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. During a high school substance abuse class, a student tells the
group, “I know that marijuana is not addicting, so why shouldn’t I use it?” Which
response is best for the nurse to provide?
A. “Marijuana is a gateway drug that always leads to harder drug use.”
B. “Altering one’s ability to think clearly places self and others at risk.”
C. “Marijuana is illegal, and you could get arrested if you are caught using it.”
D. “Most students your age who use marijuana develop severe lung disease.”
Correct Answer: B
Rationale:
The nurse should provide factual, non-judgmental information about the risks of
impaired judgment and cognition associated with marijuana use, which can lead to
safety hazards for the user and others. This approach avoids scare tactics and focuses
on immediate, realistic consequences.
Why the Other Options Are Incorrect:
Option A: This is an exaggerated scare tactic that lacks scientific nuance and may
undermine the nurse’s credibility with adolescents.
Option C: While true in many jurisdictions, focusing on legal consequences is less
effective than addressing immediate health and safety risks in an educational setting.
Option D: This is an absolute statement that is not universally true and uses fear-based
messaging, which is less effective than factual education.
Question 2. Which intervention is most important for the nurse to include in the
plan of care for a client who takes clozapine twice daily?
A. Assess the client for extrapyramidal symptoms every 8 hours.
B. Measure lying and standing blood pressures twice daily.
C. Monitor the client’s weight every 4 hours while awake.
D. Evaluate deep tendon reflexes prior to each dose.
Correct Answer: B
Rationale:
Clozapine can cause significant orthostatic hypotension due to its alpha-adrenergic
antagonist effects. Measuring lying and standing blood pressures is essential to detect
this adverse effect and prevent falls or syncope.
Why the Other Options Are Incorrect:
,Option A: Clozapine carries a low risk of extrapyramidal symptoms (EPS); however,
agranulocytosis and hypotension are greater concerns.
Option C: While weight monitoring is important due to metabolic side effects, it is not
required every 4 hours.
Option D: Deep tendon reflex monitoring is not a standard or necessary assessment for
clozapine administration.
Question 3. An older adult homeless client visits the psychiatric clinic to obtain a
prescription renewal for alprazolam. During the health assessment, the client
reports experiencing chest pain. Which action should the nurse take first?
A. Obtain the client’s blood pressure.
B. Notify the healthcare provider to renew the alprazolam prescription.
C. Assess the client for signs of substance withdrawal.
D. Provide the client with resources for emergency shelter.
Correct Answer: A
Rationale:
The client’s report of chest pain is a physiologic complaint that requires immediate
assessment. Obtaining vital signs, including blood pressure, is the first step in
determining whether the chest pain is cardiac in origin and whether emergency
intervention is needed.
Why the Other Options Are Incorrect:
Option B: Addressing the prescription renewal is not the priority when the client is
presenting with an acute physiologic symptom.
Option C: While withdrawal assessment is important for a client using alprazolam,
chest pain takes physiologic priority.
Option D: Shelter resources are important psychosocial needs but are secondary to
acute chest pain.
Question 4. An older adult tells the clinic nurse about frequently awakening
during the night and often not being able to go back to sleep. Which action(s)
should the nurse suggest to the client to help improve sleep? Select all that
apply.
, A. Establish a regular time for going to bed and getting up.
B. Take a long nap each afternoon to make up for lost sleep.
C. Avoid drinking caffeinated beverages late in the day.
D. Keep the bedroom temperature warm and use a nightlight.
E. Exercise vigorously for 60 minutes immediately before bedtime.
Correct Answers: A, C
Rationale:
Sleep hygiene education for older adults includes maintaining a consistent sleep-wake
schedule (Option A) and avoiding stimulants such as caffeine in the afternoon and
evening (Option C). These are evidence-based nonpharmacologic interventions for
insomnia.
Option A: Correct. A consistent sleep-wake schedule supports the normal circadian
rhythm.
Option B: Incorrect. Long afternoon naps disrupt the circadian rhythm and can worsen
nighttime insomnia.
Option C: Correct. Avoiding caffeine later in the day reduces stimulant-related sleep
disturbance.
Option D: Incorrect. While a nightlight may help with safety, a warm room temperature
is not specifically recommended for sleep hygiene; a cool, dark, quiet environment is
preferred.
Option E: Incorrect. Vigorous exercise immediately before bedtime is stimulating and
can interfere with the ability to fall asleep.
Question 5. A client with bipolar disorder has a serum lithium level of 2.1 mEq/L.
Which action should the nurse take?
A. Administer the next scheduled dose of lithium.
B. Encourage the client to increase fluid intake to 3 liters per day.
C. Withhold the next dose and notify the healthcare provider immediately.
D. Recheck the lithium level in 48 hours before taking any action.
Correct Answer: C
Rationale:
The therapeutic range for lithium is typically 0.6–1.2 mEq/L. A level of 2.1 mEq/L
indicates lithium toxicity, which is a medical emergency. The nurse must withhold the
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. During a high school substance abuse class, a student tells the
group, “I know that marijuana is not addicting, so why shouldn’t I use it?” Which
response is best for the nurse to provide?
