PNG 2254: Mental Health Nursing – Comprehensive
Mock Exam Questions and Answers with Rationale
Latest Edition 2026/2027
Question 1
A client diagnosed with major depressive disorder is prescribed
phenelzine, a monoamine oxidase inhibitor (MAOI). Which of the
following foods should the nurse instruct the client to strictly avoid to
prevent a life-threatening hypertensive crisis?
A. Fresh apples and bananas
B. Aged cheeses and cured meats
C. Plain boiled rice and chicken breast
D. Fresh pasteurized milk and cottage cheese
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of dietary tyramine in the
gastrointestinal tract. Consuming high-tyramine foods—such as aged
cheeses, cured or processed meats, draft beer, and fermented products—
leads to a massive release of norepinephrine, resulting in a severe and
potentially fatal hypertensive crisis.
Question 2
A nurse is caring for a client who is prescribed lithium carbonate for
bipolar disorder. Which of the following serum lithium levels indicates a
toxic level requiring immediate medical intervention?
A. 0.6 mEq/L
B. 0.9 mEq/L
, C. 1.1 mEq/L
D. 1.8 mEq/L
Correct Answer: D
Rationale: The therapeutic maintenance range for serum lithium is 0.6
to 1.2 mEq/L. Levels at or above 1.5 mEq/L begin to enter toxic ranges,
and levels approaching 1.8 mEq/L or higher manifest significant toxicity
symptoms such as coarse hand tremors, severe gastrointestinal upset,
ataxia, and confusion.
Question 3
A nurse is conducting an admission assessment for a client who
experienced a devastating house fire two weeks ago. The client is
experiencing nightmares, hypervigilance, and emotional numbing when
discussing the event. The nurse recognizes these symptoms as indicative
of:
A. Generalized anxiety disorder
B. Acute stress disorder
C. Post-traumatic stress disorder (PTSD)
D. Major depressive disorder
Correct Answer: B
Rationale: Acute stress disorder is diagnosed when characteristic post-
trauma symptoms (such as intrusive memories, avoidance, negative
mood, and hyperarousal) occur within the first month following
exposure to a traumatic event. If these symptoms persist beyond one
month, the diagnosis is revised to post-traumatic stress disorder.
Question 4
,A client with obsessive-compulsive disorder spends hours checking door
locks and light switches. Which defense mechanism is primarily
operating when the client uses ritualistic behavior to neutralize obsessive
anxiety?
A. Undoing
B. Projection
C. Displacement
D. Rationalization
Correct Answer: A
Rationale: Undoing is a defense mechanism in which an individual uses
actions or rituals to symbolically negate or undo a previous unacceptable
thought, impulse, or source of anxiety.
Question 5
A nurse is caring for an older adult client in a long-term care facility
who suddenly becomes disoriented to time and place, picks at invisible
objects on the bedsheets, and fluctuates drastically in alertness
throughout the day. This clinical presentation is characteristic of:
A. Major neurocognitive disorder (Alzheimer's type)
B. Delirium
C. Schizophrenia
D. Major depressive disorder
Correct Answer: B
Rationale: Delirium is characterized by an acute onset, fluctuating
course, altered level of consciousness, and perceptual disturbances. It is
, typically triggered by an underlying medical condition, infection,
metabolic disturbance, or medication side effect.
Question 6
A client diagnosed with schizophrenia states, "The vector of the sector
directs the electricalECTOR." The nurse identifies this specific speech
pattern as:
A. Neologism
B. Clang association
C. Word salad
D. Echolalia
Correct Answer: B
Rationale: Clang associations involve choosing words based on their
sounds rather than their meaning, resulting in rhyming phrases or
punning sequences that lack logical coherence.
Question 7
A nurse is planning care for a client experiencing an acute manic
episode associated with bipolar I disorder. Which environmental
modification should the nurse prioritize?
A. Placing the client in a high-traffic area near the nursing station to
maximize social interaction.
B. Providing a quiet, low-stimulation environment away from noisy
communal spaces.
C. Encouraging the client to participate in large group physical games
to burn off energy.
