omit objective findings and vital signs.
C. Use concise structured communication such as situation, background, assessment, recommendation.
D. Provide only personal opinions.
Correct answer: C. Use concise structured communication such as situation, background, assessment, recommendation.
Detailed rationale: Structured handoff helps convey clinical urgency and recommendations.
Why the other options are incorrect:
A. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
B. This competing interpretation is not supported by the findings. Structured handoff helps convey clinical urgency and
recommendations.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 6. A patient says, “I do not have the energy to get out of bed.” Which response supports achievable engagement?
A. “You are simply lazy.”
B. “Would you like to try one small step together, such as sitting up?”
C. “Your symptoms are not real.”
D. “You must finish ten tasks right now.”
Correct answer: B. “Would you like to try one small step together, such as sitting up?”
Detailed rationale: Small collaborative goals can support engagement in depression without blame.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
C. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
D. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
Question 7. A recently bereaved patient reports insomnia and difficulty functioning. What nursing assessment is most
appropriate?
A. Insist everyone grieves identically.
B. Tell the patient their feelings are incorrect.
C. Diagnose a specific disorder from the time since loss alone.
D. Explore grief experiences, functioning, social supports, and any suicide risk.
Correct answer: D. Explore grief experiences, functioning, social supports, and any suicide risk.
Detailed rationale: Grief is individualized; clinical assessment considers safety and the level of impairment.
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. Grief is individualized; clinical assessment considers
safety and the level of impairment.
B. This competing interpretation is not supported by the findings. Grief is individualized; clinical assessment considers
safety and the level of impairment.
C. This competing interpretation is not supported by the findings. Grief is individualized; clinical assessment considers
safety and the level of impairment.
Question 8. A new parent reports persistent low mood, hopelessness, and loss of pleasure after delivery. Which approach
is appropriate?
A. Advise stopping infant feeding as the only treatment.
B. Assume symptoms are always normal and untreatable.
C. Discourage professional help.
D. Screen for perinatal depression, functioning, and suicide risk and arrange care.
Correct answer: D. 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.
C. This competing interpretation is not supported by the findings. Perinatal depression is treatable and warrants
assessment, support, and safety screening.
Question 9. An older adult taking an SSRI develops headache, confusion, and an unexpectedly low sodium level. Which
complication should the nurse recognize?
A. A normal response requiring no action.
B. An automatic indication to give extra SSRI doses.
C. Definitive evidence of hypernatremia.
D. Possible SSRI-associated hyponatremia or SIADH.
Correct answer: D. Possible SSRI-associated hyponatremia or SIADH.
Detailed rationale: SSRIs can contribute to hyponatremia, especially in older adults.
Why the other options are incorrect:
A. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
B. This alternative is not the relevant response to the described ssri adverse effects issue. SSRIs can contribute to
hyponatremia, especially in older adults.
C. This alternative is not the relevant response to the described ssri adverse effects issue. SSRIs can contribute to
hyponatremia, especially in older adults.
Question 10. A client with severe fear of abandonment threatens self-harm after an interpersonal conflict. What is the first
nursing concern?
A. Respond with punishment or ridicule.
B. Assess immediate suicide/self-harm risk with empathy and clear boundaries.
C. Assume all threats are manipulative.
D. Wait to see if the client follows through.
Correct answer: B. Assess immediate suicide/self-harm risk with empathy and clear boundaries.
Detailed rationale: All threats of self-harm deserve assessment regardless of the patient’s diagnosis.
Why the other options are incorrect:
A. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
C. This competing interpretation is not supported by the findings. All threats of self-harm deserve assessment
regardless of the patient’s diagnosis.
Original educational practice • Not a school-issued or official examination | Page 4
NU 160 / NUR 253
Exam 3 Practice Questions | 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
• Substance use
• Eating disorders
• Personality disorders
• Psychiatric emergencies
• Recovery and transition care
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 grieving patient starts crying after discussing a loss. Which nursing response is most therapeutic?
A. Say the patient must stop crying.
B. Remain present and allow supportive silence.
C. Tell a joke to distract from grief.
D. Immediately change the topic.
Correct answer: B. Remain present and allow supportive silence.
Detailed rationale: Therapeutic silence permits expression and communicates presence.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
C. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
D. This wording or action misses the therapeutic priority. Therapeutic silence permits expression and communicates
presence.
Question 2. An underweight patient taking mirtazapine asks about common adverse effects. Which counseling point is
most relevant?
A. Increased appetite, weight gain, and sedation can occur.
B. The medication has no effect on sleep.
C. Severe dehydration always occurs.
D. It routinely causes hyperthyroidism.
Correct answer: A. Increased appetite, weight gain, and sedation can occur.
Detailed rationale: Mirtazapine commonly causes sedation and increased appetite, which influence treatment selection.
Why the other options are incorrect:
B. This alternative is not the relevant response to the described mirtazapine issue. Mirtazapine commonly causes
sedation and increased appetite, which influence treatment selection.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. This alternative is not the relevant response to the described mirtazapine issue. Mirtazapine commonly causes
sedation and increased appetite, which influence treatment selection.
Question 3. A patient starting atomoxetine asks about onset and monitoring. Which answer is most accurate?
