NR 326 Mental Health Nursing
ACTUAL EXAM 2025/2026 | Exam
3 Comprehensive Review | 100
Questions | Chamberlain University |
Verified Solutions | Pass Guaranteed -
A+ Graded
SECTION 1: MOOD DISORDERS (DEPRESSION AND
BIPOLAR)
Q1: A client with bipolar disorder is admitted in an acute manic episode. Which
nursing intervention is the priority during the first 24 hours?
A. Encourage participation in group therapy.
B. Provide high-calorie finger foods and fluids. [CORRECT]
C. Allow the client to walk freely in the hallway.
D. Limit family visits to once daily.
Correct Answer: B
Rationale: Clients in acute mania are hyperactive, distractible, and often neglect
nutrition/hydration, leading to dehydration and malnutrition. High-calorie finger foods and
fluids support metabolic needs and prevent exhaustion. Group therapy (A) may overstimulate
the client. Free walking (C) risks elopement or injury. Family visits (D) are secondary to
physiological stability.
Chamberlain Note: Mania = HYPERACTIVITY + POOR NUTRITION—prioritize safety and
basic needs!
,Q2: A client with major depressive disorder (MDD) has taken fluoxetine
(Prozac) for 4 weeks and reports no improvement. What is the nurse’s best
response?
A. "It may take 6–8 weeks to feel the full therapeutic effect." [CORRECT]
B. "I will contact your provider to request a different medication."
C. "Maybe you need to increase your dose; let me talk to the doctor."
D. "Are you sure you have been taking it every day as prescribed?"
Correct Answer: A
Rationale: SSRIs like fluoxetine require 4–8 weeks for full therapeutic effect. The client is at 4
weeks, so more time is needed. Option B is premature. Option C suggests dose adjustment
without provider input. Option D is accusatory and non-therapeutic.
Chamberlain Note: SSRIs take TIME—educate clients on realistic expectations!
Q3: A client with bipolar disorder is prescribed lithium. Which laboratory value
should the nurse monitor to assess therapeutic effectiveness?
A. Sodium
B. Lithium level (0.6–1.2 mEq/L) [CORRECT]
C. Potassium
D. Calcium
Correct Answer: B
Rationale: Lithium’s therapeutic range is 0.6–1.2 mEq/L. Levels >1.5 mEq/L risk toxicity
(tremors, nausea, confusion, seizures). Sodium (A), potassium (C), and calcium (D) are
unrelated to lithium’s therapeutic effect.
Chamberlain Note: Lithium levels = CRITICAL—monitor for toxicity (nausea, tremors,
confusion)!
Q4: A client with bipolar disorder is experiencing a manic episode. Which
behavior is most characteristic of this phase?
A. Social withdrawal and anhedonia
B. Pressured speech, grandiosity, and risk-taking [CORRECT]
C. Flat affect and psychomotor retardation
D. Excessive guilt and suicidal ideation
Correct Answer: B
Rationale: Manic episodes feature pressured speech, grandiosity, hyperactivity, poor
,judgment, and risk-taking. Social withdrawal (A), flat affect (C), and guilt (D) are depressive
symptoms.
Chamberlain Note: Mania = HIGH ENERGY + POOR JUDGMENT —safety is the priority!
Q5: A client with major depressive disorder (MDD) is started on sertraline
(Zoloft). Which side effect should the nurse monitor for in the first 2 weeks?
A. Hypotension
B. Increased suicidal ideation [CORRECT]
C. Sedation
D. Dry mouth
Correct Answer: B
Rationale: SSRIs like sertraline may increase suicidal ideation in the first 1–2 weeks before
therapeutic effects occur. Hypotension (A) is rare. Sedation (C) and dry mouth (D) are possible
but less urgent than suicide risk.
Chamberlain Note: SSRIs + early treatment = MONITOR SUICIDE RISK CLOSELY!
Q6: A client with bipolar disorder is prescribed valproate (Depakote). Which
laboratory test should the nurse monitor regularly?
A. Thyroid-stimulating hormone (TSH)
B. Liver function tests (LFTs) [CORRECT]
C. Complete blood count (CBC)
D. Electrolytes
Correct Answer: B
Rationale: Valproate can cause hepatotoxicity, so LFTs are monitored. TSH (A) is for lithium.
CBC (C) and electrolytes (D) are less specific.
