NUR 2459 MENTAL HEALTH NURSING
ADVANCED PRACTICE EXAM
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A patient diagnosed with bipolar I disorder is experiencing a manic episode. The patient is
hyperactive, hasn’t slept in 48 hours, and is demanding to use the phone. Which nursing
intervention is the priority?
A. Provide high-calorie, finger foods to be eaten while the patient is mobile.
B. Place the patient in seclusion immediately to prevent exhaustion.
C. Administer a PRN dose of a sedative-hypnotic medication.
D. Engage the patient in a competitive group activity to redirect energy.
Answer: A
Conceptual Explanation: In acute mania, the priority is maintaining physical health.
Finger foods provide necessary calories for a patient who cannot sit still to eat, preventing
exhaustion and weight loss.
2. A client is prescribed phenelzine for treatment-resistant depression. Which statement by
the client indicates a need for further teaching?
A. ‘I will avoid eating aged cheeses and smoked meats.’
,B. ‘I need to wait two weeks after stopping this med before starting an SSRI.’
C. ‘I will monitor my blood pressure regularly while on this medication.’
D. ‘I can take over-the-counter cold medicine if I develop a cough.’
Answer: D
Conceptual Explanation: Phenelzine is an MAOI. Taking OTC cold medications (often
containing sympathomimetics) can cause a hypertensive crisis.
3. A nurse is caring for a client with schizophrenia who reports hearing voices telling them to
‘hurt the doctor.’ Which action should the nurse take first?
A. Administer an antipsychotic medication immediately.
B. Ask the client if they plan to follow the command.
C. Tell the client that the voices are not real.
D. Notify the doctor of the specific threat.
Answer: B
Conceptual Explanation: The first step in assessing command hallucinations is to
determine the risk of harm by asking if the client intends to follow the command.
4. A client with a lithium level of 1.9 mEq/L is exhibiting blurred vision, ataxia, and persistent
nausea. Which action is most appropriate?
A. Continue the medication as these are expected side effects.
B. Withhold the dose and notify the provider immediately.
, C. Administer the next scheduled dose and reassess in 4 hours.
D. Request an order for an antiemetic to treat the nausea.
Answer: B
Conceptual Explanation: A lithium level of 1.9 mEq/L indicates moderate toxicity
(therapeutic range is 0.6-1.2 mEq/L). The nurse must hold the dose and notify the
provider.
5. A nurse observes a client with obsessive-compulsive disorder (OCD) washing their hands
for the tenth time in an hour. What is the most therapeutic response?
A. ‘I see you are washing your hands; let’s go for a walk together.’
B. ‘Why do you feel the need to wash your hands so frequently?’
C. ‘Stop washing your hands; you are irritating your skin.’
D. ‘You are not allowed to use the sink for the next two hours.’
Answer: A
Conceptual Explanation: Redirecting the client to a different activity helps manage the
anxiety underlying the compulsion without using shame or direct confrontation.
6. Which assessment finding in a patient taking haloperidol should the nurse report to the
provider as a medical emergency?
A. Muscle rigidity, high fever, and diaphoresis.
B. Dry mouth and constipation.
ADVANCED PRACTICE EXAM
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A patient diagnosed with bipolar I disorder is experiencing a manic episode. The patient is
hyperactive, hasn’t slept in 48 hours, and is demanding to use the phone. Which nursing
intervention is the priority?
A. Provide high-calorie, finger foods to be eaten while the patient is mobile.
B. Place the patient in seclusion immediately to prevent exhaustion.
C. Administer a PRN dose of a sedative-hypnotic medication.
D. Engage the patient in a competitive group activity to redirect energy.
Answer: A
Conceptual Explanation: In acute mania, the priority is maintaining physical health.
Finger foods provide necessary calories for a patient who cannot sit still to eat, preventing
exhaustion and weight loss.
2. A client is prescribed phenelzine for treatment-resistant depression. Which statement by
the client indicates a need for further teaching?
A. ‘I will avoid eating aged cheeses and smoked meats.’
,B. ‘I need to wait two weeks after stopping this med before starting an SSRI.’
C. ‘I will monitor my blood pressure regularly while on this medication.’
D. ‘I can take over-the-counter cold medicine if I develop a cough.’
Answer: D
Conceptual Explanation: Phenelzine is an MAOI. Taking OTC cold medications (often
containing sympathomimetics) can cause a hypertensive crisis.
3. A nurse is caring for a client with schizophrenia who reports hearing voices telling them to
‘hurt the doctor.’ Which action should the nurse take first?
A. Administer an antipsychotic medication immediately.
B. Ask the client if they plan to follow the command.
C. Tell the client that the voices are not real.
D. Notify the doctor of the specific threat.
Answer: B
Conceptual Explanation: The first step in assessing command hallucinations is to
determine the risk of harm by asking if the client intends to follow the command.
4. A client with a lithium level of 1.9 mEq/L is exhibiting blurred vision, ataxia, and persistent
nausea. Which action is most appropriate?
A. Continue the medication as these are expected side effects.
B. Withhold the dose and notify the provider immediately.
, C. Administer the next scheduled dose and reassess in 4 hours.
D. Request an order for an antiemetic to treat the nausea.
Answer: B
Conceptual Explanation: A lithium level of 1.9 mEq/L indicates moderate toxicity
(therapeutic range is 0.6-1.2 mEq/L). The nurse must hold the dose and notify the
provider.
5. A nurse observes a client with obsessive-compulsive disorder (OCD) washing their hands
for the tenth time in an hour. What is the most therapeutic response?
A. ‘I see you are washing your hands; let’s go for a walk together.’
B. ‘Why do you feel the need to wash your hands so frequently?’
C. ‘Stop washing your hands; you are irritating your skin.’
D. ‘You are not allowed to use the sink for the next two hours.’
Answer: A
Conceptual Explanation: Redirecting the client to a different activity helps manage the
anxiety underlying the compulsion without using shame or direct confrontation.
6. Which assessment finding in a patient taking haloperidol should the nurse report to the
provider as a medical emergency?
A. Muscle rigidity, high fever, and diaphoresis.
B. Dry mouth and constipation.
