NSG 3450 Exam 3: Psychiatric Mental
Health Nursing Comprehensive
Examination 2026
1. A 29-year-old patient with seasonal depression is prescribed light therapy. The nurse understands
that which additional intervention is most important to include in the plan of care?
A) Interoception training
B) Cognitive behavioral therapy
C) Aromatherapy
D) Acupuncture
ANSWER: A) Interoception training
Rationale: Interoception training helps patients recognize and interpret internal body signals, which is
particularly important for patients with seasonal depression who may have difficulty identifying
emotional and physical states. This training enhances self-awareness and emotional regulation.
Option B rationale: While CBT is effective for depression, interoception is specifically highlighted in the
exam notes as a key component of light therapy treatment.
Option C rationale: Aromatherapy may provide comfort but is not a primary intervention for seasonal
depression.
Option D rationale: Acupuncture is complementary therapy but lacks the specific emphasis on internal
awareness that interoception provides.
,2. The nurse is caring for a patient with major depression who is scheduled for electroconvulsive therapy
(ECT). Which medication classification should the nurse question if ordered prior to the procedure?
A) Benzodiazepines
B) Antihypertensives
C) Anticholinergics
D) Antidepressants
ANSWER: A) Benzodiazepines
Rationale: Benzodiazepines should be used cautiously or avoided before ECT because they increase the
seizure threshold, potentially reducing the effectiveness of the treatment. Additionally, the exam notes
indicate that benzodiazepines are specifically contraindicated in patients with alcohol use disorder.
Option B rationale: Antihypertensives may be held but are not specifically contraindicated with ECT.
Option C rationale: Anticholinergics are often given before ECT to reduce secretions and prevent
bradycardia.
Option D rationale: Antidepressants are typically continued during ECT treatment.
3. A patient with mania is admitted to the psychiatric unit. What is the priority nursing action?
A) Place the patient in a room with another manic patient
B) Provide a stimulating environment with group activities
C) Separate the patient from other patients with mania
D) Encourage competitive games to reduce energy
ANSWER: C) Separate the patient from other patients with mania
,Rationale: Patients in a manic phase can stimulate each other's manic behaviors, leading to increased
agitation, poor impulse control, and potential safety risks. Separating them prevents escalation of
symptoms and maintains a calm environment.
Option A rationale: Placing two manic patients together can exacerbate symptoms and create safety
concerns.
Option B rationale: A stimulating environment would further agitate a patient in a manic state.
Option D rationale: Competitive activities may increase agitation and aggressive behavior.
4. Which nursing diagnosis is most appropriate for a patient with anorexia nervosa who exhibits
impaired mobility?
A) Risk for injury related to muscle weakness
B) Imbalanced nutrition: less than body requirements
C) Risk for infection
D) Disturbed body image
ANSWER: A) Risk for injury related to muscle weakness
Rationale: The exam notes specifically identify "Risk for injury - Impaired Mobility" as a key nursing
diagnosis for anorexia nervosa. Muscle weakness and impaired mobility create significant fall risk and
injury potential.
Option B rationale: While nutritional imbalance is present, the question specifically addresses the
mobility impairment.
Option C rationale: Infection risk may exist but is not directly related to impaired mobility.
, Option D rationale: Body image disturbance is important but not the priority when mobility is impaired.
5. The nurse is assessing a patient with bulimia nervosa. Which clinical finding would the nurse expect to
observe?
A) Dental erosion
B) Lanugo hair
C) Bradycardia
D) Amenorrhea
ANSWER: A) Dental erosion
Rationale: Bulimia nervosa involves recurrent episodes of binge eating followed by compensatory
behaviors such as self-induced vomiting. The gastric acid from vomiting erodes tooth enamel, leading to
dental erosion. The exam notes specifically identify dental erosion as a key finding.
Option B rationale: Lanugo hair is associated with anorexia nervosa, not bulimia.
Option C rationale: Bradycardia is more commonly associated with anorexia nervosa.
Option D rationale: Amenorrhea is associated with anorexia nervosa, not bulimia.
