NUR 2459 MENTAL AND BEHAVIORAL
HEALTH NURSING FINAL
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed Phenelzine for treatment-resistant depression. Which menu choice
indicates the patient requires further teaching regarding tyramine-induced hypertensive
crisis?
A. A pepperoni pizza with aged cheddar cheese
B. Grilled chicken with a side of steamed broccoli
C. Fresh salmon with brown rice
D. Scrambled eggs and whole-wheat toast
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Patients must avoid tyramine-rich foods
like aged cheeses and cured meats (pepperoni) to prevent a life-threatening hypertensive
crisis.
,2. A nurse is caring for a patient experiencing a Lithium level of 1.8 mEq/L. Which clinical
manifestation should the nurse expect to observe?
A. Mild fine hand tremors and thirst
B. Confusion, coarse hand tremors, and ataxia
C. Polyuria and weight gain
D. Constipation and dry mouth
Answer: B
Conceptual Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity.
Symptoms include blurred vision, ataxia, persistent GI upset, and coarse tremors. Mild
tremors are common at therapeutic levels (0.6-1.2 mEq/L).
3. Which legal principle is being applied when a nurse reports a patient’s specific threat to
harm a named individual to the treatment team and authorities?
A. Beneficence
B. Duty to Warn
C. Fidelity
D. Right to refuse treatment
Answer: B
Conceptual Explanation: The Duty to Warn (Tarasoff v. Regents) requires mental health
professionals to breach confidentiality if a patient poses a specific threat to a third party.
, 4. A patient with schizophrenia is started on Clozapine. Which laboratory value is most critical
for the nurse to monitor regularly?
A. Serum potassium levels
B. Absolute Neutrophil Count (ANC)
C. Blood Urea Nitrogen (BUN)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Clozapine carries a high risk for agranulocytosis. Weekly or bi-
weekly ANC monitoring is mandatory to prevent life-threatening infections.
5. A patient experiencing Neuroleptic Malignant Syndrome (NMS) after taking Haloperidol
would most likely exhibit which set of symptoms?
A. Hypotension, bradycardia, and loose muscles
B. Restlessness, pacing, and inability to sit still
C. Severe muscle rigidity, hyperpyrexia, and diaphoresis
D. Involuntary tongue protrusion and lip smacking
Answer: C
Conceptual Explanation: NMS is a medical emergency characterized by lead-pipe muscle
rigidity, very high fever (hyperpyrexia), tachycardia, and autonomic instability.
HEALTH NURSING FINAL
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed Phenelzine for treatment-resistant depression. Which menu choice
indicates the patient requires further teaching regarding tyramine-induced hypertensive
crisis?
A. A pepperoni pizza with aged cheddar cheese
B. Grilled chicken with a side of steamed broccoli
C. Fresh salmon with brown rice
D. Scrambled eggs and whole-wheat toast
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Patients must avoid tyramine-rich foods
like aged cheeses and cured meats (pepperoni) to prevent a life-threatening hypertensive
crisis.
,2. A nurse is caring for a patient experiencing a Lithium level of 1.8 mEq/L. Which clinical
manifestation should the nurse expect to observe?
A. Mild fine hand tremors and thirst
B. Confusion, coarse hand tremors, and ataxia
C. Polyuria and weight gain
D. Constipation and dry mouth
Answer: B
Conceptual Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity.
Symptoms include blurred vision, ataxia, persistent GI upset, and coarse tremors. Mild
tremors are common at therapeutic levels (0.6-1.2 mEq/L).
3. Which legal principle is being applied when a nurse reports a patient’s specific threat to
harm a named individual to the treatment team and authorities?
A. Beneficence
B. Duty to Warn
C. Fidelity
D. Right to refuse treatment
Answer: B
Conceptual Explanation: The Duty to Warn (Tarasoff v. Regents) requires mental health
professionals to breach confidentiality if a patient poses a specific threat to a third party.
, 4. A patient with schizophrenia is started on Clozapine. Which laboratory value is most critical
for the nurse to monitor regularly?
A. Serum potassium levels
B. Absolute Neutrophil Count (ANC)
C. Blood Urea Nitrogen (BUN)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Clozapine carries a high risk for agranulocytosis. Weekly or bi-
weekly ANC monitoring is mandatory to prevent life-threatening infections.
5. A patient experiencing Neuroleptic Malignant Syndrome (NMS) after taking Haloperidol
would most likely exhibit which set of symptoms?
A. Hypotension, bradycardia, and loose muscles
B. Restlessness, pacing, and inability to sit still
C. Severe muscle rigidity, hyperpyrexia, and diaphoresis
D. Involuntary tongue protrusion and lip smacking
Answer: C
Conceptual Explanation: NMS is a medical emergency characterized by lead-pipe muscle
rigidity, very high fever (hyperpyrexia), tachycardia, and autonomic instability.
