NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
NU 160 / NUR 253
Exam 1 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
• Mental-health assessment
• Therapeutic communication
• Patient rights
• Depression and suicide prevention
• Early safety priorities
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 person reports voices instructing self-harm. Which question is highest priority?
A. “What are the voices telling you, and do you feel compelled to act?”
B. “Would you prefer a different room color?”
C. “Can you describe your favorite music?”
D. “Why do you deserve these voices?”
Correct answer: A. “What are the voices telling you, and do you feel compelled to act?”
Detailed rationale: Command content, intent, and capacity to resist are immediate risk assessment priorities.
Why the other options are incorrect:
B. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
C. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
D. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
Question 2. An older adult develops fluctuating inattention and confusion over one day. Which diagnosis is especially
important to assess?
A. Stable lifelong intellectual disability.
B. Age-expected permanent dementia by default.
C. A diagnosis of major depression without assessment.
D. Delirium from an underlying medical condition.
Correct answer: D. Delirium from an underlying medical condition.
Detailed rationale: Acute fluctuating disturbance of attention is characteristic of delirium.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Acute fluctuating disturbance of attention is
characteristic of delirium.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 3. A grieving patient starts crying after discussing a loss. Which nursing response is most therapeutic?
A. Tell a joke to distract from grief.
B. Say the patient must stop crying.
C. Immediately change the topic.
D. Remain present and allow supportive silence.
Correct answer: D. 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.
B. 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.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Question 4. A client experiencing voices frequently misses oral antipsychotic doses. Which shared-decision topic is
reasonable to discuss?
A. Eliminate all follow-up visits.
B. Use punishment for missed doses.
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. 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.
B. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
C. This would undermine informed choice, therapeutic boundaries, or confidentiality safeguards.
Question 5. A patient with OCD expresses fear that not repeating a ritual will cause harm. Which reply is therapeutic?
A. “I guarantee nothing bad can ever happen.”
B. “You must perform the ritual twice as much.”
C. “That fear feels intense; let us discuss strategies in your treatment plan to tolerate uncertainty.”
D. “The fear proves the danger is real.”
Correct answer: C. “That fear feels intense; let us discuss strategies in your treatment plan to tolerate uncertainty.”
Detailed rationale: Support distress tolerance without reinforcing compulsions or giving impossible guarantees.
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. Support distress tolerance without reinforcing compulsions or
giving impossible guarantees.
D. This wording or action misses the therapeutic priority. Support distress tolerance without reinforcing compulsions or
giving impossible guarantees.
Question 6. A person with first-ever panic-like chest tightness and dyspnea has no previous anxiety diagnosis. What is
best?
A. Assess for urgent medical causes while offering calm support.
B. Skip vital signs because anxiety explains everything.
C. Immediately discharge without assessment.
D. Assume symptoms cannot be cardiac.
Correct answer: A. Assess for urgent medical causes while offering calm support.
Detailed rationale: Chest symptoms and dyspnea need appropriate medical evaluation before attribution to panic.
Why the other options are incorrect:
B. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
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. Chest symptoms and dyspnea need appropriate
medical evaluation before attribution to panic.
Question 7. A patient becomes overwhelmed by loud television and group noise. Which milieu intervention is most
helpful?
A. Demand group participation as punishment.
B. Increase noise to force adjustment.
C. Ignore sensory overload reports.
D. Offer a lower-stimulation environment and assess sensory preferences.
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Correct answer: D. Offer a lower-stimulation environment and assess sensory preferences.
Detailed rationale: Modifying stimuli can reduce stress and promote psychiatric unit safety.
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 wording or action misses the therapeutic priority. Modifying stimuli can reduce stress and promote psychiatric
unit safety.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 8. A person treated for depression reports inability to manage medication or basic self-care. Which assessment
is most relevant?
A. Assume self-care is irrelevant to psychiatric care.
B. Evaluate activities of daily living, support availability, and immediate health risks.
C. Focus only on test scores.
D. Avoid asking about living circumstances.
Correct answer: B. Evaluate activities of daily living, support availability, and immediate health risks.
Detailed rationale: Functional safety, housing, food, and ability to follow treatment influence clinical planning.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Functional safety, housing, food, and ability to follow
treatment influence clinical planning.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 9. Four psychiatric patients are discussed: one has command hallucinations to self-harm, one requests a snack,
one needs routine education, and one asks for a book. Who should receive immediate assessment?
A. The patient requesting a snack.
B. The patient needing routine education.
C. The patient reporting commands to self-harm.
D. The patient asking for a book.
Correct answer: C. The patient reporting commands to self-harm.
Detailed rationale: Potential imminent self-harm takes priority over nonurgent requests.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
B. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
D. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
Question 10. A client with treatment-resistant major depressive disorder is exploring options. Which principle should
guide discussion of advanced treatments?
A. Use unsupervised combinations of psychotropic drugs.
B. Guarantee that every intervention cures all depression.
C. Use shared decision-making and specialist evaluation for options such as ECT or other evidence-based care.
D. Avoid discussing risks or monitoring.
Correct answer: C. Use shared decision-making and specialist evaluation for options such as ECT or other evidence-based
care.
Detailed rationale: Treatment-resistant illness merits systematic evaluation, individualized specialist options, and
informed discussion.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 4
NU 160 / NUR 253
Exam 1 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
• Mental-health assessment
• Therapeutic communication
• Patient rights
• Depression and suicide prevention
• Early safety priorities
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 person reports voices instructing self-harm. Which question is highest priority?
A. “What are the voices telling you, and do you feel compelled to act?”
B. “Would you prefer a different room color?”
C. “Can you describe your favorite music?”
D. “Why do you deserve these voices?”
Correct answer: A. “What are the voices telling you, and do you feel compelled to act?”
