,NSG3450/NSG 3450 Exam 2 | Mental Health
Nursing | Galen College | 26/27 Updated
(PDF)
1. A nurse is planning care for a patient with a new prescription for an atypical antipsychotic. Which
baseline assessment is most critical to obtain before initiating therapy?
A) Serum creatinine level
B) Fasting blood glucose level
C) Serum potassium level
D) Thyroid-stimulating hormone level
Correct Answer: Fasting blood glucose level
Rationale: Atypical antipsychotics carry a significant risk of metabolic syndrome, including
hyperglycemia and new-onset diabetes. Baseline fasting blood glucose is essential for monitoring
these changes. Creatinine, potassium, and TSH are not the primary metabolic parameters of concern
for this medication class, making them incorrect.
2. During a group therapy session, one member dominates the conversation. Which nurse response
best reflects the therapeutic technique of "redirecting"?
A) "You seem to have strong feelings about this topic."
B) "Let's hear from others who haven't had a chance to speak yet."
C) "I notice you're speaking a lot today. Is something bothering you?"
D) "Perhaps we should move on to the next agenda item."
Correct Answer: "Let's hear from others who haven't had a chance to speak yet."
Rationale: Redirecting involves gently shifting focus to include other group members, promoting
balanced participation. The correct option directly invites others to contribute, addressing the
monopolizing behavior without shaming. The other options either validate the member's feelings,
probe for underlying issues, or change the subject without inclusion.
,3. A patient with bipolar disorder who is taking lithium reports increased thirst and urination. The
nurse understands that these symptoms most likely indicate:
A) The onset of diabetes insipidus
B) A normal therapeutic response to lithium
C) The need for immediate dosage reduction
D) An allergic reaction to the medication
Correct Answer: A normal therapeutic response to lithium
Rationale: Lithium commonly causes polyuria and polydipsia due to its effect on renal concentrating
ability, which is a known and expected side effect. While it can lead to nephrogenic diabetes insipidus
with long-term use, the initial presentation is typically a normal response and does not require
immediate dosage reduction or indicate an allergy.
4. A nurse is assessing a patient's use of defense mechanisms. The patient who has just been
diagnosed with a chronic illness states, "The lab results must be wrong; I feel perfectly fine." This
statement best exemplifies which defense mechanism?
A) Repression
B) Denial
C) Rationalization
D) Displacement
Correct Answer: Denial
Rationale: Denial involves refusing to accept reality or fact, acting as if a painful event or diagnosis
does not exist. Repression involves unconsciously blocking memories, rationalization involves creating
logical excuses, and displacement involves redirecting emotions—all distinct from the outright
rejection of the diagnosis described.
5. A patient with schizophrenia is prescribed clozapine. The nurse's teaching must emphasize the
critical need for:
, A) Weekly white blood cell count monitoring
B) Daily blood pressure checks
C) Monthly liver function tests
D) Quarterly electrocardiograms
Correct Answer: Weekly white blood cell count monitoring
Rationale: Clozapine carries a black box warning for agranulocytosis, a potentially fatal drop in white
blood cells, requiring strict monitoring (initially weekly). Blood pressure, liver function, and ECG
monitoring are important for other medications but are not the unique, life-threatening risk
associated with clozapine.
6. A nurse is leading a new support group for patients with anxiety disorders. During the first session,
members are polite and hesitant to share personal information. The nurse recognizes this as
characteristic of which phase of group development?
A) Working phase
B) Orientation phase
C) Termination phase
D) Storming phase
Correct Answer: Orientation phase
Rationale: The orientation phase is marked by tentative interactions, politeness, and dependence on
the leader as members learn group norms and goals. The working phase involves active problem-
solving, the storming phase involves conflict, and the termination phase involves closure—making the
other options incorrect for this initial stage.
7. A patient is experiencing a panic attack. Which nursing intervention should be implemented first?
A) Ask the patient to identify the trigger for the anxiety
B) Instruct the patient to breathe slowly and deeply
C) Administer a prescribed PRN benzodiazepine
D) Escort the patient to a quiet, private area
Nursing | Galen College | 26/27 Updated
(PDF)
1. A nurse is planning care for a patient with a new prescription for an atypical antipsychotic. Which
baseline assessment is most critical to obtain before initiating therapy?
