NUR 3535C Clinical Reasoning & Personalized
Nursing Care
Comprehensive Final Exam (Qns & Ans)
2025
MULTIPLE CHOICE
A 34-year-old female with a history of major depressive disorder
presents with suicidal ideation. Which is the most critical
immediate nursing intervention?
A) Teach relaxation techniques
B) Remove potential harmful objects from the environment
C) Begin cognitive behavioral therapy
D) Encourage journaling
ANS: B
©2025
,Rationale: Ensuring immediate safety is the top priority in a
suicidal patient.
A patient stabilizes after a manic episode of bipolar disorder and
is currently on lithium. Which laboratory value requires the most
immediate nursing intervention?
A) Lithium level: 1.2 mEq/L
B) Sodium: 130 mmol/L
C) Creatinine: 1.0 mg/dL
D) WBC: 5,000/mm³
ANS: B
Rationale: Hyponatremia can increase lithium toxicity by
decreasing renal excretion of lithium.
Which assessment finding most supports a diagnosis of
generalized anxiety disorder (GAD) rather than panic disorder?
A) Sudden onset of intense fear
B) Persistent and excessive worry about multiple topics
C) Recurrent, unexpected panic attacks
D) Fear of dying during episodes
ANS: B
©2025
,Rationale: Persistent, excessive worry is hallmark of GAD, while
the others describe panic disorder.
A nurse evaluates a patient with schizophrenia taking an
antipsychotic who develops muscle rigidity, hyperthermia, and
autonomic dysfunction. What is the first action?
A) Increase fluid intake
B) Administer PRN anxiolytic
C) Hold antipsychotic and notify the provider
D) Initiate reality orientation
ANS: C
Rationale: Symptoms indicate neuroleptic malignant syndrome, a
medical emergency.
A young adult with social anxiety disorder is beginning exposure
therapy. Which nursing intervention is a priority?
A) Educate on the importance of medication adherence
B) Encourage avoidance of anxiety-provoking situations
C) Collaborate to set clear, incremental goals for public
interactions
D) Provide physical restraints during sessions
ANS: C
©2025
, Rationale: Gradual, planned exposure reduces anxiety over time.
A patient asks about the genetic risk for schizophrenia. Which
response is most accurate?
A) “Genetics play no role in schizophrenia.”
B) “If one parent has schizophrenia, the risk increases for the
child.”
C) “Only environmental factors matter for schizophrenia.”
D) “Schizophrenia is a communicable disease.”
ANS: B
Rationale: Genetics are a significant, though not exclusive, risk
factor for schizophrenia.
Which psychotherapeutic approach is most appropriate for
treating borderline personality disorder?
A) Electroconvulsive therapy
B) Dialectical behavior therapy
C) Psychoanalysis
D) Behavioral modification only
ANS: B
Rationale: DBT is evidence-based for borderline personality
disorder.
©2025
Nursing Care
Comprehensive Final Exam (Qns & Ans)
2025
MULTIPLE CHOICE
A 34-year-old female with a history of major depressive disorder
presents with suicidal ideation. Which is the most critical
immediate nursing intervention?
A) Teach relaxation techniques
B) Remove potential harmful objects from the environment
C) Begin cognitive behavioral therapy
D) Encourage journaling
ANS: B
©2025
,Rationale: Ensuring immediate safety is the top priority in a
suicidal patient.
A patient stabilizes after a manic episode of bipolar disorder and
is currently on lithium. Which laboratory value requires the most
immediate nursing intervention?
A) Lithium level: 1.2 mEq/L
B) Sodium: 130 mmol/L
C) Creatinine: 1.0 mg/dL
D) WBC: 5,000/mm³
ANS: B
Rationale: Hyponatremia can increase lithium toxicity by
decreasing renal excretion of lithium.
Which assessment finding most supports a diagnosis of
generalized anxiety disorder (GAD) rather than panic disorder?
A) Sudden onset of intense fear
B) Persistent and excessive worry about multiple topics
C) Recurrent, unexpected panic attacks
D) Fear of dying during episodes
ANS: B
©2025
,Rationale: Persistent, excessive worry is hallmark of GAD, while
the others describe panic disorder.
A nurse evaluates a patient with schizophrenia taking an
antipsychotic who develops muscle rigidity, hyperthermia, and
autonomic dysfunction. What is the first action?
A) Increase fluid intake
B) Administer PRN anxiolytic
C) Hold antipsychotic and notify the provider
D) Initiate reality orientation
ANS: C
Rationale: Symptoms indicate neuroleptic malignant syndrome, a
medical emergency.
A young adult with social anxiety disorder is beginning exposure
therapy. Which nursing intervention is a priority?
A) Educate on the importance of medication adherence
B) Encourage avoidance of anxiety-provoking situations
C) Collaborate to set clear, incremental goals for public
interactions
D) Provide physical restraints during sessions
ANS: C
©2025
, Rationale: Gradual, planned exposure reduces anxiety over time.
A patient asks about the genetic risk for schizophrenia. Which
response is most accurate?
A) “Genetics play no role in schizophrenia.”
B) “If one parent has schizophrenia, the risk increases for the
child.”
C) “Only environmental factors matter for schizophrenia.”
D) “Schizophrenia is a communicable disease.”
ANS: B
Rationale: Genetics are a significant, though not exclusive, risk
factor for schizophrenia.
Which psychotherapeutic approach is most appropriate for
treating borderline personality disorder?
A) Electroconvulsive therapy
B) Dialectical behavior therapy
C) Psychoanalysis
D) Behavioral modification only
ANS: B
Rationale: DBT is evidence-based for borderline personality
disorder.
©2025
