Mental Health Exam 2: Questions and Answers for
Nursing Students - Prof. Star (2026/2027)
Psychiatric-Mental Health Nursing II | Key Domains: Mood Disorders (Depressive & Bipolar), Anxiety &
Obsessive-Compulsive Disorders, Trauma & Stressor-Related Disorders, Personality Disorders,
Psychopharmacology II (Antidepressants, Mood Stabilizers), Advanced Therapeutic Communication,
and Legal/Ethical Issues in Complex Cases | Expert-Aligned Structure | Exam-Specific Practice Format
Introduction
This structured Mental Health Exam 2 Practice for 2026/2027 provides a focused set of exam-style
questions with correct answers and rationales. It is designed to prepare nursing students for a
second-semester or advanced mental health nursing exam, emphasizing the nursing management of
complex psychiatric disorders, advanced medication management, and nuanced therapeutic
interventions.
Exam Structure:
• Exam 2 Practice Set: (70 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the appropriate nursing response for the specific disorder (e.g., approach for a
manipulative patient with borderline personality disorder), the key teaching point or monitoring
parameter for a specific medication class (e.g., lithium level, SSRI discontinuation syndrome), the
priority safety intervention (e.g., for suicidal ideation or self-harm), and why alternative options are
contraindicated or represent a misunderstanding of the advanced concepts.
1 A client with bipolar I disorder is admitted in acute mania. The nurse observes pressured speech,
grandiosity, and impulsive spending. Which intervention is the priority?
A. Encourage participation in group therapy
B. Administer PRN antipsychotic as prescribed
, C. Provide high-calorie snacks throughout the day
D. Allow unrestricted phone use to manage anxiety
Answer: B. Administer PRN antipsychotic as prescribed
Rationale: Acute mania requires rapid symptom control to ensure safety. Antipsychotics (e.g.,
olanzapine, risperidone) are often used adjunctively with mood stabilizers to reduce agitation,
psychosis, and impulsivity. Group therapy and unrestricted privileges are inappropriate during
acute instability.
2 A client with major depressive disorder says, “I’ve decided to stop taking my sertraline because I
feel better.” The nurse’s best response is:
A. “That’s great! You must be fully recovered.”
B. “Stopping suddenly can cause dizziness, nausea, and ‘brain zaps.’”
C. “You should taper it over one week.”
D. “SSRIs don’t require long-term use.”
Answer: B. “Stopping suddenly can cause dizziness, nausea, and ‘brain zaps.’”
Rationale: Abrupt discontinuation of SSRIs can cause antidepressant discontinuation syndrome.
Clients should never stop without medical supervision. Tapering typically occurs over several
weeks, not days, and full remission usually requires 6–12 months of treatment.
3 A client with borderline personality disorder becomes enraged when the nurse sets a limit on
visiting hours. The client yells, “You’re just like my mother—cold and uncaring!” The nurse should
respond by:
A. Apologizing for upsetting the client
, B. Explaining that the rule applies to everyone
C. Ignoring the outburst to avoid reinforcement
D. Offering extra time later as a compromise
Answer: B. Explaining that the rule applies to everyone
Rationale: Clients with BPD often use splitting (all-good/all-bad). Consistent, non-punitive
limit-setting maintains therapeutic boundaries without reinforcing manipulation. Apologizing or
making exceptions undermines structure; ignoring may escalate distress.
4 A client taking lithium carbonate reports nausea, blurred vision, and muscle twitching. The nurse
should first:
A. Administer an antiemetic
B. Check the client’s serum lithium level
C. Encourage increased fluid intake
D. Document findings and monitor
Answer: B. Check the client’s serum lithium level
Rationale: These are early signs of lithium toxicity (levels >1.5 mEq/L). Immediate lab testing is
required. Hydration alone is insufficient; delaying assessment risks progression to seizures or coma.
5 A client with PTSD startles violently at the sound of a door slamming. The nurse’s most
therapeutic response is:
A. “It’s just a door—you’re safe here.”
, B. “That noise startled you. Would you like to sit somewhere quieter?”
C. “Try to stay calm; overreacting won’t help.”
D. “Let’s talk about your trauma now.”
Answer: B. “That noise startled you. Would you like to sit somewhere quieter?”
Rationale: This validates the client’s experience (trauma-informed care) and offers a choice to
regain control. Minimizing (“just a door”) or pushing for processing during hyperarousal can
retraumatize.
6 Which statement by a client taking fluoxetine indicates understanding of medication teaching?
A. “I’ll stop taking it if I feel jittery.”
B. “It may take 4–6 weeks to feel better.”
C. “I can drink wine in moderation.”
D. “I’ll take it at bedtime to avoid insomnia.”
Answer: B. “It may take 4–6 weeks to feel better.”
Rationale: SSRIs require weeks for full effect. Jitteriness often subsides in days; alcohol increases
CNS depression; fluoxetine is activating and should be taken in the morning to avoid sleep
disruption.
