PNG 2254: Mental Health Nursing –
Exam 2 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A client diagnosed with major depressive disorder is prescribed
fluoxetine. Which common side effect should the nurse include in the
initial medication education?
A. Severe sedation and profound weight gain
B. Insomnia, anxiety, and gastrointestinal disturbances
C. Permanent urinary retention and blurred vision
D. Bradycardia and severe hypotension
Correct Answer: B
Rationale: SSRIs like fluoxetine frequently cause initial central nervous
system activation, leading to insomnia, nervousness, or anxiety, along
with gastrointestinal side effects such as nausea and diarrhea.
Question 2
A nurse is assessing a client who presents with alternating periods of
severe depression and elevated, expansive moods lasting several weeks.
The nurse recognizes these clinical patterns as characteristic of:
A. Major depressive disorder
B. Bipolar I disorder
C. Persistent depressive disorder (dysthymia)
, D. Cyclothymic disorder
Correct Answer: B
Rationale: Bipolar I disorder is characterized by the occurrence of at
least one full manic episode, typically alternating with major depressive
episodes, resulting in marked impairment in social and occupational
functioning.
Question 3
A client is admitted to the psychiatric unit with a diagnosis of acute
mania. The client is pacing the hallway, talking in rapid, loud, rhyming
sentences, and refusing to sit for meals. Which nursing intervention is
most appropriate?
A. Engage the client in a high-energy group exercise class to burn
calories.
B. Provide high-calorie, nutritious finger foods that the client can eat
while walking.
C. Insist that the client sit quietly at the dining table for at least 30
minutes.
D. Isolate the client in a bare seclusion room until meals are finished.
Correct Answer: B
Rationale: Manic clients often cannot sit still long enough to eat a
traditional meal. Providing portable, nutrient- and calorie-dense finger
foods ensures adequate nutritional intake without triggering agitation.
Question 4
A client diagnosed with schizophrenia is prescribed a typical
antipsychotic medication. The nurse monitors closely for extrapyramidal
,symptoms (EPS). Which clinical finding is characteristic of
pseudoparkinsonism?
A. Involuntary, rhythmic writhing movements of the tongue and
facial muscles
B. Pill-rolling hand tremors, mask-like facies, and shuffling gait
C. Severe, painful muscle spasms of the neck and jaw
D. Restless pacing and an inability to remain seated
Correct Answer: B
Rationale: Pseudoparkinsonism induced by antipsychotic medications
mimics Parkinson's disease, presenting with pill-rolling tremors, rigidity,
bradykinesia, mask-like facial expression, and a shuffling gait.
Question 5
A client with obsessive-compulsive disorder spends hours checking door
locks and electrical appliances. What is the primary psychological
purpose of these compulsive behaviors?
A. To gain approval and attention from nursing staff
B. To temporarily reduce or neutralize the overwhelming anxiety
caused by obsessions
C. To punish family members for perceived past grievances
D. To improve short-term memory recall and concentration
Correct Answer: B
Rationale: Compulsions are repetitive physical or mental acts
performed to neutralize, diminish, or prevent the severe anxiety
generated by obsessive thoughts.
, Question 6
A client diagnosed with borderline personality disorder displays intense
anger toward a nurse, stating, "You are the most heartless, cruel nurse on
this unit." Two hours later, the client approaches the same nurse with a
smile, stating, "You are my absolute favorite nurse; you always
understand me." The nurse identifies this defense mechanism as:
A. Projection
B. Splitting
C. Intellectualization
D. Rationalization
Correct Answer: B
Rationale: Splitting involves viewing people, situations, or self as
entirely all-good or all-bad, commonly seen in borderline personality
disorder as clients oscillate between idealization and devaluation of
staff.
Question 7
A client is prescribed lithium carbonate for bipolar disorder. The nurse
teaches the client about the critical importance of maintaining normal
dietary sodium and fluid intake. Why does severe dietary sodium
depletion lead to lithium toxicity?
A. Low sodium levels accelerate hepatic breakdown of lithium
molecules.
B. The kidneys reabsorb lithium at a higher rate when total body
sodium is low.
C. Sodium depletion completely blocks the therapeutic absorption of
lithium in the stomach.
