NR 326 Mental Health Final Exam verified with correct answers and rationales 2026/2027
/instant pdf
1. A nurse is caring for a client admitted with major depressive disorder. Which
assessment finding requires the highest priority intervention?
A. The client reports sleeping 4 hours each night.
B. The client states, "My family would be better off without me."
C. The client has a poor appetite.
D. The client refuses to attend group therapy.
Correct Answer: B
Rationale: Statements suggesting hopelessness or that others would be better off without the
client indicate possible suicidal ideation and require immediate assessment and intervention.
2. Which therapeutic communication technique is demonstrated when the nurse
says, "Tell me more about what you're feeling today."
A. Giving advice
B. Asking an open-ended question
C. Changing the subject
D. Providing false reassurance
Correct Answer: B
Rationale: Open-ended questions encourage clients to explore their thoughts and feelings,
promoting therapeutic communication.
3. A client with generalized anxiety disorder is experiencing a panic attack. What
is the nurse's priority action?
A. Encourage the client to discuss past experiences.
B. Stay with the client and speak calmly using short, simple statements.
C. Teach relaxation techniques immediately.
D. Ask the client to complete admission paperwork.
Correct Answer: B
Rationale: During a panic attack, the priority is ensuring safety and reducing anxiety by
remaining with the client and using clear, simple communication.
,4. Which finding is most characteristic of mania?
A. Excessive energy, decreased need for sleep, and grandiosity
B. Withdrawal, hopelessness, and slowed speech
C. Flat affect and social isolation only
D. Persistent memory loss
Correct Answer: A
Rationale: Mania commonly presents with elevated mood, increased activity, grandiosity,
impulsivity, and reduced need for sleep.
5. A client with schizophrenia reports hearing voices saying, "You are
worthless." What is the nurse's best initial response?
A. "The voices are not real."
B. "I understand that the voices seem real to you. What are they saying?"
C. "Ignore the voices."
D. "Why do you think you're hearing voices?"
Correct Answer: B
Rationale: Acknowledge the client's experience without validating the hallucination and assess
the content, especially for safety concerns.
6. Which symptom is considered a positive symptom of schizophrenia?
A. Auditory hallucinations
B. Flat affect
C. Lack of motivation (avolition)
D. Social withdrawal
Correct Answer: A
Rationale: Positive symptoms add abnormal experiences, such as hallucinations, delusions, and
disorganized speech. Negative symptoms include flat affect and avolition.
,7. Which intervention is most appropriate for a client experiencing auditory
hallucinations?
A. Encourage the client to focus on reality-based activities.
B. Argue that the voices are imaginary.
C. Isolate the client from staff.
D. Reinforce the hallucinations.
Correct Answer: A
Rationale: Reality-oriented activities can help decrease the client's focus on hallucinations
without challenging the client's perception directly.
8. Which statement by a client suggests obsessive-compulsive disorder (OCD)?
A. "I have to wash my hands over and over or something bad will happen."
B. "I sleep only three hours because I have so much energy."
C. "People are reading my thoughts."
D. "Nothing makes me happy anymore."
Correct Answer: A
Rationale: OCD is characterized by intrusive thoughts (obsessions) and repetitive behaviors
(compulsions) aimed at reducing anxiety.
9. Which nursing intervention is most appropriate for a client with obsessive-
compulsive disorder?
A. Acknowledge the client's anxiety while encouraging healthier coping strategies.
B. Force the client to stop rituals immediately.
C. Participate in the compulsive behaviors.
D. Ignore the client's anxiety.
Correct Answer: A
Rationale: Recognizing the client's anxiety while gradually encouraging adaptive coping is
therapeutic. Abruptly stopping rituals can increase distress.
, 10. Which medication classification is commonly prescribed as first-line
treatment for major depressive disorder?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. Beta-blockers
C. Antihistamines
D. Antacids
Correct Answer: A
Rationale: SSRIs are frequently used as first-line medications because they are effective and
generally well tolerated.
11. A client taking lithium reports severe diarrhea, muscle weakness, and
unsteady gait. What should the nurse do first?
A. Suspect lithium toxicity and notify the provider promptly.
B. Encourage the client to take the next dose.
C. Reassure the client these are expected effects.
D. Restrict fluid intake.
Correct Answer: A
Rationale: These symptoms may indicate lithium toxicity, which requires prompt evaluation and
management.
12. Which laboratory test should be monitored regularly in a client taking
lithium?
A. Serum lithium level
B. Platelet count only
C. Blood glucose only
D. Cholesterol level only
Correct Answer: A
Rationale: Lithium has a narrow therapeutic range, making regular serum level monitoring
essential.