Chamberlain Note: Valproate = LIVER TOXICITY RISK—monitor LFTs!
Q7: A client with bipolar disorder is experiencing rapid cycling. Which
medication is most appropriate for this condition?
A. Lithium
B. Lamotrigine (Lamictal) [CORRECT]
C. Haloperidol (Haldol)
D. Fluoxetine (Prozac)
, Correct Answer: B
Rationale: Lamotrigine is FDA-approved for bipolar maintenance and rapid cycling.
Lithium (A) is less effective for rapid cycling. Haloperidol (C) is an antipsychotic. Fluoxetine (D) is
an antidepressant and contraindicated in bipolar disorder (risk of inducing mania).
Chamberlain Note: Rapid cycling = LAMOTRIGINE—avoid antidepressants!
Q8: A client with bipolar disorder is admitted for a depressive episode. Which
nursing diagnosis is most appropriate?
A. Risk for violence
B. Ineffective coping [CORRECT]
C. Disturbed sensory perception
D. Impaired social interaction
Correct Answer: B
Rationale: Ineffective coping reflects the client’s difficulty managing depressive
symptoms. Risk for violence (A) is more relevant to mania. Disturbed sensory perception (C)
and impaired social interaction (D) are less priority.
Chamberlain Note: Depression = COPING DEFICITS—focus on support and
problem-solving!
Q9: A client with bipolar disorder is prescribed carbamazepine (Tegretol).
Which teaching point is most important?
A. "Take this medication with food to prevent nausea."
B. "Report any rash or fever immediately." [CORRECT]
C. "Avoid grapefruit juice while taking this medication."
D. "You may experience weight gain with this drug."
Correct Answer: B
Rationale: Carbamazepine can cause Stevens-Johnson syndrome (severe rash) or
agranulocytosis (fever, sore throat). Clients must report these symptoms immediately.
Nausea (A), grapefruit (C), and weight gain (D) are less urgent.
Chamberlain Note: Carbamazepine = RASH/FEVER = EMERGENCY!
Q10: A client with major depressive disorder (MDD) is prescribed phenelzine
(Nardil), an MAOI. Which food should the nurse instruct the client to avoid?
ACTUAL EXAM 2025/2026 | Exam
3 Comprehensive Review | 100
Questions | Chamberlain University |
Verified Solutions | Pass Guaranteed -
A+ Graded
SECTION 1: MOOD DISORDERS (DEPRESSION AND
BIPOLAR)
Q1: A client with bipolar disorder is admitted in an acute manic episode. Which
nursing intervention is the priority during the first 24 hours?
A. Encourage participation in group therapy.
B. Provide high-calorie finger foods and fluids. [CORRECT]
C. Allow the client to walk freely in the hallway.
D. Limit family visits to once daily.
Correct Answer: B
Rationale: Clients in acute mania are hyperactive, distractible, and often neglect
nutrition/hydration, leading to dehydration and malnutrition. High-calorie finger foods and
fluids support metabolic needs and prevent exhaustion. Group therapy (A) may overstimulate
the client. Free walking (C) risks elopement or injury. Family visits (D) are secondary to
physiological stability.
Chamberlain Note: Mania = HYPERACTIVITY + POOR NUTRITION—prioritize safety and
basic needs!
,Q2: A client with major depressive disorder (MDD) has taken fluoxetine
(Prozac) for 4 weeks and reports no improvement. What is the nurse’s best
response?
A. "It may take 6–8 weeks to feel the full therapeutic effect." [CORRECT]
B. "I will contact your provider to request a different medication."
C. "Maybe you need to increase your dose; let me talk to the doctor."
D. "Are you sure you have been taking it every day as prescribed?"
Correct Answer: A
Rationale: SSRIs like fluoxetine require 4–8 weeks for full therapeutic effect. The client is at 4
weeks, so more time is needed. Option B is premature. Option C suggests dose adjustment
without provider input. Option D is accusatory and non-therapeutic.
Chamberlain Note: SSRIs take TIME—educate clients on realistic expectations!
Q3: A client with bipolar disorder is prescribed lithium. Which laboratory value
should the nurse monitor to assess therapeutic effectiveness?
