NUR2459 Mental & Behavioral Health
Nursing
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study:
A 28-year-old female with a known diagnosis of Bipolar I Disorder is
admitted during a manic episode. She exhibits elevated mood, pressured
speech, and impulsivity while also refusing medication. Which
intervention best supports advanced nursing practice in this scenario?
a) Force medication administration using restraints.
b) Engage in a collaborative discussion that acknowledges her feelings
and educates her about potential risks.
c) Involve her family to enforce compliance without addressing her
concerns.
d) Observe without intervening until she becomes more cooperative.
- Correct ANS: b)
- Rationale: A collaborative approach that respects patient autonomy,
while educating about risks, is essential in mental health nursing. It
fosters a therapeutic alliance and reduces resistance to treatment.
2. Case Study:
A 40-year-old male with treatment-resistant major depressive disorder
and recent suicidal ideation is admitted following a suicide attempt.
Which assessment tool is most appropriate for ongoing evaluation of his
suicide risk?
a) Beck Depression Inventory
b) Columbia-Suicide Severity Rating Scale
c) Minnesota Multiphasic Personality Inventory (MMPI)
d) Hamilton Anxiety Scale
- Correct ANS: b)
- Rationale: The Columbia-Suicide Severity Rating Scale is specifically
designed to assess and monitor suicide risk, making it ideal for patients
with active suicidal ideation.
3. Case Study:
A 35-year-old patient presents with severe anxiety symptoms
©2025
,accompanied by co-occurring substance use. The patient exhibits signs of
withdrawal and agitation. What is the most suitable nursing
intervention?
a) Refer solely to a substance abuse specialist.
b) Initiate a dual-diagnosis treatment plan integrating mental health
and addiction interventions.
c) Administer benzodiazepines immediately for anxiety control without
addressing substance withdrawal.
d) Delay any intervention until withdrawal symptoms subside naturally.
- Correct ANS: b)
- Rationale: Patients with co-occurring disorders benefit most from an
integrated approach that addresses both mental health and substance
use concurrently.
4. Case Study:
A patient with post-traumatic stress disorder (PTSD) following prolonged
trauma participation in cognitive processing therapy begins to show signs
of re-traumatization. What is the most appropriate nursing action?
a) Discontinue therapy immediately.
b) Ensure a safe, supportive environment and collaborate with the
therapist to adjust the treatment plan.
c) Increase the frequency of exposure therapy sessions.
d) Advise the patient to avoid discussing traumatic memories
altogether.
- Correct ANS: b)
- Rationale: Safeguarding the patient’s emotional environment and
coordinating with the treatment team to tailor therapy are central to
mitigating re-traumatization.
5. Case Study:
A 50-year-old female with major depressive disorder experiences
significant side effects (restlessness and sleep disturbances) from her
current antidepressant regimen. Which step should the nurse take next?
a) Recommend she discontinue her medication immediately.
b) Communicate with the prescriber about possible dosage
©2025
, adjustments or regimen changes.
c) Reassure her that the side effects will resolve on their own.
d) Administer a sedative as needed without consulting the prescriber.
- Correct ANS: b)
- Rationale: Collaboration with the prescriber to modify the treatment
plan is an essential component of advanced nursing practice when
managing medication side effects.
6. Case Study:
A patient with borderline personality disorder is admitted for recurrent
self-harm behaviors. Which therapeutic communication strategy is most
appropriate?
a) Confront the self-harming behavior directly to deter future acts.
b) Maintain firm boundaries while empathizing with and validating the
patient’s emotional experience.
c) Ignore the behavior to promote patient independence.
d) Reprimand the patient to discourage self-harm.
- Correct ANS: b)
- Rationale: Validating the patient’s feelings while maintaining clear
boundaries is a best-practice approach in managing borderline
personality disorder.
7. Case Study:
A patient with schizophrenia expresses persecutory delusions, claiming
that her family is poisoning her. What is the most appropriate nursing
intervention?
a) Agree with her delusions to build trust.
b) Directly confront and challenge her delusional beliefs.
c) Acknowledge her feelings without reinforcing the delusional
content.
d) Dismiss her concerns as unimportant.
- Correct ANS: c)
- Rationale: Acknowledging the patient's distress without reinforcing
delusions is key to maintaining a therapeutic relationship while
supporting reality orientation.
