NSG 221 Mental Health Exam 3: (Latest 2026/2027 Update) OCD, Mood
Disorders, Eating Disorders & Sleep | Q&A | Grade A | 100% Correct (Verified
Answers) – Nursing Program
Subject: NSG 221 – Psychiatric-Mental Health Nursing
Source: NSG 221 Mental Health Exam 3 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the optimal treatment for obsessive-compulsive disorder (OCD)?
Correct Answer: Medication and behavior therapy combo (SSRIs such as fluvoxamine and sertraline
as first-line, plus cognitive behavioral therapy with exposure and response prevention).
1. SSRI first-line for OCD at higher doses than for depression.
2. Exposure and response prevention (ERP) is gold-standard behavioral therapy.
3. Clomipramine (tricyclic) effective but more side effects.
2. What important assessment must the nurse make 2 weeks after a depressed client starts an SSRI?
Correct Answer: Ask if the client has thoughts of suicide. Two weeks after starting SSRIs, depressed
clients may have continued or increased risk of suicide.
1. Increased energy before mood improves → suicide risk.
2. Black box warning for children, adolescents, young adults.
3. Monitor weekly during first month of treatment.
3. What will the nurse notice in a patient with eating disorders?
Correct Answer: Excessive exercise; fear of gaining weight or becoming fat; preoccupied with food,
activities, and cooking; less than minimum expected bodyweight for age/height; eliminates food by self-
induced vomiting or laxatives.
1. Anorexia nervosa: refusal to maintain normal weight.
2. Bulimia: binge eating followed by compensatory behaviors (vomiting, laxatives, exercise).
3. Preoccupation with food common in starvation (thinking about food is physiologic).
4. A nurse is planning care for a client with bipolar disorder in the manic phase. Which intervention
should the nurse include?
Correct Answer: Use redirection when the client is demonstrating non-acceptable behavior; redirect
them with motor activities that channel the desire to be physically active.
1. Provide structured physical activities (walking, exercise).
2. Avoid power struggles; use calm, firm approach.
3. Low-stimulation environment; remove dangerous objects.
, 5. Who is at highest risk for relapse in anorexia nervosa?
Correct Answer: The client with the lowest bodyweight and longest duration of illness tend to relapse
most often and have the poorest outcomes. Clients with an eating disorder for over 1 year are at high
risk.
1. Early intervention improves prognosis.
2. Longer illness duration → more entrenched behaviors.
3. Relapse common; need long-term follow-up.
6. What is the drug of choice for somatic disorders?
Correct Answer: Selective serotonin reuptake inhibitors (SSRIs). Encourage the client to discuss
emotions that they experience during the visit with the family member.
1. SSRIs reduce anxiety and preoccupation with symptoms.
2. Address underlying emotion regulation deficits.
3. Psychotherapy (CBT) also first-line.
7. What are some factors that influence mood disorders? (Select all that apply)
Correct Answer: Genetics, neurochemical, neuroendocrine, psychodynamic, cultural consideration.
1. Genetic: heritability 40-70% for mood disorders.
2. Neurochemical: serotonin, norepinephrine, dopamine.
3. Psychodynamic: early loss, unmet needs; cultural: expression of symptoms.
8. What medications are used to treat bipolar disorder?
Correct Answer: Treatment involves a lifetime regimen of medication with an anti-manic agent called
lithium or anticonvulsant medications used as mood stabilizers. No anxiety medications
(benzodiazepines not first-line).
1. Lithium is gold standard for acute mania and maintenance.
2. Anticonvulsants: valproate, carbamazepine, lamotrigine.
3. Atypical antipsychotics also used (quetiapine, olanzapine).
9. What is circadian rhythm sleep disorder?
Correct Answer: When your body's internal clock, which tells you when it's time to sleep or awake, is
out of sync with your environment.
1. Types: delayed sleep phase, advanced sleep phase, shift work disorder.
2. Results in insomnia or excessive daytime sleepiness.
3. Treatment includes melatonin and bright light therapy.
10. What treatment can be used for circadian rhythm sleep-wake disorder?
Correct Answer: Melatonin and bright light therapy (exposure to bright light when wakefulness is
initiated and avoiding bright light when asleep is desired).
