NUR253 Exam 2 V3 | Mental Health
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is communicating with a client who has a diagnosis of major depressive disorder.
Which of the following statements by the nurse is an example of therapeutic communication?
A. ‘Why are you feeling so sad today?’
B. ‘Tell me more about how you have been feeling lately.’
C. ‘Everything will be okay once the medication starts working.’
D. ‘I think you should try to get out of bed and walk more.’
Answer: B
Rationale: The statement ‘Tell me more about how you have been feeling lately’ is an
open-ended question that encourages the client to express themselves. Open-ended
questions are a key component of therapeutic communication because they do not limit the
client’s response. This approach allows the nurse to gather more information and shows
the client that their feelings are being heard.
2. A client is prescribed lithium carbonate for bipolar disorder. Which of the following
laboratory values should the nurse monitor most closely for potential toxicity?
A. Serum potassium levels
B. Serum lithium levels
,C. White blood cell count
D. Blood glucose levels
Answer: B
Rationale: Monitoring serum lithium levels is crucial because the therapeutic window for
lithium is very narrow, typically between 0.6 and 1.2 mEq/L. Levels exceeding 1.5 mEq/L
can lead to toxicity, which manifests as severe GI upset, tremors, and confusion. Regular
monitoring ensures the dosage is effective while preventing life-threatening complications
associated with high levels.
3. A nurse is caring for a client who is experiencing a manic episode. Which of the following
interventions is the highest priority?
A. Ensuring the client participates in group therapy sessions.
B. Assigning the client a detailed writing task.
C. Encouraging the client to eat three large meals a day.
D. Providing a quiet environment with low stimuli.
Answer: D
Rationale: Reducing environmental stimuli is a priority for a client in a manic state to help
decrease agitation and promote safety. A quiet environment helps prevent the
overstimulation that can exacerbate manic symptoms such as hyperactivity and
distractibility. It also aids in the client’s ability to focus and potentially rest during high-
energy periods.
, 4. A nurse is assessing a client for the risk of suicide. Which of the following findings should
the nurse identify as the most significant risk factor?
A. A detailed plan with access to a lethal method.
B. The client lives with their spouse and children.
C. A history of hypertension and diabetes.
D. Recent participation in a community volunteer group.
Answer: A
Rationale: A detailed suicide plan combined with the means to carry it out represents the
highest immediate risk for self-harm. Nurses must evaluate the lethality of the method and
the availability of the tools intended for the act. Absence of a support system or protective
factors further increases this risk, but a concrete plan is the most urgent indicator.
5. A client with schizophrenia is experiencing auditory hallucinations. What is the most
appropriate initial response by the nurse?
A. ‘I don’t hear any voices; you are just imagining them.’
B. ‘I understand the voices are real to you, but I do not hear them.’
C. ‘What are the voices telling you to do?’
D. ‘You need to ignore the voices and focus on reality.’
Answer: B
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is communicating with a client who has a diagnosis of major depressive disorder.
Which of the following statements by the nurse is an example of therapeutic communication?
A. ‘Why are you feeling so sad today?’
B. ‘Tell me more about how you have been feeling lately.’
C. ‘Everything will be okay once the medication starts working.’
D. ‘I think you should try to get out of bed and walk more.’
Answer: B
Rationale: The statement ‘Tell me more about how you have been feeling lately’ is an
open-ended question that encourages the client to express themselves. Open-ended
questions are a key component of therapeutic communication because they do not limit the
client’s response. This approach allows the nurse to gather more information and shows
the client that their feelings are being heard.
2. A client is prescribed lithium carbonate for bipolar disorder. Which of the following
laboratory values should the nurse monitor most closely for potential toxicity?
A. Serum potassium levels
B. Serum lithium levels
,C. White blood cell count
D. Blood glucose levels
Answer: B
Rationale: Monitoring serum lithium levels is crucial because the therapeutic window for
lithium is very narrow, typically between 0.6 and 1.2 mEq/L. Levels exceeding 1.5 mEq/L
can lead to toxicity, which manifests as severe GI upset, tremors, and confusion. Regular
monitoring ensures the dosage is effective while preventing life-threatening complications
associated with high levels.
3. A nurse is caring for a client who is experiencing a manic episode. Which of the following
interventions is the highest priority?
A. Ensuring the client participates in group therapy sessions.
B. Assigning the client a detailed writing task.
C. Encouraging the client to eat three large meals a day.
D. Providing a quiet environment with low stimuli.
Answer: D
Rationale: Reducing environmental stimuli is a priority for a client in a manic state to help
decrease agitation and promote safety. A quiet environment helps prevent the
overstimulation that can exacerbate manic symptoms such as hyperactivity and
distractibility. It also aids in the client’s ability to focus and potentially rest during high-
energy periods.
, 4. A nurse is assessing a client for the risk of suicide. Which of the following findings should
the nurse identify as the most significant risk factor?
A. A detailed plan with access to a lethal method.
B. The client lives with their spouse and children.
C. A history of hypertension and diabetes.
D. Recent participation in a community volunteer group.
Answer: A
Rationale: A detailed suicide plan combined with the means to carry it out represents the
highest immediate risk for self-harm. Nurses must evaluate the lethality of the method and
the availability of the tools intended for the act. Absence of a support system or protective
factors further increases this risk, but a concrete plan is the most urgent indicator.
5. A client with schizophrenia is experiencing auditory hallucinations. What is the most
appropriate initial response by the nurse?
A. ‘I don’t hear any voices; you are just imagining them.’
B. ‘I understand the voices are real to you, but I do not hear them.’
C. ‘What are the voices telling you to do?’
D. ‘You need to ignore the voices and focus on reality.’
Answer: B