/instant pdf
1. A nurse is caring for a client admitted with major depressive disorder. Which
assessment finding requires the highest priority intervention?
A. The client reports sleeping 4 hours each night.
B. The client states, "My family would be better off without me."
C. The client has a poor appetite.
D. The client refuses to attend group therapy.
Correct Answer: B
Rationale: Statements suggesting hopelessness or that others would be better off without the
client indicate possible suicidal ideation and require immediate assessment and intervention.
2. Which therapeutic communication technique is demonstrated when the nurse
says, "Tell me more about what you're feeling today."
A. Giving advice
B. Asking an open-ended question
C. Changing the subject
D. Providing false reassurance
Correct Answer: B
Rationale: Open-ended questions encourage clients to explore their thoughts and feelings,
promoting therapeutic communication.
3. A client with generalized anxiety disorder is experiencing a panic attack. What
is the nurse's priority action?
A. Encourage the client to discuss past experiences.
B. Stay with the client and speak calmly using short, simple statements.
C. Teach relaxation techniques immediately.
D. Ask the client to complete admission paperwork.
Correct Answer: B
Rationale: During a panic attack, the priority is ensuring safety and reducing anxiety by
remaining with the client and using clear, simple communication.
,4. Which finding is most characteristic of mania?
A. Excessive energy, decreased need for sleep, and grandiosity
B. Withdrawal, hopelessness, and slowed speech
C. Flat affect and social isolation only
D. Persistent memory loss
Correct Answer: A
Rationale: Mania commonly presents with elevated mood, increased activity, grandiosity,
impulsivity, and reduced need for sleep.
5. A client with schizophrenia reports hearing voices saying, "You are
worthless." What is the nurse's best initial response?
A. "The voices are not real."
B. "I understand that the voices seem real to you. What are they saying?"
C. "Ignore the voices."
D. "Why do you think you're hearing voices?"
Correct Answer: B
Rationale: Acknowledge the client's experience without validating the hallucination and assess
the content, especially for safety concerns.
6. Which symptom is considered a positive symptom of schizophrenia?
A. Auditory hallucinations
B. Flat affect
C. Lack of motivation (avolition)
D. Social withdrawal
Correct Answer: A
Rationale: Positive symptoms add abnormal experiences, such as hallucinations, delusions, and
disorganized speech. Negative symptoms include flat affect and avolition.
,7. Which intervention is most appropriate for a client experiencing auditory
hallucinations?
A. Encourage the client to focus on reality-based activities.
B. Argue that the voices are imaginary.
C. Isolate the client from staff.
D. Reinforce the hallucinations.
Correct Answer: A
Rationale: Reality-oriented activities can help decrease the client's focus on hallucinations
without challenging the client's perception directly.
8. Which statement by a client suggests obsessive-compulsive disorder (OCD)?
A. "I have to wash my hands over and over or something bad will happen."
B. "I sleep only three hours because I have so much energy."
C. "People are reading my thoughts."
D. "Nothing makes me happy anymore."
Correct Answer: A
Rationale: OCD is characterized by intrusive thoughts (obsessions) and repetitive behaviors
(compulsions) aimed at reducing anxiety.
9. Which nursing intervention is most appropriate for a client with obsessive-
compulsive disorder?
A. Acknowledge the client's anxiety while encouraging healthier coping strategies.
B. Force the client to stop rituals immediately.
C. Participate in the compulsive behaviors.
D. Ignore the client's anxiety.
Correct Answer: A
Rationale: Recognizing the client's anxiety while gradually encouraging adaptive coping is
therapeutic. Abruptly stopping rituals can increase distress.
, 10. Which medication classification is commonly prescribed as first-line
treatment for major depressive disorder?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. Beta-blockers
C. Antihistamines
D. Antacids
Correct Answer: A
Rationale: SSRIs are frequently used as first-line medications because they are effective and
generally well tolerated.
11. A client taking lithium reports severe diarrhea, muscle weakness, and
unsteady gait. What should the nurse do first?
A. Suspect lithium toxicity and notify the provider promptly.
B. Encourage the client to take the next dose.
C. Reassure the client these are expected effects.
D. Restrict fluid intake.
Correct Answer: A
Rationale: These symptoms may indicate lithium toxicity, which requires prompt evaluation and
management.
12. Which laboratory test should be monitored regularly in a client taking
lithium?
A. Serum lithium level
B. Platelet count only
C. Blood glucose only
D. Cholesterol level only
Correct Answer: A
Rationale: Lithium has a narrow therapeutic range, making regular serum level monitoring
essential.