1. Light therapy entrains circadian rhythm.
2. Morning light phase advances circadian clock.
3. Evening light delays clock (used for advanced phase).
Disorders, Eating Disorders & Sleep | Q&A | Grade A | 100% Correct (Verified
Answers) – Nursing Program
Subject: NSG 221 – Psychiatric-Mental Health Nursing
Source: NSG 221 Mental Health Exam 3 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the optimal treatment for obsessive-compulsive disorder (OCD)?
Correct Answer: Medication and behavior therapy combo (SSRIs such as fluvoxamine and sertraline
as first-line, plus cognitive behavioral therapy with exposure and response prevention).
1. SSRI first-line for OCD at higher doses than for depression.
2. Exposure and response prevention (ERP) is gold-standard behavioral therapy.
3. Clomipramine (tricyclic) effective but more side effects.
2. What important assessment must the nurse make 2 weeks after a depressed client starts an SSRI?
Correct Answer: Ask if the client has thoughts of suicide. Two weeks after starting SSRIs, depressed
clients may have continued or increased risk of suicide.
1. Increased energy before mood improves → suicide risk.
2. Black box warning for children, adolescents, young adults.
3. Monitor weekly during first month of treatment.
3. What will the nurse notice in a patient with eating disorders?
Correct Answer: Excessive exercise; fear of gaining weight or becoming fat; preoccupied with food,
activities, and cooking; less than minimum expected bodyweight for age/height; eliminates food by self-
induced vomiting or laxatives.
1. Anorexia nervosa: refusal to maintain normal weight.
2. Bulimia: binge eating followed by compensatory behaviors (vomiting, laxatives, exercise).
3. Preoccupation with food common in starvation (thinking about food is physiologic).
4. A nurse is planning care for a client with bipolar disorder in the manic phase. Which intervention
should the nurse include?
Correct Answer: Use redirection when the client is demonstrating non-acceptable behavior; redirect
them with motor activities that channel the desire to be physically active.
1. Provide structured physical activities (walking, exercise).
2. Avoid power struggles; use calm, firm approach.
3. Low-stimulation environment; remove dangerous objects.
, 5. Who is at highest risk for relapse in anorexia nervosa?
Correct Answer: The client with the lowest bodyweight and longest duration of illness tend to relapse
most often and have the poorest outcomes. Clients with an eating disorder for over 1 year are at high
risk.
1. Early intervention improves prognosis.
2. Longer illness duration → more entrenched behaviors.
3. Relapse common; need long-term follow-up.
6. What is the drug of choice for somatic disorders?
Correct Answer: Selective serotonin reuptake inhibitors (SSRIs). Encourage the client to discuss
emotions that they experience during the visit with the family member.
1. SSRIs reduce anxiety and preoccupation with symptoms.
2. Address underlying emotion regulation deficits.
3. Psychotherapy (CBT) also first-line.
7. What are some factors that influence mood disorders? (Select all that apply)
Correct Answer: Genetics, neurochemical, neuroendocrine, psychodynamic, cultural consideration.
1. Genetic: heritability 40-70% for mood disorders.
2. Neurochemical: serotonin, norepinephrine, dopamine.
3. Psychodynamic: early loss, unmet needs; cultural: expression of symptoms.
8. What medications are used to treat bipolar disorder?
Correct Answer: Treatment involves a lifetime regimen of medication with an anti-manic agent called
lithium or anticonvulsant medications used as mood stabilizers. No anxiety medications
(benzodiazepines not first-line).
1. Lithium is gold standard for acute mania and maintenance.
2. Anticonvulsants: valproate, carbamazepine, lamotrigine.
3. Atypical antipsychotics also used (quetiapine, olanzapine).
9. What is circadian rhythm sleep disorder?
Correct Answer: When your body's internal clock, which tells you when it's time to sleep or awake, is
out of sync with your environment.
1. Types: delayed sleep phase, advanced sleep phase, shift work disorder.
2. Results in insomnia or excessive daytime sleepiness.
3. Treatment includes melatonin and bright light therapy.
10. What treatment can be used for circadian rhythm sleep-wake disorder?
Correct Answer: Melatonin and bright light therapy (exposure to bright light when wakefulness is
initiated and avoiding bright light when asleep is desired).
1. Light therapy entrains circadian rhythm.
2. Morning light phase advances circadian clock.
3. Evening light delays clock (used for advanced phase).
