NUR 2488 Mental Health Exam 2
Latest Update 2026/2027 | Rasmussen University
verified Questions and Answers With Rationales
100% Correct | Grade A
Section 1: Mood Disorders
Q1: A patient is admitted to the psychiatric unit with a diagnosis of major depressive disorder
(MDD). During the assessment, the patient reports sleeping only 2 hours a night, has lost 15
pounds in three weeks without trying, and states, "I feel like a burden to my family and the world
would be better off without me." Using the SIGECAPS mnemonic, which symptoms is the
patient exhibiting?
A. Sleep disturbance, Interest loss, Guilt
B. Sleep disturbance, Appetite change, Suicidality [CORRECT]
C. Psychomotor agitation, Energy deficit, Concentration deficit
D. Suicidality, Psychomotor retardation, Interest loss
Correct Answer: B
Rationale: SIGECAPS stands for Sleep disturbance, Interest loss, Guilt, Energy deficit,
Concentration deficit, Appetite change, Psychomotor changes, and Suicidality. The patient
exhibits insomnia (Sleep), weight loss (Appetite), and explicit suicidal ideation (Suicidality).
Option A is incorrect because the patient does not explicitly express guilt. Option C is incorrect
because psychomotor agitation and concentration deficits are not mentioned. Option D is
incorrect because interest loss and psychomotor retardation are not described in the scenario.
Q2: A patient diagnosed with Bipolar I Disorder is admitted during an acute manic episode.
Which of the following behaviors is most characteristic of this phase of the illness?
,A. Severe psychomotor retardation and excessive sleeping.
B. Intense fear of leaving the house and panic attacks.
C. Grandiosity, decreased need for sleep, and pressured speech. [CORRECT]
D. Unfounded beliefs that the FBI is tracking their phone calls.
Correct Answer: C
Rationale: Acute mania is characterized by an abnormally elevated mood manifesting as
grandiosity, a decreased need for sleep, pressured speech, flight of ideas, and risky behaviors.
Option A describes severe depression. Option B describes agoraphobia with panic. Option D
describes paranoid delusions, which are more characteristic of schizophrenia or schizoaffective
disorder (though mania can have psychotic features, grandiosity and sleep changes are the
hallmark).
Q3: [Medication Teaching Question 1] A patient is newly prescribed lithium (Lithobid) for
Bipolar Disorder. Which statement by the patient indicates that the teaching has been effective?
A. "I will take this medication only when I feel like I am getting manic."
B. "I need to maintain a normal salt and fluid intake and have my blood drawn to check
the drug level." [CORRECT]
C. "If I gain 5 pounds or feel a little thirsty, I should stop taking the medication immediately."
D. "I can take over-the-counter ibuprofen (Advil) for my daily headaches while on this drug."
Correct Answer: B
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L) and requires consistent
blood levels; dehydration and low sodium can cause toxicity, so normal intake is required.
Option A is incorrect because lithium must be taken daily to maintain steady blood levels, not
just when symptomatic. Option C is incorrect because mild thirst and weight gain are common
side effects, not signs of the severe toxicity that require immediate cessation (which presents
with coarse tremors, vomiting, ataxia). Option D is incorrect because NSAIDs like ibuprofen
increase lithium levels and can cause fatal toxicity.
Q4: A patient in the acute manic phase of Bipolar Disorder is running up and down the hallway,
loudly demanding to use the phone to call the President to "fix the economy." What is the nurse's
priority intervention?
A. Argue with the patient to prove they cannot actually call the President.
, B. Allow the patient to use the phone to de-escalate their agitation.
C. Calmly set limits, redirect to a low-stimulation environment, and offer PRN medication.
[CORRECT]
D. Tell the patient they are acting inappropriately and must go to their room.
Correct Answer: C
Rationale: Manic patients require clear, firm limit-setting to ensure safety, redirection to a low-
stimulus environment to reduce agitation, and pharmacological intervention to manage the acute
hyperactivity. Option A is incorrect because arguing with a delusion escalates agitation. Option B
is incorrect because reinforcing grandiose delusions and providing an unstructured activity can
worsen the mania. Option D is incorrect because using judgmental language increases
defensiveness and agitation.
Q5: [Medication Teaching Question 2] A patient has been taking paroxetine (Paxil), an SSRI, for
two years. The provider decides to discontinue the medication. The nurse educates the patient
that they must taper the medication slowly to prevent:
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Anticholinergic toxicity
D. SSRI discontinuation syndrome [CORRECT]
Correct Answer: D
Rationale: Abrupt cessation of SSRIs can lead to SSRI discontinuation syndrome, characterized
by flu-like symptoms, "brain zaps" (electric shock sensations), insomnia, dizziness, and nausea.
Option A is incorrect because serotonin syndrome is caused by combining serotonergic drugs or
overdosing, not stopping them. Option B is incorrect because EPS is associated with
antipsychotics. Option C is incorrect because anticholinergic toxicity is associated with TCAs or
antihistamines.
