NUR 210 MENTAL HEALTH NURSING COMPREHENSIVE EXAM
GUIDE 2026 EDITION
1. A client with schizophrenia is experiencing auditory hallucinations
commanding them to harm themselves. What is the nurse's
priority intervention?
A. Redirect the client to a quiet activity
B. Assess the client's suicide risk and safety immediately
C. Administer the prescribed antipsychotic medication
D. Teach the client grounding techniques
Correct Answer: B
Explanation: When clients experience command hallucinations to
harm themselves, suicide risk assessment and ensuring safety is
the absolute priority. While medication and coping strategies are
important, immediate safety assessment takes precedence.
Redirecting without assessment could miss an imminent crisis.
2. Which medication class is considered first-line treatment for
generalized anxiety disorder (GAD)?
A. Benzodiazepines
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Antipsychotics
D. Mood stabilizers
Correct Answer: B
Explanation: SSRIs are first-line pharmacotherapy for GAD due to
their efficacy and favorable side effect profile. Benzodiazepines are
avoided long-term due to addiction risk. Antipsychotics and mood
stabilizers are not first-line for GAD.
,3. A client with bipolar I disorder is in a manic episode. Which
behavior indicates the highest safety concern?
A. Talking rapidly and jumping between topics
B. Making grandiose plans for a new business
C. Acting impulsively with sexual indiscretions
D. Not sleeping for 3 days and spending money recklessly
Correct Answer: D
Explanation: Not sleeping for 3 days indicates severe mania with
risk for exhaustion, psychosis, and medical complications. Reckless
spending can lead to severe consequences. This combination
represents the highest immediate safety concern requiring
intervention.
4. What is the therapeutic range for lithium serum levels in acute
mania treatment?
A. 0.4-0.8 mEq/L
B. 0.8-1.2 mEq/L
C. 1.2-1.5 mEq/L
D. 1.5-2.0 mEq/L
Correct Answer: B
Explanation: The therapeutic range for acute mania is 0.8-1.2
mEq/L. Levels 0.4-0.8 are for maintenance. Levels above 1.5 mEq/L
indicate toxicity risk. Levels above 2.0 mEq/L are dangerous and
require immediate intervention.
,5. A client with major depressive disorder expresses hopelessness
and says "Everyone would be better off without me." What is the
nurse's best initial response?
A. "You have so much to live for."
B. "Tell me more about what you're feeling."
C. "Let's focus on the positive things in your life."
D. "Are you having thoughts of killing yourself?"
Correct Answer: D
Explanation: When a client expresses hopelessness and suggests
others would be better off without them, direct suicide risk
assessment is critical. This takes priority over therapeutic
communication techniques. The nurse must assess immediate
danger before other interventions.
6. Which symptom is most characteristic of post-traumatic stress
disorder (PTSD)?
A. Persistent sadness and anhedonia
B. Intrusive memories and avoidance of trauma reminders
C. Extreme mood swings between mania and depression
D. Delusions and auditory hallucinations
Correct Answer: B
Explanation: PTSD is characterized by intrusive memories
(flashbacks, nightmares), avoidance of trauma-related stimuli,
negative mood changes, and hyperarousal. Option A describes
depression, C describes bipolar disorder, and D describes
schizophrenia.
, 7. A client taking clozapine requires which essential monitoring?
A. Monthly liver function tests
B. Weekly blood pressure checks
C. Weekly to monthly absolute neutrophil count (ANC)
D. Daily blood glucose monitoring
Correct Answer: C
Explanation: Clozapine carries a black box warning for
agranulocytosis, requiring regular ANC monitoring (weekly
initially, then monthly if stable). This is the most critical safety
monitoring requirement for clozapine therapy.
8. Which defense mechanism is most commonly associated with
borderline personality disorder?
A. Sublimation
B. Splitting
C. Displacement
D. Rationalization
Correct Answer: B
Explanation: Splitting (viewing people or situations as all good or
all bad) is the hallmark defense mechanism in borderline
personality disorder. This contributes to unstable relationships and
self-image. The other options are more common in other
conditions.
9. A client with anorexia nervosa has a heart rate of 48 bpm and
blood pressure of 88/50 mmHg. What is the nurse's priority
action?
