NSG 3450 Mental Health Exam 3 |Questions with 100%
Correct Answers | Verified | Latest Update- Galen College
of Nursing
1. A client has recently started an MAOI antidepressant for treatment-resistant depression.
Which client finding requires immediate intervention?
A. Mild insomnia and nausea
B. A severe headache with blood pressure 186/104
C. Dry mouth and constipation
D. Feeling slightly more energetic in the morning
Correct Answer: B
Rationale:
MAOIs as a drug class carry a well-known risk for hypertensive crisis, which presents with a
sudden, severe headache and dangerously elevated blood pressure. This is the most life-
threatening adverse reaction and requires immediate action. Mild insomnia, nausea, dry
mouth, constipation, and early changes in energy are expected side effects or common
early responses to antidepressants and do not require emergent intervention.
2. The nurse teaches a client who has been prescribed an MAOI antidepressant about
dietary restrictions. Which statement indicates the need for further teaching?
A. “I will avoid cured meats and aged cheeses.”
B. “I can eat fresh fruits like apples.”
C. “I know tyramine-rich foods can raise my blood pressure dangerously.”
D. “Smoked and aged fish is always a safe choice with this medication.”
Correct Answer: D
Rationale:
Clients taking MAOIs must avoid foods high in tyramine because they can trigger
hypertensive crisis. This includes aged cheeses, cured meats, fermented products, aged
wines, and some smoked or aged fish. Fresh fruits like apples are safe. Understanding the
link between tyramine and blood pressure shows correct teaching. Saying “smoked and
aged fish is always safe” is incorrect—certain smoked/aged fish do contain tyramine and
must be avoided.
, 3. A client receiving ECT asks what will happen during the procedure. Which statement
by the nurse is most accurate?
A. “You will be awake but unable to move during the procedure.”
B. “You will receive a muscle-paralyzing medication and anesthesia before the treatment.”
C. “You will not receive any medications; the shock is brief and painless.”
D. “You will likely remember everything that happens during the treatment.”
Correct Answer: B
Rationale: During ECT, the client receives general anesthesia and a short-acting muscle
paralytic to prevent injury during the induced seizure. The client is not awake. Option A
incorrectly suggests paralysis without anesthesia—which would be cruel and inaccurate.
Option C is incorrect because medications are given and clients are not simply shocked
without anesthesia. Short-term memory loss and confusion after treatment are common,
so remembering everything is unlikely, making option D inaccurate.
4. A client recently started light therapy for seasonal depression. Which statement
should the nurse recognize as most concerning?
A. “I feel a little jittery and have a mild headache after my sessions.”
B. “I feel much more awake in the morning and fall asleep earlier at night.”
C. “I feel extremely agitated and can’t stop pacing after using the light.”
D. “I’ve noticed my appetite improving.”
Correct Answer: C
Rationale: Mild jitteriness and headache are expected side effects of light therapy and are
usually manageable. Increased wakefulness and improved appetite can be signs of
treatment response. However, extreme agitation and pacing may indicate overstimulation
or a switch toward hypomania/mania in a vulnerable client and require prompt evaluation
and possible adjustment of treatment.
5. The nurse assesses a 19-year-old client with anorexia nervosa. Which finding is the
highest priority to report to the provider?
A. Fine, downy hair over the back and shoulders
B. Reports of feeling cold all the time
,C. BMI of 15 with heart rate 48 and temperature 95°F (35°C)
D. Distorted body image and fear of gaining weight
Correct Answer: C
Rationale: A BMI of 15 with bradycardia and hypothermia indicates severe anorexia and
risk for life-threatening complications such as cardiac dysrhythmias and metabolic
acidosis.
This requires immediate attention and likely hospitalization. Lanugo, cold intolerance,
distorted body image, and intense fear of weight gain are classic findings in anorexia but
are not as acutely life-threatening as the vital sign abnormalities.
6. A client with anorexia nervosa is being admitted. Which nursing diagnosis takes
priority?
A. Disturbed body image related to fear of weight gain
B. Risk for injury related to electrolyte imbalance
C. Social isolation related to preoccupation with weight
D. Chronic low self-esteem related to perfectionism
Correct Answer: B
Rationale: In anorexia, the highest priority is physiological safety. Severe malnutrition
leads to electrolyte imbalances (especially potassium), which can cause cardiac arrest.
Therefore, risk for injury related to electrolyte imbalance is the priority. Disturbed body
image, social isolation, and chronic low self-esteem are all important but are lower in
priority than life-threatening physical risks.
