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GALEN NUR 253 EXAM 2 STUDY GUIDE 2026: 300
QUESTIONS WITH ANSWERS & RATIONALES |
MENTAL HEALTH NURSING
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Substance Use Disorders (Alcohol, Opioids, Stimulants, Sedatives) |
50 |
| 2 | Crisis Intervention & Disaster Response | 25 |
| 3 | Suicide Prevention & Risk Assessment | 25 |
| 4 | Child & Adolescent Psychiatric Disorders (ADHD, Autism, Conduct
Disorder) | 40 |
| 5 | Older Adult Mental Health (Dementia, Delirium, Depression) | 35 |
| 6 | Family Violence, Abuse, & Trauma | 25 |
| 7 | Sexual Disorders & Gender Dysphoria | 20 |
| 8 | Sleep Disorders (Insomnia, Narcolepsy, Sleep Apnea) | 20 |
| 9 | Psychiatric Emergencies (Agitation, NMS, Serotonin Syndrome) |
30 |
| 10 | High-Yield Clinical Case Questions | 30 |
| **Total** | | **300** |
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---
# SECTION 1: Substance Use Disorders (Alcohol, Opioids, Stimulants,
Sedatives) – 50 Questions
**1. A patient with alcohol use disorder reports tremors, anxiety, and
nausea 6 hours after last drink. This is:**
A. Alcohol intoxication
B. Alcohol withdrawal (early)
C. Delirium tremens
D. Wernicke's encephalopathy
**Answer: B – Alcohol withdrawal (early)**
*Rationale:* Early withdrawal (6-12 hours): tremors, anxiety,
diaphoresis, nausea, insomnia. Delirium tremens (48-72 hours):
hallucinations, seizures, autonomic instability.
**2. Which medication is first-line for alcohol withdrawal to prevent
seizures and delirium tremens?**
A. Haloperidol
B. Benzodiazepines (lorazepam, chlordiazepoxide)
C. Baclofen
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D. Naltrexone
**Answer: B – Benzodiazepines**
*Rationale:* Benzodiazepines (chlordiazepoxide, lorazepam, diazepam)
are first-line for alcohol withdrawal (CIWA-Ar protocol). They reduce
seizure and DT risk.
**3. A patient with alcohol use disorder is started on disulfiram
(Antabuse). The nurse teaches that drinking alcohol will cause:**
A. Euphoria
B. Nausea, vomiting, flushing, hypotension (acetaldehyde buildup)
C. Sedation
D. No effect
**Answer: B – Disulfiram-ethanol reaction**
*Rationale:* Disulfiram inhibits aldehyde dehydrogenase →
acetaldehyde accumulation → flushing, N/V, hypotension, palpitations.
Can be severe.
**4. A patient with opioid use disorder is in withdrawal. Which
symptoms are expected?**
A. Diarrhea, vomiting, yawning, dilated pupils, piloerection
(goosebumps)
B. Sedation, miosis (pinpoint pupils), respiratory depression
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C. Seizures
D. Hallucinations
**Answer: A – Opioid withdrawal (flu-like, dilated pupils)**
*Rationale:* Opioid withdrawal: lacrimation, yawning, rhinorrhea,
dilated pupils, diarrhea, vomiting, muscle aches (not life-threatening but
very uncomfortable).
**5. Which medication is used for opioid withdrawal and maintenance
(reduces cravings, blocks euphoria)?**
A. Buprenorphine (partial agonist) or methadone (full agonist)
B. Naltrexone (antagonist)
C. Clonidine (for withdrawal symptoms)
D. All of the above
**Answer: D – All of the above**
*Rationale:* Opioid use disorder treatment: methadone/buprenorphine
(agonist therapy), naltrexone (antagonist), clonidine (symptom
management).
