NUR 253 Mental Health Exam 3: (Latest 2026/2027) Personality
Disorders, Eating Disorders, Substance Abuse, Family Violence &
Forensic Nursing | Q&A Grade A
Complete Review: Dependent, Borderline, Histrionic, Narcissistic, Antisocial, OCD, Anorexia, Bulimia, Alcohol/Substance
Withdrawal, Rape Trauma, Elder Abuse & SANE
SUBJECT SOURCE FORMAT
Mental Health Nursing / NUR 253 Galen Exam 3 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What is the goal of milieu management in psychiatric treatment?
CORRECT ANSWER
To manage patient affect in a group context through community meetings, coping skills groups, and
socialization groups.
RATIONALE
• Milieu therapy uses the therapeutic environment to promote growth.
• Addresses behaviors by calmly reviewing therapeutic goals and boundaries.
• Avoid rejection and rescuing; consistently enforce limits.
Q2
A patient is extremely clingy, submissive, and has difficulty making everyday decisions without excessive
reassurance. Which personality disorder is most likely?
CORRECT ANSWER
Dependent Personality Disorder (fear of separation, needs others to assume responsibility).
RATIONALE
• Interventions: promote independence and empathy, avoid doing things for the patient.
• Patients feel helpless when alone due to fear of being unable to care for themselves.
• Often a result of chronic physical illness or punishment of independent behavior.
, Q3
A patient idealizes the nurse at the beginning of the shift but later becomes angry and devalues her after
a limit is set. Which defense mechanism is this?
CORRECT ANSWER
Splitting (cannot incorporate positive and negative aspects into one image; primary defense mechanism in
borderline personality disorder).
RATIONALE
• Borderline PD: instability in emotions, relationships, impulsivity (spending, binge eating, sex, substance abuse, reckless
driving).
• Nursing care: maintain calm, matter‑of‑fact response; be consistent; use behavioral contracts.
• Goal: patient verbalizes thoughts of self‑harm before acting.
Q4
A patient is uncomfortable when not the center of attention, uses physical appearance to draw attention,
and has exaggerated emotional expression. This is consistent with:
CORRECT ANSWER
Histrionic Personality Disorder (begins in early adulthood, attention‑seeking, theatrical).
RATIONALE
• Characterized by inappropriate sexual seductive behavior, exaggerated emotions.
• Thinks relationships are more intimate than they actually are.
• Earliest onset 3‑5 years with intense attachment to opposite‑sex parent.
Q5
A patient has no empathy for others, an excessive sense of entitlement, and takes advantage of others to
achieve personal goals. This is most consistent with:
CORRECT ANSWER
Narcissistic Personality Disorder (lack of empathy, grandiosity, need for admiration).
RATIONALE
• Believes they are "special" and entitled; exploits others.
• Often a result of childhood neglect/criticism; hides emptiness with self‑sufficiency.
• Not fun to be around; relationships are superficial.
Disorders, Eating Disorders, Substance Abuse, Family Violence &
Forensic Nursing | Q&A Grade A
Complete Review: Dependent, Borderline, Histrionic, Narcissistic, Antisocial, OCD, Anorexia, Bulimia, Alcohol/Substance
Withdrawal, Rape Trauma, Elder Abuse & SANE
SUBJECT SOURCE FORMAT
Mental Health Nursing / NUR 253 Galen Exam 3 Study Guide 2026/2027 Q&A Guide with Rationale
Q1
What is the goal of milieu management in psychiatric treatment?
CORRECT ANSWER
To manage patient affect in a group context through community meetings, coping skills groups, and
socialization groups.
RATIONALE
• Milieu therapy uses the therapeutic environment to promote growth.
• Addresses behaviors by calmly reviewing therapeutic goals and boundaries.
• Avoid rejection and rescuing; consistently enforce limits.
Q2
A patient is extremely clingy, submissive, and has difficulty making everyday decisions without excessive
reassurance. Which personality disorder is most likely?
CORRECT ANSWER
Dependent Personality Disorder (fear of separation, needs others to assume responsibility).
RATIONALE
• Interventions: promote independence and empathy, avoid doing things for the patient.
• Patients feel helpless when alone due to fear of being unable to care for themselves.
• Often a result of chronic physical illness or punishment of independent behavior.
, Q3
A patient idealizes the nurse at the beginning of the shift but later becomes angry and devalues her after
a limit is set. Which defense mechanism is this?
CORRECT ANSWER
Splitting (cannot incorporate positive and negative aspects into one image; primary defense mechanism in
borderline personality disorder).
RATIONALE
• Borderline PD: instability in emotions, relationships, impulsivity (spending, binge eating, sex, substance abuse, reckless
driving).
• Nursing care: maintain calm, matter‑of‑fact response; be consistent; use behavioral contracts.
• Goal: patient verbalizes thoughts of self‑harm before acting.
Q4
A patient is uncomfortable when not the center of attention, uses physical appearance to draw attention,
and has exaggerated emotional expression. This is consistent with:
CORRECT ANSWER
Histrionic Personality Disorder (begins in early adulthood, attention‑seeking, theatrical).
RATIONALE
• Characterized by inappropriate sexual seductive behavior, exaggerated emotions.
• Thinks relationships are more intimate than they actually are.
• Earliest onset 3‑5 years with intense attachment to opposite‑sex parent.
Q5
A patient has no empathy for others, an excessive sense of entitlement, and takes advantage of others to
achieve personal goals. This is most consistent with:
CORRECT ANSWER
Narcissistic Personality Disorder (lack of empathy, grandiosity, need for admiration).
RATIONALE
• Believes they are "special" and entitled; exploits others.
• Often a result of childhood neglect/criticism; hides emptiness with self‑sufficiency.
• Not fun to be around; relationships are superficial.
