NURS 222 Mental Health Nursing - Week 14 Final Mastery Quiz 2026
|WCU
1. A patient taking clozapine for treatment-resistant schizophrenia reports a
sore throat and fever. What is the priority nursing action?
A. Administer an antipyretic and document the findings.
B. Request an immediate White Blood Cell count and Absolute Neutrophil Count.
C. Advise the patient to increase fluid intake and rest.
D. Assess the patient for signs of neuroleptic malignant syndrome.
Answer: B
Rationale: Clozapine carries a high risk of agranulocytosis. A sore throat and fever are
early signs of infection that require immediate monitoring of the ANC to ensure it has not
fallen below safe levels.
2. Which assessment finding is most characteristic of Neuroleptic Malignant
Syndrome (NMS) compared to Serotonin Syndrome?
A. Hyperreflexia and myoclonus
B. ‘Lead-pipe’ muscle rigidity and severe hyperpyrexia
C. Tachycardia and diaphoresis
D. Altered mental status and agitation
Answer: B
Rationale: While both involve fever and autonomic instability, NMS is characterized by
‘lead-pipe’ rigidity, whereas Serotonin Syndrome typically involves hyperreflexia and
tremors.
,3. A patient with Bipolar I Disorder has a lithium level of 1.8 mEq/L. Which
symptom should the nurse expect to observe?
A. Fine hand tremors and mild thirst
B. Confusion, ataxia, and persistent vomiting
C. Gastrointestinal upset and blurred vision
D. Polyuria and weight gain
Answer: B
Rationale: Lithium levels between 1.5 and 2.0 mEq/L represent advanced toxicity,
characterized by blurred vision, ataxia, persistent GI upset, and mental confusion.
4. Which legal principle justifies a psychiatrist’s decision to notify a third party
of a patient’s threat to harm them?
A. Duty to Warn (Tarasoff Rule)
B. Beneficence
C. Fidelity
D. Right to Least Restrictive Treatment
Answer: A
Rationale: The Duty to Warn (based on the Tarasoff case) mandates that mental health
professionals warn identifiable third parties of potential threats of violence.
5. A nurse is assessing a child with suspected physical abuse. Which finding is
most indicative of intentional injury?
A. Bruises on the shins and knees in various stages of healing.
B. A single linear laceration on the forehead.
C. Small abrasions on the elbows.
D. A spiral fracture of the humerus in a non-ambulatory infant.
Answer: D
, Rationale: Spiral fractures in children who cannot walk are highly suspicious of physical
abuse (twisting force), whereas bruises on bony prominences like shins are common in
active children.
6. In the ‘Cycle of Violence’ associated with domestic abuse, which phase is
characterized by the victim attempting to ‘keep the peace’ to avoid an
explosion?
A. Resolution phase
B. Acute battering phase
C. Honeymoon phase
D. Tension-building phase
Answer: D
Rationale: During the tension-building phase, the victim often walks on eggshells and tries
to satisfy the abuser’s demands to prevent an escalation to physical violence.
7. A patient diagnosed with Borderline Personality Disorder is praising one
nurse while telling another nurse that they are ‘incompetent and mean.’ This is
an example of:
A. Reaction formation
B. Projective identification
C. Intellectualization
D. Splitting
Answer: D
Rationale: Splitting is a common defense mechanism in BPD where individuals view
others as entirely ‘good’ or entirely ‘bad,’ unable to integrate positive and negative
qualities.
|WCU
1. A patient taking clozapine for treatment-resistant schizophrenia reports a
sore throat and fever. What is the priority nursing action?
A. Administer an antipyretic and document the findings.
B. Request an immediate White Blood Cell count and Absolute Neutrophil Count.
C. Advise the patient to increase fluid intake and rest.
D. Assess the patient for signs of neuroleptic malignant syndrome.
Answer: B
Rationale: Clozapine carries a high risk of agranulocytosis. A sore throat and fever are
early signs of infection that require immediate monitoring of the ANC to ensure it has not
fallen below safe levels.
2. Which assessment finding is most characteristic of Neuroleptic Malignant
Syndrome (NMS) compared to Serotonin Syndrome?
A. Hyperreflexia and myoclonus
B. ‘Lead-pipe’ muscle rigidity and severe hyperpyrexia
C. Tachycardia and diaphoresis
D. Altered mental status and agitation
Answer: B
Rationale: While both involve fever and autonomic instability, NMS is characterized by
‘lead-pipe’ rigidity, whereas Serotonin Syndrome typically involves hyperreflexia and
tremors.
,3. A patient with Bipolar I Disorder has a lithium level of 1.8 mEq/L. Which
symptom should the nurse expect to observe?
A. Fine hand tremors and mild thirst
B. Confusion, ataxia, and persistent vomiting
C. Gastrointestinal upset and blurred vision
D. Polyuria and weight gain
Answer: B
Rationale: Lithium levels between 1.5 and 2.0 mEq/L represent advanced toxicity,
characterized by blurred vision, ataxia, persistent GI upset, and mental confusion.
4. Which legal principle justifies a psychiatrist’s decision to notify a third party
of a patient’s threat to harm them?
A. Duty to Warn (Tarasoff Rule)
B. Beneficence
C. Fidelity
D. Right to Least Restrictive Treatment
Answer: A
Rationale: The Duty to Warn (based on the Tarasoff case) mandates that mental health
professionals warn identifiable third parties of potential threats of violence.
5. A nurse is assessing a child with suspected physical abuse. Which finding is
most indicative of intentional injury?
A. Bruises on the shins and knees in various stages of healing.
B. A single linear laceration on the forehead.
C. Small abrasions on the elbows.
D. A spiral fracture of the humerus in a non-ambulatory infant.
Answer: D
, Rationale: Spiral fractures in children who cannot walk are highly suspicious of physical
abuse (twisting force), whereas bruises on bony prominences like shins are common in
active children.
6. In the ‘Cycle of Violence’ associated with domestic abuse, which phase is
characterized by the victim attempting to ‘keep the peace’ to avoid an
explosion?
A. Resolution phase
B. Acute battering phase
C. Honeymoon phase
D. Tension-building phase
Answer: D
Rationale: During the tension-building phase, the victim often walks on eggshells and tries
to satisfy the abuser’s demands to prevent an escalation to physical violence.
7. A patient diagnosed with Borderline Personality Disorder is praising one
nurse while telling another nurse that they are ‘incompetent and mean.’ This is
an example of:
A. Reaction formation
B. Projective identification
C. Intellectualization
D. Splitting
Answer: D
Rationale: Splitting is a common defense mechanism in BPD where individuals view
others as entirely ‘good’ or entirely ‘bad,’ unable to integrate positive and negative
qualities.
