NUR 253 – Mental Health Nursing: Exam Original
Questions & Answers
Q1: A client with generalized anxiety disorder reports constant worry and restlessness. Which is
the first nursing intervention?
a) Encourage avoidance of stressful situations
b) Teach relaxation and breathing techniques
c) Prescribe benzodiazepines immediately
d) Suggest the client isolate from friends
Answer: b) Teach relaxation and breathing techniques
Rationale: Non-pharmacologic strategies are first-line for GAD. Avoidance worsens anxiety,
medications should follow provider orders, and isolation is harmful.
Q2: A patient with bipolar disorder is taking lithium and reports nausea and tremors. The nurse’s
priority action is:
a) Increase fluid intake
b) Check lithium levels and notify provider
c) Reduce salt intake
d) Take medication with food
Answer: b) Check lithium levels and notify provider
Rationale: Symptoms indicate possible lithium toxicity; immediate assessment is critical.
Q3: Which is an early sign of serotonin syndrome in a client taking SSRIs?
a) Fever, rigidity, confusion
b) Dry mouth and constipation
c) Hypotension and bradycardia
d) Weight gain
Answer: a) Fever, rigidity, confusion
Rationale: Serotonin syndrome presents with mental status changes, autonomic instability, and
neuromuscular symptoms.
,Q4: A client with schizophrenia hears voices saying “the TV talks to me.” The nurse should:
a) Agree with the client
b) Assess hallucinations and safety
c) Advise ignoring the voices
d) Turn off the TV
Answer: b) Assess hallucinations and safety
Rationale: Safety is priority; never reinforce delusions.
Q5: Which therapy is most effective for borderline personality disorder?
a) CBT
b) DBT
c) ECT
d) Psychoanalysis
Answer: b) DBT
Rationale: DBT targets emotion regulation and interpersonal skills, evidence-based for BPD.
Q6: A client taking MAOIs must avoid:
a) Cheese, smoked meats, red wine
b) Leafy vegetables
c) Chicken and rice
d) Citrus fruits
Answer: a) Cheese, smoked meats, red wine
Rationale: Tyramine-rich foods can cause hypertensive crisis with MAOIs.
Q7: Which nursing action is appropriate for a client with PTSD experiencing nightmares?
a) Encourage sleep hygiene and relaxation
b) Suggest ignoring the nightmares
c) Reduce fluid intake at night
d) Avoid discussing trauma
Answer: a) Encourage sleep hygiene and relaxation
Rationale: Safe strategies help manage insomnia; avoidance is not therapeutic.
Q8: A client with anorexia nervosa has bradycardia and hypotension. What is the priority
nursing action?
, a) Start structured meals and monitor vitals
b) Encourage exercise
c) Discuss body image only
d) Allow fasting if requested
Answer: a) Start structured meals and monitor vitals
Rationale: Medical stabilization is priority; bradycardia and hypotension are dangerous.
Q9: A patient with depression is prescribed an SSRI. Which statement shows correct
understanding?
a) “I can stop when I feel better.”
b) “It may take 4–6 weeks to work.”
c) “I can double the dose if I miss one.”
d) “Alcohol is safe while on this drug.”
Answer: b) “It may take 4–6 weeks to work.”
Rationale: SSRIs take time for therapeutic effect; abrupt changes or alcohol are unsafe.
Q10: A client admitted for suicidal ideation should be placed:
a) On 1:1 observation
b) In a locked room alone
c) Allowed to walk unsupervised
d) In a group therapy room
Answer: a) On 1:1 observation
Rationale: Continuous observation ensures safety for high-risk clients.
Q11: Which is a positive symptom of schizophrenia?
a) Flat affect
b) Hallucinations
c) Social withdrawal
d) Poor grooming
Answer: b) Hallucinations
Rationale: Positive symptoms add behaviors (hallucinations, delusions), negative symptoms
reflect deficits.
Questions & Answers
Q1: A client with generalized anxiety disorder reports constant worry and restlessness. Which is
the first nursing intervention?
a) Encourage avoidance of stressful situations
b) Teach relaxation and breathing techniques
c) Prescribe benzodiazepines immediately
d) Suggest the client isolate from friends
Answer: b) Teach relaxation and breathing techniques
Rationale: Non-pharmacologic strategies are first-line for GAD. Avoidance worsens anxiety,
medications should follow provider orders, and isolation is harmful.
Q2: A patient with bipolar disorder is taking lithium and reports nausea and tremors. The nurse’s
priority action is:
a) Increase fluid intake
b) Check lithium levels and notify provider
c) Reduce salt intake
d) Take medication with food
Answer: b) Check lithium levels and notify provider
Rationale: Symptoms indicate possible lithium toxicity; immediate assessment is critical.
Q3: Which is an early sign of serotonin syndrome in a client taking SSRIs?
a) Fever, rigidity, confusion
b) Dry mouth and constipation
c) Hypotension and bradycardia
d) Weight gain
Answer: a) Fever, rigidity, confusion
Rationale: Serotonin syndrome presents with mental status changes, autonomic instability, and
neuromuscular symptoms.
,Q4: A client with schizophrenia hears voices saying “the TV talks to me.” The nurse should:
a) Agree with the client
b) Assess hallucinations and safety
c) Advise ignoring the voices
d) Turn off the TV
Answer: b) Assess hallucinations and safety
Rationale: Safety is priority; never reinforce delusions.
Q5: Which therapy is most effective for borderline personality disorder?
a) CBT
b) DBT
c) ECT
d) Psychoanalysis
Answer: b) DBT
Rationale: DBT targets emotion regulation and interpersonal skills, evidence-based for BPD.
Q6: A client taking MAOIs must avoid:
a) Cheese, smoked meats, red wine
b) Leafy vegetables
c) Chicken and rice
d) Citrus fruits
Answer: a) Cheese, smoked meats, red wine
Rationale: Tyramine-rich foods can cause hypertensive crisis with MAOIs.
Q7: Which nursing action is appropriate for a client with PTSD experiencing nightmares?
a) Encourage sleep hygiene and relaxation
b) Suggest ignoring the nightmares
c) Reduce fluid intake at night
d) Avoid discussing trauma
Answer: a) Encourage sleep hygiene and relaxation
Rationale: Safe strategies help manage insomnia; avoidance is not therapeutic.
Q8: A client with anorexia nervosa has bradycardia and hypotension. What is the priority
nursing action?
, a) Start structured meals and monitor vitals
b) Encourage exercise
c) Discuss body image only
d) Allow fasting if requested
Answer: a) Start structured meals and monitor vitals
Rationale: Medical stabilization is priority; bradycardia and hypotension are dangerous.
Q9: A patient with depression is prescribed an SSRI. Which statement shows correct
understanding?
a) “I can stop when I feel better.”
b) “It may take 4–6 weeks to work.”
c) “I can double the dose if I miss one.”
d) “Alcohol is safe while on this drug.”
Answer: b) “It may take 4–6 weeks to work.”
Rationale: SSRIs take time for therapeutic effect; abrupt changes or alcohol are unsafe.
Q10: A client admitted for suicidal ideation should be placed:
a) On 1:1 observation
b) In a locked room alone
c) Allowed to walk unsupervised
d) In a group therapy room
Answer: a) On 1:1 observation
Rationale: Continuous observation ensures safety for high-risk clients.
Q11: Which is a positive symptom of schizophrenia?
a) Flat affect
b) Hallucinations
c) Social withdrawal
d) Poor grooming
Answer: b) Hallucinations
Rationale: Positive symptoms add behaviors (hallucinations, delusions), negative symptoms
reflect deficits.
