NSG 350 Mental Health Week 1 Exam ACTUAL
EXAM 2026/2027 | Psychiatric-Mental Health
Nursing Foundations | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION A: MULTIPLE CHOICE QUESTIONS (80 Questions)
Q1: The nurse is admitting a client who was involuntarily committed to the psychiatric unit. Which
action by the nurse best demonstrates understanding of the client's legal rights upon admission?
A. Placing the client in seclusion until they agree to participate in treatment
B. Providing the client with written information about their right to refuse treatment [CORRECT]
C. Explaining that the client must sign a consent form for all medications
D. Informing the client that they have lost their right to confidentiality
Correct Answer: B
Rationale: Clients who are involuntarily committed retain the right to refuse treatment except in
emergencies. The nurse must provide information about these rights, including the right to refuse
medication and treatment, to ensure informed decision-making and uphold patient autonomy. This
action demonstrates respect for legal rights and supports the therapeutic relationship by establishing
trust through transparency.
Q2: A client diagnosed with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through
the television." Which response by the nurse is most therapeutic?
A. "That's not true. The FBI has no interest in you."
B. "Let's talk about something else to take your mind off it."
C. "It must be frightening to feel like you're being watched." [CORRECT]
D. "I'll check to see if there are any cameras in your room."
Correct Answer: C
Rationale: Acknowledging the client's feelings without validating the delusion is an effective therapeutic
communication technique. This response demonstrates empathy, validates the emotional experience,
and maintains the therapeutic relationship while avoiding argumentation or reinforcement of the
,delusion. The nurse focuses on the affective component of the delusion rather than the content, which
reduces distress and fosters trust.
Q3: A client tells the nurse, "I've been so sad lately. Nothing matters anymore." Which response by the
nurse reflects active listening and encourages further expression?
A. "You should try to think more positively."
B. "I understand exactly how you feel."
C. "Tell me more about what 'nothing matters' means to you." [CORRECT]
D. "Everyone gets sad sometimes. You'll feel better soon."
Correct Answer: C
Rationale: Active listening involves using open-ended questions to explore the client's subjective
experience. This response invites the client to elaborate on their feelings, which facilitates assessment
and demonstrates genuine interest in their perspective. Open-ended questions are foundational to
therapeutic communication because they prevent the nurse from imposing interpretations and allow
the client to direct the conversation toward what is most meaningful to them.
Q4: The nurse is caring for a client who uses the defense mechanism of projection. Which client
statement best illustrates this defense mechanism?
A. "I don't need to worry about my drinking. My boss drinks way more than I do."
B. "My wife is the one with a temper problem, not me. She's always angry." [CORRECT]
C. "I can't remember anything about the accident. It's all a blank."
D. "I'm going to be the best nurse on the unit, no matter what."
Correct Answer: B
Rationale: Projection involves attributing one's own unacceptable thoughts, feelings, or behaviors to
another person. By blaming the spouse for having a temper, the client is unconsciously displacing their
own anger issues onto someone else, which is the hallmark of this primitive defense mechanism.
Projection protects the ego from anxiety by externalizing internal conflicts.
Q5: A client with major depressive disorder states, "I've been taking my sertraline every day like you
said." The nurse notes the client appears more agitated than during the previous session. What is the
nurse's priority action?
A. Document the client's agitation and continue monitoring
B. Instruct the client to stop taking the medication immediately
,C. Assess the client for signs of serotonin syndrome [CORRECT]
D. Tell the client to take a PRN dose of lorazepam
Correct Answer: C
Rationale: Sertraline (an SSRI) can cause serotonin syndrome, especially with new starts or dose
changes. Early signs include agitation, restlessness, tachycardia, and hyperthermia. The nurse should
assess for additional symptoms to prevent progression to a life-threatening emergency. Serotonin
syndrome requires immediate intervention including discontinuation of the serotonergic agent,
supportive care, and possible administration of cyproheptadine.
Q6: A client with bipolar disorder is prescribed lithium carbonate. The nurse reviews the client's
laboratory results and notes a serum lithium level of 1.8 mEq/L. Which nursing action is priority?
A. Administer the next scheduled dose as ordered
B. Hold the dose and notify the physician [CORRECT]
C. Encourage the client to increase fluid intake
D. Document the result and continue routine monitoring
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L for maintenance and 1.0 to 1.5 mEq/L
for acute mania. A level of 1.8 mEq/L indicates lithium toxicity, which can cause severe neurological,
cardiac, and renal complications. The nurse must hold the dose and notify the physician immediately.
Toxicity symptoms include coarse tremor, ataxia, confusion, seizures, and potentially fatal arrhythmias.
Q7: The nurse is conducting a mental status examination and asks the client to interpret the proverb "A
rolling stone gathers no moss." The client responds, "Stones don't grow moss because they keep
moving." Which component of the mental status exam is being assessed, and what does this response
indicate?
