FINAL EXAM STUDY GUIDE: NR326 / NR 326 MENTAL
HEALTH (LATEST UPDATE) | ALL
POSSIBLE AND CURRENTLY MOST TESTED 100
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS ANSWER KEY ALREADY A+ GRADED MOST
RECENT!!!
1. A client with schizophrenia tells the nurse, "The FBI is monitoring my thoughts
through the television." Which is the most appropriate initial therapeutic response
by the nurse?
A. "That must be very frightening for you."
B. "The FBI is not monitoring your thoughts."
C. "Let's talk about something else for a while."
D. "Why do you think the FBI is doing that?"
Correct Answer: A
Rationale: Option A validates the client's feelings without confirming the delusion,
which is a therapeutic communication technique. Options B and D challenge the
delusion directly, which can increase the client's anxiety and defensiveness. Option
C dismisses the client's concern and avoids addressing the underlying emotion,
thereby damaging the therapeutic alliance.
2. A nurse is assessing a client with major depressive disorder. Which of the
following findings would be most consistent with this diagnosis?
,A. Grandiose beliefs about personal abilities.
B. Excessive energy and a decreased need for sleep.
C. Persistent anhedonia and a flat affect.
D. Rapid, pressured speech and flight of ideas.
Correct Answer: C
Rationale: Anhedonia (loss of interest or pleasure) and flat or blunted affect are
hallmark symptoms of major depressive disorder. Options A, B, and D are
characteristic of manic or hypomanic episodes, which are associated with bipolar
disorder, not unipolar depression.
3. A client is experiencing severe anxiety and is unable to sit still, pacing back and
forth. The nurse should first:
A. Administer a PRN dose of lorazepam.
B. Place the client in seclusion for safety.
C. Offer the client a warm beverage and a quiet place to sit.
D. Maintain a calm, quiet environment and stay with the client.
Correct Answer: D
Rationale: The priority is to provide a safe, calm, and supportive environment. The
nurse's presence conveys a sense of safety and can help decrease the client's
anxiety. Seclusion (B) is a restrictive measure used only when less restrictive
interventions have failed. Medication (A) may be necessary but is not the first-line
intervention. A warm beverage may be contraindicated if the client is not able to
sit still.
4. A client with bipolar disorder is in a manic phase and states, "I'm going to buy a
new car today and drive to the coast." Which nursing intervention is most
appropriate?
A. Allow the client to go as this may help expend excess energy.
B. Explain the financial implications of this impulsive decision.
C. Set firm limits and redirect the client to a structured activity.
D. Ask the client to discuss their feelings about this idea in a group session.
Correct Answer: C
Rationale: During a manic episode, clients have poor impulse control and
,judgment. Setting firm, consistent limits on potentially harmful or impulsive
behaviors is crucial for safety. Redirecting to a structured, non-stimulating activity
helps channel energy constructively. Allowing the client to act on the impulse (A) is
unsafe. Reasoning with the client (B) is ineffective due to impaired judgment.
Group therapy (D) is not appropriate for a client who is easily distractible and
overstimulating to others.
5. Which of the following statements by a client with borderline personality
disorder indicates the use of the defense mechanism of splitting?
A. "I feel like I'm not really here, like I'm watching myself from outside."
B. "The night nurse is the only one who understands me. The day nurse is cruel and
doesn't care."
C. "I know I drank too much last night, but it was because my boss was so unfair to
me."
D. "I can't remember anything that happened during the argument with my
partner."
Correct Answer: B
Rationale: Splitting is the inability to integrate positive and negative aspects of
self and others, leading to viewing people as all-good or all-bad. Option B is a
classic example of splitting. Option A is depersonalization. Option C is
rationalization. Option D is repression.
6. A nurse is caring for a client with alcohol use disorder who is undergoing
detoxification. What is the priority nursing assessment?
A. Liver function tests.
B. Nutritional status.
C. Vital signs and neurological status.
D. Assessment of the client's support system.
Correct Answer: C
Rationale: During alcohol detoxification, the priority is to monitor for symptoms of
alcohol withdrawal, which can include life-threatening complications such as
seizures, tachycardia, hypertension, and delirium tremens. Frequent monitoring of
vital signs and neurological status is essential for early detection and intervention.
, While other assessments are important, they are not the immediate priority
during the acute detoxification phase.
7. A client on the psychiatric unit is exhibiting signs of a panic attack, including
chest pain, palpitations, and a feeling of impending doom. What is the nurse's first
action?
A. Assess the client's cardiac status and vital signs.
B. Administer a PRN dose of alprazolam.
C. Encourage the client to use deep breathing techniques.
D. Reassure the client that they are safe.
Correct Answer: A
Rationale: The first action is to rule out a medical cause for the physical
symptoms, such as a cardiac event. In a psychiatric setting, it is crucial to
differentiate between anxiety symptoms and a physical emergency. Obtaining a
full set of vital signs and cardiac monitoring is the priority before implementing
any psychiatric interventions. This ensures that the client's physical safety is
addressed first.
8. Which nursing intervention is most important for a client diagnosed with
anorexia nervosa?
A. Allowing the client to make decisions about food choices.
B. Supervising the client for 60-90 minutes after meals.
C. Encouraging the client to discuss feelings about body image.
D. Weighing the client every morning before breakfast.
Correct Answer: B
Rationale: The most critical physical complication of anorexia nervosa is
malnutrition and the risk of refeeding syndrome. However, the immediate
behavioral priority is preventing purging behaviors (self-induced vomiting, laxative
use, or excessive exercise) to maintain hydration and electrolyte balance. Strict
supervision for at least one hour after meals is essential to break the cycle of
bingeing and purging and to promote nutritional intake and weight restoration.