A. “Marijuana is a gateway drug that always leads to harder drug use.”
B. “Altering one’s ability to think clearly places self and others at risk.”
C. “Marijuana is illegal, and you could get arrested if you are caught using it.”
D. “Most students your age who use marijuana develop severe lung disease.”
Correct Answer: B
Rationale:
The nurse should provide factual, non-judgmental information about the risks of
impaired judgment and cognition associated with marijuana use, which can lead to
safety hazards for the user and others. This approach avoids scare tactics and focuses
on immediate, realistic consequences.
Why the Other Options Are Incorrect:
Option A: This is an exaggerated scare tactic that lacks scientific nuance and may
undermine the nurse’s credibility with adolescents.
Option C: While true in many jurisdictions, focusing on legal consequences is less
effective than addressing immediate health and safety risks in an educational setting.
Option D: This is an absolute statement that is not universally true and uses fear-based
messaging, which is less effective than factual education.
Question 2. Which intervention is most important for the nurse to include in the
plan of care for a client who takes clozapine twice daily?
A. Assess the client for extrapyramidal symptoms every 8 hours.
B. Measure lying and standing blood pressures twice daily.
C. Monitor the client’s weight every 4 hours while awake.
D. Evaluate deep tendon reflexes prior to each dose.
Correct Answer: B
Rationale:
Clozapine can cause significant orthostatic hypotension due to its alpha-adrenergic
antagonist effects. Measuring lying and standing blood pressures is essential to detect
this adverse effect and prevent falls or syncope.
Why the Other Options Are Incorrect:
,Option A: Clozapine carries a low risk of extrapyramidal symptoms (EPS); however,
agranulocytosis and hypotension are greater concerns.
Option C: While weight monitoring is important due to metabolic side effects, it is not
required every 4 hours.
Option D: Deep tendon reflex monitoring is not a standard or necessary assessment for
clozapine administration.
Question 3. An older adult homeless client visits the psychiatric clinic to obtain a
prescription renewal for alprazolam. During the health assessment, the client
reports experiencing chest pain. Which action should the nurse take first?
A. Obtain the client’s blood pressure.
B. Notify the healthcare provider to renew the alprazolam prescription.
C. Assess the client for signs of substance withdrawal.
D. Provide the client with resources for emergency shelter.
Correct Answer: A
Rationale:
The client’s report of chest pain is a physiologic complaint that requires immediate
assessment. Obtaining vital signs, including blood pressure, is the first step in
determining whether the chest pain is cardiac in origin and whether emergency
intervention is needed.
Why the Other Options Are Incorrect:
Option B: Addressing the prescription renewal is not the priority when the client is
presenting with an acute physiologic symptom.
Option C: While withdrawal assessment is important for a client using alprazolam,
chest pain takes physiologic priority.
Option D: Shelter resources are important psychosocial needs but are secondary to
acute chest pain.
Question 4. An older adult tells the clinic nurse about frequently awakening
during the night and often not being able to go back to sleep. Which action(s)
should the nurse suggest to the client to help improve sleep? Select all that
apply.
, A. Establish a regular time for going to bed and getting up.
B. Take a long nap each afternoon to make up for lost sleep.
C. Avoid drinking caffeinated beverages late in the day.
D. Keep the bedroom temperature warm and use a nightlight.
E. Exercise vigorously for 60 minutes immediately before bedtime.
Correct Answers: A, C
Rationale:
Sleep hygiene education for older adults includes maintaining a consistent sleep-wake
schedule (Option A) and avoiding stimulants such as caffeine in the afternoon and
evening (Option C). These are evidence-based nonpharmacologic interventions for
insomnia.
Option A: Correct. A consistent sleep-wake schedule supports the normal circadian
rhythm.
Option B: Incorrect. Long afternoon naps disrupt the circadian rhythm and can worsen
nighttime insomnia.
Option C: Correct. Avoiding caffeine later in the day reduces stimulant-related sleep
disturbance.
Option D: Incorrect. While a nightlight may help with safety, a warm room temperature
is not specifically recommended for sleep hygiene; a cool, dark, quiet environment is
preferred.
Option E: Incorrect. Vigorous exercise immediately before bedtime is stimulating and
can interfere with the ability to fall asleep.
Question 5. A client with bipolar disorder has a serum lithium level of 2.1 mEq/L.
Which action should the nurse take?
A. Administer the next scheduled dose of lithium.
B. Encourage the client to increase fluid intake to 3 liters per day.
C. Withhold the next dose and notify the healthcare provider immediately.
D. Recheck the lithium level in 48 hours before taking any action.
Correct Answer: C
Rationale:
The therapeutic range for lithium is typically 0.6–1.2 mEq/L. A level of 2.1 mEq/L
indicates lithium toxicity, which is a medical emergency. The nurse must withhold the