A) Serum creatinine level
B) Fasting blood glucose level
C) Serum potassium level
D) Thyroid-stimulating hormone level
Correct Answer: Fasting blood glucose level
Rationale: Atypical antipsychotics carry a significant risk of metabolic syndrome, including
hyperglycemia and new-onset diabetes. Baseline fasting blood glucose is essential for monitoring
these changes. Creatinine, potassium, and TSH are not the primary metabolic parameters of concern
for this medication class, making them incorrect.
2. During a group therapy session, one member dominates the conversation. Which nurse response
best reflects the therapeutic technique of "redirecting"?
A) "You seem to have strong feelings about this topic."
B) "Let's hear from others who haven't had a chance to speak yet."
C) "I notice you're speaking a lot today. Is something bothering you?"
D) "Perhaps we should move on to the next agenda item."
Correct Answer: "Let's hear from others who haven't had a chance to speak yet."
Rationale: Redirecting involves gently shifting focus to include other group members, promoting
balanced participation. The correct option directly invites others to contribute, addressing the
monopolizing behavior without shaming. The other options either validate the member's feelings,
probe for underlying issues, or change the subject without inclusion.
,3. A patient with bipolar disorder who is taking lithium reports increased thirst and urination. The
nurse understands that these symptoms most likely indicate:
A) The onset of diabetes insipidus
B) A normal therapeutic response to lithium
C) The need for immediate dosage reduction
D) An allergic reaction to the medication
Correct Answer: A normal therapeutic response to lithium
Rationale: Lithium commonly causes polyuria and polydipsia due to its effect on renal concentrating
ability, which is a known and expected side effect. While it can lead to nephrogenic diabetes insipidus
with long-term use, the initial presentation is typically a normal response and does not require
immediate dosage reduction or indicate an allergy.
4. A nurse is assessing a patient's use of defense mechanisms. The patient who has just been
diagnosed with a chronic illness states, "The lab results must be wrong; I feel perfectly fine." This
statement best exemplifies which defense mechanism?
A) Repression
B) Denial
C) Rationalization
D) Displacement
Correct Answer: Denial
Rationale: Denial involves refusing to accept reality or fact, acting as if a painful event or diagnosis
does not exist. Repression involves unconsciously blocking memories, rationalization involves creating
logical excuses, and displacement involves redirecting emotions—all distinct from the outright
rejection of the diagnosis described.
5. A patient with schizophrenia is prescribed clozapine. The nurse's teaching must emphasize the
critical need for:
, A) Weekly white blood cell count monitoring
B) Daily blood pressure checks
C) Monthly liver function tests
D) Quarterly electrocardiograms
Correct Answer: Weekly white blood cell count monitoring
Rationale: Clozapine carries a black box warning for agranulocytosis, a potentially fatal drop in white
blood cells, requiring strict monitoring (initially weekly). Blood pressure, liver function, and ECG
monitoring are important for other medications but are not the unique, life-threatening risk
associated with clozapine.
6. A nurse is leading a new support group for patients with anxiety disorders. During the first session,
members are polite and hesitant to share personal information. The nurse recognizes this as
characteristic of which phase of group development?
A) Working phase
B) Orientation phase
C) Termination phase
D) Storming phase
Correct Answer: Orientation phase
Rationale: The orientation phase is marked by tentative interactions, politeness, and dependence on
the leader as members learn group norms and goals. The working phase involves active problem-
solving, the storming phase involves conflict, and the termination phase involves closure—making the
other options incorrect for this initial stage.
7. A patient is experiencing a panic attack. Which nursing intervention should be implemented first?
A) Ask the patient to identify the trigger for the anxiety
B) Instruct the patient to breathe slowly and deeply
C) Administer a prescribed PRN benzodiazepine
D) Escort the patient to a quiet, private area