A. Abstract thinking; concrete thinking [CORRECT]
B. Memory; immediate recall
C. Judgment; impaired judgment
D. Insight; lack of insight
Correct Answer: A
Rationale: Proverb interpretation assesses abstract thinking, the ability to understand symbolic or
metaphorical meaning rather than literal interpretation. The client's literal response ("stones don't grow
moss because they keep moving") indicates concrete thinking, which is commonly associated with
schizophrenia, intellectual disability, or organic brain disorders. Concrete thinking impairs the ability to
generalize, problem-solve, and understand figurative language.
, Q8: A client with borderline personality disorder becomes angry and threatens self-harm when the
nurse sets a limit on phone call duration. Which defense mechanism is the client most likely using?
A. Sublimation
B. Splitting [CORRECT]
C. Intellectualization
D. Reaction formation
Correct Answer: B
Rationale: Splitting is a primitive defense mechanism characteristic of borderline personality disorder in
which individuals view people, situations, or themselves as all good or all bad, with no middle ground.
When the nurse sets a limit, the client may shift from idealizing the nurse to devaluing them, perceiving
the limit as abandonment or persecution. Splitting protects the ego from the anxiety of ambivalence by
compartmentalizing experiences into extreme categories.
Q9: The nurse is caring for a client who was found wandering in traffic and is unable to provide a
coherent history. The client appears disheveled, has poor hygiene, and is responding to internal stimuli.
Which type of admission is most appropriate?
A. Voluntary admission
B. Involuntary emergency admission [CORRECT]
C. Observational admission
D. Outpatient commitment
Correct Answer: B
Rationale: Involuntary emergency admission is appropriate when a client presents an imminent danger
to self or others, or is gravely disabled and unable to meet basic needs. The client's behavior (wandering
in traffic, incoherence, poor self-care, responding to hallucinations) indicates imminent danger and
grave disability, meeting criteria for emergency involuntary commitment. This legal process protects the
client and society while ensuring due process rights are observed.
Q10: A client tells the nurse, "I don't need my antipsychotic medication. The voices stopped, so I'm
cured." Which nursing response demonstrates the best understanding of psychoeducation principles?
A. "You're right. If the voices stopped, you don't need medication anymore."
B. "The voices stopped because the medication is working. Stopping it may cause the symptoms to
return." [CORRECT]
C. "You must take your medication or you'll be committed again."
D. "The doctor knows what's best for you. Just keep taking it."
EXAM 2026/2027 | Psychiatric-Mental Health
Nursing Foundations | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION A: MULTIPLE CHOICE QUESTIONS (80 Questions)
Q1: The nurse is admitting a client who was involuntarily committed to the psychiatric unit. Which
action by the nurse best demonstrates understanding of the client's legal rights upon admission?
A. Placing the client in seclusion until they agree to participate in treatment
B. Providing the client with written information about their right to refuse treatment [CORRECT]
C. Explaining that the client must sign a consent form for all medications
D. Informing the client that they have lost their right to confidentiality
Correct Answer: B
Rationale: Clients who are involuntarily committed retain the right to refuse treatment except in
emergencies. The nurse must provide information about these rights, including the right to refuse
medication and treatment, to ensure informed decision-making and uphold patient autonomy. This
action demonstrates respect for legal rights and supports the therapeutic relationship by establishing
trust through transparency.
Q2: A client diagnosed with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through
the television." Which response by the nurse is most therapeutic?
A. "That's not true. The FBI has no interest in you."
B. "Let's talk about something else to take your mind off it."
C. "It must be frightening to feel like you're being watched." [CORRECT]
D. "I'll check to see if there are any cameras in your room."
Correct Answer: C
Rationale: Acknowledging the client's feelings without validating the delusion is an effective therapeutic
communication technique. This response demonstrates empathy, validates the emotional experience,
and maintains the therapeutic relationship while avoiding argumentation or reinforcement of the
,delusion. The nurse focuses on the affective component of the delusion rather than the content, which
reduces distress and fosters trust.
Q3: A client tells the nurse, "I've been so sad lately. Nothing matters anymore." Which response by the
nurse reflects active listening and encourages further expression?
A. "You should try to think more positively."
B. "I understand exactly how you feel."
C. "Tell me more about what 'nothing matters' means to you." [CORRECT]
D. "Everyone gets sad sometimes. You'll feel better soon."
Correct Answer: C
Rationale: Active listening involves using open-ended questions to explore the client's subjective
experience. This response invites the client to elaborate on their feelings, which facilitates assessment
and demonstrates genuine interest in their perspective. Open-ended questions are foundational to
therapeutic communication because they prevent the nurse from imposing interpretations and allow
the client to direct the conversation toward what is most meaningful to them.
Q4: The nurse is caring for a client who uses the defense mechanism of projection. Which client
statement best illustrates this defense mechanism?