Q6: Which of the following are common metabolic side effects associated with atypical
antipsychotics (such as olanzapine or quetiapine) used in bipolar disorder? (Select all that apply)
A. Severe muscle rigidity and tremors
B. Weight gain [CORRECT]
C. Hyperglycemia and type 2 diabetes mellitus [CORRECT]
Latest Update 2026/2027 | Rasmussen University
verified Questions and Answers With Rationales
100% Correct | Grade A
Section 1: Mood Disorders
Q1: A patient is admitted to the psychiatric unit with a diagnosis of major depressive disorder
(MDD). During the assessment, the patient reports sleeping only 2 hours a night, has lost 15
pounds in three weeks without trying, and states, "I feel like a burden to my family and the world
would be better off without me." Using the SIGECAPS mnemonic, which symptoms is the
patient exhibiting?
A. Sleep disturbance, Interest loss, Guilt
B. Sleep disturbance, Appetite change, Suicidality [CORRECT]
C. Psychomotor agitation, Energy deficit, Concentration deficit
D. Suicidality, Psychomotor retardation, Interest loss
Correct Answer: B
Rationale: SIGECAPS stands for Sleep disturbance, Interest loss, Guilt, Energy deficit,
Concentration deficit, Appetite change, Psychomotor changes, and Suicidality. The patient
exhibits insomnia (Sleep), weight loss (Appetite), and explicit suicidal ideation (Suicidality).
Option A is incorrect because the patient does not explicitly express guilt. Option C is incorrect
because psychomotor agitation and concentration deficits are not mentioned. Option D is
incorrect because interest loss and psychomotor retardation are not described in the scenario.
Q2: A patient diagnosed with Bipolar I Disorder is admitted during an acute manic episode.
Which of the following behaviors is most characteristic of this phase of the illness?
,A. Severe psychomotor retardation and excessive sleeping.
B. Intense fear of leaving the house and panic attacks.
C. Grandiosity, decreased need for sleep, and pressured speech. [CORRECT]
D. Unfounded beliefs that the FBI is tracking their phone calls.
Correct Answer: C
Rationale: Acute mania is characterized by an abnormally elevated mood manifesting as
grandiosity, a decreased need for sleep, pressured speech, flight of ideas, and risky behaviors.
Option A describes severe depression. Option B describes agoraphobia with panic. Option D
describes paranoid delusions, which are more characteristic of schizophrenia or schizoaffective
disorder (though mania can have psychotic features, grandiosity and sleep changes are the
hallmark).
Q3: [Medication Teaching Question 1] A patient is newly prescribed lithium (Lithobid) for
Bipolar Disorder. Which statement by the patient indicates that the teaching has been effective?
A. "I will take this medication only when I feel like I am getting manic."
B. "I need to maintain a normal salt and fluid intake and have my blood drawn to check
the drug level." [CORRECT]
C. "If I gain 5 pounds or feel a little thirsty, I should stop taking the medication immediately."
D. "I can take over-the-counter ibuprofen (Advil) for my daily headaches while on this drug."
Correct Answer: B
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L) and requires consistent
blood levels; dehydration and low sodium can cause toxicity, so normal intake is required.
Option A is incorrect because lithium must be taken daily to maintain steady blood levels, not
just when symptomatic. Option C is incorrect because mild thirst and weight gain are common
side effects, not signs of the severe toxicity that require immediate cessation (which presents
with coarse tremors, vomiting, ataxia). Option D is incorrect because NSAIDs like ibuprofen
increase lithium levels and can cause fatal toxicity.
Q4: A patient in the acute manic phase of Bipolar Disorder is running up and down the hallway,
loudly demanding to use the phone to call the President to "fix the economy." What is the nurse's
priority intervention?
A. Argue with the patient to prove they cannot actually call the President.
, B. Allow the patient to use the phone to de-escalate their agitation.
C. Calmly set limits, redirect to a low-stimulation environment, and offer PRN medication.
[CORRECT]
D. Tell the patient they are acting inappropriately and must go to their room.
Correct Answer: C
Rationale: Manic patients require clear, firm limit-setting to ensure safety, redirection to a low-
stimulus environment to reduce agitation, and pharmacological intervention to manage the acute
hyperactivity. Option A is incorrect because arguing with a delusion escalates agitation. Option B
is incorrect because reinforcing grandiose delusions and providing an unstructured activity can
worsen the mania. Option D is incorrect because using judgmental language increases
defensiveness and agitation.
Q5: [Medication Teaching Question 2] A patient has been taking paroxetine (Paxil), an SSRI, for
two years. The provider decides to discontinue the medication. The nurse educates the patient
that they must taper the medication slowly to prevent:
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Anticholinergic toxicity
D. SSRI discontinuation syndrome [CORRECT]
Correct Answer: D
Rationale: Abrupt cessation of SSRIs can lead to SSRI discontinuation syndrome, characterized
by flu-like symptoms, "brain zaps" (electric shock sensations), insomnia, dizziness, and nausea.
Option A is incorrect because serotonin syndrome is caused by combining serotonergic drugs or
overdosing, not stopping them. Option B is incorrect because EPS is associated with
antipsychotics. Option C is incorrect because anticholinergic toxicity is associated with TCAs or
antihistamines.
Q6: Which of the following are common metabolic side effects associated with atypical
antipsychotics (such as olanzapine or quetiapine) used in bipolar disorder? (Select all that apply)
A. Severe muscle rigidity and tremors
B. Weight gain [CORRECT]
C. Hyperglycemia and type 2 diabetes mellitus [CORRECT]
