NUR 253 Exam 2 V3 | Mental
Health Nursing Q&A with Rationale
| Galen College of Nursing
1. A nurse is caring for a client who is experiencing a manic episode. Which of the following
activities should the nurse recommend?
A. Attending a group therapy session with fifteen other peers.
B. Participating in a competitive game of basketball.
C. Writing in a journal in a quiet area.
D. Leading a fast-paced aerobics class for the unit.
Correct Answer: C
Expert Explanation: Writing in a journal provides a low-stimulus activity that helps the
client focus their energy without overstimulation. Manic clients benefit from a calm
environment to prevent the escalation of symptoms. High-energy or group activities can be
too distracting or provocative during an acute phase.
2. A client is admitted for major depressive disorder and expresses feelings of worthlessness.
Which nursing action is a priority?
A. Encouraging the client to attend all group sessions.
B. Helping the client identify personal strengths and past successes.
,C. Teaching the client about the side effects of SSRIs.
D. Assessing the client for suicidal ideation or a plan.
Correct Answer: D
Expert Explanation: Safety is the highest priority when managing a client with severe
depression. Assessing for suicidal intent allows the nurse to implement necessary safety
precautions immediately. While building self-esteem and education are important, they
follow the establishment of physical safety.
3. A nurse is educating a client starting Lithium Carbonate for Bipolar Disorder. Which
statement by the client indicates understanding?
A. “I should restrict my salt intake to keep the medication level high.”
B. “If I feel nauseous, I should double my dose to compensate.”
C. “I will drink 2 to 3 liters of fluid daily to stay hydrated.”
D. “I can stop taking the medication once my mood feels stable.”
Correct Answer: C
Expert Explanation: Adequate hydration is essential for clients taking lithium to maintain
therapeutic levels and prevent toxicity. Sodium intake should remain consistent rather
than restricted, as low sodium can lead to lithium retention. The client must understand
that the medication is for long-term maintenance and requires blood monitoring.
, 4. Which of the following is a symptom of Neuroleptic Malignant Syndrome (NMS)?
A. Hypotension and bradycardia.
B. Extreme muscle rigidity and high fever.
C. Increased appetite and weight gain.
D. Hyperactivity and pressured speech.
Correct Answer: B
Expert Explanation: NMS is a life-threatening complication of antipsychotic medications
characterized by lead-pipe muscle rigidity and hyperpyrexia. It is considered a medical
emergency that requires immediate discontinuation of the offending drug. Supportive care
such as cooling blankets and hydration is typically initiated.
5. A nurse is using therapeutic communication with a client who says, ‘I feel like nobody cares
about me.’ Which response is most appropriate?
A. “Why do you feel that way?”
B. “I’m sure your family cares about you very much.”
C. “You shouldn’t feel that way because we are here for you.”
D. “It sounds like you are feeling very lonely right now.”
Correct Answer: D
Expert Explanation: Reflecting the client’s feelings validates their emotional experience
and encourages further communication. Using ‘why’ questions can make a client feel
Health Nursing Q&A with Rationale
| Galen College of Nursing
1. A nurse is caring for a client who is experiencing a manic episode. Which of the following
activities should the nurse recommend?
A. Attending a group therapy session with fifteen other peers.
B. Participating in a competitive game of basketball.
C. Writing in a journal in a quiet area.
D. Leading a fast-paced aerobics class for the unit.
Correct Answer: C
Expert Explanation: Writing in a journal provides a low-stimulus activity that helps the
client focus their energy without overstimulation. Manic clients benefit from a calm
environment to prevent the escalation of symptoms. High-energy or group activities can be
too distracting or provocative during an acute phase.
2. A client is admitted for major depressive disorder and expresses feelings of worthlessness.
Which nursing action is a priority?
A. Encouraging the client to attend all group sessions.
B. Helping the client identify personal strengths and past successes.
,C. Teaching the client about the side effects of SSRIs.
D. Assessing the client for suicidal ideation or a plan.
Correct Answer: D
Expert Explanation: Safety is the highest priority when managing a client with severe
depression. Assessing for suicidal intent allows the nurse to implement necessary safety
precautions immediately. While building self-esteem and education are important, they
follow the establishment of physical safety.
3. A nurse is educating a client starting Lithium Carbonate for Bipolar Disorder. Which
statement by the client indicates understanding?
A. “I should restrict my salt intake to keep the medication level high.”
B. “If I feel nauseous, I should double my dose to compensate.”
C. “I will drink 2 to 3 liters of fluid daily to stay hydrated.”
D. “I can stop taking the medication once my mood feels stable.”
Correct Answer: C
Expert Explanation: Adequate hydration is essential for clients taking lithium to maintain
therapeutic levels and prevent toxicity. Sodium intake should remain consistent rather
than restricted, as low sodium can lead to lithium retention. The client must understand
that the medication is for long-term maintenance and requires blood monitoring.
, 4. Which of the following is a symptom of Neuroleptic Malignant Syndrome (NMS)?
A. Hypotension and bradycardia.
B. Extreme muscle rigidity and high fever.
C. Increased appetite and weight gain.
D. Hyperactivity and pressured speech.
Correct Answer: B
Expert Explanation: NMS is a life-threatening complication of antipsychotic medications
characterized by lead-pipe muscle rigidity and hyperpyrexia. It is considered a medical
emergency that requires immediate discontinuation of the offending drug. Supportive care
such as cooling blankets and hydration is typically initiated.
5. A nurse is using therapeutic communication with a client who says, ‘I feel like nobody cares
about me.’ Which response is most appropriate?
A. “Why do you feel that way?”
B. “I’m sure your family cares about you very much.”
C. “You shouldn’t feel that way because we are here for you.”
D. “It sounds like you are feeling very lonely right now.”
Correct Answer: D
Expert Explanation: Reflecting the client’s feelings validates their emotional experience
and encourages further communication. Using ‘why’ questions can make a client feel