A. "I don't need to worry about my drinking. My boss drinks way more than I do."
B. "My wife is the one with a temper problem, not me. She's always angry." [CORRECT]
C. "I can't remember anything about the accident. It's all a blank."
D. "I'm going to be the best nurse on the unit, no matter what."
Correct Answer: B
Rationale: Projection involves attributing one's own unacceptable thoughts, feelings, or behaviors to
another person. By blaming the spouse for having a temper, the client is unconsciously displacing their
own anger issues onto someone else, which is the hallmark of this primitive defense mechanism.
Projection protects the ego from anxiety by externalizing internal conflicts.
Q5: A client with major depressive disorder states, "I've been taking my sertraline every day like you
said." The nurse notes the client appears more agitated than during the previous session. What is the
nurse's priority action?
A. Document the client's agitation and continue monitoring
B. Instruct the client to stop taking the medication immediately
,C. Assess the client for signs of serotonin syndrome [CORRECT]
D. Tell the client to take a PRN dose of lorazepam
Correct Answer: C
Rationale: Sertraline (an SSRI) can cause serotonin syndrome, especially with new starts or dose
changes. Early signs include agitation, restlessness, tachycardia, and hyperthermia. The nurse should
assess for additional symptoms to prevent progression to a life-threatening emergency. Serotonin
syndrome requires immediate intervention including discontinuation of the serotonergic agent,
supportive care, and possible administration of cyproheptadine.
Q6: A client with bipolar disorder is prescribed lithium carbonate. The nurse reviews the client's
laboratory results and notes a serum lithium level of 1.8 mEq/L. Which nursing action is priority?
A. Administer the next scheduled dose as ordered
B. Hold the dose and notify the physician [CORRECT]
C. Encourage the client to increase fluid intake
D. Document the result and continue routine monitoring
Correct Answer: B
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L for maintenance and 1.0 to 1.5 mEq/L
for acute mania. A level of 1.8 mEq/L indicates lithium toxicity, which can cause severe neurological,
cardiac, and renal complications. The nurse must hold the dose and notify the physician immediately.
Toxicity symptoms include coarse tremor, ataxia, confusion, seizures, and potentially fatal arrhythmias.
Q7: The nurse is conducting a mental status examination and asks the client to interpret the proverb "A
rolling stone gathers no moss." The client responds, "Stones don't grow moss because they keep
moving." Which component of the mental status exam is being assessed, and what does this response
indicate?
A. Abstract thinking; concrete thinking [CORRECT]
B. Memory; immediate recall
C. Judgment; impaired judgment
D. Insight; lack of insight
Correct Answer: A
Rationale: Proverb interpretation assesses abstract thinking, the ability to understand symbolic or
metaphorical meaning rather than literal interpretation. The client's literal response ("stones don't grow
moss because they keep moving") indicates concrete thinking, which is commonly associated with
schizophrenia, intellectual disability, or organic brain disorders. Concrete thinking impairs the ability to
generalize, problem-solve, and understand figurative language.
, Q8: A client with borderline personality disorder becomes angry and threatens self-harm when the
nurse sets a limit on phone call duration. Which defense mechanism is the client most likely using?
A. Sublimation
B. Splitting [CORRECT]
C. Intellectualization
D. Reaction formation
Correct Answer: B
Rationale: Splitting is a primitive defense mechanism characteristic of borderline personality disorder in
which individuals view people, situations, or themselves as all good or all bad, with no middle ground.
When the nurse sets a limit, the client may shift from idealizing the nurse to devaluing them, perceiving
the limit as abandonment or persecution. Splitting protects the ego from the anxiety of ambivalence by
compartmentalizing experiences into extreme categories.
Q9: The nurse is caring for a client who was found wandering in traffic and is unable to provide a
coherent history. The client appears disheveled, has poor hygiene, and is responding to internal stimuli.
Which type of admission is most appropriate?
A. Voluntary admission
B. Involuntary emergency admission [CORRECT]
C. Observational admission
D. Outpatient commitment
Correct Answer: B
Rationale: Involuntary emergency admission is appropriate when a client presents an imminent danger
to self or others, or is gravely disabled and unable to meet basic needs. The client's behavior (wandering
in traffic, incoherence, poor self-care, responding to hallucinations) indicates imminent danger and
grave disability, meeting criteria for emergency involuntary commitment. This legal process protects the
client and society while ensuring due process rights are observed.
Q10: A client tells the nurse, "I don't need my antipsychotic medication. The voices stopped, so I'm
cured." Which nursing response demonstrates the best understanding of psychoeducation principles?
A. "You're right. If the voices stopped, you don't need medication anymore."
B. "The voices stopped because the medication is working. Stopping it may cause the symptoms to
return." [CORRECT]
C. "You must take your medication or you'll be committed again."
D. "The doctor knows what's best for you. Just keep taking it."
