NUR 356 Final Exam: Mental Health Theory & Application
V3 - Arizona College Updated and Latest Questions and
Correct Answers with Rationale
1. A client with schizophrenia is started on Clozapine. Which laboratory value is the priority for the nurse to
monitor?
A. Blood glucose levels
B. Serum potassium
C. White blood cell (WBC) count
D. Liver function tests
Ans: C
Explanation: Clozapine is an atypical antipsychotic that carries a significant risk for agranulocytosis. The
nurse must monitor the WBC count and absolute neutrophil count weekly at the start of therapy. If the
WBC count drops below a specific threshold, the medication must be discontinued immediately. This
intervention prevents life-threatening infections caused by a severely compromised immune system.
While glucose and liver tests are important, the immediate safety risk lies in bone marrow suppression.
2. A nurse is assessing a client for lithium toxicity. Which of the following findings should the nurse identify
as an early sign of toxicity?
A. Diarrhea and vomiting
B. Coarse hand tremors
C. Severe hypotension
D. Seizures
Ans: A
,Explanation: Early lithium toxicity usually manifests as gastrointestinal distress such as nausea,
vomiting, or diarrhea. These symptoms occur when the serum lithium level exceeds the narrow
therapeutic range of 0.6 to 1.2 mEq/L. Coarse tremors and seizures are typically indicative of more
advanced or severe toxicity levels. The nurse should educate the client to report these early signs
immediately to prevent further escalation. Maintaining adequate sodium and fluid intake is essential to
preventing lithium accumulation in the body.
3. A client is experiencing a manic episode. Which of the following nursing interventions is the priority?
A. Encouraging participation in group therapy
B. Administering high-dose sedatives
C. Setting strict limits on behavior
D. Providing high-calorie finger foods
Ans: D
Explanation: Clients in a manic state are often hyperactive and cannot sit still long enough to eat a full
meal. Providing high-calorie finger foods allows the client to maintain nutrition while remaining mobile.
This intervention addresses the physical risk of exhaustion and weight loss associated with mania. Group
therapy is often too stimulating and counterproductive during an acute manic phase. Safety and
nutritional maintenance are the core focuses of care during this period.
4. A nurse is caring for a client with Borderline Personality Disorder who is ‘splitting’ staff members. How
should the nurse respond?
A. Hold a staff meeting to ensure a consistent approach
B. Confront the client about their manipulative behavior
C. Allow the client to choose which nurse they prefer
, D. Ignore the behavior until the client stops
Ans: A
Explanation: Splitting is a common defense mechanism where a client views people as either all good or
all bad. Consistency among the treatment team is vital to prevent the client from playing staff against one
another. Regular staff meetings help align care plans and maintain professional boundaries with the
client. Confronting the client aggressively may worsen the situation and damage the therapeutic
relationship. The goal is to provide a stable milieu that discourages manipulative interpersonal dynamics.
5. A client has been prescribed a Monoamine Oxidase Inhibitor (MAOI). Which food choice indicates the
client understands the dietary restrictions?
A. Pepperoni pizza
B. Avocado salad with red wine
C. Aged cheddar cheese and crackers
D. Grilled chicken and broccoli
Ans: D
Explanation: Clients taking MAOIs must follow a low-tyramine diet to avoid a hypertensive crisis. Foods
like aged cheeses, cured meats, and red wine are high in tyramine and must be avoided. Grilled chicken
and fresh vegetables are safe options that do not contain tyramine. The nurse should teach the client that
a hypertensive crisis is a medical emergency characterized by a severe headache. Constant vigilance
regarding dietary intake is necessary for the duration of the drug therapy.
6. Which of the following is a symptom of Neuroleptic Malignant Syndrome (NMS)?
A. Hypothermia
B. Severe muscle rigidity
V3 - Arizona College Updated and Latest Questions and
Correct Answers with Rationale
1. A client with schizophrenia is started on Clozapine. Which laboratory value is the priority for the nurse to
monitor?
A. Blood glucose levels
B. Serum potassium
C. White blood cell (WBC) count
D. Liver function tests
Ans: C
Explanation: Clozapine is an atypical antipsychotic that carries a significant risk for agranulocytosis. The
nurse must monitor the WBC count and absolute neutrophil count weekly at the start of therapy. If the
WBC count drops below a specific threshold, the medication must be discontinued immediately. This
intervention prevents life-threatening infections caused by a severely compromised immune system.
While glucose and liver tests are important, the immediate safety risk lies in bone marrow suppression.
2. A nurse is assessing a client for lithium toxicity. Which of the following findings should the nurse identify
as an early sign of toxicity?
A. Diarrhea and vomiting
B. Coarse hand tremors
C. Severe hypotension
D. Seizures
Ans: A
,Explanation: Early lithium toxicity usually manifests as gastrointestinal distress such as nausea,
vomiting, or diarrhea. These symptoms occur when the serum lithium level exceeds the narrow
therapeutic range of 0.6 to 1.2 mEq/L. Coarse tremors and seizures are typically indicative of more
advanced or severe toxicity levels. The nurse should educate the client to report these early signs
immediately to prevent further escalation. Maintaining adequate sodium and fluid intake is essential to
preventing lithium accumulation in the body.
3. A client is experiencing a manic episode. Which of the following nursing interventions is the priority?
A. Encouraging participation in group therapy
B. Administering high-dose sedatives
C. Setting strict limits on behavior
D. Providing high-calorie finger foods
Ans: D
Explanation: Clients in a manic state are often hyperactive and cannot sit still long enough to eat a full
meal. Providing high-calorie finger foods allows the client to maintain nutrition while remaining mobile.
This intervention addresses the physical risk of exhaustion and weight loss associated with mania. Group
therapy is often too stimulating and counterproductive during an acute manic phase. Safety and
nutritional maintenance are the core focuses of care during this period.
4. A nurse is caring for a client with Borderline Personality Disorder who is ‘splitting’ staff members. How
should the nurse respond?
A. Hold a staff meeting to ensure a consistent approach
B. Confront the client about their manipulative behavior
C. Allow the client to choose which nurse they prefer
, D. Ignore the behavior until the client stops
Ans: A
Explanation: Splitting is a common defense mechanism where a client views people as either all good or
all bad. Consistency among the treatment team is vital to prevent the client from playing staff against one
another. Regular staff meetings help align care plans and maintain professional boundaries with the
client. Confronting the client aggressively may worsen the situation and damage the therapeutic
relationship. The goal is to provide a stable milieu that discourages manipulative interpersonal dynamics.
5. A client has been prescribed a Monoamine Oxidase Inhibitor (MAOI). Which food choice indicates the
client understands the dietary restrictions?
A. Pepperoni pizza
B. Avocado salad with red wine
C. Aged cheddar cheese and crackers
D. Grilled chicken and broccoli
Ans: D
Explanation: Clients taking MAOIs must follow a low-tyramine diet to avoid a hypertensive crisis. Foods
like aged cheeses, cured meats, and red wine are high in tyramine and must be avoided. Grilled chicken
and fresh vegetables are safe options that do not contain tyramine. The nurse should teach the client that
a hypertensive crisis is a medical emergency characterized by a severe headache. Constant vigilance
regarding dietary intake is necessary for the duration of the drug therapy.
6. Which of the following is a symptom of Neuroleptic Malignant Syndrome (NMS)?
A. Hypothermia
B. Severe muscle rigidity