6. Which laboratory finding is most critical to monitor in a patient with bulimia nervosa?
A) Complete blood count
B) Serum potassium levels
C) Liver function tests
D) Thyroid function tests
ANSWER: B) Serum potassium levels
Health Nursing Comprehensive
Examination 2026
1. A 29-year-old patient with seasonal depression is prescribed light therapy. The nurse understands
that which additional intervention is most important to include in the plan of care?
A) Interoception training
B) Cognitive behavioral therapy
C) Aromatherapy
D) Acupuncture
ANSWER: A) Interoception training
Rationale: Interoception training helps patients recognize and interpret internal body signals, which is
particularly important for patients with seasonal depression who may have difficulty identifying
emotional and physical states. This training enhances self-awareness and emotional regulation.
Option B rationale: While CBT is effective for depression, interoception is specifically highlighted in the
exam notes as a key component of light therapy treatment.
Option C rationale: Aromatherapy may provide comfort but is not a primary intervention for seasonal
depression.
Option D rationale: Acupuncture is complementary therapy but lacks the specific emphasis on internal
awareness that interoception provides.
,2. The nurse is caring for a patient with major depression who is scheduled for electroconvulsive therapy
(ECT). Which medication classification should the nurse question if ordered prior to the procedure?
A) Benzodiazepines
B) Antihypertensives
C) Anticholinergics
D) Antidepressants
ANSWER: A) Benzodiazepines
Rationale: Benzodiazepines should be used cautiously or avoided before ECT because they increase the
seizure threshold, potentially reducing the effectiveness of the treatment. Additionally, the exam notes
indicate that benzodiazepines are specifically contraindicated in patients with alcohol use disorder.
Option B rationale: Antihypertensives may be held but are not specifically contraindicated with ECT.
Option C rationale: Anticholinergics are often given before ECT to reduce secretions and prevent
bradycardia.
Option D rationale: Antidepressants are typically continued during ECT treatment.
3. A patient with mania is admitted to the psychiatric unit. What is the priority nursing action?
A) Place the patient in a room with another manic patient
B) Provide a stimulating environment with group activities
C) Separate the patient from other patients with mania
D) Encourage competitive games to reduce energy
ANSWER: C) Separate the patient from other patients with mania
,Rationale: Patients in a manic phase can stimulate each other's manic behaviors, leading to increased
agitation, poor impulse control, and potential safety risks. Separating them prevents escalation of
symptoms and maintains a calm environment.
Option A rationale: Placing two manic patients together can exacerbate symptoms and create safety
concerns.
Option B rationale: A stimulating environment would further agitate a patient in a manic state.
Option D rationale: Competitive activities may increase agitation and aggressive behavior.
4. Which nursing diagnosis is most appropriate for a patient with anorexia nervosa who exhibits
impaired mobility?
A) Risk for injury related to muscle weakness
B) Imbalanced nutrition: less than body requirements
C) Risk for infection
D) Disturbed body image
ANSWER: A) Risk for injury related to muscle weakness
Rationale: The exam notes specifically identify "Risk for injury - Impaired Mobility" as a key nursing
diagnosis for anorexia nervosa. Muscle weakness and impaired mobility create significant fall risk and
injury potential.
Option B rationale: While nutritional imbalance is present, the question specifically addresses the
mobility impairment.
Option C rationale: Infection risk may exist but is not directly related to impaired mobility.
, Option D rationale: Body image disturbance is important but not the priority when mobility is impaired.
5. The nurse is assessing a patient with bulimia nervosa. Which clinical finding would the nurse expect to
observe?
A) Dental erosion
B) Lanugo hair
C) Bradycardia
D) Amenorrhea
ANSWER: A) Dental erosion
Rationale: Bulimia nervosa involves recurrent episodes of binge eating followed by compensatory
behaviors such as self-induced vomiting. The gastric acid from vomiting erodes tooth enamel, leading to
dental erosion. The exam notes specifically identify dental erosion as a key finding.
Option B rationale: Lanugo hair is associated with anorexia nervosa, not bulimia.
Option C rationale: Bradycardia is more commonly associated with anorexia nervosa.
Option D rationale: Amenorrhea is associated with anorexia nervosa, not bulimia.
6. Which laboratory finding is most critical to monitor in a patient with bulimia nervosa?
A) Complete blood count
B) Serum potassium levels
C) Liver function tests
D) Thyroid function tests
ANSWER: B) Serum potassium levels