**6. A patient overdoses on heroin and is unresponsive with respiratory
rate of 4 breaths/min. The nurse should administer:**
A. Flumazenil
B. Naloxone (Narcan) IV/IM
GALEN NUR 253 EXAM 2 STUDY GUIDE 2026: 300
QUESTIONS WITH ANSWERS & RATIONALES |
MENTAL HEALTH NURSING
# Table of Contents
| Section | Topic | Question Count |
|---------|-------|----------------|
| 1 | Substance Use Disorders (Alcohol, Opioids, Stimulants, Sedatives) |
50 |
| 2 | Crisis Intervention & Disaster Response | 25 |
| 3 | Suicide Prevention & Risk Assessment | 25 |
| 4 | Child & Adolescent Psychiatric Disorders (ADHD, Autism, Conduct
Disorder) | 40 |
| 5 | Older Adult Mental Health (Dementia, Delirium, Depression) | 35 |
| 6 | Family Violence, Abuse, & Trauma | 25 |
| 7 | Sexual Disorders & Gender Dysphoria | 20 |
| 8 | Sleep Disorders (Insomnia, Narcolepsy, Sleep Apnea) | 20 |
| 9 | Psychiatric Emergencies (Agitation, NMS, Serotonin Syndrome) |
30 |
| 10 | High-Yield Clinical Case Questions | 30 |
| **Total** | | **300** |
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---
# SECTION 1: Substance Use Disorders (Alcohol, Opioids, Stimulants,
Sedatives) – 50 Questions
**1. A patient with alcohol use disorder reports tremors, anxiety, and
nausea 6 hours after last drink. This is:**
A. Alcohol intoxication
B. Alcohol withdrawal (early)
C. Delirium tremens
D. Wernicke's encephalopathy
**Answer: B – Alcohol withdrawal (early)**
*Rationale:* Early withdrawal (6-12 hours): tremors, anxiety,
diaphoresis, nausea, insomnia. Delirium tremens (48-72 hours):
hallucinations, seizures, autonomic instability.
**2. Which medication is first-line for alcohol withdrawal to prevent
seizures and delirium tremens?**
A. Haloperidol
B. Benzodiazepines (lorazepam, chlordiazepoxide)
C. Baclofen
,3|Page
D. Naltrexone
**Answer: B – Benzodiazepines**
*Rationale:* Benzodiazepines (chlordiazepoxide, lorazepam, diazepam)
are first-line for alcohol withdrawal (CIWA-Ar protocol). They reduce
seizure and DT risk.
**3. A patient with alcohol use disorder is started on disulfiram
(Antabuse). The nurse teaches that drinking alcohol will cause:**
A. Euphoria
B. Nausea, vomiting, flushing, hypotension (acetaldehyde buildup)
C. Sedation
D. No effect
**Answer: B – Disulfiram-ethanol reaction**
*Rationale:* Disulfiram inhibits aldehyde dehydrogenase →
acetaldehyde accumulation → flushing, N/V, hypotension, palpitations.
Can be severe.
**4. A patient with opioid use disorder is in withdrawal. Which
symptoms are expected?**
A. Diarrhea, vomiting, yawning, dilated pupils, piloerection
(goosebumps)
B. Sedation, miosis (pinpoint pupils), respiratory depression
, 4|Page
C. Seizures
D. Hallucinations
**Answer: A – Opioid withdrawal (flu-like, dilated pupils)**
*Rationale:* Opioid withdrawal: lacrimation, yawning, rhinorrhea,
dilated pupils, diarrhea, vomiting, muscle aches (not life-threatening but
very uncomfortable).
**5. Which medication is used for opioid withdrawal and maintenance
(reduces cravings, blocks euphoria)?**
A. Buprenorphine (partial agonist) or methadone (full agonist)
B. Naltrexone (antagonist)
C. Clonidine (for withdrawal symptoms)
D. All of the above
**Answer: D – All of the above**
*Rationale:* Opioid use disorder treatment: methadone/buprenorphine
(agonist therapy), naltrexone (antagonist), clonidine (symptom
management).
**6. A patient overdoses on heroin and is unresponsive with respiratory
rate of 4 breaths/min. The nurse should administer:**
A. Flumazenil
B. Naloxone (Narcan) IV/IM
