NUR 252 Mental Health Nursing Final Exam Version 2 2026 |Galen
College
1. A nurse is assessing a client who has a prescription for lithium carbonate.
Which of the following findings should the nurse identify as an early sign of
lithium toxicity?
A. Severe hypotension
B. Blurred vision
C. Fine hand tremors and nausea
D. Seizures and coma
Answer: C
Rationale: Early signs of lithium toxicity include gastrointestinal upset, fine hand tremors,
muscle weakness, and polyuria.
2. A client is diagnosed with Borderline Personality Disorder. The nurse observes
the client praising one nurse while demeaning another. Which defense
mechanism is this?
A. Reaction formation
B. Projection
C. Splitting
D. Undoing
Answer: C
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image, common in BPD.
,3. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
A. Teach the client abdominal breathing
B. Administer an anti-anxiety medication
C. Explain the physical causes of the symptoms
D. Stay with the client and remain calm
Answer: D
Rationale: The priority during a panic attack is to ensure the client’s safety and provide a
calming presence to reduce anxiety.
4. A client with Schizophrenia reports hearing voices telling them to ‘hurt the
person in the hallway.’ What is the nurse’s priority action?
A. Ask the client to describe what the voices look like
B. Tell the client that the voices are not real
C. Ask the client directly what the voices are saying
D. Instruct the client to go to their room immediately
Answer: C
Rationale: Identifying command hallucinations is critical for safety assessment to
determine if the client or others are at risk.
5. Which of the following laboratory tests should a nurse monitor for a client
who is taking clozapine?
A. Serum potassium
B. Platelet count
C. White blood cell count
D. Blood urea nitrogen
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis, requiring weekly or bi-weekly
monitoring of the WBC and Absolute Neutrophil Count.
, 6. A client taking a Monoamine Oxidase Inhibitor (MAOI) reports a sudden
severe headache and neck stiffness. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Hypertensive crisis
Answer: D
Rationale: Ingesting tyramine while taking MAOIs can cause a hypertensive crisis,
characterized by headache, nausea, and high blood pressure.
7. A nurse is preparing to administer thiamine to a client with chronic alcohol
use disorder. The nurse knows thiamine is given to prevent which condition?
A. Delirium tremens
B. Alcoholic hepatitis
C. Wernicke-Korsakoff syndrome
D. Acute pancreatitis
Answer: C
Rationale: Thiamine (Vitamin B1) is essential for clients with alcohol use disorder to
prevent permanent neurological damage from Wernicke-Korsakoff syndrome.
8. A client with PTSD is experiencing a flashback. Which of the following is an
appropriate grounding technique?
A. Encouraging the client to close their eyes
B. Leaving the client alone to process the event
C. Asking the client to list five things they can see in the room
D. Turning off all lights and minimizing noise
Answer: C
Rationale: Grounding techniques like identifying environmental objects help the client
stay in the present moment and end the flashback.
College
1. A nurse is assessing a client who has a prescription for lithium carbonate.
Which of the following findings should the nurse identify as an early sign of
lithium toxicity?
A. Severe hypotension
B. Blurred vision
C. Fine hand tremors and nausea
D. Seizures and coma
Answer: C
Rationale: Early signs of lithium toxicity include gastrointestinal upset, fine hand tremors,
muscle weakness, and polyuria.
2. A client is diagnosed with Borderline Personality Disorder. The nurse observes
the client praising one nurse while demeaning another. Which defense
mechanism is this?
A. Reaction formation
B. Projection
C. Splitting
D. Undoing
Answer: C
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image, common in BPD.
,3. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
A. Teach the client abdominal breathing
B. Administer an anti-anxiety medication
C. Explain the physical causes of the symptoms
D. Stay with the client and remain calm
Answer: D
Rationale: The priority during a panic attack is to ensure the client’s safety and provide a
calming presence to reduce anxiety.
4. A client with Schizophrenia reports hearing voices telling them to ‘hurt the
person in the hallway.’ What is the nurse’s priority action?
A. Ask the client to describe what the voices look like
B. Tell the client that the voices are not real
C. Ask the client directly what the voices are saying
D. Instruct the client to go to their room immediately
Answer: C
Rationale: Identifying command hallucinations is critical for safety assessment to
determine if the client or others are at risk.
5. Which of the following laboratory tests should a nurse monitor for a client
who is taking clozapine?
A. Serum potassium
B. Platelet count
C. White blood cell count
D. Blood urea nitrogen
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis, requiring weekly or bi-weekly
monitoring of the WBC and Absolute Neutrophil Count.
, 6. A client taking a Monoamine Oxidase Inhibitor (MAOI) reports a sudden
severe headache and neck stiffness. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Hypertensive crisis
Answer: D
Rationale: Ingesting tyramine while taking MAOIs can cause a hypertensive crisis,
characterized by headache, nausea, and high blood pressure.
7. A nurse is preparing to administer thiamine to a client with chronic alcohol
use disorder. The nurse knows thiamine is given to prevent which condition?
A. Delirium tremens
B. Alcoholic hepatitis
C. Wernicke-Korsakoff syndrome
D. Acute pancreatitis
Answer: C
Rationale: Thiamine (Vitamin B1) is essential for clients with alcohol use disorder to
prevent permanent neurological damage from Wernicke-Korsakoff syndrome.
8. A client with PTSD is experiencing a flashback. Which of the following is an
appropriate grounding technique?
A. Encouraging the client to close their eyes
B. Leaving the client alone to process the event
C. Asking the client to list five things they can see in the room
D. Turning off all lights and minimizing noise
Answer: C
Rationale: Grounding techniques like identifying environmental objects help the client
stay in the present moment and end the flashback.