GUIDE 2026 EDITION
1. A client with schizophrenia is experiencing auditory hallucinations
commanding them to harm themselves. What is the nurse's
priority intervention?
A. Redirect the client to a quiet activity
B. Assess the client's suicide risk and safety immediately
C. Administer the prescribed antipsychotic medication
D. Teach the client grounding techniques
Correct Answer: B
Explanation: When clients experience command hallucinations to
harm themselves, suicide risk assessment and ensuring safety is
the absolute priority. While medication and coping strategies are
important, immediate safety assessment takes precedence.
Redirecting without assessment could miss an imminent crisis.
2. Which medication class is considered first-line treatment for
generalized anxiety disorder (GAD)?
A. Benzodiazepines
B. Selective serotonin reuptake inhibitors (SSRIs)
C. Antipsychotics
D. Mood stabilizers
Correct Answer: B
Explanation: SSRIs are first-line pharmacotherapy for GAD due to
their efficacy and favorable side effect profile. Benzodiazepines are
avoided long-term due to addiction risk. Antipsychotics and mood
stabilizers are not first-line for GAD.
,3. A client with bipolar I disorder is in a manic episode. Which
behavior indicates the highest safety concern?
A. Talking rapidly and jumping between topics
B. Making grandiose plans for a new business
C. Acting impulsively with sexual indiscretions
D. Not sleeping for 3 days and spending money recklessly
Correct Answer: D
Explanation: Not sleeping for 3 days indicates severe mania with
risk for exhaustion, psychosis, and medical complications. Reckless
spending can lead to severe consequences. This combination
represents the highest immediate safety concern requiring
intervention.
4. What is the therapeutic range for lithium serum levels in acute
mania treatment?
A. 0.4-0.8 mEq/L
B. 0.8-1.2 mEq/L
C. 1.2-1.5 mEq/L
D. 1.5-2.0 mEq/L
Correct Answer: B
Explanation: The therapeutic range for acute mania is 0.8-1.2
mEq/L. Levels 0.4-0.8 are for maintenance. Levels above 1.5 mEq/L
indicate toxicity risk. Levels above 2.0 mEq/L are dangerous and
require immediate intervention.
,5. A client with major depressive disorder expresses hopelessness
and says "Everyone would be better off without me." What is the
nurse's best initial response?
A. "You have so much to live for."
B. "Tell me more about what you're feeling."
C. "Let's focus on the positive things in your life."
D. "Are you having thoughts of killing yourself?"
Correct Answer: D
Explanation: When a client expresses hopelessness and suggests
others would be better off without them, direct suicide risk
assessment is critical. This takes priority over therapeutic
communication techniques. The nurse must assess immediate
danger before other interventions.
6. Which symptom is most characteristic of post-traumatic stress
disorder (PTSD)?
A. Persistent sadness and anhedonia
B. Intrusive memories and avoidance of trauma reminders
C. Extreme mood swings between mania and depression
D. Delusions and auditory hallucinations
Correct Answer: B
Explanation: PTSD is characterized by intrusive memories
(flashbacks, nightmares), avoidance of trauma-related stimuli,
negative mood changes, and hyperarousal. Option A describes
depression, C describes bipolar disorder, and D describes
schizophrenia.
, 7. A client taking clozapine requires which essential monitoring?
A. Monthly liver function tests
B. Weekly blood pressure checks
C. Weekly to monthly absolute neutrophil count (ANC)
D. Daily blood glucose monitoring
Correct Answer: C
Explanation: Clozapine carries a black box warning for
agranulocytosis, requiring regular ANC monitoring (weekly
initially, then monthly if stable). This is the most critical safety
monitoring requirement for clozapine therapy.
8. Which defense mechanism is most commonly associated with
borderline personality disorder?
A. Sublimation
B. Splitting
C. Displacement
D. Rationalization
Correct Answer: B
Explanation: Splitting (viewing people or situations as all good or
all bad) is the hallmark defense mechanism in borderline
personality disorder. This contributes to unstable relationships and
self-image. The other options are more common in other
conditions.
9. A client with anorexia nervosa has a heart rate of 48 bpm and
blood pressure of 88/50 mmHg. What is the nurse's priority
action?
