NSG 524
EXAM 2
(Mental Health Nursing)
Actual Questions w/Correct Answers
(NCLEX (NGN) style Questions)
Herzing University
What you Will Get:
• 50 verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept reinforcement.
,Question 1. An adult client was admitted yesterday after demonstrating an
outburst of anger with a grocery clerk after finding that the store was out of a
specific brand of bread. The police were called when the client began throwing
bread around the store and screaming to have that brand of bread immediately.
Which question should the nurse ask this client during the initial intake
interview?
A. "When was the last time you felt sad or depressed?"
B. "When was the last time you experienced a manic episode?"
C. "Do you hear voices telling you to buy that brand of bread?"
D. "Have you ever thought about harming the grocery clerk?"
Correct Answer: B
Rationale:
The client’s behavior demonstrates classic symptoms of mania: irritability, impulsivity,
pressured behavior, and an exaggerated emotional response to a minor frustration.
During an initial intake interview for a client displaying acute manic behaviors, the nurse
should assess the history of manic episodes to confirm a potential bipolar diagnosis and
establish a baseline for treatment.
Incorrect:
Option A: While depression screening is important, the acute presentation of irritability,
aggression, and impulsive behavior is more indicative of mania than depression.
Option C: Auditory hallucinations are not the primary concern based on the presented
behavior; the scenario describes behavioral dyscontrol rather than psychosis.
Option D: Assessing homicidal ideation is relevant, but the immediate priority in this
context is to evaluate for a manic episode, which explains the overall clinical picture and
guides the plan of care.
Question 2. A 24-year-old male client presents to the clinic with reports of feeling
unwell, lacking energy, and often feeling like not going to work. He has missed
five days of work in the past two weeks. The client reports loss of appetite and
that he has not been making healthy food choices. He also reports disruptive
sleep habits, an inability to sleep at night, and a desire to sleep a great deal
during the day. The client has not been seen in the clinic for several months and
did not follow up after having annual labs done nine months ago as requested by
the HCP. Which factor is the most important for the nurse to include in an initial
assessment of the client?
A. Recent laboratory values and medication allergies
B. Recent losses experienced, relationships, substance use, sleep patterns
,C. Family history of cardiovascular disease and diabetes
D. Client’s occupational skills and job performance reviews
Correct Answer: B
Rationale:
The client is presenting with classic neurovegetative symptoms of depression: fatigue,
anhedonia (lack of interest in work), appetite changes, and sleep disturbances. The
most important initial assessment factors are psychosocial stressors (recent losses),
interpersonal support (relationships), substance use (which can mimic or worsen
depression), and a detailed sleep history (insomnia/hypersomnia are core diagnostic
criteria for major depressive disorder).
Incorrect:
Option A: While labs are important, they are not the priority in this acute psychosocial
presentation.
Option C: Family medical history is relevant for long-term health but does not address
the immediate mental health crisis.
Option D: Job performance is a consequence of the illness, not an assessment priority
for diagnosing and treating the underlying condition.
Question 3. (Select all that apply.) The nurse is reviewing the client’s mental
health history. Which statement by the client is the highest priority to document?
(Select all that apply.)
A. "I feel like I have no energy to do anything anymore."
B. "I have been fighting a lot with my girlfriend lately."
C. "I deny any thoughts of self-harm or suicide."
D. "I have been drinking more alcohol than usual."
Correct Answers: A, C, D
Rationale:
A: Anergia (lack of energy) is a core neurovegetative symptom of major depression and
must be documented to track severity and treatment response.
C: A formal denial of suicidal ideation is a critical safety assessment and a required
documentation element for any client presenting with depressive symptoms.
D: Increased alcohol use is a red flag for self-medication, substance use disorder, and
increased suicide risk; it requires immediate assessment and intervention.
Incorrect:
Option B: While relationship conflict is a psychosocial stressor, it is not the highest
, priority compared to safety screening (suicide denial) and symptom severity (anergia,
substance use).
Question 4. The client’s symptoms are indicators of which mental health
disorder?
A. Bipolar I Disorder
B. Generalized Anxiety Disorder
C. Depression
D. Schizoaffective Disorder
Correct Answer: C
Rationale:
The client exhibits the hallmark symptoms of major depressive disorder: persistent low
energy, anhedonia, appetite loss, sleep disturbance (insomnia with daytime
hypersomnia), and functional impairment (missing work). These neurovegetative
symptoms collectively point to depression.
Incorrect:
Option A: Bipolar I requires a history of mania, which is not present here.
Option B: Generalized anxiety disorder is characterized by excessive worry and
physiological hyperarousal, not the profound energy and sleep changes seen here.
Option D: Schizoaffective disorder requires psychotic symptoms plus mood episodes;
no psychosis is reported.
Question 5. For each nursing action, indicate whether the action is an example of
therapeutic communication or nontherapeutic communication. Each action must
have one response selected.
