NURS 328 COMPREHENSIVE MENTAL
HEALTH NURSING EXAMINATION
QUESTIONS AND ANSWERS
1. A patient diagnosed with Schizophrenia is prescribed Clozapine. Which laboratory value
must the nurse monitor most closely to prevent a potentially fatal adverse effect?
A. Platelet count
B. Serum Glucose
C. Absolute Neutrophil Count (ANC)
D. Blood Urea Nitrogen (BUN)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Absolute Neutrophil Count (ANC) must be monitored weekly for the first 6 months to
ensure it remains above 1500/mm³.
2. A client in the manic phase of Bipolar I Disorder is pacing the halls and interrupting others.
Which nursing intervention is most appropriate?
A. Administer a PRN dose of a stimulant medication
B. Encourage the client to lead a group exercise class
,C. Provide a large meal in the dining room
D. Place the client in a quiet area with low stimuli
Answer: D
Conceptual Explanation: Mania requires a low-stimulus environment to prevent
escalating agitation. Finger foods should be provided rather than large sit-down meals, and
high-energy activities should be redirected to quiet tasks.
3. A nurse is caring for a client receiving Lithium Carbonate. The client’s serum lithium level is
1.8 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose
B. Document the finding as within therapeutic range
C. Hold the medication and notify the provider
D. Encourage the client to increase sodium intake
Answer: C
Conceptual Explanation: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of
1.8 mEq/L indicates moderate toxicity, requiring immediate cessation of the drug and
medical assessment.
4. Which assessment finding is most characteristic of Neuroleptic Malignant Syndrome
(NMS)?
A. Lead-pipe muscle rigidity and hyperpyrexia
, B. Hypotension and bradycardia
C. Hyperreflexia and myoclonus
D. Urticaria and maculopapular rash
Answer: A
Conceptual Explanation: NMS is a medical emergency caused by antipsychotics,
characterized by severe muscle rigidity, high fever (hyperpyrexia), autonomic instability,
and altered mental status.
5. A client with Anorexia Nervosa has a BMI of 15 and is being started on nutritional
replacement. Which electrolyte imbalance is the priority for the nurse to monitor to prevent
Refeeding Syndrome?
A. Hypophosphatemia
B. Hyperkalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: A
Conceptual Explanation: Refeeding syndrome is characterized by a rapid drop in serum
phosphorus (hypophosphatemia) as insulin causes phosphorus to move into the cells,
leading to cardiac and respiratory failure.
HEALTH NURSING EXAMINATION
QUESTIONS AND ANSWERS
1. A patient diagnosed with Schizophrenia is prescribed Clozapine. Which laboratory value
must the nurse monitor most closely to prevent a potentially fatal adverse effect?
A. Platelet count
B. Serum Glucose
C. Absolute Neutrophil Count (ANC)
D. Blood Urea Nitrogen (BUN)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Absolute Neutrophil Count (ANC) must be monitored weekly for the first 6 months to
ensure it remains above 1500/mm³.
2. A client in the manic phase of Bipolar I Disorder is pacing the halls and interrupting others.
Which nursing intervention is most appropriate?
A. Administer a PRN dose of a stimulant medication
B. Encourage the client to lead a group exercise class
,C. Provide a large meal in the dining room
D. Place the client in a quiet area with low stimuli
Answer: D
Conceptual Explanation: Mania requires a low-stimulus environment to prevent
escalating agitation. Finger foods should be provided rather than large sit-down meals, and
high-energy activities should be redirected to quiet tasks.
3. A nurse is caring for a client receiving Lithium Carbonate. The client’s serum lithium level is
1.8 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose
B. Document the finding as within therapeutic range
C. Hold the medication and notify the provider
D. Encourage the client to increase sodium intake
Answer: C
Conceptual Explanation: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of
1.8 mEq/L indicates moderate toxicity, requiring immediate cessation of the drug and
medical assessment.
4. Which assessment finding is most characteristic of Neuroleptic Malignant Syndrome
(NMS)?
A. Lead-pipe muscle rigidity and hyperpyrexia
, B. Hypotension and bradycardia
C. Hyperreflexia and myoclonus
D. Urticaria and maculopapular rash
Answer: A
Conceptual Explanation: NMS is a medical emergency caused by antipsychotics,
characterized by severe muscle rigidity, high fever (hyperpyrexia), autonomic instability,
and altered mental status.
5. A client with Anorexia Nervosa has a BMI of 15 and is being started on nutritional
replacement. Which electrolyte imbalance is the priority for the nurse to monitor to prevent
Refeeding Syndrome?
A. Hypophosphatemia
B. Hyperkalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: A
Conceptual Explanation: Refeeding syndrome is characterized by a rapid drop in serum
phosphorus (hypophosphatemia) as insulin causes phosphorus to move into the cells,
leading to cardiac and respiratory failure.
