NUR 253 Exam 4 V1 | Mental
Health Nursing Q&A with Rationale
| Galen College of Nursing
1. A patient is prescribed Lithium carbonate for the management of bipolar disorder. Which
of the following lab values indicates a therapeutic maintenance level?
A. 0.2 to 0.4 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.5 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for Lithium during maintenance therapy is 0.6
to 1.2 mEq/L. Levels below this range are generally ineffective for mood stabilization, while
levels above 1.5 mEq/L represent toxicity. The nurse must monitor the patient for signs of
toxicity such as tremors, confusion, and ataxia.
2. A nurse is caring for an adolescent with Anorexia Nervosa. Which physical assessment
finding is most characteristic of this disorder?
A. Hypertension
B. Tachycardia
,C. Hyperthermia
D. Lanugo
Correct Answer: D
Expert Explanation: Lanugo, which is fine, downy hair growth on the face and back, is a
compensatory mechanism for heat loss in malnourished patients. These patients typically
exhibit hypotension and bradycardia rather than high blood pressure or fast heart rates.
The nurse should prioritize monitoring for electrolyte imbalances and cardiac arrhythmias.
3. A patient in a manic phase of Bipolar I disorder is pacing the hallways and refusing to sit for
meals. Which nutritional intervention is most appropriate?
A. Serve a three-course meal in the dining room
B. Place the patient in a quiet room for meals
C. Wait until the patient is calm to offer food
D. Provide high-calorie finger foods
Correct Answer: D
Expert Explanation: High-calorie finger foods allow the patient to maintain nutritional
intake while satisfying the need for movement during mania. Manic patients often lack the
focus to sit through a full meal or follow dining room protocols. The nurse must ensure
these snacks are nutrient-dense to prevent exhaustion and physical collapse.
, 4. A nurse is administering Haloperidol to a patient with Schizophrenia. Which side effect
should the nurse prioritize as a potentially life-threatening emergency?
A. Dry mouth
B. Blurry vision
C. Constipation
D. Neuroleptic Malignant Syndrome
Correct Answer: D
Expert Explanation: Neuroleptic Malignant Syndrome (NMS) is a rare but fatal reaction to
antipsychotic medications characterized by high fever and muscle rigidity. While dry
mouth and constipation are common anticholinergic side effects, they are not life-
threatening. The nurse must immediately stop the medication and notify the provider if
NMS is suspected.
5. A patient with Borderline Personality Disorder tells a nurse, ‘The day nurse is wonderful,
but you are the worst nurse on the unit.’ This behavior is an example of:
A. Splitting
B. Projection
C. Rationalization
D. Reaction Formation
Correct Answer: A
Health Nursing Q&A with Rationale
| Galen College of Nursing
1. A patient is prescribed Lithium carbonate for the management of bipolar disorder. Which
of the following lab values indicates a therapeutic maintenance level?
A. 0.2 to 0.4 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.5 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for Lithium during maintenance therapy is 0.6
to 1.2 mEq/L. Levels below this range are generally ineffective for mood stabilization, while
levels above 1.5 mEq/L represent toxicity. The nurse must monitor the patient for signs of
toxicity such as tremors, confusion, and ataxia.
2. A nurse is caring for an adolescent with Anorexia Nervosa. Which physical assessment
finding is most characteristic of this disorder?
A. Hypertension
B. Tachycardia
,C. Hyperthermia
D. Lanugo
Correct Answer: D
Expert Explanation: Lanugo, which is fine, downy hair growth on the face and back, is a
compensatory mechanism for heat loss in malnourished patients. These patients typically
exhibit hypotension and bradycardia rather than high blood pressure or fast heart rates.
The nurse should prioritize monitoring for electrolyte imbalances and cardiac arrhythmias.
3. A patient in a manic phase of Bipolar I disorder is pacing the hallways and refusing to sit for
meals. Which nutritional intervention is most appropriate?
A. Serve a three-course meal in the dining room
B. Place the patient in a quiet room for meals
C. Wait until the patient is calm to offer food
D. Provide high-calorie finger foods
Correct Answer: D
Expert Explanation: High-calorie finger foods allow the patient to maintain nutritional
intake while satisfying the need for movement during mania. Manic patients often lack the
focus to sit through a full meal or follow dining room protocols. The nurse must ensure
these snacks are nutrient-dense to prevent exhaustion and physical collapse.
, 4. A nurse is administering Haloperidol to a patient with Schizophrenia. Which side effect
should the nurse prioritize as a potentially life-threatening emergency?
A. Dry mouth
B. Blurry vision
C. Constipation
D. Neuroleptic Malignant Syndrome
Correct Answer: D
Expert Explanation: Neuroleptic Malignant Syndrome (NMS) is a rare but fatal reaction to
antipsychotic medications characterized by high fever and muscle rigidity. While dry
mouth and constipation are common anticholinergic side effects, they are not life-
threatening. The nurse must immediately stop the medication and notify the provider if
NMS is suspected.
5. A patient with Borderline Personality Disorder tells a nurse, ‘The day nurse is wonderful,
but you are the worst nurse on the unit.’ This behavior is an example of:
A. Splitting
B. Projection
C. Rationalization
D. Reaction Formation
Correct Answer: A
