NUR 253 EXAM 3 | ACTUAL TEST
QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS -
GALEN.
1. Trauma & Stressor-Related Disorders
A patient who survived a mass shooting reports recurrent nightmares,
flashbacks, hypervigilance, and avoidance of crowds. These symptoms
have persisted for 4 months. Which diagnosis is most likely?
A) Acute stress disorder
B) Post-traumatic stress disorder (PTSD)
C) Generalized anxiety disorder
D) Adjustment disorder
Correct ,,,,answer,,,: B) Post-traumatic stress disorder (PTSD) ✅
Rationale: PTSD requires symptom duration >1 month. Acute stress
disorder is <1 month. Avoidance, re-experiencing
(flashbacks/nightmares), and hyperarousal (hypervigilance) are hallmark
PTSD symptoms .
2. Trauma & Stressor-Related Disorders
A patient reports severe anxiety, insomnia, and difficulty concentrating
that began 2 weeks after losing their job. There is no history of trauma.
What is the most likely diagnosis?
A) PTSD
B) Acute stress disorder
C) Adjustment disorder
,D) Major depressive disorder
Correct ,,,,answer,,,: C) Adjustment disorder ✅
Rationale: Adjustment disorder occurs within 3 months of an identifiable
stressor (job loss) and causes emotional/behavioral symptoms. It lacks
the trauma re-experiencing seen in PTSD .
3. Trauma & Stressor-Related Disorders
The nurse is caring for a client who was found confused and wandering
around a playground. The client is unable to identify who they are and
where they live. The nurse expects that the client is experiencing:
A) Acute stress disorder
B) Dissociative fugue
C) Depersonalization disorder
D) Dissociative identity disorder
Correct ,,,,answer,,,: B) Dissociative fugue ✅
Rationale: Dissociative fugue is a subtype of dissociative amnesia
characterized by sudden unexpected travel and an inability to recall one's
identity and information about some or all of the past .
4. Trauma & Stressor-Related Disorders
Which medication is a first-line treatment for nightmares associated with
PTSD?
A) Prazosin
B) Clonidine
C) Propranolol
D) Hydroxyzine
Correct ,,,,answer,,,: A) Prazosin ✅
Rationale: Prazosin (alpha-1 antagonist) is evidence-based for PTSD-
related nightmares and sleep disturbances. It reduces sympathetic tone
during REM sleep .
,5. Trauma & Stressor-Related Disorders
A child with post-traumatic stress disorder (PTSD) has stopped playing
with friends and draws pictures of themselves as a "bad guy." Which
response is appropriate for the nurse to tell the parents?
A) "Don't worry. This will pass with time."
B) "Just let them be alone, a child this age needs to deal with these
emotions internally."
C) "Let's speak with a doctor, your child needs some intense therapy."
D) "This is part of the grieving process and a response to the trauma."
Correct ,,,,answer,,,: D) "This is part of the grieving process and a
response to the trauma." ✅
Rationale: This response validates the parents' concerns, provides
psychoeducation about the child's response to trauma, and normalizes
the grieving process .
6. Somatic Symptom Disorders
The nurse is caring for a client with unexplained recurring abdominal pain.
Multiple medical tests have been administered with no significant
findings. Which assessment question should the nurse ask?
A) "Have you been seen by anyone in the past for this problem?"
B) "Are you experiencing any recent stress at work?"
C) "Do you have a family history of gastrointestinal disorders?"
D) "Have you traveled outside the country recently?"
Correct ,,,,answer,,,: A) "Have you been seen by anyone in the past for
this problem?" ✅
Rationale: This question helps the nurse understand the chronicity and
pattern of health-seeking behaviors. Clients with somatic symptom
disorder often have a long history of seeking medical care for unexplained
physical symptoms .
, 7. Somatic Symptom Disorders
A client was in an argument with their spouse, the spouse asked for a
divorce, and suddenly, the client could not hear anymore. Which
condition should the nurse identify?
A) Conversion disorder
B) Major depressive disorder
C) Acute stress disorder
D) Schizophrenia
Correct ,,,,answer,,,: A) Conversion disorder ✅
Rationale: Conversion disorder (functional neurological symptom
disorder) involves neurological symptoms (e.g., deafness, blindness,
paralysis) that cannot be explained by medical findings and occur in
response to psychological conflict or stress .
8. Neurocognitive Disorders (Dementia)
The nurse is teaching the family of a client who has severe Alzheimer's
disease about the side effects of a newly prescribed medication,
donepezil (Aricept). Which side effect should the nurse include?
A) Gastrointestinal upset
B) Increased appetite
C) Constipation
D) Insomnia
Correct ,,,,answer,,,: A) Gastrointestinal upset ✅
Rationale: Donepezil (Aricept), a cholinesterase inhibitor, commonly
causes gastrointestinal side effects including nausea, vomiting, diarrhea,
and loss of appetite .
9. Neurocognitive Disorders (Dementia)
One client shouts at another "move along, you're blocking the road." The
other client turns and shakes his fist. What is an appropriate action by the
nurse?
QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS -
GALEN.
1. Trauma & Stressor-Related Disorders
A patient who survived a mass shooting reports recurrent nightmares,
flashbacks, hypervigilance, and avoidance of crowds. These symptoms
have persisted for 4 months. Which diagnosis is most likely?
A) Acute stress disorder
B) Post-traumatic stress disorder (PTSD)
C) Generalized anxiety disorder
D) Adjustment disorder
Correct ,,,,answer,,,: B) Post-traumatic stress disorder (PTSD) ✅
Rationale: PTSD requires symptom duration >1 month. Acute stress
disorder is <1 month. Avoidance, re-experiencing
(flashbacks/nightmares), and hyperarousal (hypervigilance) are hallmark
PTSD symptoms .
2. Trauma & Stressor-Related Disorders
A patient reports severe anxiety, insomnia, and difficulty concentrating
that began 2 weeks after losing their job. There is no history of trauma.
What is the most likely diagnosis?
A) PTSD
B) Acute stress disorder
C) Adjustment disorder
,D) Major depressive disorder
Correct ,,,,answer,,,: C) Adjustment disorder ✅
Rationale: Adjustment disorder occurs within 3 months of an identifiable
stressor (job loss) and causes emotional/behavioral symptoms. It lacks
the trauma re-experiencing seen in PTSD .
3. Trauma & Stressor-Related Disorders
The nurse is caring for a client who was found confused and wandering
around a playground. The client is unable to identify who they are and
where they live. The nurse expects that the client is experiencing:
A) Acute stress disorder
B) Dissociative fugue
C) Depersonalization disorder
D) Dissociative identity disorder
Correct ,,,,answer,,,: B) Dissociative fugue ✅
Rationale: Dissociative fugue is a subtype of dissociative amnesia
characterized by sudden unexpected travel and an inability to recall one's
identity and information about some or all of the past .
4. Trauma & Stressor-Related Disorders
Which medication is a first-line treatment for nightmares associated with
PTSD?
A) Prazosin
B) Clonidine
C) Propranolol
D) Hydroxyzine
Correct ,,,,answer,,,: A) Prazosin ✅
Rationale: Prazosin (alpha-1 antagonist) is evidence-based for PTSD-
related nightmares and sleep disturbances. It reduces sympathetic tone
during REM sleep .
,5. Trauma & Stressor-Related Disorders
A child with post-traumatic stress disorder (PTSD) has stopped playing
with friends and draws pictures of themselves as a "bad guy." Which
response is appropriate for the nurse to tell the parents?
A) "Don't worry. This will pass with time."
B) "Just let them be alone, a child this age needs to deal with these
emotions internally."
C) "Let's speak with a doctor, your child needs some intense therapy."
D) "This is part of the grieving process and a response to the trauma."
Correct ,,,,answer,,,: D) "This is part of the grieving process and a
response to the trauma." ✅
Rationale: This response validates the parents' concerns, provides
psychoeducation about the child's response to trauma, and normalizes
the grieving process .
6. Somatic Symptom Disorders
The nurse is caring for a client with unexplained recurring abdominal pain.
Multiple medical tests have been administered with no significant
findings. Which assessment question should the nurse ask?
A) "Have you been seen by anyone in the past for this problem?"
B) "Are you experiencing any recent stress at work?"
C) "Do you have a family history of gastrointestinal disorders?"
D) "Have you traveled outside the country recently?"
Correct ,,,,answer,,,: A) "Have you been seen by anyone in the past for
this problem?" ✅
Rationale: This question helps the nurse understand the chronicity and
pattern of health-seeking behaviors. Clients with somatic symptom
disorder often have a long history of seeking medical care for unexplained
physical symptoms .
, 7. Somatic Symptom Disorders
A client was in an argument with their spouse, the spouse asked for a
divorce, and suddenly, the client could not hear anymore. Which
condition should the nurse identify?
A) Conversion disorder
B) Major depressive disorder
C) Acute stress disorder
D) Schizophrenia
Correct ,,,,answer,,,: A) Conversion disorder ✅
Rationale: Conversion disorder (functional neurological symptom
disorder) involves neurological symptoms (e.g., deafness, blindness,
paralysis) that cannot be explained by medical findings and occur in
response to psychological conflict or stress .
8. Neurocognitive Disorders (Dementia)
The nurse is teaching the family of a client who has severe Alzheimer's
disease about the side effects of a newly prescribed medication,
donepezil (Aricept). Which side effect should the nurse include?
A) Gastrointestinal upset
B) Increased appetite
C) Constipation
D) Insomnia
Correct ,,,,answer,,,: A) Gastrointestinal upset ✅
Rationale: Donepezil (Aricept), a cholinesterase inhibitor, commonly
causes gastrointestinal side effects including nausea, vomiting, diarrhea,
and loss of appetite .
9. Neurocognitive Disorders (Dementia)
One client shouts at another "move along, you're blocking the road." The
other client turns and shakes his fist. What is an appropriate action by the
nurse?
