Mental Health Nursing Exam 9 - NUR 253 & NUR 256 2026 |Galen
College
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most therapeutic response?
A. “I don’t hear the voices, but I can see that they are making you anxious.”
B. “The voices are not real; you should try to ignore them.”
C. “What are the voices telling you to do right now?”
D. “Why do you think you are hearing voices today?”
Answer: A
Rationale: Acknowledging the client’s feelings while presenting reality without devaluing
their experience is the most therapeutic approach.
2. A client is prescribed Lithium Carbonate for Bipolar I Disorder. What is the
therapeutic serum level for maintenance?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L indicate toxicity.
,3. A client with Depression is starting Phenelzine (an MAOI). Which food should
the nurse instruct the client to avoid?
A. Fresh green beans
B. Cottage cheese
C. Grilled chicken breast
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs require a low-tyramine diet. Aged cheeses, cured meats, and fermented
products can cause a hypertensive crisis.
4. Which assessment finding is a hallmark symptom of Neuroleptic Malignant
Syndrome (NMS)?
A. Hypothermia and bradycardia
B. Increased appetite and somnolence
C. Respiratory depression and miosis
D. Muscular rigidity and high fever
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by severe
muscle rigidity, hyperpyrexia, and autonomic instability.
5. A client has been admitted for Alcohol Withdrawal. Which medication is the
gold standard for managing acute withdrawal symptoms?
A. Disulfiram
B. Methadone
C. Lorazepam
D. Fluoxetine
Answer: C
Rationale: Benzodiazepines like Lorazepam or Chlordiazepoxide are used to prevent
seizures and delirium tremens during alcohol withdrawal.
, 6. A client with Anorexia Nervosa has a BMI of 14. What is the priority nursing
intervention?
A. Initiate family therapy sessions
B. Discuss the client’s distorted body image
C. Supervise the client for 2 hours after meals
D. Monitor electrolyte levels and cardiac rhythm
Answer: D
Rationale: Physical stability is the priority. Severe malnutrition leads to life-threatening
electrolyte imbalances and cardiac arrhythmias.
7. A nurse observes a client with OCD washing their hands for the 10th time in
an hour. What should the nurse do?
A. Force the client to stop immediately to reduce anxiety
B. Tell the client that their hands are already clean
C. Lock the bathroom to prevent the ritual
D. Allow the behavior but set a time limit later in the treatment plan
Answer: D
Rationale: Initially, rituals should be allowed as they are a coping mechanism for anxiety.
Limits are set gradually as the client learns new coping skills.
8. A client with Antisocial Personality Disorder is demanding a special snack
outside of meal times. What is the best response?
A. “I’ll get it for you just this once.”
B. “Snacks are only available during scheduled meal times.”
C. “Why do you feel you deserve special treatment?”
D. “If you behave for an hour, I will get you the snack.”
Answer: B
Rationale: Setting firm, consistent limits is essential for clients with Antisocial Personality
Disorder to prevent manipulation.
College
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most therapeutic response?
A. “I don’t hear the voices, but I can see that they are making you anxious.”
B. “The voices are not real; you should try to ignore them.”
C. “What are the voices telling you to do right now?”
D. “Why do you think you are hearing voices today?”
Answer: A
Rationale: Acknowledging the client’s feelings while presenting reality without devaluing
their experience is the most therapeutic approach.
2. A client is prescribed Lithium Carbonate for Bipolar I Disorder. What is the
therapeutic serum level for maintenance?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L indicate toxicity.
,3. A client with Depression is starting Phenelzine (an MAOI). Which food should
the nurse instruct the client to avoid?
A. Fresh green beans
B. Cottage cheese
C. Grilled chicken breast
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs require a low-tyramine diet. Aged cheeses, cured meats, and fermented
products can cause a hypertensive crisis.
4. Which assessment finding is a hallmark symptom of Neuroleptic Malignant
Syndrome (NMS)?
A. Hypothermia and bradycardia
B. Increased appetite and somnolence
C. Respiratory depression and miosis
D. Muscular rigidity and high fever
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by severe
muscle rigidity, hyperpyrexia, and autonomic instability.
5. A client has been admitted for Alcohol Withdrawal. Which medication is the
gold standard for managing acute withdrawal symptoms?
A. Disulfiram
B. Methadone
C. Lorazepam
D. Fluoxetine
Answer: C
Rationale: Benzodiazepines like Lorazepam or Chlordiazepoxide are used to prevent
seizures and delirium tremens during alcohol withdrawal.
, 6. A client with Anorexia Nervosa has a BMI of 14. What is the priority nursing
intervention?
A. Initiate family therapy sessions
B. Discuss the client’s distorted body image
C. Supervise the client for 2 hours after meals
D. Monitor electrolyte levels and cardiac rhythm
Answer: D
Rationale: Physical stability is the priority. Severe malnutrition leads to life-threatening
electrolyte imbalances and cardiac arrhythmias.
7. A nurse observes a client with OCD washing their hands for the 10th time in
an hour. What should the nurse do?
A. Force the client to stop immediately to reduce anxiety
B. Tell the client that their hands are already clean
C. Lock the bathroom to prevent the ritual
D. Allow the behavior but set a time limit later in the treatment plan
Answer: D
Rationale: Initially, rituals should be allowed as they are a coping mechanism for anxiety.
Limits are set gradually as the client learns new coping skills.
8. A client with Antisocial Personality Disorder is demanding a special snack
outside of meal times. What is the best response?
A. “I’ll get it for you just this once.”
B. “Snacks are only available during scheduled meal times.”
C. “Why do you feel you deserve special treatment?”
D. “If you behave for an hour, I will get you the snack.”
Answer: B
Rationale: Setting firm, consistent limits is essential for clients with Antisocial Personality
Disorder to prevent manipulation.