A. It always works within minutes.
B. Atomoxetine is the standard antidote for opioid overdose.
C. Benefit can build over weeks; monitor mood and cardiovascular status.
D. Monitoring is never needed.
Correct answer: C. Benefit can build over weeks; monitor mood and cardiovascular status.
Detailed rationale: Atomoxetine is a nonstimulant ADHD medication requiring follow-up for efficacy and adverse effects.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. Adding or relying on these substances does not address the problem and may introduce new safety risks.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 4. A client asks about zolpidem and night-time behaviors not remembered the next day. What is the correct
safety message?
A. Combine the medicine with alcohol to sleep more deeply.
B. Complex sleep behaviors require immediate medication review and avoidance of further doses until evaluated.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
C. Sleep-driving is a harmless intended effect.
D. Take extra medication after unexplained activities.
Correct answer: B. Complex sleep behaviors require immediate medication review and avoidance of further doses until
evaluated.
Detailed rationale: Z-drugs carry serious warnings for complex sleep behaviors and impairment.
Why the other options are incorrect:
A. Adding or relying on these substances does not address the problem and may introduce new safety risks.
C. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
D. This alternative is not the relevant response to the described sleep issue. Z-drugs carry serious warnings for complex
sleep behaviors and impairment.
Question 5. A client’s agitation has sharply worsened over the last hour. Which handoff format can clarify urgent
communication?
A. Delay telling the team until morning.
B. Omit objective findings and vital signs.
C. Use concise structured communication such as situation, background, assessment, recommendation.
D. Provide only personal opinions.
Correct answer: C. Use concise structured communication such as situation, background, assessment, recommendation.
Detailed rationale: Structured handoff helps convey clinical urgency and recommendations.
Why the other options are incorrect:
A. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
B. This competing interpretation is not supported by the findings. Structured handoff helps convey clinical urgency and
recommendations.
D. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
Question 6. A patient says, “I do not have the energy to get out of bed.” Which response supports achievable engagement?
A. “You are simply lazy.”
B. “Would you like to try one small step together, such as sitting up?”
C. “Your symptoms are not real.”
D. “You must finish ten tasks right now.”
Correct answer: B. “Would you like to try one small step together, such as sitting up?”
Detailed rationale: Small collaborative goals can support engagement in depression without blame.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
C. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
D. This wording or action misses the therapeutic priority. Small collaborative goals can support engagement in
depression without blame.
Question 7. A recently bereaved patient reports insomnia and difficulty functioning. What nursing assessment is most
appropriate?
A. Insist everyone grieves identically.
B. Tell the patient their feelings are incorrect.
C. Diagnose a specific disorder from the time since loss alone.
D. Explore grief experiences, functioning, social supports, and any suicide risk.
Correct answer: D. Explore grief experiences, functioning, social supports, and any suicide risk.
Detailed rationale: Grief is individualized; clinical assessment considers safety and the level of impairment.
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. Grief is individualized; clinical assessment considers
safety and the level of impairment.
B. This competing interpretation is not supported by the findings. Grief is individualized; clinical assessment considers
safety and the level of impairment.
C. This competing interpretation is not supported by the findings. Grief is individualized; clinical assessment considers
safety and the level of impairment.
Question 8. A new parent reports persistent low mood, hopelessness, and loss of pleasure after delivery. Which approach
is appropriate?
A. Advise stopping infant feeding as the only treatment.
B. Assume symptoms are always normal and untreatable.
C. Discourage professional help.
D. Screen for perinatal depression, functioning, and suicide risk and arrange care.
Correct answer: D. 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.
C. This competing interpretation is not supported by the findings. Perinatal depression is treatable and warrants
assessment, support, and safety screening.
Question 9. An older adult taking an SSRI develops headache, confusion, and an unexpectedly low sodium level. Which
complication should the nurse recognize?
A. A normal response requiring no action.
B. An automatic indication to give extra SSRI doses.
C. Definitive evidence of hypernatremia.
D. Possible SSRI-associated hyponatremia or SIADH.
Correct answer: D. Possible SSRI-associated hyponatremia or SIADH.
Detailed rationale: SSRIs can contribute to hyponatremia, especially in older adults.
Why the other options are incorrect:
A. The symptoms are not established as harmless treatment effects; important warning signs must not be minimized.
B. This alternative is not the relevant response to the described ssri adverse effects issue. SSRIs can contribute to
hyponatremia, especially in older adults.
C. This alternative is not the relevant response to the described ssri adverse effects issue. SSRIs can contribute to
hyponatremia, especially in older adults.
Question 10. A client with severe fear of abandonment threatens self-harm after an interpersonal conflict. What is the first
nursing concern?
A. Respond with punishment or ridicule.
B. Assess immediate suicide/self-harm risk with empathy and clear boundaries.
C. Assume all threats are manipulative.
D. Wait to see if the client follows through.
Correct answer: B. Assess immediate suicide/self-harm risk with empathy and clear boundaries.
Detailed rationale: All threats of self-harm deserve assessment regardless of the patient’s diagnosis.
Why the other options are incorrect:
A. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
C. This competing interpretation is not supported by the findings. All threats of self-harm deserve assessment
regardless of the patient’s diagnosis.
Original educational practice • Not a school-issued or official examination | Page 4
