DEPARTMENT OF PSYCHIATRIC AND MENTAL
HEALTH NURSING
NUR 371 PSYCHIATRIC NURSING FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A client diagnosed with schizophrenia states, "The FBI is tracking me using satellite
beams through my television." How should the nurse respond in a therapeutic manner?
A) "That is completely impossible; television signals cannot track individuals."
B) "I understand that feels very real to you, but I do not see any tracking equipment
here."
C) "Why do you think the FBI would be interested in tracking you?"
D) "Let's turn off the television so the signals stop reaching your brain."
Rationale: Validating feelings while presenting reality gently avoids arguing or reinforcing delusional thinking.
2. A client receiving haloperidol develops severe muscle rigidity, a temperature of 40.2°C
(104.4°F), diaphoresis, autonomic instability, and altered consciousness. What condition
is present?
A) Acute dystonic reaction
B) Akathisia
C) Neuroleptic Malignant Syndrome (NMS)
D) Tardive dyskinesia
Rationale: NMS is a life-threatening reaction to antipsychotics marked by high fever, severe "lead-pipe" muscle
rigidity, autonomic instability, and altered mental status.
3. What immediate pharmacological intervention is indicated to reverse an acute
dystonic reaction caused by high-potency typical antipsychotics?
A) Intravenous or intramuscular Benztropine or Diphenhydramine
B) Oral Haloperidol booster dose
C) Subcutaneous Insulin
D) Oral Dantrolene sodium
Rationale: Anticholinergic drugs like benztropine or diphenhydramine restore dopamine-acetylcholine balance,
, quickly relieving muscle spasms in acute dystonia.
4. A client diagnosed with major depressive disorder is prescribed a Monoamine Oxidase
Inhibitor (MAOI). Which food item must the client avoid to prevent a hypertensive crisis?
A) Fresh apples and oranges
B) Aged cheeses, cured meats, red wine, and fava beans
C) White bread and boiled white rice
D) Steamed chicken breast and broccoli
Rationale: MAOIs block tyramine breakdown; consuming tyramine-rich foods (aged cheese, cured meat, wine)
causes severe norepinephrine release and hypertensive crisis.
5. What laboratory parameter requires regular monitoring in a client prescribed clozapine
for treatment-resistant schizophrenia?
A) Absolute Neutrophil Count (ANC) and White Blood Cell (WBC) count
B) Serum creatinine and blood urea nitrogen
C) Serum sodium and potassium levels
D) Prothrombin time and INR
Rationale: Clozapine carries a boxed warning for agranulocytosis; regular ANC monitoring is mandatory to
prevent severe infection.
6. A client taking lithium carbonate for bipolar disorder presents with coarse hand
tremors, severe diarrhea, vomiting, confusion, and ataxia. What is the nurse's priority
action?
A) Administer the next scheduled lithium dose with food
B) Hold the lithium dose immediately and request a stat serum lithium level
C) Reassure the client that these are common minor side effects
D) Administer a dose of oral potassium chloride
Rationale: Coarse tremors, GI distress, ataxia, and confusion signal lithium toxicity (>1.5 mEq/L), requiring
immediate drug cessation and level checks.
7. What therapeutic serum lithium level range is targeted during maintenance therapy for
bipolar I disorder?
A) 0.6 to 1.2 mEq/L
B) 1.5 to 2.5 mEq/L
C) 3.0 to 4.5 mEq/L
D) 0.1 to 0.4 mEq/L
Rationale: The therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L; levels above 1.5 mEq/L increase
toxicity risks.
HEALTH NURSING
NUR 371 PSYCHIATRIC NURSING FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A client diagnosed with schizophrenia states, "The FBI is tracking me using satellite
beams through my television." How should the nurse respond in a therapeutic manner?
A) "That is completely impossible; television signals cannot track individuals."
B) "I understand that feels very real to you, but I do not see any tracking equipment
here."
C) "Why do you think the FBI would be interested in tracking you?"
D) "Let's turn off the television so the signals stop reaching your brain."
Rationale: Validating feelings while presenting reality gently avoids arguing or reinforcing delusional thinking.
2. A client receiving haloperidol develops severe muscle rigidity, a temperature of 40.2°C
(104.4°F), diaphoresis, autonomic instability, and altered consciousness. What condition
is present?
A) Acute dystonic reaction
B) Akathisia
C) Neuroleptic Malignant Syndrome (NMS)
D) Tardive dyskinesia
Rationale: NMS is a life-threatening reaction to antipsychotics marked by high fever, severe "lead-pipe" muscle
rigidity, autonomic instability, and altered mental status.
3. What immediate pharmacological intervention is indicated to reverse an acute
dystonic reaction caused by high-potency typical antipsychotics?
A) Intravenous or intramuscular Benztropine or Diphenhydramine
B) Oral Haloperidol booster dose
C) Subcutaneous Insulin
D) Oral Dantrolene sodium
Rationale: Anticholinergic drugs like benztropine or diphenhydramine restore dopamine-acetylcholine balance,
, quickly relieving muscle spasms in acute dystonia.
4. A client diagnosed with major depressive disorder is prescribed a Monoamine Oxidase
Inhibitor (MAOI). Which food item must the client avoid to prevent a hypertensive crisis?
A) Fresh apples and oranges
B) Aged cheeses, cured meats, red wine, and fava beans
C) White bread and boiled white rice
D) Steamed chicken breast and broccoli
Rationale: MAOIs block tyramine breakdown; consuming tyramine-rich foods (aged cheese, cured meat, wine)
causes severe norepinephrine release and hypertensive crisis.
5. What laboratory parameter requires regular monitoring in a client prescribed clozapine
for treatment-resistant schizophrenia?
A) Absolute Neutrophil Count (ANC) and White Blood Cell (WBC) count
B) Serum creatinine and blood urea nitrogen
C) Serum sodium and potassium levels
D) Prothrombin time and INR
Rationale: Clozapine carries a boxed warning for agranulocytosis; regular ANC monitoring is mandatory to
prevent severe infection.
6. A client taking lithium carbonate for bipolar disorder presents with coarse hand
tremors, severe diarrhea, vomiting, confusion, and ataxia. What is the nurse's priority
action?
A) Administer the next scheduled lithium dose with food
B) Hold the lithium dose immediately and request a stat serum lithium level
C) Reassure the client that these are common minor side effects
D) Administer a dose of oral potassium chloride
Rationale: Coarse tremors, GI distress, ataxia, and confusion signal lithium toxicity (>1.5 mEq/L), requiring
immediate drug cessation and level checks.
7. What therapeutic serum lithium level range is targeted during maintenance therapy for
bipolar I disorder?
A) 0.6 to 1.2 mEq/L
B) 1.5 to 2.5 mEq/L
C) 3.0 to 4.5 mEq/L
D) 0.1 to 0.4 mEq/L
Rationale: The therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L; levels above 1.5 mEq/L increase
toxicity risks.
