MENTAL AND BEHAVIORAL HEALTH
NURSING ADVANCED EXAM GUIDE
QUESTIONS AND ANSWERS
1. A client is admitted to the psychiatric unit with a diagnosis of Schizophrenia, Paranoid
Type. Which nursing intervention is most appropriate when the client refuses to eat because
he believes the food is poisoned?
A. Tell the client that the food is not poisoned and everyone else is eating it.
B. Provide the client with factory-sealed food containers or pre-packaged items.
C. Offer to taste the food in front of the client to prove its safety.
D. Place the client on a nasogastric tube to ensure adequate nutrition.
Answer: B
Conceptual Explanation: Providing pre-packaged or factory-sealed food helps build trust
and minimizes the client’s fear of poisoning, as it bypasses the perceived threat of staff
tampering with the food.
2. A nurse is caring for a client who is experiencing a hypertensive crisis after taking
Phenelzine (Nardil). Which question is most important for the nurse to ask?
A. Have you recently consumed aged cheese, red wine, or cured meats?
,B. Did you take an extra dose of your medication today?
C. Are you experiencing any blurred vision or chest pain?
D. How long have you been taking this medication?
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Consuming tyramine-rich foods (aged
cheese, wine, cured meats) can cause a life-threatening hypertensive crisis.
3. A nurse observes a client with Obsessive-Compulsive Disorder (OCD) washing their hands
for the 10th time in an hour. What is the nurse’s best initial action?
A. Lock the bathroom door to prevent the client from washing their hands.
B. Tell the client that their hands are clean and they need to stop.
C. Allow the client to finish the ritual but set limits for the future.
D. Redirect the client to a group activity immediately.
Answer: C
Conceptual Explanation: In the initial phase of treatment for OCD, stopping the ritual
abruptly can cause extreme anxiety. The nurse should allow the ritual but work on a plan to
gradually limit the time spent on it.
4. Which of the following findings should the nurse prioritize in a client taking Clozapine?
A. Weight gain of 2 lbs in a week.
B. Drowsiness during the day.
, C. Complaints of dry mouth and constipation.
D. A white blood cell (WBC) count of 2,500/mm³.
Answer: D
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. A WBC count
below 3,000/mm³ requires immediate intervention and discontinuation of the drug.
5. A client tells the nurse, ‘The FBI has bugs in my room and they are listening to everything I
say.’ Which response by the nurse is therapeutic?
A. I don’t see any bugs in here; you are safe with us.
B. That sounds very frightening for you. I don’t see any bugs, but I believe you are scared.
C. Why do you think the FBI would be interested in your conversations?
D. Let’s go look for the bugs together so I can prove they aren’t there.
Answer: B
Conceptual Explanation: This response acknowledges the client’s feelings (empathy)
while presenting reality without directly challenging or validating the delusion.
6. During a suicide assessment, which factor represents the highest risk for a client?
A. The client expresses feelings of hopelessness.
B. The client has a history of previous attempts.
C. The client lives alone and is socially isolated.
NURSING ADVANCED EXAM GUIDE
QUESTIONS AND ANSWERS
1. A client is admitted to the psychiatric unit with a diagnosis of Schizophrenia, Paranoid
Type. Which nursing intervention is most appropriate when the client refuses to eat because
he believes the food is poisoned?
A. Tell the client that the food is not poisoned and everyone else is eating it.
B. Provide the client with factory-sealed food containers or pre-packaged items.
C. Offer to taste the food in front of the client to prove its safety.
D. Place the client on a nasogastric tube to ensure adequate nutrition.
Answer: B
Conceptual Explanation: Providing pre-packaged or factory-sealed food helps build trust
and minimizes the client’s fear of poisoning, as it bypasses the perceived threat of staff
tampering with the food.
2. A nurse is caring for a client who is experiencing a hypertensive crisis after taking
Phenelzine (Nardil). Which question is most important for the nurse to ask?
A. Have you recently consumed aged cheese, red wine, or cured meats?
,B. Did you take an extra dose of your medication today?
C. Are you experiencing any blurred vision or chest pain?
D. How long have you been taking this medication?
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Consuming tyramine-rich foods (aged
cheese, wine, cured meats) can cause a life-threatening hypertensive crisis.
3. A nurse observes a client with Obsessive-Compulsive Disorder (OCD) washing their hands
for the 10th time in an hour. What is the nurse’s best initial action?
A. Lock the bathroom door to prevent the client from washing their hands.
B. Tell the client that their hands are clean and they need to stop.
C. Allow the client to finish the ritual but set limits for the future.
D. Redirect the client to a group activity immediately.
Answer: C
Conceptual Explanation: In the initial phase of treatment for OCD, stopping the ritual
abruptly can cause extreme anxiety. The nurse should allow the ritual but work on a plan to
gradually limit the time spent on it.
4. Which of the following findings should the nurse prioritize in a client taking Clozapine?
A. Weight gain of 2 lbs in a week.
B. Drowsiness during the day.
, C. Complaints of dry mouth and constipation.
D. A white blood cell (WBC) count of 2,500/mm³.
Answer: D
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. A WBC count
below 3,000/mm³ requires immediate intervention and discontinuation of the drug.
5. A client tells the nurse, ‘The FBI has bugs in my room and they are listening to everything I
say.’ Which response by the nurse is therapeutic?
A. I don’t see any bugs in here; you are safe with us.
B. That sounds very frightening for you. I don’t see any bugs, but I believe you are scared.
C. Why do you think the FBI would be interested in your conversations?
D. Let’s go look for the bugs together so I can prove they aren’t there.
Answer: B
Conceptual Explanation: This response acknowledges the client’s feelings (empathy)
while presenting reality without directly challenging or validating the delusion.
6. During a suicide assessment, which factor represents the highest risk for a client?
A. The client expresses feelings of hopelessness.
B. The client has a history of previous attempts.
C. The client lives alone and is socially isolated.
