NR 547 MENTAL HEALTH
NURSINGCOMPREHENSIVE FINAL EXAM PRACTICE
TEST (2026)
200 PRACTICE QUESTIONS • ANSWERS & RATIONALES
Q1. A client with major depressive disorder states, "I'm a burden to my
family. They would be better off without me." Which response by the nurse
is most therapeutic?
A. "You shouldn't feel that way. Your family loves you very much."
B. "Why do you think your family would be better off without you?"
C. "You are feeling like a burden to your family?"
D. "Let's talk about the positive things you have done for your family."
Correct Answer: C
Rationale: Option C uses the therapeutic communication technique of
*reflecting*, which validates the client's feelings and encourages them to explore
their thoughts further. Option A provides false reassurance and is dismissive.
Option B uses "why," which can make the client feel defensive or interrogated.
Option D changes the subject and invalidates the client's current emotional state.
2.
Q2. A client with schizophrenia has been taking haloperidol for the past
week. The nurse notes the client has a temperature of 103.2°F (39.5°C),
severe "lead-pipe" muscle rigidity, diaphoresis, and altered mental status.
Which action should the nurse take first?
A. Administer benztropine as prescribed.
B. Notify the healthcare provider immediately.
C. Encourage oral fluid intake.
D. Document the findings and continue to monitor.
Correct Answer: B
Rationale: The client is exhibiting classic signs of Neuroleptic Malignant
Syndrome (NMS), a rare but life-threatening reaction to typical antipsychotics
(like haloperidol). Symptoms include high fever, severe "lead-pipe" muscle
rigidity, altered mental status, and autonomic instability. This is a medical
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
,emergency requiring immediate notification of the healthcare provider,
discontinuation of the drug, and supportive care. 3.
Q3. A client admitted for severe depression is scheduled for discharge
tomorrow. Which statement by the client requires immediate follow-up by
the nurse?
A. "I have made an appointment with my therapist for next week."
B. "I finally feel like I have some energy to do things again."
C. "I am glad I will be going home to my supportive family."
D. "I have been writing in my journal every day."
Correct Answer: B
Rationale: A sudden return of energy in a severely depressed client is a major
red flag for suicide risk. While the depression may have previously left them too
fatigued to act on suicidal ideation, the return of energy provides them with the
physical capability to carry out a plan. Options A, C, and D are positive indicators
of coping and readiness for discharge. 4.
Q4. A client with bipolar disorder is taking lithium carbonate. Which finding
should the nurse report to the healthcare provider as a potential sign of
lithium toxicity?
A. Mild hand tremor
B. Polyuria and polydipsia
C. Vomiting and severe diarrhea
D. Weight gain of 2 lbs in a week
Correct Answer: C
Rationale: Severe gastrointestinal symptoms (vomiting, severe diarrhea), coarse
hand tremors, ataxia, and confusion are hallmark signs of lithium toxicity. Mild
hand tremor, polyuria, polydipsia, and mild weight gain are common, expected
side effects of therapeutic lithium levels, not necessarily toxicity. 5.
Q5. A client is experiencing an acute panic attack in the clinic. Which
intervention is the nurse's priority?
A. Teach the client deep breathing exercises.
B. Ask the client to identify the trigger of the panic attack.
C. Stay with the client and speak in calm, short, simple sentences.
D. Administer an oral dose of alprazolam immediately.
Correct Answer: C
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
,Rationale: During an acute panic attack, a client’s cognitive ability to process
information is severely limited. The priority is to provide a sense of safety and
grounding by staying with the client and using a calm, reassuring voice with
short, simple sentences. Teaching deep breathing (Option A) or exploring
triggers (Option B) is more appropriate *after* the panic attack has subsided. 6.
Q6. A client with borderline personality disorder says to the nurse, "The
night shift nurse is so much nicer than you. You don't care about me at all."
Which response by the nurse is most appropriate?
A. "I do care about you. Let's talk about why you feel that way."
B. "That is not true. I have been doing everything I can to help you."
C. "You are splitting the staff, and that is not acceptable behavior."
D. "I am assigned to care for you today. Let's focus on your treatment plan."
Correct Answer: D
Rationale: This is a classic example of "splitting," a manipulation tactic common
in borderline personality disorder. The nurse must maintain professional
boundaries, avoid becoming defensive (Option B), avoid validating the
manipulation (Option A), and avoid labeling the behavior aggressively (Option C).
Redirecting to the treatment plan in an objective, matter-of-fact manner is the
most therapeutic approach. 7.
Q7. A client is admitted with a history of chronic alcohol abuse. The last
drink was 12 hours ago. Which assessment finding should the nurse
anticipate and monitor for?
