NUR253 Exam 3 V1 | Mental Health
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Instruct the client to use deep breathing techniques.
B. Administer PRN antianxiety medication.
C. Stay with the client and remain calm.
D. Ask the client to describe what triggered the attack.
Answer: C
Rationale: Staying with the client provides a sense of security and safety during a period of
intense fear. A calm presence helps to decrease the client’s anxiety level by modeling
controlled behavior. The nurse should avoid asking complex questions until the acute panic
has subsided.
2. A client diagnosed with schizophrenia is prescribed Clozapine. Which laboratory value
should the nurse monitor most closely?
A. Serum potassium levels
B. Platelet count
C. Blood urea nitrogen (BUN)
,D. White blood cell (WBC) count
Answer: D
Rationale: Clozapine carries a high risk for agranulocytosis, which is a severe reduction in
white blood cells. Nurses must monitor the WBC count and absolute neutrophil count
(ANC) weekly at the start of therapy. If the WBC falls below a certain threshold, the
medication must be discontinued immediately to prevent life-threatening infection.
3. A client with Bipolar Disorder is in the manic phase. Which meal choice is most appropriate
for this client?
A. Steak with mashed potatoes and gravy
B. Soup and a salad with dressing
C. Spaghetti with meatballs
D. Chicken nuggets and an apple
Answer: D
Rationale: Clients in a manic state are often hyperactive and unable to sit down for a full
meal. Providing ‘finger foods’ allows them to consume calories while remaining on the
move. Chicken nuggets and an apple are portable and provide necessary protein and
nutrients.
4. Which of the following is a primary characteristic of Borderline Personality Disorder?
A. Lack of remorse for violating the rights of others
, B. Grandiosity and a need for admiration
C. Excessive emotionality and attention-seeking
D. Instability of affect, identity, and relationships
Answer: D
Rationale: Borderline Personality Disorder is defined by a pattern of instability in
interpersonal relationships and self-image. These clients often exhibit ‘splitting,’ which is
the tendency to view people as all good or all bad. They may also struggle with impulsive
behaviors and a chronic fear of abandonment.
5. A nurse is teaching a client who has a new prescription for Lithium Carbonate. Which of the
following should be included in the teaching?
A. Limit sodium intake to 1 gram per day.
B. Drink 2 to 3 liters of fluid daily.
C. Stop taking the medication if you experience a fine hand tremor.
D. Expect to lose weight during the first month of therapy.
Answer: B
Rationale: Adequate fluid intake is essential to maintain lithium levels and prevent
toxicity. Lithium is a salt, and dehydration can cause the kidneys to reabsorb lithium,
leading to dangerously high serum levels. Clients should also maintain a consistent intake
of dietary sodium to keep levels stable.
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Instruct the client to use deep breathing techniques.
B. Administer PRN antianxiety medication.
C. Stay with the client and remain calm.
D. Ask the client to describe what triggered the attack.
Answer: C
Rationale: Staying with the client provides a sense of security and safety during a period of
intense fear. A calm presence helps to decrease the client’s anxiety level by modeling
controlled behavior. The nurse should avoid asking complex questions until the acute panic
has subsided.
2. A client diagnosed with schizophrenia is prescribed Clozapine. Which laboratory value
should the nurse monitor most closely?
A. Serum potassium levels
B. Platelet count
C. Blood urea nitrogen (BUN)
,D. White blood cell (WBC) count
Answer: D
Rationale: Clozapine carries a high risk for agranulocytosis, which is a severe reduction in
white blood cells. Nurses must monitor the WBC count and absolute neutrophil count
(ANC) weekly at the start of therapy. If the WBC falls below a certain threshold, the
medication must be discontinued immediately to prevent life-threatening infection.
3. A client with Bipolar Disorder is in the manic phase. Which meal choice is most appropriate
for this client?
A. Steak with mashed potatoes and gravy
B. Soup and a salad with dressing
C. Spaghetti with meatballs
D. Chicken nuggets and an apple
Answer: D
Rationale: Clients in a manic state are often hyperactive and unable to sit down for a full
meal. Providing ‘finger foods’ allows them to consume calories while remaining on the
move. Chicken nuggets and an apple are portable and provide necessary protein and
nutrients.
4. Which of the following is a primary characteristic of Borderline Personality Disorder?
A. Lack of remorse for violating the rights of others
, B. Grandiosity and a need for admiration
C. Excessive emotionality and attention-seeking
D. Instability of affect, identity, and relationships
Answer: D
Rationale: Borderline Personality Disorder is defined by a pattern of instability in
interpersonal relationships and self-image. These clients often exhibit ‘splitting,’ which is
the tendency to view people as all good or all bad. They may also struggle with impulsive
behaviors and a chronic fear of abandonment.
5. A nurse is teaching a client who has a new prescription for Lithium Carbonate. Which of the
following should be included in the teaching?
A. Limit sodium intake to 1 gram per day.
B. Drink 2 to 3 liters of fluid daily.
C. Stop taking the medication if you experience a fine hand tremor.
D. Expect to lose weight during the first month of therapy.
Answer: B
Rationale: Adequate fluid intake is essential to maintain lithium levels and prevent
toxicity. Lithium is a salt, and dehydration can cause the kidneys to reabsorb lithium,
leading to dangerously high serum levels. Clients should also maintain a consistent intake
of dietary sodium to keep levels stable.
