NR 326 MENTAL HEALTH NURSING
FINAL EXAM STUDY GUIDE ACTUAL
QUESTIONS & ANSWERS (GUARANTEE
PASS) CHAMBERLAIN
1. A nurse is caring for a client with schizophrenia who reports hearing voices telling them
that the food is poisoned. Which response by the nurse is therapeutic?
A. “Why do you think the voices are telling you the food is poisoned?”
B. “The food is not poisoned; I saw the chef prepare it myself.”
C. “I understand the voices are real to you, but I do not hear them.”
D. “If you don’t eat, we will have to start an IV for nutrition.”
Answer: C
Conceptual Explanation: Acknowledging the client’s feelings while presenting reality is a
therapeutic technique for hallucinations. B is argumentative, C uses ‘why’ which is non-
therapeutic, and D is threatening.
2. A client is admitted for lithium toxicity. The nurse notes a lithium level of 2.1 mEq/L. Which
clinical manifestation should the nurse expect to observe?
A. Mild thirst and polyuria
B. Blurred vision and severe hypotension
,C. Giddiness and coarse hand tremors
D. Constipation and weight gain
Answer: C
Conceptual Explanation: Lithium levels between 2.0 and 2.5 mEq/L typically manifest as
blurred vision, ataxia, giddiness, and coarse tremors. Mild thirst is seen at therapeutic
levels.
3. A nurse is assessing a client with Borderline Personality Disorder. The client states, ‘You are
the only nurse who understands me; the others are all mean.’ This is an example of which
defense mechanism?
A. Projection
B. Dissociation
C. Reaction Formation
D. Splitting
Answer: D
Conceptual Explanation: Splitting is common in Borderline Personality Disorder, where
the individual views people or situations as either all good or all bad.
4. Which medication is considered the first-line treatment for a client experiencing an acute
panic attack?
A. Fluoxetine
, B. Buspirone
C. Alprazolam
D. Amitriptyline
Answer: C
Conceptual Explanation: Benzodiazepines like Alprazolam have a rapid onset and are
used for acute anxiety. SSRIs and Buspirone take weeks to become effective.
5. A client with Major Depressive Disorder is prescribed Phenelzine (an MAOI). Which food
choice by the client indicates a need for further teaching?
A. Pepperoni pizza with extra cheese
B. Fresh grilled chicken breast
C. Steamed broccoli and carrots
D. Apples with peanut butter
Answer: A
Conceptual Explanation: Pepperoni and aged cheeses contain tyramine, which can cause
a hypertensive crisis when taken with MAOIs.
6. A nurse is caring for a client with anorexia nervosa. Which of the following is the priority
nursing intervention during the first week of refeeding?
A. Discussing the client’s distorted body image
B. Encouraging the client to exercise to improve mood
FINAL EXAM STUDY GUIDE ACTUAL
QUESTIONS & ANSWERS (GUARANTEE
PASS) CHAMBERLAIN
1. A nurse is caring for a client with schizophrenia who reports hearing voices telling them
that the food is poisoned. Which response by the nurse is therapeutic?
A. “Why do you think the voices are telling you the food is poisoned?”
B. “The food is not poisoned; I saw the chef prepare it myself.”
C. “I understand the voices are real to you, but I do not hear them.”
D. “If you don’t eat, we will have to start an IV for nutrition.”
Answer: C
Conceptual Explanation: Acknowledging the client’s feelings while presenting reality is a
therapeutic technique for hallucinations. B is argumentative, C uses ‘why’ which is non-
therapeutic, and D is threatening.
2. A client is admitted for lithium toxicity. The nurse notes a lithium level of 2.1 mEq/L. Which
clinical manifestation should the nurse expect to observe?
A. Mild thirst and polyuria
B. Blurred vision and severe hypotension
,C. Giddiness and coarse hand tremors
D. Constipation and weight gain
Answer: C
Conceptual Explanation: Lithium levels between 2.0 and 2.5 mEq/L typically manifest as
blurred vision, ataxia, giddiness, and coarse tremors. Mild thirst is seen at therapeutic
levels.
3. A nurse is assessing a client with Borderline Personality Disorder. The client states, ‘You are
the only nurse who understands me; the others are all mean.’ This is an example of which
defense mechanism?
A. Projection
B. Dissociation
C. Reaction Formation
D. Splitting
Answer: D
Conceptual Explanation: Splitting is common in Borderline Personality Disorder, where
the individual views people or situations as either all good or all bad.
4. Which medication is considered the first-line treatment for a client experiencing an acute
panic attack?
A. Fluoxetine
, B. Buspirone
C. Alprazolam
D. Amitriptyline
Answer: C
Conceptual Explanation: Benzodiazepines like Alprazolam have a rapid onset and are
used for acute anxiety. SSRIs and Buspirone take weeks to become effective.
5. A client with Major Depressive Disorder is prescribed Phenelzine (an MAOI). Which food
choice by the client indicates a need for further teaching?
A. Pepperoni pizza with extra cheese
B. Fresh grilled chicken breast
C. Steamed broccoli and carrots
D. Apples with peanut butter
Answer: A
Conceptual Explanation: Pepperoni and aged cheeses contain tyramine, which can cause
a hypertensive crisis when taken with MAOIs.
6. A nurse is caring for a client with anorexia nervosa. Which of the following is the priority
nursing intervention during the first week of refeeding?
A. Discussing the client’s distorted body image
B. Encouraging the client to exercise to improve mood
