NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
NU 160 / NUR 253
Exam 2 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
• Mood disorders
• Psychotic disorders
• Trauma and anxiety
• Medication effects
• Crisis assessment
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 patient on lithium is told to follow a very low-sodium diet unexpectedly. Which concern is appropriate?
A. The patient should immediately double the dose.
B. A zero-sodium diet is the standard lithium treatment.
C. Major sodium changes can alter renal lithium handling and raise toxicity risk.
D. Sodium intake cannot change lithium concentration.
Correct answer: C. Major sodium changes can alter renal lithium handling and raise toxicity risk.
Detailed rationale: Consistent hydration and sodium intake support safer lithium therapy.
Why the other options are incorrect:
A. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
B. This alternative is not the relevant response to the described lithium issue. Consistent hydration and sodium intake
support safer lithium therapy.
D. This alternative is not the relevant response to the described lithium issue. Consistent hydration and sodium intake
support safer lithium therapy.
Question 2. A client with chronic auditory hallucinations asks for a coping method. Which option may help?
A. Instruct them to obey harmful voices.
B. Encourage stopping all care abruptly.
C. Insist hallucinations can be cured with willpower.
D. Discuss individually useful coping skills, grounding, and engagement with treatment.
Correct answer: D. Discuss individually useful coping skills, grounding, and engagement with treatment.
Detailed rationale: Collaborative coping strategies may reduce distress without reinforcing hallucinations.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Collaborative coping strategies may reduce distress without
reinforcing hallucinations.
B. This wording or action misses the therapeutic priority. Collaborative coping strategies may reduce distress without
reinforcing hallucinations.
C. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
Question 3. A reproductive-age client on valproate requests pregnancy counseling. Which teaching is most important?
A. Review major fetal risks and discuss safer individualized treatment with the prescriber.
B. Stop all psychiatric drugs without consultation.
C. Folic acid removes every fetal risk from valproate.
D. Valproate is risk-free in pregnancy.
Correct answer: A. Review major fetal risks and discuss safer individualized treatment with the prescriber.
Detailed rationale: Valproate is associated with major fetal risks; treatment decisions require careful specialist review.
Why the other options are incorrect:
B. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
C. This alternative is not the relevant response to the described valproate issue. Valproate is associated with major fetal
risks; treatment decisions require careful specialist review.
D. This alternative is not the relevant response to the described valproate issue. Valproate is associated with major fetal
risks; treatment decisions require careful specialist review.
Question 4. A manic patient has not slept or eaten and is pacing constantly. Which nursing approach is most useful?
A. Offer frequent confrontations about unrealistic plans.
B. Provide a low-stimulation setting and accessible high-calorie finger foods while assessing safety.
C. Delay physical assessment until mania resolves.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
D. Schedule multiple demanding group activities.
Correct answer: B. Provide a low-stimulation setting and accessible high-calorie finger foods while assessing safety.
Detailed rationale: Mania may impair attention to food, sleep, and hydration; environment and nutrition matter.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Mania may impair attention to food, sleep, and
hydration; environment and nutrition matter.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
D. This competing interpretation is not supported by the findings. Mania may impair attention to food, sleep, and
hydration; environment and nutrition matter.
Question 5. A trauma survivor has intrusive memories, avoidance, hypervigilance, and impaired functioning months after
an event. Which disorder is a key consideration?
A. Substance intoxication in every case.
B. Posttraumatic stress disorder.
C. Simple transient sadness with no need for assessment.
D. Alzheimer disease by definition.
Correct answer: B. 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.
C. 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 6. An acutely manic patient repeatedly forgets to eat. What nutrition strategy is reasonable?
A. Offer frequent portable nutrient-dense foods and monitor intake.
B. Avoid monitoring hydration.
C. Require lengthy seated meals during intense agitation.
D. Withhold food until the patient sits still.
Correct answer: A. Offer frequent portable nutrient-dense foods and monitor intake.
Detailed rationale: High activity and poor sustained attention can impair nutrition in mania.
Why the other options are incorrect:
B. This response fails to address the priority clinical concern and could worsen the patient’s condition.
C. This competing interpretation is not supported by the findings. High activity and poor sustained attention can impair
nutrition in mania.
D. This competing interpretation is not supported by the findings. High activity and poor sustained attention can impair
nutrition in mania.
Question 7. A patient wants buspirone to stop an acute panic attack immediately. Which explanation is accurate?
A. Buspirone permanently cures anxiety after one dose.
B. Buspirone acts as rapidly as IV sedatives.
C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
D. Buspirone must be taken only when panic peaks.
Correct answer: C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
Detailed rationale: Buspirone generally requires consistent dosing over time and does not promptly abort a panic attack.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
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 8. A client experiencing voices frequently misses oral antipsychotic doses. Which shared-decision topic is
reasonable to discuss?
