Chamberlain University - NR326 Mental Health Nursing Final Exam
questions answers rationales
NR 326: Mental Health Nursing Comprehensive
Question 1: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 1). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 1] Administer scheduled and PRN chlordiazepoxide or lorazepam
as prescribed.
Rationale: Clinical Rationale Variant 1: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 2: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario Variant
2). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 2] Hold the next dose, assess for diarrhea, vomiting, and tremors,
and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 2: Signs of toxicity require immediate cessation of the
drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 3: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 3). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 3] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 3: Clients with BPD frequently use splitting to pit staff
against one another; consistency across the team minimizes this defense mechanism.
Question 4: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 4). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 4] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 4: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
,Question 5: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 5). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 5] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 5: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 6: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 6). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 6] Administer scheduled and PRN chlordiazepoxide or lorazepam
as prescribed.
Rationale: Clinical Rationale Variant 6: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 7: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario Variant
7). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 7] Hold the next dose, assess for diarrhea, vomiting, and tremors,
and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 7: Signs of toxicity require immediate cessation of the
drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 8: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 8). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 8] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 8: Clients with BPD frequently use splitting to pit staff
against one another; consistency across the team minimizes this defense mechanism.
,Question 9: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 9). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 9] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 9: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
Question 10: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 10). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 10] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 10: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 11: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 11). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 11] Administer scheduled and PRN chlordiazepoxide or
lorazepam as prescribed.
Rationale: Clinical Rationale Variant 11: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 12: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario
Variant 12). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 12] Hold the next dose, assess for diarrhea, vomiting, and
tremors, and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 12: Signs of toxicity require immediate cessation of
the drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 13: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 13). Which of the following actions should the nurse prioritize?
, Correct Answer: [Variant 13] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 13: Clients with BPD frequently use splitting to pit
staff against one another; consistency across the team minimizes this defense mechanism.
Question 14: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 14). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 14] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 14: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
Question 15: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 15). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 15] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 15: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 16: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 16). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 16] Administer scheduled and PRN chlordiazepoxide or
lorazepam as prescribed.
Rationale: Clinical Rationale Variant 16: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 17: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario
Variant 17). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 17] Hold the next dose, assess for diarrhea, vomiting, and
tremors, and obtain a serum lithium level.
questions answers rationales
NR 326: Mental Health Nursing Comprehensive
Question 1: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 1). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 1] Administer scheduled and PRN chlordiazepoxide or lorazepam
as prescribed.
Rationale: Clinical Rationale Variant 1: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 2: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario Variant
2). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 2] Hold the next dose, assess for diarrhea, vomiting, and tremors,
and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 2: Signs of toxicity require immediate cessation of the
drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 3: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 3). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 3] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 3: Clients with BPD frequently use splitting to pit staff
against one another; consistency across the team minimizes this defense mechanism.
Question 4: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 4). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 4] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 4: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
,Question 5: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 5). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 5] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 5: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 6: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 6). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 6] Administer scheduled and PRN chlordiazepoxide or lorazepam
as prescribed.
Rationale: Clinical Rationale Variant 6: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 7: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario Variant
7). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 7] Hold the next dose, assess for diarrhea, vomiting, and tremors,
and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 7: Signs of toxicity require immediate cessation of the
drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 8: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 8). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 8] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 8: Clients with BPD frequently use splitting to pit staff
against one another; consistency across the team minimizes this defense mechanism.
,Question 9: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 9). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 9] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 9: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
Question 10: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 10). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 10] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 10: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 11: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 11). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 11] Administer scheduled and PRN chlordiazepoxide or
lorazepam as prescribed.
Rationale: Clinical Rationale Variant 11: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 12: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario
Variant 12). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 12] Hold the next dose, assess for diarrhea, vomiting, and
tremors, and obtain a serum lithium level.
Rationale: Clinical Rationale Variant 12: Signs of toxicity require immediate cessation of
the drug and serum level verification due to its narrow therapeutic index (0.6-1.2 mEq/L).
Question 13: A nurse is caring for a client with Borderline Personality Disorder (BPD)
(Scenario Variant 13). Which of the following actions should the nurse prioritize?
, Correct Answer: [Variant 13] Rotate staff assignments and maintain strict behavioral
boundaries to minimize splitting behaviors.
Rationale: Clinical Rationale Variant 13: Clients with BPD frequently use splitting to pit
staff against one another; consistency across the team minimizes this defense mechanism.
Question 14: A nurse is caring for a client with Alzheimer's Disease experiencing severe
sundowning (Scenario Variant 14). Which of the following actions should the nurse
prioritize?
Correct Answer: [Variant 14] Keep the room well-lit during late afternoon and maintain a
strict, calm routine.
Rationale: Clinical Rationale Variant 14: Adequate lighting and routines help minimize
confusion, agitation, and disorientation associated with sundowning.
Question 15: A nurse is caring for a client with Neuroleptic Malignant Syndrome (NMS)
(Scenario Variant 15). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 15] Immediately discontinue the antipsychotic medication and
notify the healthcare provider.
Rationale: Clinical Rationale Variant 15: NMS is a medical emergency characterized by
hyperpyrexia, muscle rigidity, and autonomic instability; stopping the offending drug is the
immediate first action.
Question 16: A nurse is caring for a client with Alcohol Withdrawal Delirium (Delirium
Tremens) (Scenario Variant 16). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 16] Administer scheduled and PRN chlordiazepoxide or
lorazepam as prescribed.
Rationale: Clinical Rationale Variant 16: Benzodiazepines are the gold standard to prevent
seizures, DTs, and stabilize vital signs during alcohol withdrawal.
Question 17: A nurse is caring for a client with Lithium Carbonate Toxicity (Scenario
Variant 17). Which of the following actions should the nurse prioritize?
Correct Answer: [Variant 17] Hold the next dose, assess for diarrhea, vomiting, and
tremors, and obtain a serum lithium level.
