CEA MENTAL HEALTH NURSING EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant Download
PDF
EXAM COVERAGE
1. Neurobiological Foundations, Psychopharmacology, and Advanced Psychopathology
2. Therapeutic Modalities, Crisis Intervention, and Evidence-Based Psychotherapy
3. Forensic Psychiatry, Ethics, and Specialized Population Mental Health Care
1. A 34-year-old male with schizophrenia who is stabilized on clozapine presents to the psychiatric
clinic reporting severe malaise, fever, and a sore throat. Laboratory studies reveal a total white
blood cell count of 2,200/mcL and an absolute neutrophil count of 900/mcL. What is the
immediate priority nursing intervention?
A. Administer a stat dose of oral diphenhydramine to manage potential extrapyramidal
symptoms
B. Immediately withhold clozapine, notify the prescribing provider, and institute strict
infection control precautions
C. Recheck the complete blood count in 24 hours while maintaining the current clozapine dosage
D. Switch the patient immediately to high-potency typical antipsychotic medication
CORRECT ANSWER : B
Rationale: Clozapine carries a significant risk of agranulocytosis, which requires immediate
discontinuation of the medication if the absolute neutrophil count drops below 1,000/mcL to
prevent life-threatening sepsis. Continuing the medication or delaying notification endangers the
patient, while options A and D do not address the urgent blood dyscrasia.
2. A 28-year-old female diagnosed with bipolar I disorder is admitted in a severe manic state. She
is prescribed lithium carbonate 900 mg daily. Which baseline laboratory assessments must be
reviewed before initiating therapy?
A. Complete blood count, liver function tests, and erythrocyte sedimentation rate
B. Serum creatinine, blood urea nitrogen, thyroid-stimulating hormone, and a baseline
electrocardiogram
, C. Serum glucose, hemoglobin A1c, and lipid panel
D. Serum folate, vitamin B12 levels, and coagulation profiles
CORRECT ANSWER : B
Rationale: Lithium is excreted almost exclusively by the kidneys and can alter thyroid function,
making renal function tests (creatinine, BUN) and thyroid function tests (TSH) mandatory
baselines. An ECG is also indicated due to potential cardiac conduction effects. The other panels
are not primary baselines for lithium therapy.
3. A 45-year-old male is brought to the emergency department exhibiting psychomotor agitation,
confusion, diaphoresis, tachycardia, and myoclonus. He recently started sertraline and was
prescribed tramadol for chronic back pain. What condition is most likely occurring?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Acute lithium toxicity
CORRECT ANSWER : B
Rationale: Serotonin syndrome arises from overstimulation of central and peripheral serotonin
receptors, typically triggered by combining serotonergic agents like an SSRI (sertraline) with an
opioid that inhibits serotonin reuptake (tramadol). Key signs include autonomic instability,
altered mental status, and neuromuscular hyperactivity like myoclonus. Neuroleptic malignant
syndrome involves dopamine blockade, whereas anticholinergic toxicity features dry skin and
urinary retention rather than diaphoresis and hyperreflexia.
4. A psychiatric-mental health nurse is evaluating a patient taking haloperidol who exhibits
rhythmic, involuntary movements of the tongue, chewing motions, and purposeless jerky
movements of the extremities. What is the appropriate nursing action?
A. Administer benztropine immediately to reverse acute dystonic reactions
B. Assess the symptoms using the Abnormal Involuntary Movement Scale (AIMS) and
notify the provider for possible medication discontinuation
C. Reassure the patient that these are temporary side effects that resolve spontaneously within
hours
D. Increase the fluid intake and encourage heavy carbohydrate snacks
, CORRECT ANSWER : B
Rationale: These symptoms indicate tardive dyskinesia, a potentially irreversible side effect of
long-term dopamine antagonist use. The nurse must use the AIMS tool to quantify movements
and notify the provider, as continuation can make the condition permanent. Benztropine treats
acute extrapyramidal symptoms, not tardive dyskinesia, which can actually worsen with
anticholinergics.
5. A 52-year-old male with major depressive disorder is prescribed phenelzine, a monoamine
oxidase inhibitor (MAOI). When providing dietary education, which food item must the nurse
instruct the patient to strictly avoid?
A. Fresh apples and steamed white rice
B. Aged cheeses and cured meats
C. Pasteurized milk and cottage cheese
D. Freshly caught baked white fish
CORRECT ANSWER : B
Rationale: MAOIs inhibit the breakdown of dietary tyramine in the gut. Consuming tyramine-
rich foods such as aged cheeses, cured meats, and fermented products can precipitate a
hypertensive crisis due to massive norepinephrine release. Fresh foods like milk, cottage cheese,
and fresh fish are safe.