Exam 2 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A client diagnosed with major depressive disorder is prescribed
fluoxetine. Which common side effect should the nurse include in the
initial medication education?
A. Severe sedation and profound weight gain
B. Insomnia, anxiety, and gastrointestinal disturbances
C. Permanent urinary retention and blurred vision
D. Bradycardia and severe hypotension
Correct Answer: B
Rationale: SSRIs like fluoxetine frequently cause initial central nervous
system activation, leading to insomnia, nervousness, or anxiety, along
with gastrointestinal side effects such as nausea and diarrhea.
Question 2
A nurse is assessing a client who presents with alternating periods of
severe depression and elevated, expansive moods lasting several weeks.
The nurse recognizes these clinical patterns as characteristic of:
A. Major depressive disorder
B. Bipolar I disorder
C. Persistent depressive disorder (dysthymia)
, D. Cyclothymic disorder
Correct Answer: B
Rationale: Bipolar I disorder is characterized by the occurrence of at
least one full manic episode, typically alternating with major depressive
episodes, resulting in marked impairment in social and occupational
functioning.
Question 3
A client is admitted to the psychiatric unit with a diagnosis of acute
mania. The client is pacing the hallway, talking in rapid, loud, rhyming
sentences, and refusing to sit for meals. Which nursing intervention is
most appropriate?
A. Engage the client in a high-energy group exercise class to burn
calories.
B. Provide high-calorie, nutritious finger foods that the client can eat
while walking.
C. Insist that the client sit quietly at the dining table for at least 30
minutes.
D. Isolate the client in a bare seclusion room until meals are finished.
Correct Answer: B
Rationale: Manic clients often cannot sit still long enough to eat a
traditional meal. Providing portable, nutrient- and calorie-dense finger
foods ensures adequate nutritional intake without triggering agitation.
Question 4
A client diagnosed with schizophrenia is prescribed a typical
antipsychotic medication. The nurse monitors closely for extrapyramidal
,symptoms (EPS). Which clinical finding is characteristic of
pseudoparkinsonism?
A. Involuntary, rhythmic writhing movements of the tongue and
facial muscles
B. Pill-rolling hand tremors, mask-like facies, and shuffling gait
C. Severe, painful muscle spasms of the neck and jaw
D. Restless pacing and an inability to remain seated
Correct Answer: B
Rationale: Pseudoparkinsonism induced by antipsychotic medications
mimics Parkinson's disease, presenting with pill-rolling tremors, rigidity,
bradykinesia, mask-like facial expression, and a shuffling gait.
Question 5
A client with obsessive-compulsive disorder spends hours checking door
locks and electrical appliances. What is the primary psychological
purpose of these compulsive behaviors?
A. To gain approval and attention from nursing staff
B. To temporarily reduce or neutralize the overwhelming anxiety
caused by obsessions
C. To punish family members for perceived past grievances
D. To improve short-term memory recall and concentration
Correct Answer: B
Rationale: Compulsions are repetitive physical or mental acts
performed to neutralize, diminish, or prevent the severe anxiety
generated by obsessive thoughts.
, Question 6
A client diagnosed with borderline personality disorder displays intense
anger toward a nurse, stating, "You are the most heartless, cruel nurse on
this unit." Two hours later, the client approaches the same nurse with a
smile, stating, "You are my absolute favorite nurse; you always
understand me." The nurse identifies this defense mechanism as:
A. Projection
B. Splitting
C. Intellectualization
D. Rationalization
Correct Answer: B
Rationale: Splitting involves viewing people, situations, or self as
entirely all-good or all-bad, commonly seen in borderline personality
disorder as clients oscillate between idealization and devaluation of
staff.
Question 7
A client is prescribed lithium carbonate for bipolar disorder. The nurse
teaches the client about the critical importance of maintaining normal
dietary sodium and fluid intake. Why does severe dietary sodium
depletion lead to lithium toxicity?
A. Low sodium levels accelerate hepatic breakdown of lithium
molecules.
B. The kidneys reabsorb lithium at a higher rate when total body
sodium is low.
C. Sodium depletion completely blocks the therapeutic absorption of
lithium in the stomach.