A. Bradycardia and hypotension
B. Tremors, diaphoresis, and hypertension
C. Pinpoint pupils and respiratory depression
D. Hyperphagia and hypersomnia
Correct Answer: B
Rationale: Alcohol withdrawal typically peaks within 24–72 hours and presents
with autonomic hyperactivity. Expected findings include tremors ("the shakes"),
diaphoresis, tachycardia, hypertension, anxiety, and potentially seizures or
delirium tremens (DTs). 8.
Q8. A client with severe schizophrenia is refusing antipsychotic
medication, stating, "The pills are poisoned." The client is alert, oriented,
and not currently deemed a danger to self or others. Which action by the
nurse is most appropriate?
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
, A. Administer the medication in liquid form to hide the taste.
B. Respect the client's right to refuse the medication and document the refusal.
C. Apply physical restraints to administer the medication safely.
D. Tell the client that they will lose their unit privileges if they do not take the
medication.
Correct Answer: B
Rationale: Competent clients have the legal and ethical right to refuse
medication, even if the refusal is based on a delusion, *unless* they are an
imminent danger to themselves or others, or have a specific court order for
treatment. Covert administration (Option A), coercion (Option D), or forced
administration without legal justification (Option C) are violations of patient rights
and nursing ethics. 9.
Q9. A client with post-traumatic stress disorder (PTSD) reports frequent
nightmares and flashbacks. Which medication class is typically considered
first-line pharmacological treatment for these core symptoms?
A. Benzodiazepines
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Typical antipsychotics
D. Beta-blockers
Correct Answer: B
Rationale: SSRIs (e.g., sertraline, paroxetine) are the first-line pharmacological
treatment for PTSD, as they help manage core symptoms like intrusive thoughts,
avoidance, and hyperarousal. Benzodiazepines (Option A) are generally avoided
in PTSD due to their high potential for abuse and lack of efficacy in treating the
core trauma symptoms. 10.
Q10. A parent of a child newly prescribed methylphenidate for ADHD asks
the nurse about side effects. Which statement by the parent indicates a
need for further teaching?
A. "I will give the medication in the morning to prevent insomnia."
B. "I should monitor my child's weight and appetite regularly."
C. "I will stop the medication immediately if my child complains of a mild
headache."
D. "I understand this medication may increase my child's heart rate."
Correct Answer: C
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
NURSINGCOMPREHENSIVE FINAL EXAM PRACTICE
TEST (2026)
200 PRACTICE QUESTIONS • ANSWERS & RATIONALES
Q1. A client with major depressive disorder states, "I'm a burden to my
family. They would be better off without me." Which response by the nurse
is most therapeutic?
A. "You shouldn't feel that way. Your family loves you very much."
B. "Why do you think your family would be better off without you?"
C. "You are feeling like a burden to your family?"
D. "Let's talk about the positive things you have done for your family."
Correct Answer: C
Rationale: Option C uses the therapeutic communication technique of
*reflecting*, which validates the client's feelings and encourages them to explore
their thoughts further. Option A provides false reassurance and is dismissive.
Option B uses "why," which can make the client feel defensive or interrogated.
Option D changes the subject and invalidates the client's current emotional state.
2.
Q2. A client with schizophrenia has been taking haloperidol for the past
week. The nurse notes the client has a temperature of 103.2°F (39.5°C),
severe "lead-pipe" muscle rigidity, diaphoresis, and altered mental status.
Which action should the nurse take first?
A. Administer benztropine as prescribed.
B. Notify the healthcare provider immediately.
C. Encourage oral fluid intake.
D. Document the findings and continue to monitor.
Correct Answer: B
Rationale: The client is exhibiting classic signs of Neuroleptic Malignant
Syndrome (NMS), a rare but life-threatening reaction to typical antipsychotics
(like haloperidol). Symptoms include high fever, severe "lead-pipe" muscle
rigidity, altered mental status, and autonomic instability. This is a medical
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
,emergency requiring immediate notification of the healthcare provider,
discontinuation of the drug, and supportive care. 3.
Q3. A client admitted for severe depression is scheduled for discharge
tomorrow. Which statement by the client requires immediate follow-up by
the nurse?
A. "I have made an appointment with my therapist for next week."
B. "I finally feel like I have some energy to do things again."
C. "I am glad I will be going home to my supportive family."
D. "I have been writing in my journal every day."
Correct Answer: B
Rationale: A sudden return of energy in a severely depressed client is a major
red flag for suicide risk. While the depression may have previously left them too
fatigued to act on suicidal ideation, the return of energy provides them with the
physical capability to carry out a plan. Options A, C, and D are positive indicators
of coping and readiness for discharge. 4.
