NURS 201 MENTAL HEALTH AND
PSYCHIATRIC NURSING
COMPREHENSIVE EXAMINATION
1. A patient with schizophrenia is started on Clozapine. Which laboratory value is the priority
for the nurse to monitor?
A. Absolute Neutrophil Count (ANC)
B. Serum potassium levels
C. Liver function tests (ALT/AST)
D. Blood Urea Nitrogen (BUN)
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis, a potentially fatal
drop in white blood cell count. Monitoring the ANC is mandatory for patients receiving this
medication.
2. A nurse is caring for a client experiencing a manic episode. Which meal choice is most
appropriate for this client?
A. A steak and potato dinner with a side salad
,B. A bowl of hot chicken noodle soup
C. A ham and cheese wrap and an apple
D. Spaghetti and meatballs with garlic bread
Answer: C
Conceptual Explanation: Clients in a manic state are often hyperactive and unable to sit
down to eat. Portable, high-protein, high-calorie ‘finger foods’ like a wrap are most
appropriate.
3. A client is admitted for major depressive disorder. Which of the following statements by
the nurse illustrates the therapeutic technique of ‘offering self’?
A. ‘Why do you feel so sad today?’
B. ‘I will sit here with you for a while.’
C. ‘Most people feel better after a few days of medication.’
D. ‘You should try to participate in group therapy.’
Answer: B
Conceptual Explanation: ‘Offering self’ involves making oneself available to the client
without making demands, which helps build trust.
4. Which assessment finding is most characteristic of Neuroleptic Malignant Syndrome
(NMS)?
A. Hypotension and bradycardia
, B. Muscle flaccidity and diarrhea
C. Hypothermia and sedation
D. Severe muscle rigidity and hyperpyrexia
Answer: D
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ muscle rigidity, high fever (hyperpyrexia), and autonomic
instability.
5. A client with Borderline Personality Disorder (BPD) tells Nurse A, ‘You are the only one who
cares. Nurse B is so mean.’ This behavior is known as:
A. Splitting
B. Reaction formation
C. Projection
D. Rationalization
Answer: A
Conceptual Explanation: Splitting is a common defense mechanism in BPD where
individuals view others as ‘all good’ or ‘all bad,’ often causing conflict among staff.
6. A patient is prescribed Phenelzine (an MAOI). Which food should the nurse instruct the
patient to avoid?
A. Fresh green beans
PSYCHIATRIC NURSING
COMPREHENSIVE EXAMINATION
1. A patient with schizophrenia is started on Clozapine. Which laboratory value is the priority
for the nurse to monitor?
A. Absolute Neutrophil Count (ANC)
B. Serum potassium levels
C. Liver function tests (ALT/AST)
D. Blood Urea Nitrogen (BUN)
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis, a potentially fatal
drop in white blood cell count. Monitoring the ANC is mandatory for patients receiving this
medication.
2. A nurse is caring for a client experiencing a manic episode. Which meal choice is most
appropriate for this client?
A. A steak and potato dinner with a side salad
,B. A bowl of hot chicken noodle soup
C. A ham and cheese wrap and an apple
D. Spaghetti and meatballs with garlic bread
Answer: C
Conceptual Explanation: Clients in a manic state are often hyperactive and unable to sit
down to eat. Portable, high-protein, high-calorie ‘finger foods’ like a wrap are most
appropriate.
3. A client is admitted for major depressive disorder. Which of the following statements by
the nurse illustrates the therapeutic technique of ‘offering self’?
A. ‘Why do you feel so sad today?’
B. ‘I will sit here with you for a while.’
C. ‘Most people feel better after a few days of medication.’
D. ‘You should try to participate in group therapy.’
Answer: B
Conceptual Explanation: ‘Offering self’ involves making oneself available to the client
without making demands, which helps build trust.
4. Which assessment finding is most characteristic of Neuroleptic Malignant Syndrome
(NMS)?
A. Hypotension and bradycardia
, B. Muscle flaccidity and diarrhea
C. Hypothermia and sedation
D. Severe muscle rigidity and hyperpyrexia
Answer: D
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ muscle rigidity, high fever (hyperpyrexia), and autonomic
instability.
5. A client with Borderline Personality Disorder (BPD) tells Nurse A, ‘You are the only one who
cares. Nurse B is so mean.’ This behavior is known as:
A. Splitting
B. Reaction formation
C. Projection
D. Rationalization
Answer: A
Conceptual Explanation: Splitting is a common defense mechanism in BPD where
individuals view others as ‘all good’ or ‘all bad,’ often causing conflict among staff.
6. A patient is prescribed Phenelzine (an MAOI). Which food should the nurse instruct the
patient to avoid?
A. Fresh green beans
