NURS 222: Mental Health/Psychiatric Nursing - Exam 2 Practice 2026
|WCU
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory value
is the priority for the nurse to monitor throughout treatment?
A. Blood Urea Nitrogen (BUN)
B. White Blood Cell (WBC) count
C. Serum Potassium
D. Hemoglobin A1C
Answer: B
Rationale: Clozapine carries a high risk of agranulocytosis. Strict monitoring of the WBC
count and Absolute Neutrophil Count (ANC) is required by law to prevent fatal infections.
2. A client is experiencing an acute manic episode. Which meal choice is most
appropriate for the nurse to provide?
A. Chicken fingers and an apple
B. Soup and a side salad
C. Steak and baked potato
D. Spaghetti and meatballs
Answer: A
Rationale: Patients in acute mania have high energy and cannot sit still to eat. ‘Finger
foods’ that are high in protein and calories allow them to eat while moving.
,3. Which assessment finding is most indicative of Neuroleptic Malignant
Syndrome (NMS) in a patient taking Haloperidol?
A. Hyperpyrexia and muscle rigidity
B. Hypotension and bradycardia
C. Restlessness and pacing
D. Dry mouth and blurred vision
Answer: A
Rationale: NMS is a life-threatening emergency characterized by severe muscle rigidity,
high fever (hyperpyrexia), tachycardia, and autonomic instability.
4. A nurse is caring for a client with Major Depressive Disorder. The client states,
‘I don’t think I can go on anymore.’ Which is the nurse’s priority action?
A. Ask the client, ‘Do you have a plan to hurt yourself?’
B. Notify the family immediately
C. Administer an ordered antidepressant
D. Document the statement in the chart
Answer: A
Rationale: Safety is the priority. The nurse must directly assess for suicidal ideation and
the lethality of a potential plan.
5. A patient taking Lithium Carbonate for Bipolar Disorder has a serum level of
1.8 mEq/L. What is the nurse’s first action?
A. Hold the medication and notify the provider
B. Increase fluid intake
C. Administer the next dose as scheduled
D. Request a repeat lab draw in 24 hours
Answer: A
Rationale: The therapeutic range for Lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates moderate toxicity; the drug must be held.
, 6. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs)?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Answer: C
Rationale: SSRIs work by inhibiting the reuptake of serotonin in the synaptic cleft,
increasing its availability to improve mood.
7. A patient on Phenelzine (an MAOI) must avoid which of the following foods
to prevent a hypertensive crisis?
A. Aged cheddar cheese and red wine
B. Fresh apples and oranges
C. Grilled chicken and white rice
D. Boiled eggs and toast
Answer: A
Rationale: MAOIs interact with tyramine-rich foods (aged cheeses, fermented meats, red
wine), leading to a massive release of norepinephrine and hypertensive crisis.
8. A nurse observes a patient with Schizophrenia standing in the corner,
motionless, in an awkward position for several hours. This is documented as:
A. Akathisia
B. Anhedonia
C. Echolalia
D. Waxy flexibility
Answer: D
Rationale: Waxy flexibility is a catatonic symptom where the patient maintains a given
posture for long periods even if it is uncomfortable.
|WCU
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory value
is the priority for the nurse to monitor throughout treatment?
A. Blood Urea Nitrogen (BUN)
B. White Blood Cell (WBC) count
C. Serum Potassium
D. Hemoglobin A1C
Answer: B
Rationale: Clozapine carries a high risk of agranulocytosis. Strict monitoring of the WBC
count and Absolute Neutrophil Count (ANC) is required by law to prevent fatal infections.
2. A client is experiencing an acute manic episode. Which meal choice is most
appropriate for the nurse to provide?
A. Chicken fingers and an apple
B. Soup and a side salad
C. Steak and baked potato
D. Spaghetti and meatballs
Answer: A
Rationale: Patients in acute mania have high energy and cannot sit still to eat. ‘Finger
foods’ that are high in protein and calories allow them to eat while moving.
,3. Which assessment finding is most indicative of Neuroleptic Malignant
Syndrome (NMS) in a patient taking Haloperidol?
A. Hyperpyrexia and muscle rigidity
B. Hypotension and bradycardia
C. Restlessness and pacing
D. Dry mouth and blurred vision
Answer: A
Rationale: NMS is a life-threatening emergency characterized by severe muscle rigidity,
high fever (hyperpyrexia), tachycardia, and autonomic instability.
4. A nurse is caring for a client with Major Depressive Disorder. The client states,
‘I don’t think I can go on anymore.’ Which is the nurse’s priority action?
A. Ask the client, ‘Do you have a plan to hurt yourself?’
B. Notify the family immediately
C. Administer an ordered antidepressant
D. Document the statement in the chart
Answer: A
Rationale: Safety is the priority. The nurse must directly assess for suicidal ideation and
the lethality of a potential plan.
5. A patient taking Lithium Carbonate for Bipolar Disorder has a serum level of
1.8 mEq/L. What is the nurse’s first action?
A. Hold the medication and notify the provider
B. Increase fluid intake
C. Administer the next dose as scheduled
D. Request a repeat lab draw in 24 hours
Answer: A
Rationale: The therapeutic range for Lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates moderate toxicity; the drug must be held.
, 6. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs)?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Answer: C
Rationale: SSRIs work by inhibiting the reuptake of serotonin in the synaptic cleft,
increasing its availability to improve mood.
7. A patient on Phenelzine (an MAOI) must avoid which of the following foods
to prevent a hypertensive crisis?
A. Aged cheddar cheese and red wine
B. Fresh apples and oranges
C. Grilled chicken and white rice
D. Boiled eggs and toast
Answer: A
Rationale: MAOIs interact with tyramine-rich foods (aged cheeses, fermented meats, red
wine), leading to a massive release of norepinephrine and hypertensive crisis.
8. A nurse observes a patient with Schizophrenia standing in the corner,
motionless, in an awkward position for several hours. This is documented as:
A. Akathisia
B. Anhedonia
C. Echolalia
D. Waxy flexibility
Answer: D
Rationale: Waxy flexibility is a catatonic symptom where the patient maintains a given
posture for long periods even if it is uncomfortable.
