NUR253 Exam 3 V2 | Mental Health
Nursing Q&A with Rationale | Galen
College of Nursing
1. A patient is prescribed Lithium Carbonate for Bipolar Disorder. What is the therapeutic
blood level range for this medication?
A. 0.1 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.5 mEq/L
D. 3.0 - 4.5 mEq/L
Answer: B
Rationale: The standard therapeutic range for lithium is 0.6 to 1.2 mEq/L for most adult
patients. Monitoring is essential because the window between a therapeutic dose and a
toxic dose is very narrow. Nurses must educate patients on the importance of regular blood
tests to prevent toxicity.
2. Which laboratory test is most critical for a nurse to monitor for a patient taking Clozapine?
A. Serum Glucose
B. Liver Function Tests
C. Platelet count
D. White Blood Cell (WBC) count
,Answer: D
Rationale: Clozapine is associated with a risk of agranulocytosis, which is a dangerous
drop in white blood cells. Patients must have weekly or bi-weekly blood draws to ensure
their immune system remains functional. A significant decrease in WBC requires
immediate discontinuation of the medication to prevent life-threatening infections.
3. A patient taking an SSRI for depression presents with high fever, muscle rigidity, and rapid
changes in mental status. What condition should the nurse suspect?
A. Agranulocytosis
B. Neuroleptic Malignant Syndrome
C. Tardive Dyskinesia
D. Serotonin Syndrome
Answer: D
Rationale: Serotonin syndrome occurs when there is an over-activation of serotonin
receptors in the central nervous system. Common symptoms include hyperthermia,
agitation, and hyperreflexia. This is a medical emergency that requires immediate cessation
of the causative drug and supportive care.
4. When educating a patient on Phenelzine (an MAOI), which food should the nurse instruct
them to avoid?
A. Fresh Apples
B. Grilled Chicken
, C. Aged Cheese
D. Scrambled Eggs
Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, which can lead to a hypertensive
crisis if high-tyramine foods are consumed. Aged cheeses, cured meats, and red wines are
high in tyramine and must be strictly avoided. The nurse must provide a detailed list of safe
and unsafe foods to ensure patient safety.
5. A patient with Schizophrenia exhibits involuntary tongue thrusting and lip-smacking. How
should the nurse document this finding?
A. Akathisia
B. Tardive Dyskinesia
C. Dystonia
D. Pseudo-parkinsonism
Answer: B
Rationale: Tardive dyskinesia is a late-occurring side effect of long-term antipsychotic use
characterized by repetitive, involuntary movements. It often affects the face, mouth, and
tongue, such as grimacing or lip-smacking. The nurse should use the Abnormal Involuntary
Movement Scale (AIMS) to track the progression of these symptoms.
Nursing Q&A with Rationale | Galen
College of Nursing
1. A patient is prescribed Lithium Carbonate for Bipolar Disorder. What is the therapeutic
blood level range for this medication?
A. 0.1 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.5 mEq/L
D. 3.0 - 4.5 mEq/L
Answer: B
Rationale: The standard therapeutic range for lithium is 0.6 to 1.2 mEq/L for most adult
patients. Monitoring is essential because the window between a therapeutic dose and a
toxic dose is very narrow. Nurses must educate patients on the importance of regular blood
tests to prevent toxicity.
2. Which laboratory test is most critical for a nurse to monitor for a patient taking Clozapine?
A. Serum Glucose
B. Liver Function Tests
C. Platelet count
D. White Blood Cell (WBC) count
,Answer: D
Rationale: Clozapine is associated with a risk of agranulocytosis, which is a dangerous
drop in white blood cells. Patients must have weekly or bi-weekly blood draws to ensure
their immune system remains functional. A significant decrease in WBC requires
immediate discontinuation of the medication to prevent life-threatening infections.
3. A patient taking an SSRI for depression presents with high fever, muscle rigidity, and rapid
changes in mental status. What condition should the nurse suspect?
A. Agranulocytosis
B. Neuroleptic Malignant Syndrome
C. Tardive Dyskinesia
D. Serotonin Syndrome
Answer: D
Rationale: Serotonin syndrome occurs when there is an over-activation of serotonin
receptors in the central nervous system. Common symptoms include hyperthermia,
agitation, and hyperreflexia. This is a medical emergency that requires immediate cessation
of the causative drug and supportive care.
4. When educating a patient on Phenelzine (an MAOI), which food should the nurse instruct
them to avoid?
A. Fresh Apples
B. Grilled Chicken
, C. Aged Cheese
D. Scrambled Eggs
Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, which can lead to a hypertensive
crisis if high-tyramine foods are consumed. Aged cheeses, cured meats, and red wines are
high in tyramine and must be strictly avoided. The nurse must provide a detailed list of safe
and unsafe foods to ensure patient safety.
5. A patient with Schizophrenia exhibits involuntary tongue thrusting and lip-smacking. How
should the nurse document this finding?
A. Akathisia
B. Tardive Dyskinesia
C. Dystonia
D. Pseudo-parkinsonism
Answer: B
Rationale: Tardive dyskinesia is a late-occurring side effect of long-term antipsychotic use
characterized by repetitive, involuntary movements. It often affects the face, mouth, and
tongue, such as grimacing or lip-smacking. The nurse should use the Abnormal Involuntary
Movement Scale (AIMS) to track the progression of these symptoms.