7 A client with OCD spends 3 hours daily washing hands until they bleed. The nurse should
collaborate with the treatment team to implement:
A. Complete restriction of handwashing
Nursing Students - Prof. Star (2026/2027)
Psychiatric-Mental Health Nursing II | Key Domains: Mood Disorders (Depressive & Bipolar), Anxiety &
Obsessive-Compulsive Disorders, Trauma & Stressor-Related Disorders, Personality Disorders,
Psychopharmacology II (Antidepressants, Mood Stabilizers), Advanced Therapeutic Communication,
and Legal/Ethical Issues in Complex Cases | Expert-Aligned Structure | Exam-Specific Practice Format
Introduction
This structured Mental Health Exam 2 Practice for 2026/2027 provides a focused set of exam-style
questions with correct answers and rationales. It is designed to prepare nursing students for a
second-semester or advanced mental health nursing exam, emphasizing the nursing management of
complex psychiatric disorders, advanced medication management, and nuanced therapeutic
interventions.
Exam Structure:
• Exam 2 Practice Set: (70 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the appropriate nursing response for the specific disorder (e.g., approach for a
manipulative patient with borderline personality disorder), the key teaching point or monitoring
parameter for a specific medication class (e.g., lithium level, SSRI discontinuation syndrome), the
priority safety intervention (e.g., for suicidal ideation or self-harm), and why alternative options are
contraindicated or represent a misunderstanding of the advanced concepts.
1 A client with bipolar I disorder is admitted in acute mania. The nurse observes pressured speech,
grandiosity, and impulsive spending. Which intervention is the priority?
A. Encourage participation in group therapy
B. Administer PRN antipsychotic as prescribed
, C. Provide high-calorie snacks throughout the day
D. Allow unrestricted phone use to manage anxiety
Answer: B. Administer PRN antipsychotic as prescribed
Rationale: Acute mania requires rapid symptom control to ensure safety. Antipsychotics (e.g.,
olanzapine, risperidone) are often used adjunctively with mood stabilizers to reduce agitation,
psychosis, and impulsivity. Group therapy and unrestricted privileges are inappropriate during
acute instability.
2 A client with major depressive disorder says, “I’ve decided to stop taking my sertraline because I
feel better.” The nurse’s best response is:
A. “That’s great! You must be fully recovered.”
B. “Stopping suddenly can cause dizziness, nausea, and ‘brain zaps.’”
C. “You should taper it over one week.”
D. “SSRIs don’t require long-term use.”
Answer: B. “Stopping suddenly can cause dizziness, nausea, and ‘brain zaps.’”
Rationale: Abrupt discontinuation of SSRIs can cause antidepressant discontinuation syndrome.
Clients should never stop without medical supervision. Tapering typically occurs over several
weeks, not days, and full remission usually requires 6–12 months of treatment.
3 A client with borderline personality disorder becomes enraged when the nurse sets a limit on
visiting hours. The client yells, “You’re just like my mother—cold and uncaring!” The nurse should
respond by:
A. Apologizing for upsetting the client
, B. Explaining that the rule applies to everyone
C. Ignoring the outburst to avoid reinforcement
D. Offering extra time later as a compromise
Answer: B. Explaining that the rule applies to everyone
Rationale: Clients with BPD often use splitting (all-good/all-bad). Consistent, non-punitive
limit-setting maintains therapeutic boundaries without reinforcing manipulation. Apologizing or
making exceptions undermines structure; ignoring may escalate distress.
4 A client taking lithium carbonate reports nausea, blurred vision, and muscle twitching. The nurse
should first:
A. Administer an antiemetic
B. Check the client’s serum lithium level
C. Encourage increased fluid intake
D. Document findings and monitor
Answer: B. Check the client’s serum lithium level
Rationale: These are early signs of lithium toxicity (levels >1.5 mEq/L). Immediate lab testing is
required. Hydration alone is insufficient; delaying assessment risks progression to seizures or coma.
5 A client with PTSD startles violently at the sound of a door slamming. The nurse’s most
therapeutic response is:
A. “It’s just a door—you’re safe here.”
, B. “That noise startled you. Would you like to sit somewhere quieter?”
C. “Try to stay calm; overreacting won’t help.”
D. “Let’s talk about your trauma now.”
Answer: B. “That noise startled you. Would you like to sit somewhere quieter?”
Rationale: This validates the client’s experience (trauma-informed care) and offers a choice to
regain control. Minimizing (“just a door”) or pushing for processing during hyperarousal can
retraumatize.
6 Which statement by a client taking fluoxetine indicates understanding of medication teaching?
A. “I’ll stop taking it if I feel jittery.”
B. “It may take 4–6 weeks to feel better.”
C. “I can drink wine in moderation.”
D. “I’ll take it at bedtime to avoid insomnia.”
Answer: B. “It may take 4–6 weeks to feel better.”
Rationale: SSRIs require weeks for full effect. Jitteriness often subsides in days; alcohol increases
CNS depression; fluoxetine is activating and should be taken in the morning to avoid sleep
disruption.
7 A client with OCD spends 3 hours daily washing hands until they bleed. The nurse should
collaborate with the treatment team to implement:
A. Complete restriction of handwashing
