NSG 3130 FINAL EXAM: PSYCHIATRIC-
MENTAL HEALTH NURSING
QUESTIONS AND ANSWERS
1. A client is prescribed Clozapine (Clozaril) for treatment-resistant schizophrenia. Which
laboratory result would necessitate the nurse to withhold the medication and notify the
provider immediately?
A. A serum potassium level of 3.6 mEq/L
B. A fasting blood glucose of 110 mg/dL
C. A White Blood Cell (WBC) count of 2,800/mm³ and ANC of 1,200/mm³
D. A total cholesterol level of 210 mg/dL
Answer: C
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. A WBC count
below 3,000/mm³ or an Absolute Neutrophil Count (ANC) below 1,500/mm³ requires
immediate cessation of the drug to prevent life-threatening infection.
,2. A client with bipolar disorder is being discharged on Lithium Carbonate. Which statement
by the client indicates a need for further teaching regarding medication safety?
A. ‘I will make sure to drink 2 to 3 liters of water every day.’
B. ‘I need to have my blood levels checked regularly.’
C. ‘I will restrict my salt intake to help lose the weight I gained.’
D. ‘I should stop the medication and call my doctor if I have persistent diarrhea.’
Answer: C
Conceptual Explanation: Lithium is a salt. If sodium intake is restricted, the kidneys
reabsorb lithium to compensate, leading to toxic levels. Clients must maintain a consistent,
normal sodium intake.
3. A nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS). Which
constellation of symptoms is most indicative of this potentially fatal condition?
A. Hyperreflexia, diarrhea, and abdominal cramping
B. Urinary retention, blurred vision, and dry mouth
C. Pinpoint pupils, respiratory depression, and bradycardia
D. Severe muscle rigidity, hyperpyrexia, and diaphoresis
Answer: D
, Conceptual Explanation: NMS is characterized by ‘lead-pipe’ muscle rigidity, high fever
(hyperpyrexia), autonomic instability (tachycardia, diaphoresis), and altered mental status.
Option A describes Serotonin Syndrome.
4. Which nursing intervention is the priority when caring for a client experiencing a panic-
level attack?
A. Teaching the client deep breathing relaxation techniques
B. Staying with the client and using short, simple sentences
C. Asking the client to describe what triggered the panic
D. Encouraging the client to walk around the unit to expend energy
Answer: B
Conceptual Explanation: In a panic state, the client is unable to process complex
information or learn new skills. Safety and presence are the priorities; short, simple
communication helps the client feel grounded.
5. A client who has been taking Phenelzine (Nardil) for depression arrives at the emergency
department with a severe headache, nausea, and a blood pressure of 200/118 mmHg. What
is the nurse’s first action?
A. Ask the client if they have consumed aged cheese or red wine
B. Administer a PRN dose of an SSRI
C. Place the client in a supine position with feet elevated
MENTAL HEALTH NURSING
QUESTIONS AND ANSWERS
1. A client is prescribed Clozapine (Clozaril) for treatment-resistant schizophrenia. Which
laboratory result would necessitate the nurse to withhold the medication and notify the
provider immediately?
A. A serum potassium level of 3.6 mEq/L
B. A fasting blood glucose of 110 mg/dL
C. A White Blood Cell (WBC) count of 2,800/mm³ and ANC of 1,200/mm³
D. A total cholesterol level of 210 mg/dL
Answer: C
Conceptual Explanation: Clozapine carries a high risk of agranulocytosis. A WBC count
below 3,000/mm³ or an Absolute Neutrophil Count (ANC) below 1,500/mm³ requires
immediate cessation of the drug to prevent life-threatening infection.
,2. A client with bipolar disorder is being discharged on Lithium Carbonate. Which statement
by the client indicates a need for further teaching regarding medication safety?
A. ‘I will make sure to drink 2 to 3 liters of water every day.’
B. ‘I need to have my blood levels checked regularly.’
C. ‘I will restrict my salt intake to help lose the weight I gained.’
D. ‘I should stop the medication and call my doctor if I have persistent diarrhea.’
Answer: C
Conceptual Explanation: Lithium is a salt. If sodium intake is restricted, the kidneys
reabsorb lithium to compensate, leading to toxic levels. Clients must maintain a consistent,
normal sodium intake.
3. A nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS). Which
constellation of symptoms is most indicative of this potentially fatal condition?
A. Hyperreflexia, diarrhea, and abdominal cramping
B. Urinary retention, blurred vision, and dry mouth
C. Pinpoint pupils, respiratory depression, and bradycardia
D. Severe muscle rigidity, hyperpyrexia, and diaphoresis
Answer: D
, Conceptual Explanation: NMS is characterized by ‘lead-pipe’ muscle rigidity, high fever
(hyperpyrexia), autonomic instability (tachycardia, diaphoresis), and altered mental status.
Option A describes Serotonin Syndrome.
4. Which nursing intervention is the priority when caring for a client experiencing a panic-
level attack?
A. Teaching the client deep breathing relaxation techniques
B. Staying with the client and using short, simple sentences
C. Asking the client to describe what triggered the panic
D. Encouraging the client to walk around the unit to expend energy
Answer: B
Conceptual Explanation: In a panic state, the client is unable to process complex
information or learn new skills. Safety and presence are the priorities; short, simple
communication helps the client feel grounded.
5. A client who has been taking Phenelzine (Nardil) for depression arrives at the emergency
department with a severe headache, nausea, and a blood pressure of 200/118 mmHg. What
is the nurse’s first action?
A. Ask the client if they have consumed aged cheese or red wine
B. Administer a PRN dose of an SSRI
C. Place the client in a supine position with feet elevated