Table
Nursing Action Therapeutic Nontherapeutic
Inform client of medication times ☑ ☐
Discuss client's appearance and daily ☐ ☑
activities
EXAM 2
(Mental Health Nursing)
Actual Questions w/Correct Answers
(NCLEX (NGN) style Questions)
Herzing University
What you Will Get:
• 50 verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept reinforcement.
,Question 1. An adult client was admitted yesterday after demonstrating an
outburst of anger with a grocery clerk after finding that the store was out of a
specific brand of bread. The police were called when the client began throwing
bread around the store and screaming to have that brand of bread immediately.
Which question should the nurse ask this client during the initial intake
interview?
A. "When was the last time you felt sad or depressed?"
B. "When was the last time you experienced a manic episode?"
C. "Do you hear voices telling you to buy that brand of bread?"
D. "Have you ever thought about harming the grocery clerk?"
Correct Answer: B
Rationale:
The client’s behavior demonstrates classic symptoms of mania: irritability, impulsivity,
pressured behavior, and an exaggerated emotional response to a minor frustration.
During an initial intake interview for a client displaying acute manic behaviors, the nurse
should assess the history of manic episodes to confirm a potential bipolar diagnosis and
establish a baseline for treatment.
Incorrect:
Option A: While depression screening is important, the acute presentation of irritability,
aggression, and impulsive behavior is more indicative of mania than depression.
Option C: Auditory hallucinations are not the primary concern based on the presented
behavior; the scenario describes behavioral dyscontrol rather than psychosis.
Option D: Assessing homicidal ideation is relevant, but the immediate priority in this
context is to evaluate for a manic episode, which explains the overall clinical picture and
guides the plan of care.
Question 2. A 24-year-old male client presents to the clinic with reports of feeling
unwell, lacking energy, and often feeling like not going to work. He has missed
five days of work in the past two weeks. The client reports loss of appetite and
that he has not been making healthy food choices. He also reports disruptive
sleep habits, an inability to sleep at night, and a desire to sleep a great deal
during the day. The client has not been seen in the clinic for several months and
did not follow up after having annual labs done nine months ago as requested by
the HCP. Which factor is the most important for the nurse to include in an initial
assessment of the client?
A. Recent laboratory values and medication allergies
B. Recent losses experienced, relationships, substance use, sleep patterns
,C. Family history of cardiovascular disease and diabetes
D. Client’s occupational skills and job performance reviews
Correct Answer: B
Rationale:
The client is presenting with classic neurovegetative symptoms of depression: fatigue,
anhedonia (lack of interest in work), appetite changes, and sleep disturbances. The
most important initial assessment factors are psychosocial stressors (recent losses),
interpersonal support (relationships), substance use (which can mimic or worsen
depression), and a detailed sleep history (insomnia/hypersomnia are core diagnostic
criteria for major depressive disorder).
Incorrect:
Option A: While labs are important, they are not the priority in this acute psychosocial
presentation.
Option C: Family medical history is relevant for long-term health but does not address
the immediate mental health crisis.
Option D: Job performance is a consequence of the illness, not an assessment priority
for diagnosing and treating the underlying condition.
Question 3. (Select all that apply.) The nurse is reviewing the client’s mental
health history. Which statement by the client is the highest priority to document?
(Select all that apply.)
A. "I feel like I have no energy to do anything anymore."
B. "I have been fighting a lot with my girlfriend lately."
C. "I deny any thoughts of self-harm or suicide."
D. "I have been drinking more alcohol than usual."
Correct Answers: A, C, D
Rationale:
A: Anergia (lack of energy) is a core neurovegetative symptom of major depression and
must be documented to track severity and treatment response.
C: A formal denial of suicidal ideation is a critical safety assessment and a required
documentation element for any client presenting with depressive symptoms.
D: Increased alcohol use is a red flag for self-medication, substance use disorder, and
increased suicide risk; it requires immediate assessment and intervention.
Incorrect:
Option B: While relationship conflict is a psychosocial stressor, it is not the highest
, priority compared to safety screening (suicide denial) and symptom severity (anergia,
substance use).
Question 4. The client’s symptoms are indicators of which mental health
disorder?
A. Bipolar I Disorder
B. Generalized Anxiety Disorder
C. Depression
D. Schizoaffective Disorder
Correct Answer: C
Rationale:
The client exhibits the hallmark symptoms of major depressive disorder: persistent low
energy, anhedonia, appetite loss, sleep disturbance (insomnia with daytime
hypersomnia), and functional impairment (missing work). These neurovegetative
symptoms collectively point to depression.
Incorrect:
Option A: Bipolar I requires a history of mania, which is not present here.
Option B: Generalized anxiety disorder is characterized by excessive worry and
physiological hyperarousal, not the profound energy and sleep changes seen here.
Option D: Schizoaffective disorder requires psychotic symptoms plus mood episodes;
no psychosis is reported.
Question 5. For each nursing action, indicate whether the action is an example of
therapeutic communication or nontherapeutic communication. Each action must
have one response selected.
Table
Nursing Action Therapeutic Nontherapeutic
Inform client of medication times ☑ ☐
Discuss client's appearance and daily ☐ ☑
activities
