NUR 256 Psych Exam 3 Test – 2026
Edition with questions and well verified
answers
Question 1
A client with schizophrenia states, "The FBI is tracking my thoughts through the TV." How should the
nurse respond?
A. "The FBI does not track thoughts through TVs."
B. "I understand that feels very real to you, but I do not see a TV tracking you."
C. "Why do you believe the FBI is targeting you?"
D. "Let us discuss how the TV is controlling your thoughts."
Answer: B
Rationale: A is incorrect because arguing with delusions increases defensiveness. B is correct because it
acknowledges feelings without validating the delusion. C is incorrect because asking "why" increases
paranoia. D is incorrect because exploring delusion mechanics reinforces psychosis.
Question 2
A client taking clozapine develops a fever and sore throat. What is the priority action?
A. Administer acetaminophen.
B. Obtain a stat complete blood count (CBC).
C. Encourage fluid intake.
D. Place the client in isolation.
Answer: B
Rationale: A is incorrect because this masks the fever. B is correct because clozapine can cause
agranulocytosis, requiring immediate WBC evaluation. C is incorrect because it does not address the
infection risk. D is incorrect because medical evaluation is the priority.
,Question 3
Which client requires the nurse's immediate attention?
A. A client with bipolar disorder taking lithium with a level of 1.0 mEq/L.
B. A client taking phenelzine who ate aged cheese.
C. A client on haloperidol complaining of dry mouth.
D. A client on sertraline reporting mild insomnia.
Answer: B
Rationale: A is incorrect because 1.0 is therapeutic. B is correct because aged cheese with an MAOI can
cause a fatal hypertensive crisis. C is incorrect because dry mouth is a manageable anticholinergic effect.
D is incorrect because mild insomnia is a common, non-urgent SSRI side effect.
Question 4
A client with borderline personality disorder says, "You are the best nurse here; the others are useless."
This is an example of:
A. Projection
B. Splitting
C. Displacement
D. Sublimation
Answer: B
Rationale: A is incorrect because projection attributes one's own feelings to others. B is correct because
splitting is viewing people as all good or all bad. C is incorrect because displacement redirects emotions
to a safer target. D is incorrect because sublimation channels impulses into positive activities.
Question 5
A client in alcohol withdrawal is diaphoretic and reports seeing bugs on the wall. Which medication is
anticipated?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Buprenorphine
Answer: B
Rationale: A is incorrect because naloxone is for opioids. B is correct because benzodiazepines prevent
seizures and manage withdrawal symptoms. C is incorrect because disulfiram is for maintenance, not
acute withdrawal. D is incorrect because buprenorphine is for opioid withdrawal.
,Question 6
A client with anorexia nervosa has a potassium level of 2.8 mEq/L. What is the priority concern?
A. Renal failure
B. Cardiac dysrhythmias
C. Seizures
D. Respiratory depression
Answer: B
Rationale: A is incorrect because hypokalemia does not immediately cause renal failure. B is correct
because severe hypokalemia can cause fatal cardiac arrhythmias. C is incorrect because seizures are
more related to sodium imbalances. D is incorrect because respiratory depression is not the primary risk
of low potassium.
Question 7
A client with PTSD experiences a flashback. What is the best intervention?
A. Explore the traumatic event.
B. Use grounding techniques.
C. Leave the client alone.
D. Administer an antipsychotic.
Answer: B
Rationale: A is incorrect because exploring trauma during a flashback increases distress. B is correct
because grounding reorients the client to the present. C is incorrect because isolation increases fear. D is
incorrect because antipsychotics are not first-line for acute flashbacks.
Question 8
A client taking tranylcypromine asks about dietary restrictions. Which food must be avoided?
A. Fresh apples
B. Aged cheddar cheese
C. Baked chicken
D. White rice
Answer: B
Rationale: A is incorrect because fresh fruits are safe. B is correct because aged cheeses contain
tyramine, which can cause a hypertensive crisis with MAOIs. C is incorrect because fresh meats are safe.
D is incorrect because grains are safe.
, Question 9
A depressed client suddenly appears cheerful and gives away prized possessions. What is the priority
action?
A. Discharge the client.
B. Assess for suicide risk.
C. Document the improved mood.
D. Encourage group participation.
Answer: B
Rationale: A is incorrect because sudden improvement can indicate a suicide decision. B is correct
because the client may now have the energy to execute a suicide plan. C is incorrect because
documenting ignores the safety risk. D is incorrect because group participation is not the immediate
priority.
Question 10
A client on haloperidol develops a temperature of 104°F and lead-pipe rigidity. Which medication is
anticipated?
A. Dantrolene
B. Naloxone
C. Flumazenil
D. Protamine
Answer: A
Rationale: A is correct because dantrolene treats Neuroleptic Malignant Syndrome. B is incorrect
because naloxone reverses opioids. C is incorrect because flumazenil reverses benzodiazepines. D is
incorrect because protamine reverses heparin.
Question 11
A client with narcissistic personality disorder demands special privileges. How should the nurse
respond?
