NUR 185 Final Exam - Complete Questions, Correct Answers and
Detailed Explanations - Latest Update 2026/2027 | 100%
Guaranteed Pass || Graded A+ (Hondros).
1. A client admitted to the psychiatric unit states, “I don't see any reason to
keep living anymore.” What is the nurse's priority response?
A. “You should focus on the positive things in your life.”
B. “Are you thinking about killing yourself?”
C. “Your family would be devastated if you died.”
D. “Let's talk about this after you have rested.”
Correct Answer: B. “Are you thinking about killing yourself?”
Explanation: Any statement suggesting hopelessness or death requires direct
suicide assessment. Asking clearly about suicidal thoughts does not increase
suicide risk and allows the nurse to determine the immediacy of the danger,
including the presence of a plan, intent, and access to means.
2. A client experiencing severe anxiety is pacing rapidly and repeatedly
stating, “Something terrible is going to happen.” Which nursing intervention is
most appropriate?
A. Provide lengthy explanations about anxiety.
B. Encourage the client to make several decisions independently.
C. Remain with the client and use short, simple statements.
D. Encourage the client to participate in a group activity.
Correct Answer: C. Remain with the client and use short, simple
statements.
Explanation: Severe anxiety significantly reduces attention, concentration,
and the ability to process complex information. The nurse should remain with
the client, provide reassurance through presence, reduce environmental
stimulation, and use brief, simple communication until anxiety decreases.
pg. 1
,3. A client says to the nurse, “Nobody understands what I'm going through.”
Which response demonstrates therapeutic communication?
A. “I understand exactly how you feel.”
B. “You shouldn't think that nobody understands.”
C. “Tell me more about what makes you feel misunderstood.”
D. “Your family probably understands you better than you think.”
Correct Answer: C. “Tell me more about what makes you feel
misunderstood.”
Explanation: An open-ended response encourages the client to explore
feelings and experiences. The nurse should avoid assuming that they know
exactly how the client feels. Therapeutic communication focuses on
understanding the client's perspective rather than immediately offering
reassurance or advice.
4. A client with schizophrenia tells the nurse, “The television announcer is
sending secret messages directly to me.” Which response is most appropriate?
A. “Yes, the announcer is talking specifically to you.”
B. “That's impossible because television cannot communicate with you.”
C. “I don't believe the television is sending you messages, but I understand
that this feels real to you.”
D. “You need to stop watching television.”
Correct Answer: C. “I don't believe the television is sending you
messages, but I understand that this feels real to you.”
Explanation: The nurse should acknowledge the client's emotional
experience without validating the delusion. Presenting reality in a calm,
nonargumentative manner helps maintain the therapeutic relationship while
avoiding reinforcement of psychotic thinking.
5. A client taking an antipsychotic medication develops high fever, severe
muscle rigidity, altered consciousness, and unstable blood pressure. Which
condition should the nurse suspect?
pg. 2
,A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Akathisia
Correct Answer: B. Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a potentially life-
threatening reaction to antipsychotic medications. Classic findings include
severe muscle rigidity, hyperthermia, altered mental status, autonomic
instability, and often elevated creatine kinase. The medication should be
stopped and emergency medical management initiated.
6. A client receiving an antipsychotic medication develops repetitive tongue
movements, lip smacking, and facial grimacing. Which adverse effect is most
likely?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Explanation: Tardive dyskinesia is characterized by involuntary repetitive
movements, particularly involving the mouth, tongue, face, and sometimes
limbs. It can become persistent, so the nurse should promptly report new
abnormal movements for evaluation.
7. A client taking lithium reports vomiting and diarrhea for the past 24 hours.
What is the nurse's priority concern?
A. Lithium may become ineffective.
B. Dehydration may increase lithium toxicity.
C. Gastrointestinal symptoms indicate therapeutic lithium levels.
D. The client should double the next lithium dose.
pg. 3
, Correct Answer: B. Dehydration may increase lithium toxicity.
Explanation: Lithium is handled by the kidneys in a manner closely related to
sodium and fluid balance. Significant fluid loss can increase lithium
concentration and cause toxicity. Persistent vomiting or diarrhea should be
reported, and hydration status and lithium levels may need assessment.
8. Which statement by a client taking lithium demonstrates appropriate
understanding of the medication?
A. “I should drastically reduce my salt intake.”
B. “I should maintain consistent fluid and sodium intake.”
C. “I can stop taking lithium when I feel better.”
D. “I should avoid drinking fluids after taking lithium.”
Correct Answer: B. “I should maintain consistent fluid and sodium
intake.”
Explanation: Consistency in sodium and fluid intake helps maintain relatively
stable lithium concentrations. Sudden sodium restriction, dehydration, or
excessive fluid loss can alter lithium levels and increase the risk of toxicity.
9. A client taking an SSRI says, “I've been taking it for five days, but I don't feel
any better.” Which response is most appropriate?
A. “The medication is not working, so stop taking it.”
B. “You should take twice the prescribed dose.”
C. “Antidepressants may take several weeks to produce their full therapeutic
effect.”
D. “You should immediately switch to an antipsychotic.”
Correct Answer: C. “Antidepressants may take several weeks to produce
their full therapeutic effect.”
