NUR 384 Exam 3 – Mental Health Nursing (2026)
Concordia University | Practice Questions &
Rationales
1. A client is brought to the emergency department by police
after threatening to jump off a bridge. The client states, "I have
no reason to live anymore." Which legal criterion allows the
healthcare provider to hospitalize the client involuntarily?
A) The client is unable to provide for basic personal needs.
B) The client poses an imminent danger to self or others.
C) The client has a severe and persistent mental illness.
D) The client lacks insight into their psychiatric condition.
<span style="color:red;">Answer: B) The client poses an
imminent danger to self or others.</span>
Rationale: Involuntary commitment (civil commitment) requires
that the individual poses an imminent, physical danger to
themselves (e.g., suicidal intent) or others (e.g., homicidal
intent), or is gravely disabled and unable to meet basic survival
needs.
,2. A client with severe Alzheimer’s disease is admitted to a
medical unit for dehydration. The client repeatedly tries to pull
out their IV line and shouts, "Get these snakes off me!" Which
nursing intervention is the priority?
A) Administer a PRN dose of haloperidol.
B) Apply soft wrist restraints immediately.
C) Assess the client for underlying physical causes of the
delirium.
D) Remind the client that there are no snakes and they are in a
hospital.
<span style="color:red;">Answer: C) Assess the client for
underlying physical causes of the delirium.</span>
Rationale: Clients with dementia are highly susceptible to
delirium superimposed on dementia, which is often triggered
by physical issues like dehydration, infection, or medication
interactions. The priority is to assess and treat the underlying
physical cause of the sudden change in behavior/hallucinations.
3. A nurse is caring for a client with Lewy Body Dementia (LBD).
The nurse knows that which pharmacological intervention must
be strictly avoided in this client?
A) Cholinesterase inhibitors (e.g., donepezil)
,B) Traditional antipsychotics (e.g., haloperidol)
C) Selective serotonin reuptake inhibitors (e.g., sertraline)
D) NMDA receptor antagonists (e.g., memantine)
<span style="color:red;">Answer: B) Traditional antipsychotics
(e.g., haloperidol)</span>
Rationale: Clients with LBD have severe neuroleptic sensitivity.
Administering traditional (or even some atypical) antipsychotics
can cause irreversible parkinsonism, severe rigidity, and even
death.
4. A client with a history of alcohol use disorder is prescribed
naltrexone. The nurse understands that the primary mechanism
of action of this medication is to:
A) Produce severe nausea and vomiting if alcohol is consumed.
B) Block the pleasurable, euphoric effects of alcohol.
C) Decrease alcohol cravings by acting on GABA receptors.
D) Replace alcohol with a safer, controlled substance.
<span style="color:red;">Answer: B) Block the pleasurable,
euphoric effects of alcohol.</span>
Rationale: Naltrexone is an opioid antagonist. It blocks the
endogenous opioid release that occurs when drinking alcohol,
, thereby reducing the craving and the rewarding/euphoric
effects of alcohol. Disulfiram is the medication that causes
nausea/vomiting.
5. A nurse is conducting a mental status examination on a client
with depression. The client states, "It's no use, everything I try
turns out wrong. I always fail." Which cognitive distortion is the
client exhibiting?
A) Magical thinking
B) Dichotomous thinking
C) Overgeneralization
D) Mind reading
<span style="color:red;">Answer: C) Overgeneralization</span>
Rationale: Overgeneralization involves taking a single negative
event and applying it globally to all situations ("everything I try
turns out wrong," "I always fail"). This is a core cognitive
distortion seen in depression.
6. A 9-year-old child is admitted to a psychiatric unit. The child is
highly active, interrupts constantly, and has difficulty waiting
their turn during group activities. Which medication does the
nurse anticipate administering?
Concordia University | Practice Questions &
Rationales
1. A client is brought to the emergency department by police
after threatening to jump off a bridge. The client states, "I have
no reason to live anymore." Which legal criterion allows the
healthcare provider to hospitalize the client involuntarily?
A) The client is unable to provide for basic personal needs.
B) The client poses an imminent danger to self or others.
C) The client has a severe and persistent mental illness.
D) The client lacks insight into their psychiatric condition.
<span style="color:red;">Answer: B) The client poses an
imminent danger to self or others.</span>
Rationale: Involuntary commitment (civil commitment) requires
that the individual poses an imminent, physical danger to
themselves (e.g., suicidal intent) or others (e.g., homicidal
intent), or is gravely disabled and unable to meet basic survival
needs.
,2. A client with severe Alzheimer’s disease is admitted to a
medical unit for dehydration. The client repeatedly tries to pull
out their IV line and shouts, "Get these snakes off me!" Which
nursing intervention is the priority?
A) Administer a PRN dose of haloperidol.
B) Apply soft wrist restraints immediately.
C) Assess the client for underlying physical causes of the
delirium.
D) Remind the client that there are no snakes and they are in a
hospital.
<span style="color:red;">Answer: C) Assess the client for
underlying physical causes of the delirium.</span>
Rationale: Clients with dementia are highly susceptible to
delirium superimposed on dementia, which is often triggered
by physical issues like dehydration, infection, or medication
interactions. The priority is to assess and treat the underlying
physical cause of the sudden change in behavior/hallucinations.
3. A nurse is caring for a client with Lewy Body Dementia (LBD).
The nurse knows that which pharmacological intervention must
be strictly avoided in this client?
A) Cholinesterase inhibitors (e.g., donepezil)
,B) Traditional antipsychotics (e.g., haloperidol)
C) Selective serotonin reuptake inhibitors (e.g., sertraline)
D) NMDA receptor antagonists (e.g., memantine)
<span style="color:red;">Answer: B) Traditional antipsychotics
(e.g., haloperidol)</span>
Rationale: Clients with LBD have severe neuroleptic sensitivity.
Administering traditional (or even some atypical) antipsychotics
can cause irreversible parkinsonism, severe rigidity, and even
death.
4. A client with a history of alcohol use disorder is prescribed
naltrexone. The nurse understands that the primary mechanism
of action of this medication is to:
A) Produce severe nausea and vomiting if alcohol is consumed.
B) Block the pleasurable, euphoric effects of alcohol.
C) Decrease alcohol cravings by acting on GABA receptors.
D) Replace alcohol with a safer, controlled substance.
<span style="color:red;">Answer: B) Block the pleasurable,
euphoric effects of alcohol.</span>
Rationale: Naltrexone is an opioid antagonist. It blocks the
endogenous opioid release that occurs when drinking alcohol,
, thereby reducing the craving and the rewarding/euphoric
effects of alcohol. Disulfiram is the medication that causes
nausea/vomiting.
5. A nurse is conducting a mental status examination on a client
with depression. The client states, "It's no use, everything I try
turns out wrong. I always fail." Which cognitive distortion is the
client exhibiting?
A) Magical thinking
B) Dichotomous thinking
C) Overgeneralization
D) Mind reading
<span style="color:red;">Answer: C) Overgeneralization</span>
Rationale: Overgeneralization involves taking a single negative
event and applying it globally to all situations ("everything I try
turns out wrong," "I always fail"). This is a core cognitive
distortion seen in depression.
6. A 9-year-old child is admitted to a psychiatric unit. The child is
highly active, interrupts constantly, and has difficulty waiting
their turn during group activities. Which medication does the
nurse anticipate administering?