6. A 21-year-old college student is admitted following a suicide attempt by intentional overdose.
During the initial interview, the patient states, "Life is completely pointless, and everyone would
be better off without me." What is the most appropriate initial nursing response?
A. "Why do you feel that your friends and family would be better off without you?"
B. "Are you currently thinking about ending your life or killing yourself?"
C. "Let's focus on your positive qualities and your bright future in college."
D. "You should not talk like that when you have so much support around you."
CORRECT ANSWER : B
Rationale: Directly asking about active suicidal ideation is safe, clinically indicated, and dispels
the myth that addressing suicide plants the idea. Option A uses a challenging "why" question,
option C prematurely minimizes the patient's emotional pain, and option D dismisses valid
feelings.
, 7. A patient with schizophrenia believes that the local television news anchors are broadcasting
secret, personalized messages specifically directed at them. How should the nurse document and
respond to this phenomenon?
A. Validate the belief to maintain a therapeutic nurse-patient alliance
B. Document the observation as ideas of reference and avoid arguing or reinforcing the
delusion
C. Challenge the logic of the belief by pointing out that the news broadcast reaches millions of
people
D. Agree that the coincidence is strange to build rapid rapport
CORRECT ANSWER : B
Rationale: Validating or agreeing with a delusion reinforces psychosis, while challenging or
arguing can provoke defensiveness or agitation. The nurse should acknowledge the patient's
feelings without validating the false belief and document the symptom objectively as ideas of
reference.
8. A 39-year-old female presents with recurrent, unexpected panic attacks accompanied by intense
fear of dying, followed by a persistent month-long worry about having future attacks and
modifying her daily routines to avoid triggers. What is the primary diagnosis?
A. Agoraphobia without history of panic disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Specific phobia, situational type
CORRECT ANSWER : B
Rationale: Panic disorder is characterized by recurrent unexpected panic attacks combined with
persistent concern or worry about future attacks and maladaptive behavioral changes related to
the attacks. Generalized anxiety disorder features chronic, diffuse worry across multiple
domains rather than discrete panic surges.
9. A 60-year-old male client with severe major depressive disorder is scheduled to undergo
electroconvulsive therapy (ECT). Which physiological monitoring and pre-procedure preparation
is essential for the nurse to perform?
A. Restrict all oral intake for 48 hours prior to the procedure to prevent aspiration
Answers/Plus a Rationale Updated 2026 A+/Instant Download
EXAM COVERAGE
1. Neurobiological Foundations, Psychopharmacology, and Advanced Psychopathology
2. Therapeutic Modalities, Crisis Intervention, and Evidence-Based Psychotherapy
3. Forensic Psychiatry, Ethics, and Specialized Population Mental Health Care
1. A 34-year-old male with schizophrenia who is stabilized on clozapine presents to the psychiatric
clinic reporting severe malaise, fever, and a sore throat. Laboratory studies reveal a total white
blood cell count of 2,200/mcL and an absolute neutrophil count of 900/mcL. What is the
immediate priority nursing intervention?
A. Administer a stat dose of oral diphenhydramine to manage potential extrapyramidal
symptoms
B. Immediately withhold clozapine, notify the prescribing provider, and institute strict
infection control precautions
C. Recheck the complete blood count in 24 hours while maintaining the current clozapine dosage
D. Switch the patient immediately to high-potency typical antipsychotic medication
CORRECT ANSWER : B
Rationale: Clozapine carries a significant risk of agranulocytosis, which requires immediate
discontinuation of the medication if the absolute neutrophil count drops below 1,000/mcL to
prevent life-threatening sepsis. Continuing the medication or delaying notification endangers the
patient, while options A and D do not address the urgent blood dyscrasia.
2. A 28-year-old female diagnosed with bipolar I disorder is admitted in a severe manic state. She
is prescribed lithium carbonate 900 mg daily. Which baseline laboratory assessments must be
reviewed before initiating therapy?
A. Complete blood count, liver function tests, and erythrocyte sedimentation rate
B. Serum creatinine, blood urea nitrogen, thyroid-stimulating hormone, and a baseline
electrocardiogram
, C. Serum glucose, hemoglobin A1c, and lipid panel
D. Serum folate, vitamin B12 levels, and coagulation profiles
CORRECT ANSWER : B
Rationale: Lithium is excreted almost exclusively by the kidneys and can alter thyroid function,
making renal function tests (creatinine, BUN) and thyroid function tests (TSH) mandatory
baselines. An ECG is also indicated due to potential cardiac conduction effects. The other panels
are not primary baselines for lithium therapy.