HEALTH (LATEST UPDATE) | ALL
POSSIBLE AND CURRENTLY MOST TESTED 100
PRACTICE QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS WITH DETAILED RATIONALES
PLUS ANSWER KEY ALREADY A+ GRADED MOST
RECENT!!!
1. A client with schizophrenia tells the nurse, "The FBI is monitoring my thoughts
through the television." Which is the most appropriate initial therapeutic response
by the nurse?
A. "That must be very frightening for you."
B. "The FBI is not monitoring your thoughts."
C. "Let's talk about something else for a while."
D. "Why do you think the FBI is doing that?"
Correct Answer: A
Rationale: Option A validates the client's feelings without confirming the delusion,
which is a therapeutic communication technique. Options B and D challenge the
delusion directly, which can increase the client's anxiety and defensiveness. Option
C dismisses the client's concern and avoids addressing the underlying emotion,
thereby damaging the therapeutic alliance.
2. A nurse is assessing a client with major depressive disorder. Which of the
following findings would be most consistent with this diagnosis?
,A. Grandiose beliefs about personal abilities.
B. Excessive energy and a decreased need for sleep.
C. Persistent anhedonia and a flat affect.
D. Rapid, pressured speech and flight of ideas.
Correct Answer: C
Rationale: Anhedonia (loss of interest or pleasure) and flat or blunted affect are
hallmark symptoms of major depressive disorder. Options A, B, and D are
characteristic of manic or hypomanic episodes, which are associated with bipolar
disorder, not unipolar depression.
3. A client is experiencing severe anxiety and is unable to sit still, pacing back and
forth. The nurse should first:
A. Administer a PRN dose of lorazepam.
B. Place the client in seclusion for safety.
C. Offer the client a warm beverage and a quiet place to sit.
D. Maintain a calm, quiet environment and stay with the client.
Correct Answer: D
Rationale: The priority is to provide a safe, calm, and supportive environment. The
nurse's presence conveys a sense of safety and can help decrease the client's
anxiety. Seclusion (B) is a restrictive measure used only when less restrictive
interventions have failed. Medication (A) may be necessary but is not the first-line
intervention. A warm beverage may be contraindicated if the client is not able to
sit still.
4. A client with bipolar disorder is in a manic phase and states, "I'm going to buy a
new car today and drive to the coast." Which nursing intervention is most
appropriate?
A. Allow the client to go as this may help expend excess energy.
B. Explain the financial implications of this impulsive decision.
C. Set firm limits and redirect the client to a structured activity.
D. Ask the client to discuss their feelings about this idea in a group session.
Correct Answer: C
Rationale: During a manic episode, clients have poor impulse control and
,judgment. Setting firm, consistent limits on potentially harmful or impulsive
behaviors is crucial for safety. Redirecting to a structured, non-stimulating activity
helps channel energy constructively. Allowing the client to act on the impulse (A) is
unsafe. Reasoning with the client (B) is ineffective due to impaired judgment.
Group therapy (D) is not appropriate for a client who is easily distractible and
overstimulating to others.
5. Which of the following statements by a client with borderline personality
disorder indicates the use of the defense mechanism of splitting?
A. "I feel like I'm not really here, like I'm watching myself from outside."
B. "The night nurse is the only one who understands me. The day nurse is cruel and
doesn't care."
C. "I know I drank too much last night, but it was because my boss was so unfair to
me."
D. "I can't remember anything that happened during the argument with my
partner."
Correct Answer: B
Rationale: Splitting is the inability to integrate positive and negative aspects of
self and others, leading to viewing people as all-good or all-bad. Option B is a
classic example of splitting. Option A is depersonalization. Option C is
rationalization. Option D is repression.
6. A nurse is caring for a client with alcohol use disorder who is undergoing
detoxification. What is the priority nursing assessment?
A. Liver function tests.
B. Nutritional status.
C. Vital signs and neurological status.
D. Assessment of the client's support system.
Correct Answer: C
Rationale: During alcohol detoxification, the priority is to monitor for symptoms of
alcohol withdrawal, which can include life-threatening complications such as
seizures, tachycardia, hypertension, and delirium tremens. Frequent monitoring of
vital signs and neurological status is essential for early detection and intervention.
, While other assessments are important, they are not the immediate priority
during the acute detoxification phase.
7. A client on the psychiatric unit is exhibiting signs of a panic attack, including
chest pain, palpitations, and a feeling of impending doom. What is the nurse's first
action?
A. Assess the client's cardiac status and vital signs.
B. Administer a PRN dose of alprazolam.
C. Encourage the client to use deep breathing techniques.
D. Reassure the client that they are safe.
Correct Answer: A
Rationale: The first action is to rule out a medical cause for the physical
symptoms, such as a cardiac event. In a psychiatric setting, it is crucial to
differentiate between anxiety symptoms and a physical emergency. Obtaining a
full set of vital signs and cardiac monitoring is the priority before implementing
any psychiatric interventions. This ensures that the client's physical safety is
addressed first.
8. Which nursing intervention is most important for a client diagnosed with
anorexia nervosa?
A. Allowing the client to make decisions about food choices.
B. Supervising the client for 60-90 minutes after meals.
C. Encouraging the client to discuss feelings about body image.
D. Weighing the client every morning before breakfast.
Correct Answer: B
Rationale: The most critical physical complication of anorexia nervosa is
malnutrition and the risk of refeeding syndrome. However, the immediate
behavioral priority is preventing purging behaviors (self-induced vomiting, laxative
use, or excessive exercise) to maintain hydration and electrolyte balance. Strict
supervision for at least one hour after meals is essential to break the cycle of
bingeing and purging and to promote nutritional intake and weight restoration.