Explanation: SSRIs generally do not produce their full antidepressant effect
within a few days. Clients should be encouraged to take the medication
pg. 4
Detailed Explanations - Latest Update 2026/2027 | 100%
Guaranteed Pass || Graded A+ (Hondros).
1. A client admitted to the psychiatric unit states, “I don't see any reason to
keep living anymore.” What is the nurse's priority response?
A. “You should focus on the positive things in your life.”
B. “Are you thinking about killing yourself?”
C. “Your family would be devastated if you died.”
D. “Let's talk about this after you have rested.”
Correct Answer: B. “Are you thinking about killing yourself?”
Explanation: Any statement suggesting hopelessness or death requires direct
suicide assessment. Asking clearly about suicidal thoughts does not increase
suicide risk and allows the nurse to determine the immediacy of the danger,
including the presence of a plan, intent, and access to means.
2. A client experiencing severe anxiety is pacing rapidly and repeatedly
stating, “Something terrible is going to happen.” Which nursing intervention is
most appropriate?
A. Provide lengthy explanations about anxiety.
B. Encourage the client to make several decisions independently.
C. Remain with the client and use short, simple statements.
D. Encourage the client to participate in a group activity.
Correct Answer: C. Remain with the client and use short, simple
statements.
Explanation: Severe anxiety significantly reduces attention, concentration,
and the ability to process complex information. The nurse should remain with
the client, provide reassurance through presence, reduce environmental
stimulation, and use brief, simple communication until anxiety decreases.
pg. 1
,3. A client says to the nurse, “Nobody understands what I'm going through.”
Which response demonstrates therapeutic communication?
A. “I understand exactly how you feel.”
B. “You shouldn't think that nobody understands.”
C. “Tell me more about what makes you feel misunderstood.”
D. “Your family probably understands you better than you think.”
Correct Answer: C. “Tell me more about what makes you feel
misunderstood.”
Explanation: An open-ended response encourages the client to explore
feelings and experiences. The nurse should avoid assuming that they know
exactly how the client feels. Therapeutic communication focuses on
understanding the client's perspective rather than immediately offering
reassurance or advice.
4. A client with schizophrenia tells the nurse, “The television announcer is
sending secret messages directly to me.” Which response is most appropriate?
A. “Yes, the announcer is talking specifically to you.”
B. “That's impossible because television cannot communicate with you.”
C. “I don't believe the television is sending you messages, but I understand
that this feels real to you.”
D. “You need to stop watching television.”
Correct Answer: C. “I don't believe the television is sending you
messages, but I understand that this feels real to you.”
Explanation: The nurse should acknowledge the client's emotional
experience without validating the delusion. Presenting reality in a calm,
nonargumentative manner helps maintain the therapeutic relationship while
avoiding reinforcement of psychotic thinking.
5. A client taking an antipsychotic medication develops high fever, severe
muscle rigidity, altered consciousness, and unstable blood pressure. Which
condition should the nurse suspect?
pg. 2
,A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Akathisia
Correct Answer: B. Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a potentially life-
threatening reaction to antipsychotic medications. Classic findings include
severe muscle rigidity, hyperthermia, altered mental status, autonomic
instability, and often elevated creatine kinase. The medication should be
stopped and emergency medical management initiated.
6. A client receiving an antipsychotic medication develops repetitive tongue
movements, lip smacking, and facial grimacing. Which adverse effect is most
likely?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Explanation: Tardive dyskinesia is characterized by involuntary repetitive
movements, particularly involving the mouth, tongue, face, and sometimes
limbs. It can become persistent, so the nurse should promptly report new
abnormal movements for evaluation.
7. A client taking lithium reports vomiting and diarrhea for the past 24 hours.
What is the nurse's priority concern?
A. Lithium may become ineffective.
B. Dehydration may increase lithium toxicity.
C. Gastrointestinal symptoms indicate therapeutic lithium levels.
D. The client should double the next lithium dose.
pg. 3
, Correct Answer: B. Dehydration may increase lithium toxicity.
Explanation: Lithium is handled by the kidneys in a manner closely related to
sodium and fluid balance. Significant fluid loss can increase lithium
concentration and cause toxicity. Persistent vomiting or diarrhea should be
reported, and hydration status and lithium levels may need assessment.
8. Which statement by a client taking lithium demonstrates appropriate
understanding of the medication?
A. “I should drastically reduce my salt intake.”
B. “I should maintain consistent fluid and sodium intake.”
C. “I can stop taking lithium when I feel better.”
D. “I should avoid drinking fluids after taking lithium.”
Correct Answer: B. “I should maintain consistent fluid and sodium
intake.”
Explanation: Consistency in sodium and fluid intake helps maintain relatively
stable lithium concentrations. Sudden sodium restriction, dehydration, or
excessive fluid loss can alter lithium levels and increase the risk of toxicity.
9. A client taking an SSRI says, “I've been taking it for five days, but I don't feel
any better.” Which response is most appropriate?
A. “The medication is not working, so stop taking it.”
B. “You should take twice the prescribed dose.”
C. “Antidepressants may take several weeks to produce their full therapeutic
effect.”
D. “You should immediately switch to an antipsychotic.”
Correct Answer: C. “Antidepressants may take several weeks to produce
their full therapeutic effect.”
Explanation: SSRIs generally do not produce their full antidepressant effect
within a few days. Clients should be encouraged to take the medication
pg. 4