A. Argue about the rules.
B. Set firm, consistent limits.
C. Give in to avoid anger.
D. Ignore the demands.
Answer: B
Edition with questions and well verified
answers
Question 1
A client with schizophrenia states, "The FBI is tracking my thoughts through the TV." How should the
nurse respond?
A. "The FBI does not track thoughts through TVs."
B. "I understand that feels very real to you, but I do not see a TV tracking you."
C. "Why do you believe the FBI is targeting you?"
D. "Let us discuss how the TV is controlling your thoughts."
Answer: B
Rationale: A is incorrect because arguing with delusions increases defensiveness. B is correct because it
acknowledges feelings without validating the delusion. C is incorrect because asking "why" increases
paranoia. D is incorrect because exploring delusion mechanics reinforces psychosis.
Question 2
A client taking clozapine develops a fever and sore throat. What is the priority action?
A. Administer acetaminophen.
B. Obtain a stat complete blood count (CBC).
C. Encourage fluid intake.
D. Place the client in isolation.
Answer: B
Rationale: A is incorrect because this masks the fever. B is correct because clozapine can cause
agranulocytosis, requiring immediate WBC evaluation. C is incorrect because it does not address the
infection risk. D is incorrect because medical evaluation is the priority.
,Question 3
Which client requires the nurse's immediate attention?
A. A client with bipolar disorder taking lithium with a level of 1.0 mEq/L.
B. A client taking phenelzine who ate aged cheese.
C. A client on haloperidol complaining of dry mouth.
D. A client on sertraline reporting mild insomnia.
Answer: B
Rationale: A is incorrect because 1.0 is therapeutic. B is correct because aged cheese with an MAOI can
cause a fatal hypertensive crisis. C is incorrect because dry mouth is a manageable anticholinergic effect.
D is incorrect because mild insomnia is a common, non-urgent SSRI side effect.
Question 4
A client with borderline personality disorder says, "You are the best nurse here; the others are useless."
This is an example of:
A. Projection
B. Splitting
C. Displacement
D. Sublimation
Answer: B
Rationale: A is incorrect because projection attributes one's own feelings to others. B is correct because
splitting is viewing people as all good or all bad. C is incorrect because displacement redirects emotions
to a safer target. D is incorrect because sublimation channels impulses into positive activities.
Question 5
A client in alcohol withdrawal is diaphoretic and reports seeing bugs on the wall. Which medication is
anticipated?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Buprenorphine
Answer: B
Rationale: A is incorrect because naloxone is for opioids. B is correct because benzodiazepines prevent
seizures and manage withdrawal symptoms. C is incorrect because disulfiram is for maintenance, not
acute withdrawal. D is incorrect because buprenorphine is for opioid withdrawal.
,Question 6
A client with anorexia nervosa has a potassium level of 2.8 mEq/L. What is the priority concern?
A. Renal failure
B. Cardiac dysrhythmias
C. Seizures
D. Respiratory depression
Answer: B
Rationale: A is incorrect because hypokalemia does not immediately cause renal failure. B is correct
because severe hypokalemia can cause fatal cardiac arrhythmias. C is incorrect because seizures are
more related to sodium imbalances. D is incorrect because respiratory depression is not the primary risk
of low potassium.
Question 7
A client with PTSD experiences a flashback. What is the best intervention?
A. Explore the traumatic event.
B. Use grounding techniques.
C. Leave the client alone.
D. Administer an antipsychotic.
Answer: B
Rationale: A is incorrect because exploring trauma during a flashback increases distress. B is correct
because grounding reorients the client to the present. C is incorrect because isolation increases fear. D is
incorrect because antipsychotics are not first-line for acute flashbacks.
Question 8
A client taking tranylcypromine asks about dietary restrictions. Which food must be avoided?
A. Fresh apples
B. Aged cheddar cheese
C. Baked chicken
D. White rice
Answer: B
Rationale: A is incorrect because fresh fruits are safe. B is correct because aged cheeses contain
tyramine, which can cause a hypertensive crisis with MAOIs. C is incorrect because fresh meats are safe.
D is incorrect because grains are safe.
, Question 9
A depressed client suddenly appears cheerful and gives away prized possessions. What is the priority
action?
A. Discharge the client.
B. Assess for suicide risk.
C. Document the improved mood.
D. Encourage group participation.
Answer: B
Rationale: A is incorrect because sudden improvement can indicate a suicide decision. B is correct
because the client may now have the energy to execute a suicide plan. C is incorrect because
documenting ignores the safety risk. D is incorrect because group participation is not the immediate
priority.
Question 10
A client on haloperidol develops a temperature of 104°F and lead-pipe rigidity. Which medication is
anticipated?
A. Dantrolene
B. Naloxone
C. Flumazenil
D. Protamine
Answer: A
Rationale: A is correct because dantrolene treats Neuroleptic Malignant Syndrome. B is incorrect
because naloxone reverses opioids. C is incorrect because flumazenil reverses benzodiazepines. D is
incorrect because protamine reverses heparin.
Question 11
A client with narcissistic personality disorder demands special privileges. How should the nurse
respond?
A. Argue about the rules.
B. Set firm, consistent limits.
C. Give in to avoid anger.
D. Ignore the demands.
Answer: B
