Exam 4 Mental Health
Comprehensive Psychiatric-Mental Health
Nursing Examination 2026
1. A client is brought to the emergency department by police after being found screaming in the park
and reporting hearing music when no music is playing. The nurse recognizes this as which type of
symptom?
A. Visual hallucinations
B. Auditory hallucinations
C. Delusional thinking
D. Disorganized speech
ANSWER B
Rationale:
Option A is incorrect because visual hallucinations involve seeing things that aren't present, not hearing
sounds.
Option B is correct because auditory hallucinations involve hearing sounds, voices, or music that have no
external source. The client hearing music when no music is playing is a classic example of auditory
hallucinations.
Option C is incorrect because delusions are false beliefs, not false perceptions. While the client may
have delusions, the specific symptom described is perceptual.
Option D is incorrect because disorganized speech refers to incoherent or illogical speech patterns, not
perceptual disturbances.
2. A nurse is caring for a client receiving ataxia-inducing medication. Which side effect should the nurse
monitor for?
,A. Insomnia
B. Increased appetite
C. Constipation
D. Hypertension
ANSWER A
Rationale:
Option A is correct because insomnia is a common side effect associated with medications that cause
ataxia and sedation effects. The nervous system disruption can interfere with normal sleep patterns.
Option B is incorrect because increased appetite is not typically associated with ataxia-related
medications.
Option C is incorrect because constipation is more commonly associated with anticholinergic
medications, not specifically ataxia.
Option D is incorrect because hypertension is not a typical side effect of ataxia-inducing medications;
hypotension is more common.
3. A child is prescribed methylphenidate for ADHD. Which side effects should the nurse teach the
parents to monitor? (Select All That Apply)
A. Headache
B. Lethargy
C. Increased appetite
D. Weight gain
E. Insomnia
ANSWER A, B
Rationale:
Option A is correct because headache is a common side effect of methylphenidate (Ritalin) in children.
Option B is correct because lethargy can occur with methylphenidate use, particularly as the medication
wears off or with improper dosing.
Option C is incorrect because methylphenidate typically causes decreased appetite, not increased
appetite.
Option D is incorrect because weight loss, not weight gain, is a common side effect due to appetite
suppression.
Option E is incorrect while insomnia can occur, the question specifically asks about HA and lethargy as
noted in standard side effect profiles.
,4. A nurse is called to testify in court about a client who completed suicide. The nurse's role in this
situation is best described as:
A. Character witness
B. Expert witness
C. Fact witness
D. Advocate witness
ANSWER B
Rationale:
Option A is incorrect because a character witness testifies about a person's general character traits, not
professional care provided.
Option B is correct because when a nurse testifies about professional standards of care, clinical
judgment, and whether appropriate nursing interventions were provided in a suicide case, they serve as
an expert witness.
Option C is incorrect because while the nurse may provide facts, in cases involving professional
standards and clinical judgment about suicide prevention, the nurse serves as an expert witness.
Option D is incorrect because "advocate witness" is not a recognized legal category of witness.
5. A client is prescribed clozapine for treatment-resistant schizophrenia. Which laboratory value is most
important for the nurse to monitor?
A. Liver function tests
B. White blood cell count
C. Blood glucose level
D. Thyroid function tests
ANSWER B
Rationale:
Option A is incorrect because while liver function should be monitored, it is not the priority with
clozapine.
Option B is correct because clozapine can cause agranulocytosis, a potentially life-threatening condition
characterized by a severe decrease in white blood cells (WBC < 4,000/mm³). Regular WBC monitoring is
essential.
Option C is incorrect because while clozapine can affect blood glucose, WBC monitoring takes priority
due to the risk of agranulocytosis.
Option D is incorrect because thyroid function is not the primary concern with clozapine therapy.
, 6. A forensic nurse is conducting an assessment. Which actions should the nurse include? (Select All That
Apply)
A. Collect and preserve evidence
B. Document findings objectively
C. Provide testimony in legal proceedings
D. Make judgments about guilt or innocence
E. Maintain chain of custody
ANSWER A, B, C, E
Rationale:
Option A is correct because collecting and preserving evidence is a primary role of the forensic nurse.
Option B is correct because objective documentation is essential for legal proceedings and maintaining
credibility.
Option C is correct because forensic nurses may be called to provide expert testimony about their
findings.
Option D is incorrect because determining guilt or innocence is the role of the legal system, not the
nurse.
Option E is correct because maintaining the chain of custody is critical for evidence to be admissible in
court.
7. A community health nurse is developing a primary prevention program for abuse. Which intervention
is most appropriate?
A. Providing crisis intervention services
B. Teaching stress management techniques
C. Implementing programs to increase self-esteem
D. Establishing support groups for victims
ANSWER C
Rationale:
Option A is incorrect because crisis intervention is secondary prevention, occurring after abuse has
happened.
Option B is incorrect because while stress management is helpful, it is not the most effective primary
prevention strategy.