3. A 45-year-old male is brought to the emergency department exhibiting psychomotor agitation,
confusion, diaphoresis, tachycardia, and myoclonus. He recently started sertraline and was
prescribed tramadol for chronic back pain. What condition is most likely occurring?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Acute lithium toxicity
CORRECT ANSWER : B
Rationale: Serotonin syndrome arises from overstimulation of central and peripheral serotonin
receptors, typically triggered by combining serotonergic agents like an SSRI (sertraline) with an
opioid that inhibits serotonin reuptake (tramadol). Key signs include autonomic instability,
altered mental status, and neuromuscular hyperactivity like myoclonus. Neuroleptic malignant
syndrome involves dopamine blockade, whereas anticholinergic toxicity features dry skin and
urinary retention rather than diaphoresis and hyperreflexia.
4. A psychiatric-mental health nurse is evaluating a patient taking haloperidol who exhibits
rhythmic, involuntary movements of the tongue, chewing motions, and purposeless jerky
movements of the extremities. What is the appropriate nursing action?
A. Administer benztropine immediately to reverse acute dystonic reactions
B. Assess the symptoms using the Abnormal Involuntary Movement Scale (AIMS) and
notify the provider for possible medication discontinuation
C. Reassure the patient that these are temporary side effects that resolve spontaneously within
hours
D. Increase the fluid intake and encourage heavy carbohydrate snacks
, CORRECT ANSWER : B
Rationale: These symptoms indicate tardive dyskinesia, a potentially irreversible side effect of
long-term dopamine antagonist use. The nurse must use the AIMS tool to quantify movements
and notify the provider, as continuation can make the condition permanent. Benztropine treats
acute extrapyramidal symptoms, not tardive dyskinesia, which can actually worsen with
anticholinergics.
5. A 52-year-old male with major depressive disorder is prescribed phenelzine, a monoamine
oxidase inhibitor (MAOI). When providing dietary education, which food item must the nurse
instruct the patient to strictly avoid?
A. Fresh apples and steamed white rice
B. Aged cheeses and cured meats
C. Pasteurized milk and cottage cheese
D. Freshly caught baked white fish
CORRECT ANSWER : B
Rationale: MAOIs inhibit the breakdown of dietary tyramine in the gut. Consuming tyramine-
rich foods such as aged cheeses, cured meats, and fermented products can precipitate a
hypertensive crisis due to massive norepinephrine release. Fresh foods like milk, cottage cheese,
and fresh fish are safe.
6. A 21-year-old college student is admitted following a suicide attempt by intentional overdose.
During the initial interview, the patient states, "Life is completely pointless, and everyone would
be better off without me." What is the most appropriate initial nursing response?
A. "Why do you feel that your friends and family would be better off without you?"
B. "Are you currently thinking about ending your life or killing yourself?"
C. "Let's focus on your positive qualities and your bright future in college."
D. "You should not talk like that when you have so much support around you."
CORRECT ANSWER : B
Rationale: Directly asking about active suicidal ideation is safe, clinically indicated, and dispels
the myth that addressing suicide plants the idea. Option A uses a challenging "why" question,
option C prematurely minimizes the patient's emotional pain, and option D dismisses valid
feelings.
, 7. A patient with schizophrenia believes that the local television news anchors are broadcasting
secret, personalized messages specifically directed at them. How should the nurse document and
respond to this phenomenon?
A. Validate the belief to maintain a therapeutic nurse-patient alliance
B. Document the observation as ideas of reference and avoid arguing or reinforcing the
delusion
C. Challenge the logic of the belief by pointing out that the news broadcast reaches millions of
people
D. Agree that the coincidence is strange to build rapid rapport
CORRECT ANSWER : B
Rationale: Validating or agreeing with a delusion reinforces psychosis, while challenging or
arguing can provoke defensiveness or agitation. The nurse should acknowledge the patient's
feelings without validating the false belief and document the symptom objectively as ideas of
reference.
8. A 39-year-old female presents with recurrent, unexpected panic attacks accompanied by intense
fear of dying, followed by a persistent month-long worry about having future attacks and
modifying her daily routines to avoid triggers. What is the primary diagnosis?
A. Agoraphobia without history of panic disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Specific phobia, situational type
CORRECT ANSWER : B
Rationale: Panic disorder is characterized by recurrent unexpected panic attacks combined with
persistent concern or worry about future attacks and maladaptive behavioral changes related to
the attacks. Generalized anxiety disorder features chronic, diffuse worry across multiple
domains rather than discrete panic surges.
9. A 60-year-old male client with severe major depressive disorder is scheduled to undergo
electroconvulsive therapy (ECT). Which physiological monitoring and pre-procedure preparation
is essential for the nurse to perform?
A. Restrict all oral intake for 48 hours prior to the procedure to prevent aspiration