A. Use punishment for missed doses.
B. Eliminate all follow-up visits.
C. Secretly add medication to food without consent.
D. Whether a long-acting injectable option could support adherence.
Correct answer: D. Whether a long-acting injectable option could support adherence.
Detailed rationale: Long-acting formulations may benefit some patients; decisions require informed consent and
individualized evaluation.
Why the other options are incorrect:
A. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
B. This alternative is not the relevant response to the described adherence issue. Long-acting formulations may benefit
some patients; decisions require informed consent and individualized evaluation.
C. This would undermine informed choice, therapeutic boundaries, or confidentiality safeguards.
Question 9. A person with opioid use disorder asks about evidence-based ongoing treatment. Which option is appropriate?
A. Insist withdrawal alone is always sufficient.
B. Discuss medications such as buprenorphine or methadone with a qualified clinician.
C. Suggest unregulated opioids for self-treatment.
D. Guarantee that a single counseling session cures addiction.
Correct answer: B. Discuss medications such as buprenorphine or methadone with a qualified clinician.
Detailed rationale: Medications for opioid use disorder reduce overdose risk and improve retention in treatment.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. 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 10. A patient asks if every conversation is private even when an immediate threat to safety is identified. Which
explanation is accurate?
A. Guarantee absolute secrecy under all circumstances.
B. Avoid explaining limits of confidentiality.
C. Discuss confidentiality and explain applicable safety-related legal and professional exceptions.
D. Threaten to tell the entire community.
Correct answer: C. Discuss confidentiality and explain applicable safety-related legal and professional exceptions.
Detailed rationale: Trust is strengthened by transparent discussion of confidentiality and its lawful exceptions.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. This wording or action misses the therapeutic priority. Trust is strengthened by transparent discussion of
confidentiality and its lawful exceptions.
D. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
Question 11. A person treated for depression reports inability to manage medication or basic self-care. Which assessment
is most relevant?
A. Avoid asking about living circumstances.
Original educational practice • Not a school-issued or official examination | Page 4
NU 160 / NUR 253
Exam 2 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
• Mood disorders
• Psychotic disorders
• Trauma and anxiety
• Medication effects
• Crisis assessment
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 patient on lithium is told to follow a very low-sodium diet unexpectedly. Which concern is appropriate?
A. The patient should immediately double the dose.
B. A zero-sodium diet is the standard lithium treatment.
C. Major sodium changes can alter renal lithium handling and raise toxicity risk.
D. Sodium intake cannot change lithium concentration.
Correct answer: C. Major sodium changes can alter renal lithium handling and raise toxicity risk.
Detailed rationale: Consistent hydration and sodium intake support safer lithium therapy.
Why the other options are incorrect:
A. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
B. This alternative is not the relevant response to the described lithium issue. Consistent hydration and sodium intake
support safer lithium therapy.
D. This alternative is not the relevant response to the described lithium issue. Consistent hydration and sodium intake
support safer lithium therapy.
Question 2. A client with chronic auditory hallucinations asks for a coping method. Which option may help?
A. Instruct them to obey harmful voices.
B. Encourage stopping all care abruptly.
C. Insist hallucinations can be cured with willpower.
D. Discuss individually useful coping skills, grounding, and engagement with treatment.
Correct answer: D. Discuss individually useful coping skills, grounding, and engagement with treatment.
Detailed rationale: Collaborative coping strategies may reduce distress without reinforcing hallucinations.
Why the other options are incorrect:
A. This wording or action misses the therapeutic priority. Collaborative coping strategies may reduce distress without
reinforcing hallucinations.
B. This wording or action misses the therapeutic priority. Collaborative coping strategies may reduce distress without
reinforcing hallucinations.
C. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
Question 3. A reproductive-age client on valproate requests pregnancy counseling. Which teaching is most important?
A. Review major fetal risks and discuss safer individualized treatment with the prescriber.
B. Stop all psychiatric drugs without consultation.
C. Folic acid removes every fetal risk from valproate.
D. Valproate is risk-free in pregnancy.
Correct answer: A. Review major fetal risks and discuss safer individualized treatment with the prescriber.
Detailed rationale: Valproate is associated with major fetal risks; treatment decisions require careful specialist review.
Why the other options are incorrect:
B. Dose increases or self-directed medicine changes can cause harm; assess and coordinate with the prescribing team.
C. This alternative is not the relevant response to the described valproate issue. Valproate is associated with major fetal
risks; treatment decisions require careful specialist review.