A. Sodium
B. Lithium level (0.6–1.2 mEq/L) [CORRECT]
C. Potassium
D. Calcium
Correct Answer: B
Rationale: Lithium’s therapeutic range is 0.6–1.2 mEq/L. Levels >1.5 mEq/L risk toxicity
(tremors, nausea, confusion, seizures). Sodium (A), potassium (C), and calcium (D) are
unrelated to lithium’s therapeutic effect.
Chamberlain Note: Lithium levels = CRITICAL—monitor for toxicity (nausea, tremors,
confusion)!
Q4: A client with bipolar disorder is experiencing a manic episode. Which
behavior is most characteristic of this phase?
A. Social withdrawal and anhedonia
B. Pressured speech, grandiosity, and risk-taking [CORRECT]
C. Flat affect and psychomotor retardation
D. Excessive guilt and suicidal ideation
Correct Answer: B
Rationale: Manic episodes feature pressured speech, grandiosity, hyperactivity, poor
,judgment, and risk-taking. Social withdrawal (A), flat affect (C), and guilt (D) are depressive
symptoms.
Chamberlain Note: Mania = HIGH ENERGY + POOR JUDGMENT —safety is the priority!
Q5: A client with major depressive disorder (MDD) is started on sertraline
(Zoloft). Which side effect should the nurse monitor for in the first 2 weeks?
A. Hypotension
B. Increased suicidal ideation [CORRECT]
C. Sedation
D. Dry mouth
Correct Answer: B
Rationale: SSRIs like sertraline may increase suicidal ideation in the first 1–2 weeks before
therapeutic effects occur. Hypotension (A) is rare. Sedation (C) and dry mouth (D) are possible
but less urgent than suicide risk.
Chamberlain Note: SSRIs + early treatment = MONITOR SUICIDE RISK CLOSELY!
Q6: A client with bipolar disorder is prescribed valproate (Depakote). Which
laboratory test should the nurse monitor regularly?
A. Thyroid-stimulating hormone (TSH)
B. Liver function tests (LFTs) [CORRECT]
C. Complete blood count (CBC)
D. Electrolytes
Correct Answer: B
Rationale: Valproate can cause hepatotoxicity, so LFTs are monitored. TSH (A) is for lithium.
CBC (C) and electrolytes (D) are less specific.
Chamberlain Note: Valproate = LIVER TOXICITY RISK—monitor LFTs!
Q7: A client with bipolar disorder is experiencing rapid cycling. Which
medication is most appropriate for this condition?
A. Lithium
B. Lamotrigine (Lamictal) [CORRECT]
C. Haloperidol (Haldol)
D. Fluoxetine (Prozac)
, Correct Answer: B
Rationale: Lamotrigine is FDA-approved for bipolar maintenance and rapid cycling.
Lithium (A) is less effective for rapid cycling. Haloperidol (C) is an antipsychotic. Fluoxetine (D) is
an antidepressant and contraindicated in bipolar disorder (risk of inducing mania).
Chamberlain Note: Rapid cycling = LAMOTRIGINE—avoid antidepressants!
Q8: A client with bipolar disorder is admitted for a depressive episode. Which
nursing diagnosis is most appropriate?
A. Risk for violence
B. Ineffective coping [CORRECT]
C. Disturbed sensory perception
D. Impaired social interaction
Correct Answer: B
Rationale: Ineffective coping reflects the client’s difficulty managing depressive
symptoms. Risk for violence (A) is more relevant to mania. Disturbed sensory perception (C)
and impaired social interaction (D) are less priority.
Chamberlain Note: Depression = COPING DEFICITS—focus on support and
problem-solving!
Q9: A client with bipolar disorder is prescribed carbamazepine (Tegretol).
Which teaching point is most important?
A. "Take this medication with food to prevent nausea."
B. "Report any rash or fever immediately." [CORRECT]
C. "Avoid grapefruit juice while taking this medication."
D. "You may experience weight gain with this drug."
Correct Answer: B
Rationale: Carbamazepine can cause Stevens-Johnson syndrome (severe rash) or
agranulocytosis (fever, sore throat). Clients must report these symptoms immediately.
Nausea (A), grapefruit (C), and weight gain (D) are less urgent.
Chamberlain Note: Carbamazepine = RASH/FEVER = EMERGENCY!
Q10: A client with major depressive disorder (MDD) is prescribed phenelzine
(Nardil), an MAOI. Which food should the nurse instruct the client to avoid?