Mock Exam Questions and Answers with Rationale
Latest Edition 2026/2027
Question 1
A client diagnosed with major depressive disorder is prescribed
phenelzine, a monoamine oxidase inhibitor (MAOI). Which of the
following foods should the nurse instruct the client to strictly avoid to
prevent a life-threatening hypertensive crisis?
A. Fresh apples and bananas
B. Aged cheeses and cured meats
C. Plain boiled rice and chicken breast
D. Fresh pasteurized milk and cottage cheese
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of dietary tyramine in the
gastrointestinal tract. Consuming high-tyramine foods—such as aged
cheeses, cured or processed meats, draft beer, and fermented products—
leads to a massive release of norepinephrine, resulting in a severe and
potentially fatal hypertensive crisis.
Question 2
A nurse is caring for a client who is prescribed lithium carbonate for
bipolar disorder. Which of the following serum lithium levels indicates a
toxic level requiring immediate medical intervention?
A. 0.6 mEq/L
B. 0.9 mEq/L
, C. 1.1 mEq/L
D. 1.8 mEq/L
Correct Answer: D
Rationale: The therapeutic maintenance range for serum lithium is 0.6
to 1.2 mEq/L. Levels at or above 1.5 mEq/L begin to enter toxic ranges,
and levels approaching 1.8 mEq/L or higher manifest significant toxicity
symptoms such as coarse hand tremors, severe gastrointestinal upset,
ataxia, and confusion.
Question 3
A nurse is conducting an admission assessment for a client who
experienced a devastating house fire two weeks ago. The client is
experiencing nightmares, hypervigilance, and emotional numbing when
discussing the event. The nurse recognizes these symptoms as indicative
of:
A. Generalized anxiety disorder
B. Acute stress disorder
C. Post-traumatic stress disorder (PTSD)
D. Major depressive disorder
Correct Answer: B
Rationale: Acute stress disorder is diagnosed when characteristic post-
trauma symptoms (such as intrusive memories, avoidance, negative
mood, and hyperarousal) occur within the first month following
exposure to a traumatic event. If these symptoms persist beyond one
month, the diagnosis is revised to post-traumatic stress disorder.
Question 4
,A client with obsessive-compulsive disorder spends hours checking door
locks and light switches. Which defense mechanism is primarily
operating when the client uses ritualistic behavior to neutralize obsessive
anxiety?
A. Undoing
B. Projection
C. Displacement
D. Rationalization
Correct Answer: A
Rationale: Undoing is a defense mechanism in which an individual uses
actions or rituals to symbolically negate or undo a previous unacceptable
thought, impulse, or source of anxiety.
Question 5
A nurse is caring for an older adult client in a long-term care facility
who suddenly becomes disoriented to time and place, picks at invisible
objects on the bedsheets, and fluctuates drastically in alertness
throughout the day. This clinical presentation is characteristic of:
A. Major neurocognitive disorder (Alzheimer's type)
B. Delirium
C. Schizophrenia
D. Major depressive disorder
Correct Answer: B
Rationale: Delirium is characterized by an acute onset, fluctuating
course, altered level of consciousness, and perceptual disturbances. It is
, typically triggered by an underlying medical condition, infection,
metabolic disturbance, or medication side effect.
Question 6
A client diagnosed with schizophrenia states, "The vector of the sector
directs the electricalECTOR." The nurse identifies this specific speech
pattern as:
A. Neologism
B. Clang association
C. Word salad
D. Echolalia
Correct Answer: B
Rationale: Clang associations involve choosing words based on their
sounds rather than their meaning, resulting in rhyming phrases or
punning sequences that lack logical coherence.
Question 7
A nurse is planning care for a client experiencing an acute manic
episode associated with bipolar I disorder. Which environmental
modification should the nurse prioritize?
A. Placing the client in a high-traffic area near the nursing station to
maximize social interaction.
B. Providing a quiet, low-stimulation environment away from noisy
communal spaces.
C. Encouraging the client to participate in large group physical games
to burn off energy.