D. This alternative is not the relevant response to the described valproate issue. Valproate is associated with major fetal
risks; treatment decisions require careful specialist review.
Question 4. A manic patient has not slept or eaten and is pacing constantly. Which nursing approach is most useful?
A. Offer frequent confrontations about unrealistic plans.
B. Provide a low-stimulation setting and accessible high-calorie finger foods while assessing safety.
C. Delay physical assessment until mania resolves.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
D. Schedule multiple demanding group activities.
Correct answer: B. Provide a low-stimulation setting and accessible high-calorie finger foods while assessing safety.
Detailed rationale: Mania may impair attention to food, sleep, and hydration; environment and nutrition matter.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Mania may impair attention to food, sleep, and
hydration; environment and nutrition matter.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
D. This competing interpretation is not supported by the findings. Mania may impair attention to food, sleep, and
hydration; environment and nutrition matter.
Question 5. A trauma survivor has intrusive memories, avoidance, hypervigilance, and impaired functioning months after
an event. Which disorder is a key consideration?
A. Substance intoxication in every case.
B. Posttraumatic stress disorder.
C. Simple transient sadness with no need for assessment.
D. Alzheimer disease by definition.
Correct answer: B. 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.
C. 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 6. An acutely manic patient repeatedly forgets to eat. What nutrition strategy is reasonable?
A. Offer frequent portable nutrient-dense foods and monitor intake.
B. Avoid monitoring hydration.
C. Require lengthy seated meals during intense agitation.
D. Withhold food until the patient sits still.
Correct answer: A. Offer frequent portable nutrient-dense foods and monitor intake.
Detailed rationale: High activity and poor sustained attention can impair nutrition in mania.
Why the other options are incorrect:
B. This response fails to address the priority clinical concern and could worsen the patient’s condition.
C. This competing interpretation is not supported by the findings. High activity and poor sustained attention can impair
nutrition in mania.
D. This competing interpretation is not supported by the findings. High activity and poor sustained attention can impair
nutrition in mania.
Question 7. A patient wants buspirone to stop an acute panic attack immediately. Which explanation is accurate?
A. Buspirone permanently cures anxiety after one dose.
B. Buspirone acts as rapidly as IV sedatives.
C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
D. Buspirone must be taken only when panic peaks.
Correct answer: C. Buspirone is not an immediate rescue medication; benefit develops with regular use.
Detailed rationale: Buspirone generally requires consistent dosing over time and does not promptly abort a panic attack.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
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 8. A client experiencing voices frequently misses oral antipsychotic doses. Which shared-decision topic is
reasonable to discuss?
A. Use punishment for missed doses.
B. Eliminate all follow-up visits.
C. Secretly add medication to food without consent.
D. Whether a long-acting injectable option could support adherence.
Correct answer: D. Whether a long-acting injectable option could support adherence.
Detailed rationale: Long-acting formulations may benefit some patients; decisions require informed consent and
individualized evaluation.
Why the other options are incorrect:
A. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
B. This alternative is not the relevant response to the described adherence issue. Long-acting formulations may benefit
some patients; decisions require informed consent and individualized evaluation.
C. This would undermine informed choice, therapeutic boundaries, or confidentiality safeguards.
Question 9. A person with opioid use disorder asks about evidence-based ongoing treatment. Which option is appropriate?
A. Insist withdrawal alone is always sufficient.
B. Discuss medications such as buprenorphine or methadone with a qualified clinician.
C. Suggest unregulated opioids for self-treatment.
D. Guarantee that a single counseling session cures addiction.
Correct answer: B. Discuss medications such as buprenorphine or methadone with a qualified clinician.
Detailed rationale: Medications for opioid use disorder reduce overdose risk and improve retention in treatment.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. 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 10. A patient asks if every conversation is private even when an immediate threat to safety is identified. Which
explanation is accurate?
A. Guarantee absolute secrecy under all circumstances.
B. Avoid explaining limits of confidentiality.
C. Discuss confidentiality and explain applicable safety-related legal and professional exceptions.
D. Threaten to tell the entire community.
Correct answer: C. Discuss confidentiality and explain applicable safety-related legal and professional exceptions.
Detailed rationale: Trust is strengthened by transparent discussion of confidentiality and its lawful exceptions.
Why the other options are incorrect:
A. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
B. This wording or action misses the therapeutic priority. Trust is strengthened by transparent discussion of
confidentiality and its lawful exceptions.
D. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
Question 11. A person treated for depression reports inability to manage medication or basic self-care. Which assessment
is most relevant?
A. Avoid asking about living circumstances.
Original educational practice • Not a school-issued or official examination | Page 4
