NR 326 MENTAL HEALTH NURSING
COMPREHENSIVE EXAM STUDY GUIDE
ACTUAL QUESTIONS & ANSWERS
(GUARANTEE PASS) CHAMBERLAIN
1. A nurse is caring for a client experiencing a panic attack. Which of the following nursing
interventions should take priority?
A. Encourage the client to describe their feelings in detail.
B. Stay with the client and maintain a calm, quiet environment.
C. Instruct the client to practice deep breathing techniques.
D. Administer an oral dose of lorazepam immediately.
Answer: B
Conceptual Explanation: Safety and presence are priorities during a panic attack. Staying
with the client provides reassurance, and a quiet environment helps decrease stimuli that
exacerbate the attack.
2. A client with schizophrenia is experiencing auditory hallucinations. The client states, ‘The
voices are telling me I am a bad person.’ Which response by the nurse is therapeutic?
A. I don’t hear any voices, but I understand that they are real to you.
B. Why do you think the voices are saying that to you?
,C. You should try to ignore the voices and focus on our conversation.
D. Don’t listen to them; you are a good person.
Answer: A
Conceptual Explanation: This response acknowledges the client’s experience (validating
their reality) without agreeing with the hallucination, which is a key technique in
therapeutic communication for psychosis.
3. Which clinical manifestation should a nurse identify as a potential sign of Lithium toxicity in
a client with Bipolar Disorder?
A. Mild hand tremors and thirst
B. Increased appetite and weight gain
C. Coarse tremors, ataxia, and confusion
D. Constipation and dry mouth
Answer: C
Conceptual Explanation: While mild tremors are common side effects, coarse tremors,
ataxia (lack of coordination), and mental confusion are classic signs of moderate to severe
lithium toxicity.
4. A client is prescribed phenelzine (an MAOI). Which food item should the nurse instruct the
client to avoid to prevent a hypertensive crisis?
A. Fresh chicken and steamed broccoli
, B. Apples and oranges
C. Whole wheat bread and butter
D. Aged cheddar cheese and red wine
Answer: D
Conceptual Explanation: MAOIs interact with tyramine-rich foods (like aged cheeses,
cured meats, and red wine), which can lead to a dangerous increase in blood pressure
(hypertensive crisis).
5. A client with Borderline Personality Disorder is ‘splitting’ staff members by praising the
night nurse and criticizing the day nurse. What is the most appropriate nursing action?
A. Allow the client to choose which nurse they want to work with.
B. Hold a staff meeting to ensure a consistent approach to the client’s care.
C. Agree with the client to maintain a positive rapport.
D. Confront the client about their manipulative behavior immediately.
Answer: B
Conceptual Explanation: Consistency is vital when dealing with splitting. Staff must
communicate and maintain a united front to prevent the client from manipulating the
environment.
6. During a suicide risk assessment, which of the following represents the highest risk factor?
A. The client expresses vague thoughts of wishing they were dead.
COMPREHENSIVE EXAM STUDY GUIDE
ACTUAL QUESTIONS & ANSWERS
(GUARANTEE PASS) CHAMBERLAIN
1. A nurse is caring for a client experiencing a panic attack. Which of the following nursing
interventions should take priority?
A. Encourage the client to describe their feelings in detail.
B. Stay with the client and maintain a calm, quiet environment.
C. Instruct the client to practice deep breathing techniques.
D. Administer an oral dose of lorazepam immediately.
Answer: B
Conceptual Explanation: Safety and presence are priorities during a panic attack. Staying
with the client provides reassurance, and a quiet environment helps decrease stimuli that
exacerbate the attack.
2. A client with schizophrenia is experiencing auditory hallucinations. The client states, ‘The
voices are telling me I am a bad person.’ Which response by the nurse is therapeutic?
A. I don’t hear any voices, but I understand that they are real to you.
B. Why do you think the voices are saying that to you?
,C. You should try to ignore the voices and focus on our conversation.
D. Don’t listen to them; you are a good person.
Answer: A
Conceptual Explanation: This response acknowledges the client’s experience (validating
their reality) without agreeing with the hallucination, which is a key technique in
therapeutic communication for psychosis.
3. Which clinical manifestation should a nurse identify as a potential sign of Lithium toxicity in
a client with Bipolar Disorder?
A. Mild hand tremors and thirst
B. Increased appetite and weight gain
C. Coarse tremors, ataxia, and confusion
D. Constipation and dry mouth
Answer: C
Conceptual Explanation: While mild tremors are common side effects, coarse tremors,
ataxia (lack of coordination), and mental confusion are classic signs of moderate to severe
lithium toxicity.
4. A client is prescribed phenelzine (an MAOI). Which food item should the nurse instruct the
client to avoid to prevent a hypertensive crisis?
A. Fresh chicken and steamed broccoli
, B. Apples and oranges
C. Whole wheat bread and butter
D. Aged cheddar cheese and red wine
Answer: D
Conceptual Explanation: MAOIs interact with tyramine-rich foods (like aged cheeses,
cured meats, and red wine), which can lead to a dangerous increase in blood pressure
(hypertensive crisis).
5. A client with Borderline Personality Disorder is ‘splitting’ staff members by praising the
night nurse and criticizing the day nurse. What is the most appropriate nursing action?
A. Allow the client to choose which nurse they want to work with.
B. Hold a staff meeting to ensure a consistent approach to the client’s care.
C. Agree with the client to maintain a positive rapport.
D. Confront the client about their manipulative behavior immediately.
Answer: B
Conceptual Explanation: Consistency is vital when dealing with splitting. Staff must
communicate and maintain a united front to prevent the client from manipulating the
environment.
6. During a suicide risk assessment, which of the following represents the highest risk factor?
A. The client expresses vague thoughts of wishing they were dead.