Detailed rationale: Command content, intent, and capacity to resist are immediate risk assessment priorities.
Why the other options are incorrect:
B. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
C. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
D. This wording or action misses the therapeutic priority. Command content, intent, and capacity to resist are
immediate risk assessment priorities.
Question 2. An older adult develops fluctuating inattention and confusion over one day. Which diagnosis is especially
important to assess?
A. Stable lifelong intellectual disability.
B. Age-expected permanent dementia by default.
C. A diagnosis of major depression without assessment.
D. Delirium from an underlying medical condition.
Correct answer: D. Delirium from an underlying medical condition.
Detailed rationale: Acute fluctuating disturbance of attention is characteristic of delirium.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Acute fluctuating disturbance of attention is
characteristic of delirium.
B. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 3. A grieving patient starts crying after discussing a loss. Which nursing response is most therapeutic?
A. Tell a joke to distract from grief.
B. Say the patient must stop crying.
C. Immediately change the topic.
D. Remain present and allow supportive silence.
Correct answer: D. 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.
B. 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.
Original educational practice • Not a school-issued or official examination | Page 2
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Question 4. A client experiencing voices frequently misses oral antipsychotic doses. Which shared-decision topic is
reasonable to discuss?
A. Eliminate all follow-up visits.
B. Use punishment for missed doses.
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. 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.
B. A punitive or stigmatizing response damages trust instead of addressing the person’s treatment or safety needs.
C. This would undermine informed choice, therapeutic boundaries, or confidentiality safeguards.
Question 5. A patient with OCD expresses fear that not repeating a ritual will cause harm. Which reply is therapeutic?
A. “I guarantee nothing bad can ever happen.”
B. “You must perform the ritual twice as much.”
C. “That fear feels intense; let us discuss strategies in your treatment plan to tolerate uncertainty.”
D. “The fear proves the danger is real.”
Correct answer: C. “That fear feels intense; let us discuss strategies in your treatment plan to tolerate uncertainty.”
Detailed rationale: Support distress tolerance without reinforcing compulsions or giving impossible guarantees.
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. Support distress tolerance without reinforcing compulsions or
giving impossible guarantees.
D. This wording or action misses the therapeutic priority. Support distress tolerance without reinforcing compulsions or
giving impossible guarantees.
Question 6. A person with first-ever panic-like chest tightness and dyspnea has no previous anxiety diagnosis. What is
best?
A. Assess for urgent medical causes while offering calm support.
B. Skip vital signs because anxiety explains everything.
C. Immediately discharge without assessment.
D. Assume symptoms cannot be cardiac.
Correct answer: A. Assess for urgent medical causes while offering calm support.
Detailed rationale: Chest symptoms and dyspnea need appropriate medical evaluation before attribution to panic.
Why the other options are incorrect:
B. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
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. Chest symptoms and dyspnea need appropriate
medical evaluation before attribution to panic.
Question 7. A patient becomes overwhelmed by loud television and group noise. Which milieu intervention is most
helpful?
A. Demand group participation as punishment.
B. Increase noise to force adjustment.
C. Ignore sensory overload reports.
D. Offer a lower-stimulation environment and assess sensory preferences.
Original educational practice • Not a school-issued or official examination | Page 3
, NU 160 / NUR 253 | 2026–2027 PRACTICE RESOURCE
Correct answer: D. Offer a lower-stimulation environment and assess sensory preferences.
Detailed rationale: Modifying stimuli can reduce stress and promote psychiatric unit safety.
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 wording or action misses the therapeutic priority. Modifying stimuli can reduce stress and promote psychiatric
unit safety.
C. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 8. A person treated for depression reports inability to manage medication or basic self-care. Which assessment
is most relevant?
A. Assume self-care is irrelevant to psychiatric care.
B. Evaluate activities of daily living, support availability, and immediate health risks.
C. Focus only on test scores.
D. Avoid asking about living circumstances.
Correct answer: B. Evaluate activities of daily living, support availability, and immediate health risks.
Detailed rationale: Functional safety, housing, food, and ability to follow treatment influence clinical planning.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Functional safety, housing, food, and ability to follow
treatment influence clinical planning.
C. It makes an unjustified absolute claim; the correct interpretation depends on the symptoms and evidence.
D. The described clinical warning signs require assessment or intervention rather than ignoring or delaying them.
Question 9. Four psychiatric patients are discussed: one has command hallucinations to self-harm, one requests a snack,
one needs routine education, and one asks for a book. Who should receive immediate assessment?
A. The patient requesting a snack.
B. The patient needing routine education.
C. The patient reporting commands to self-harm.
D. The patient asking for a book.
Correct answer: C. The patient reporting commands to self-harm.
Detailed rationale: Potential imminent self-harm takes priority over nonurgent requests.
Why the other options are incorrect:
A. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
B. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
D. This competing interpretation is not supported by the findings. Potential imminent self-harm takes priority over
nonurgent requests.
Question 10. A client with treatment-resistant major depressive disorder is exploring options. Which principle should
guide discussion of advanced treatments?
A. Use unsupervised combinations of psychotropic drugs.
B. Guarantee that every intervention cures all depression.
C. Use shared decision-making and specialist evaluation for options such as ECT or other evidence-based care.
D. Avoid discussing risks or monitoring.
Correct answer: C. Use shared decision-making and specialist evaluation for options such as ECT or other evidence-based
care.
Detailed rationale: Treatment-resistant illness merits systematic evaluation, individualized specialist options, and
informed discussion.
Why the other options are incorrect:
Original educational practice • Not a school-issued or official examination | Page 4