Q4. A client with bipolar disorder is taking lithium carbonate. Which finding
should the nurse report to the healthcare provider as a potential sign of
lithium toxicity?
A. Mild hand tremor
B. Polyuria and polydipsia
C. Vomiting and severe diarrhea
D. Weight gain of 2 lbs in a week
Correct Answer: C
Rationale: Severe gastrointestinal symptoms (vomiting, severe diarrhea), coarse
hand tremors, ataxia, and confusion are hallmark signs of lithium toxicity. Mild
hand tremor, polyuria, polydipsia, and mild weight gain are common, expected
side effects of therapeutic lithium levels, not necessarily toxicity. 5.
Q5. A client is experiencing an acute panic attack in the clinic. Which
intervention is the nurse's priority?
A. Teach the client deep breathing exercises.
B. Ask the client to identify the trigger of the panic attack.
C. Stay with the client and speak in calm, short, simple sentences.
D. Administer an oral dose of alprazolam immediately.
Correct Answer: C
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
,Rationale: During an acute panic attack, a client’s cognitive ability to process
information is severely limited. The priority is to provide a sense of safety and
grounding by staying with the client and using a calm, reassuring voice with
short, simple sentences. Teaching deep breathing (Option A) or exploring
triggers (Option B) is more appropriate *after* the panic attack has subsided. 6.
Q6. A client with borderline personality disorder says to the nurse, "The
night shift nurse is so much nicer than you. You don't care about me at all."
Which response by the nurse is most appropriate?
A. "I do care about you. Let's talk about why you feel that way."
B. "That is not true. I have been doing everything I can to help you."
C. "You are splitting the staff, and that is not acceptable behavior."
D. "I am assigned to care for you today. Let's focus on your treatment plan."
Correct Answer: D
Rationale: This is a classic example of "splitting," a manipulation tactic common
in borderline personality disorder. The nurse must maintain professional
boundaries, avoid becoming defensive (Option B), avoid validating the
manipulation (Option A), and avoid labeling the behavior aggressively (Option C).
Redirecting to the treatment plan in an objective, matter-of-fact manner is the
most therapeutic approach. 7.
Q7. A client is admitted with a history of chronic alcohol abuse. The last
drink was 12 hours ago. Which assessment finding should the nurse
anticipate and monitor for?
A. Bradycardia and hypotension
B. Tremors, diaphoresis, and hypertension
C. Pinpoint pupils and respiratory depression
D. Hyperphagia and hypersomnia
Correct Answer: B
Rationale: Alcohol withdrawal typically peaks within 24–72 hours and presents
with autonomic hyperactivity. Expected findings include tremors ("the shakes"),
diaphoresis, tachycardia, hypertension, anxiety, and potentially seizures or
delirium tremens (DTs). 8.
Q8. A client with severe schizophrenia is refusing antipsychotic
medication, stating, "The pills are poisoned." The client is alert, oriented,
and not currently deemed a danger to self or others. Which action by the
nurse is most appropriate?
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
, A. Administer the medication in liquid form to hide the taste.
B. Respect the client's right to refuse the medication and document the refusal.
C. Apply physical restraints to administer the medication safely.
D. Tell the client that they will lose their unit privileges if they do not take the
medication.
Correct Answer: B
Rationale: Competent clients have the legal and ethical right to refuse
medication, even if the refusal is based on a delusion, *unless* they are an
imminent danger to themselves or others, or have a specific court order for
treatment. Covert administration (Option A), coercion (Option D), or forced
administration without legal justification (Option C) are violations of patient rights
and nursing ethics. 9.
Q9. A client with post-traumatic stress disorder (PTSD) reports frequent
nightmares and flashbacks. Which medication class is typically considered
first-line pharmacological treatment for these core symptoms?
A. Benzodiazepines
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Typical antipsychotics
D. Beta-blockers
Correct Answer: B
Rationale: SSRIs (e.g., sertraline, paroxetine) are the first-line pharmacological
treatment for PTSD, as they help manage core symptoms like intrusive thoughts,
avoidance, and hyperarousal. Benzodiazepines (Option A) are generally avoided
in PTSD due to their high potential for abuse and lack of efficacy in treating the
core trauma symptoms. 10.
Q10. A parent of a child newly prescribed methylphenidate for ADHD asks
the nurse about side effects. Which statement by the parent indicates a
need for further teaching?
A. "I will give the medication in the morning to prevent insomnia."
B. "I should monitor my child's weight and appetite regularly."
C. "I will stop the medication immediately if my child complains of a mild
headache."
D. "I understand this medication may increase my child's heart rate."
Correct Answer: C
NR 547 Mental Health Nursing • Final Exam Practice Test (2026)