Comprehensive Psychiatric-Mental Health
Nursing Examination 2026
1. A client is brought to the emergency department by police after being found screaming in the park
and reporting hearing music when no music is playing. The nurse recognizes this as which type of
symptom?
A. Visual hallucinations
B. Auditory hallucinations
C. Delusional thinking
D. Disorganized speech
ANSWER B
Rationale:
Option A is incorrect because visual hallucinations involve seeing things that aren't present, not hearing
sounds.
Option B is correct because auditory hallucinations involve hearing sounds, voices, or music that have no
external source. The client hearing music when no music is playing is a classic example of auditory
hallucinations.
Option C is incorrect because delusions are false beliefs, not false perceptions. While the client may
have delusions, the specific symptom described is perceptual.
Option D is incorrect because disorganized speech refers to incoherent or illogical speech patterns, not
perceptual disturbances.
2. A nurse is caring for a client receiving ataxia-inducing medication. Which side effect should the nurse
monitor for?
,A. Insomnia
B. Increased appetite
C. Constipation
D. Hypertension
ANSWER A
Rationale:
Option A is correct because insomnia is a common side effect associated with medications that cause
ataxia and sedation effects. The nervous system disruption can interfere with normal sleep patterns.
Option B is incorrect because increased appetite is not typically associated with ataxia-related
medications.
Option C is incorrect because constipation is more commonly associated with anticholinergic
medications, not specifically ataxia.
Option D is incorrect because hypertension is not a typical side effect of ataxia-inducing medications;
hypotension is more common.
3. A child is prescribed methylphenidate for ADHD. Which side effects should the nurse teach the
parents to monitor? (Select All That Apply)
A. Headache
B. Lethargy
C. Increased appetite
D. Weight gain
E. Insomnia
ANSWER A, B
Rationale:
Option A is correct because headache is a common side effect of methylphenidate (Ritalin) in children.
Option B is correct because lethargy can occur with methylphenidate use, particularly as the medication
wears off or with improper dosing.
Option C is incorrect because methylphenidate typically causes decreased appetite, not increased
appetite.
Option D is incorrect because weight loss, not weight gain, is a common side effect due to appetite
suppression.
Option E is incorrect while insomnia can occur, the question specifically asks about HA and lethargy as
noted in standard side effect profiles.
,4. A nurse is called to testify in court about a client who completed suicide. The nurse's role in this
situation is best described as:
A. Character witness
B. Expert witness
C. Fact witness
D. Advocate witness
ANSWER B
Rationale:
Option A is incorrect because a character witness testifies about a person's general character traits, not
professional care provided.
Option B is correct because when a nurse testifies about professional standards of care, clinical
judgment, and whether appropriate nursing interventions were provided in a suicide case, they serve as
an expert witness.
Option C is incorrect because while the nurse may provide facts, in cases involving professional
standards and clinical judgment about suicide prevention, the nurse serves as an expert witness.
Option D is incorrect because "advocate witness" is not a recognized legal category of witness.
5. A client is prescribed clozapine for treatment-resistant schizophrenia. Which laboratory value is most
important for the nurse to monitor?
A. Liver function tests
B. White blood cell count
C. Blood glucose level
D. Thyroid function tests
ANSWER B
Rationale:
Option A is incorrect because while liver function should be monitored, it is not the priority with
clozapine.
Option B is correct because clozapine can cause agranulocytosis, a potentially life-threatening condition
characterized by a severe decrease in white blood cells (WBC < 4,000/mm³). Regular WBC monitoring is
essential.
Option C is incorrect because while clozapine can affect blood glucose, WBC monitoring takes priority
due to the risk of agranulocytosis.
Option D is incorrect because thyroid function is not the primary concern with clozapine therapy.
, 6. A forensic nurse is conducting an assessment. Which actions should the nurse include? (Select All That
Apply)
A. Collect and preserve evidence
B. Document findings objectively
C. Provide testimony in legal proceedings
D. Make judgments about guilt or innocence
E. Maintain chain of custody
ANSWER A, B, C, E
Rationale:
Option A is correct because collecting and preserving evidence is a primary role of the forensic nurse.
Option B is correct because objective documentation is essential for legal proceedings and maintaining
credibility.
Option C is correct because forensic nurses may be called to provide expert testimony about their
findings.
Option D is incorrect because determining guilt or innocence is the role of the legal system, not the
nurse.
Option E is correct because maintaining the chain of custody is critical for evidence to be admissible in
court.
7. A community health nurse is developing a primary prevention program for abuse. Which intervention
is most appropriate?
A. Providing crisis intervention services
B. Teaching stress management techniques
C. Implementing programs to increase self-esteem
D. Establishing support groups for victims
ANSWER C
Rationale:
Option A is incorrect because crisis intervention is secondary prevention, occurring after abuse has
happened.
Option B is incorrect because while stress management is helpful, it is not the most effective primary
prevention strategy.