©2025
Nursing
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study:
A 28-year-old female with a known diagnosis of Bipolar I Disorder is
admitted during a manic episode. She exhibits elevated mood, pressured
speech, and impulsivity while also refusing medication. Which
intervention best supports advanced nursing practice in this scenario?
a) Force medication administration using restraints.
b) Engage in a collaborative discussion that acknowledges her feelings
and educates her about potential risks.
c) Involve her family to enforce compliance without addressing her
concerns.
d) Observe without intervening until she becomes more cooperative.
- Correct ANS: b)
- Rationale: A collaborative approach that respects patient autonomy,
while educating about risks, is essential in mental health nursing. It
fosters a therapeutic alliance and reduces resistance to treatment.
2. Case Study:
A 40-year-old male with treatment-resistant major depressive disorder
and recent suicidal ideation is admitted following a suicide attempt.
Which assessment tool is most appropriate for ongoing evaluation of his
suicide risk?
a) Beck Depression Inventory
b) Columbia-Suicide Severity Rating Scale
c) Minnesota Multiphasic Personality Inventory (MMPI)
d) Hamilton Anxiety Scale
- Correct ANS: b)
- Rationale: The Columbia-Suicide Severity Rating Scale is specifically
designed to assess and monitor suicide risk, making it ideal for patients
with active suicidal ideation.
3. Case Study:
A 35-year-old patient presents with severe anxiety symptoms
©2025
,accompanied by co-occurring substance use. The patient exhibits signs of
withdrawal and agitation. What is the most suitable nursing
intervention?
a) Refer solely to a substance abuse specialist.
b) Initiate a dual-diagnosis treatment plan integrating mental health
and addiction interventions.
c) Administer benzodiazepines immediately for anxiety control without
addressing substance withdrawal.
d) Delay any intervention until withdrawal symptoms subside naturally.
- Correct ANS: b)
- Rationale: Patients with co-occurring disorders benefit most from an
integrated approach that addresses both mental health and substance
use concurrently.
4. Case Study:
A patient with post-traumatic stress disorder (PTSD) following prolonged
trauma participation in cognitive processing therapy begins to show signs
of re-traumatization. What is the most appropriate nursing action?
a) Discontinue therapy immediately.
b) Ensure a safe, supportive environment and collaborate with the
therapist to adjust the treatment plan.
c) Increase the frequency of exposure therapy sessions.
d) Advise the patient to avoid discussing traumatic memories
altogether.
- Correct ANS: b)
- Rationale: Safeguarding the patient’s emotional environment and
coordinating with the treatment team to tailor therapy are central to
mitigating re-traumatization.
5. Case Study:
A 50-year-old female with major depressive disorder experiences
significant side effects (restlessness and sleep disturbances) from her
current antidepressant regimen. Which step should the nurse take next?
a) Recommend she discontinue her medication immediately.
b) Communicate with the prescriber about possible dosage
©2025
, adjustments or regimen changes.
c) Reassure her that the side effects will resolve on their own.
d) Administer a sedative as needed without consulting the prescriber.
- Correct ANS: b)
- Rationale: Collaboration with the prescriber to modify the treatment
plan is an essential component of advanced nursing practice when
managing medication side effects.
6. Case Study:
A patient with borderline personality disorder is admitted for recurrent
self-harm behaviors. Which therapeutic communication strategy is most
appropriate?
a) Confront the self-harming behavior directly to deter future acts.
b) Maintain firm boundaries while empathizing with and validating the
patient’s emotional experience.
c) Ignore the behavior to promote patient independence.
d) Reprimand the patient to discourage self-harm.
- Correct ANS: b)
- Rationale: Validating the patient’s feelings while maintaining clear
boundaries is a best-practice approach in managing borderline
personality disorder.
7. Case Study:
A patient with schizophrenia expresses persecutory delusions, claiming
that her family is poisoning her. What is the most appropriate nursing
intervention?
a) Agree with her delusions to build trust.
b) Directly confront and challenge her delusional beliefs.
c) Acknowledge her feelings without reinforcing the delusional
content.
d) Dismiss her concerns as unimportant.
- Correct ANS: c)
- Rationale: Acknowledging the patient's distress without reinforcing
delusions is key to maintaining a therapeutic relationship while
supporting reality orientation.
©2025
