NSG 3450 Final Exam V2 | NSG 3450
Mental Health Guide | Actual Q&A with
Rationale (NSG3450 Final Exam) | Galen
College of Nursing
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most appropriate initial response by the nurse?
A. “I don’t hear the voices you are talking about, but I understand they are real to you.”
B. “You should try to ignore the voices and focus on the television.”
C. “What are the voices telling you to do right now?”
D. “The voices are just a result of your chemical imbalance and are not real.”
Answer: C
Rationale: Assessing the content of the hallucinations is the priority to ensure the safety of
the client and others. The nurse must determine if the hallucinations are command-
oriented in nature. This step precedes validating the client’s feelings or presenting reality
regarding the auditory stimuli.
2. A client is prescribed Lithium Carbonate for the treatment of Bipolar I Disorder. Which
serum lithium level would the nurse identify as within the therapeutic range?
A. 0.4 mEq/L
B. 0.9 mEq/L
,C. 1.8 mEq/L
D. 2.2 mEq/L
Answer: B
Rationale: The therapeutic range for lithium is generally considered to be 0.6 to 1.2 mEq/L
for maintenance therapy. Levels below 0.6 are usually sub-therapeutic, while levels above
1.5 indicate toxicity. Regular blood monitoring is essential to prevent complications such as
renal impairment or neurological damage.
3. A nurse is evaluating a client for Extrapyramidal Symptoms (EPS). Which of the following
findings should the nurse document as akathisia?
A. Involuntary upward deviation of the eyes
B. Continuous restlessness and the inability to sit still
C. Muscular weakness and lack of energy
D. Muscle spasms of the neck and back
Answer: B
Rationale: Akathisia is characterized by subjective feelings of inner restlessness and the
objective need to move. It is a common side effect of first-generation antipsychotics but can
occur with second-generation agents as well. Managing this symptom often involves
reducing the medication dosage or administering beta-blockers.
, 4. A client with Major Depressive Disorder is started on Phenelzine. Which food choice by the
client indicates an understanding of dietary restrictions?
A. Smoked salmon on a sourdough bagel
B. Pepperoni pizza with extra cheese
C. A glass of red wine and aged cheddar
D. Grilled chicken with a side of steamed broccoli
Answer: D
Rationale: Phenelzine is an MAOI that requires a low-tyramine diet to prevent a
hypertensive crisis. Foods like aged cheeses, cured meats, and fermented products are high
in tyramine and must be avoided. Grilled chicken and fresh vegetables are safe options that
do not contain tyramine concentrations.
5. A nurse is performing a suicide risk assessment. Which client statement represents the
highest level of lethality?
A. “I have a loaded gun in my nightstand and I’m going to use it tonight.”
B. “I have been thinking about ending it all if things don’t get better.”
C. “I bought some extra pills last week just in case I need them.”
D. “Sometimes I wish I could just go to sleep and never wake up.”
Answer: A
Mental Health Guide | Actual Q&A with
Rationale (NSG3450 Final Exam) | Galen
College of Nursing
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most appropriate initial response by the nurse?
A. “I don’t hear the voices you are talking about, but I understand they are real to you.”
B. “You should try to ignore the voices and focus on the television.”
C. “What are the voices telling you to do right now?”
D. “The voices are just a result of your chemical imbalance and are not real.”
Answer: C
Rationale: Assessing the content of the hallucinations is the priority to ensure the safety of
the client and others. The nurse must determine if the hallucinations are command-
oriented in nature. This step precedes validating the client’s feelings or presenting reality
regarding the auditory stimuli.
2. A client is prescribed Lithium Carbonate for the treatment of Bipolar I Disorder. Which
serum lithium level would the nurse identify as within the therapeutic range?
A. 0.4 mEq/L
B. 0.9 mEq/L
,C. 1.8 mEq/L
D. 2.2 mEq/L
Answer: B
Rationale: The therapeutic range for lithium is generally considered to be 0.6 to 1.2 mEq/L
for maintenance therapy. Levels below 0.6 are usually sub-therapeutic, while levels above
1.5 indicate toxicity. Regular blood monitoring is essential to prevent complications such as
renal impairment or neurological damage.
3. A nurse is evaluating a client for Extrapyramidal Symptoms (EPS). Which of the following
findings should the nurse document as akathisia?
A. Involuntary upward deviation of the eyes
B. Continuous restlessness and the inability to sit still
C. Muscular weakness and lack of energy
D. Muscle spasms of the neck and back
Answer: B
Rationale: Akathisia is characterized by subjective feelings of inner restlessness and the
objective need to move. It is a common side effect of first-generation antipsychotics but can
occur with second-generation agents as well. Managing this symptom often involves
reducing the medication dosage or administering beta-blockers.
, 4. A client with Major Depressive Disorder is started on Phenelzine. Which food choice by the
client indicates an understanding of dietary restrictions?
A. Smoked salmon on a sourdough bagel
B. Pepperoni pizza with extra cheese
C. A glass of red wine and aged cheddar
D. Grilled chicken with a side of steamed broccoli
Answer: D
Rationale: Phenelzine is an MAOI that requires a low-tyramine diet to prevent a
hypertensive crisis. Foods like aged cheeses, cured meats, and fermented products are high
in tyramine and must be avoided. Grilled chicken and fresh vegetables are safe options that
do not contain tyramine concentrations.
5. A nurse is performing a suicide risk assessment. Which client statement represents the
highest level of lethality?
A. “I have a loaded gun in my nightstand and I’m going to use it tonight.”
B. “I have been thinking about ending it all if things don’t get better.”
C. “I bought some extra pills last week just in case I need them.”
D. “Sometimes I wish I could just go to sleep and never wake up.”
Answer: A
