NR 326 MENTAL HEALTH NURSING
COMPREHENSIVE EXAM QUESTIONS
WITH CORRECT ANSWERS 2026/2027
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which response by the nurse is most therapeutic?
A. “What are the voices telling you to do right now?”
B. “I understand the voices are real to you, but I do not hear them.”
C. “The voices are just a part of your illness and will go away with medication.”
D. “You should try to ignore the voices and focus on our conversation.”
Answer: A
Conceptual Explanation: Safety is the priority. The nurse must first determine if the
hallucinations are ‘command’ in nature to assess the risk of harm to the client or others.
2. A client is prescribed Lithium Carbonate for Bipolar I Disorder. Which laboratory value
should the nurse prioritize monitoring?
A. Serum Sodium
B. Serum Glucose
,C. Alanine Aminotransferase (ALT)
D. Prothrombin Time (PT)
Answer: A
Conceptual Explanation: Lithium is a salt; low sodium levels can lead to lithium retention
and toxicity. Maintaining adequate sodium intake is crucial.
3. The nurse identifies that a client is using ‘reaction formation’ as a defense mechanism
when they perform which action?
A. A client who dislikes a neighbor spends hours helping them garden.
B. A client who is angry at their boss comes home and yells at their spouse.
C. A client forgets a traumatic event from their childhood.
D. A client blames their partner for their own substance abuse issues.
Answer: A
Conceptual Explanation: Reaction formation involves expressing the opposite emotion or
behavior of what is actually felt.
4. A client is admitted for alcohol withdrawal. Which assessment finding is most indicative of
Delirium Tremens (DTs)?
A. Visual hallucinations and autonomic hyperactivity
B. Bradycardia and somnolence
C. Fine hand tremors and nausea
, D. Hypotension and pin-point pupils
Answer: A
Conceptual Explanation: DTs are characterized by severe disorientation, agitation, visual
hallucinations, and signs of autonomic instability like tachycardia and hypertension.
5. A nurse is caring for a client with Anorexia Nervosa. Which finding would necessitate
immediate hospitalization?
A. Body weight 15% below ideal
B. Heart rate of 38 beats per minute
C. Potassium level of 3.8 mEq/L
D. Consuming 1200 calories per day
Answer: B
Conceptual Explanation: A heart rate below 40 bpm indicates severe cardiovascular
instability and is a criteria for acute hospitalization.
6. A client with Major Depressive Disorder is starting Phenelzine (an MAOI). Which food
choice indicates the client needs further teaching?
A. A sandwich with aged cheddar cheese and pepperoni
B. Grilled chicken and steamed broccoli
C. Fresh apples and peanut butter
D. Scrambled eggs and toast
COMPREHENSIVE EXAM QUESTIONS
WITH CORRECT ANSWERS 2026/2027
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which response by the nurse is most therapeutic?
A. “What are the voices telling you to do right now?”
B. “I understand the voices are real to you, but I do not hear them.”
C. “The voices are just a part of your illness and will go away with medication.”
D. “You should try to ignore the voices and focus on our conversation.”
Answer: A
Conceptual Explanation: Safety is the priority. The nurse must first determine if the
hallucinations are ‘command’ in nature to assess the risk of harm to the client or others.
2. A client is prescribed Lithium Carbonate for Bipolar I Disorder. Which laboratory value
should the nurse prioritize monitoring?
A. Serum Sodium
B. Serum Glucose
,C. Alanine Aminotransferase (ALT)
D. Prothrombin Time (PT)
Answer: A
Conceptual Explanation: Lithium is a salt; low sodium levels can lead to lithium retention
and toxicity. Maintaining adequate sodium intake is crucial.
3. The nurse identifies that a client is using ‘reaction formation’ as a defense mechanism
when they perform which action?
A. A client who dislikes a neighbor spends hours helping them garden.
B. A client who is angry at their boss comes home and yells at their spouse.
C. A client forgets a traumatic event from their childhood.
D. A client blames their partner for their own substance abuse issues.
Answer: A
Conceptual Explanation: Reaction formation involves expressing the opposite emotion or
behavior of what is actually felt.
4. A client is admitted for alcohol withdrawal. Which assessment finding is most indicative of
Delirium Tremens (DTs)?
A. Visual hallucinations and autonomic hyperactivity
B. Bradycardia and somnolence
C. Fine hand tremors and nausea
, D. Hypotension and pin-point pupils
Answer: A
Conceptual Explanation: DTs are characterized by severe disorientation, agitation, visual
hallucinations, and signs of autonomic instability like tachycardia and hypertension.
5. A nurse is caring for a client with Anorexia Nervosa. Which finding would necessitate
immediate hospitalization?
A. Body weight 15% below ideal
B. Heart rate of 38 beats per minute
C. Potassium level of 3.8 mEq/L
D. Consuming 1200 calories per day
Answer: B
Conceptual Explanation: A heart rate below 40 bpm indicates severe cardiovascular
instability and is a criteria for acute hospitalization.
6. A client with Major Depressive Disorder is starting Phenelzine (an MAOI). Which food
choice indicates the client needs further teaching?
A. A sandwich with aged cheddar cheese and pepperoni
B. Grilled chicken and steamed broccoli
C. Fresh apples and peanut butter
D. Scrambled eggs and toast