7. The nurse cares for a client with bulimia nervosa who has been bingeing and
purging. Which assessment finding is the most important to monitor?
A. Tooth enamel erosion and swollen parotid glands
B. Reports of feeling out of control while eating
C. Serum potassium level of 2.9 mEq/L
D. History of constipation and use of laxatives
Correct Answer: C
Rationale: A potassium level of 2.9 mEq/L is critically low and can cause life-
threatening cardiac dysrhythmias, especially in clients who purge through vomiting or
laxatives. Dental erosion and parotid swelling are classic physical findings but not
immediately life-
, threatening. Feelings of loss of control and laxative abuse are significant for treatment
planning but not as urgent as electrolyte imbalance.
8. Which clinical picture best differentiates bulimia nervosa from anorexia nervosa?
A. Severe underweight, lanugo, refusal to eat
B. Normal or slightly overweight body weight with dental erosion
C. Amenorrhea and constant feeling of cold
D. Primarily restrictive intake without purging behaviors
Correct Answer: B
Rationale: Clients with bulimia often maintain a normal or slightly increased weight but
have recurrent binge-and-purge episodes leading to dental erosion and enlarged parotid
glands. Severe underweight with lanugo, cold intolerance, amenorrhea, and purely
restrictive behavior patterns are more typical of anorexia. Restrictive intake without
compensatory purging also fits anorexia more than bulimia.
9. The nurse teaches a client with binge eating disorder about treatment. Which
statement indicates understanding?
A. “I’ll probably need to be hospitalized for a long time.”
B. “I may be prescribed Vyvanse along with therapy.”
C. “I’ll be started on diuretics to control my weight.”
D. “Inducing vomiting after I overeat will help prevent weight gain.”
Correct Answer: B
Rationale: Binge eating disorder is associated with obesity and recurrent episodes of
overeating without purging. Treatment often includes SSRIs, SNRIs, and lisdexamfetamine
(Vyvanse) along with psychotherapy. Long-term hospitalization is not typically indicated.
Diuretics and self-induced vomiting are unsafe and reinforce disordered patterns.
10. Which client presentation is most consistent with avoidant/restrictive food intake
disorder rather than anorexia nervosa?
A. Adolescent with low BMI, intense fear of gaining weight, and body image distortion
B. Child with very limited food preferences, low BMI, but no concern about body size
Correct Answers | Verified | Latest Update- Galen College
of Nursing
1. A client has recently started an MAOI antidepressant for treatment-resistant depression.
Which client finding requires immediate intervention?
A. Mild insomnia and nausea
B. A severe headache with blood pressure 186/104
C. Dry mouth and constipation
D. Feeling slightly more energetic in the morning
Correct Answer: B
Rationale:
MAOIs as a drug class carry a well-known risk for hypertensive crisis, which presents with a
sudden, severe headache and dangerously elevated blood pressure. This is the most life-
threatening adverse reaction and requires immediate action. Mild insomnia, nausea, dry
mouth, constipation, and early changes in energy are expected side effects or common
early responses to antidepressants and do not require emergent intervention.
2. The nurse teaches a client who has been prescribed an MAOI antidepressant about
dietary restrictions. Which statement indicates the need for further teaching?
A. “I will avoid cured meats and aged cheeses.”
B. “I can eat fresh fruits like apples.”
C. “I know tyramine-rich foods can raise my blood pressure dangerously.”
D. “Smoked and aged fish is always a safe choice with this medication.”
Correct Answer: D
Rationale:
Clients taking MAOIs must avoid foods high in tyramine because they can trigger
hypertensive crisis. This includes aged cheeses, cured meats, fermented products, aged
wines, and some smoked or aged fish. Fresh fruits like apples are safe. Understanding the
link between tyramine and blood pressure shows correct teaching. Saying “smoked and
aged fish is always safe” is incorrect—certain smoked/aged fish do contain tyramine and
must be avoided.
, 3. A client receiving ECT asks what will happen during the procedure. Which statement
by the nurse is most accurate?
A. “You will be awake but unable to move during the procedure.”
B. “You will receive a muscle-paralyzing medication and anesthesia before the treatment.”
C. “You will not receive any medications; the shock is brief and painless.”
D. “You will likely remember everything that happens during the treatment.”
Correct Answer: B
Rationale: During ECT, the client receives general anesthesia and a short-acting muscle
paralytic to prevent injury during the induced seizure. The client is not awake. Option A
incorrectly suggests paralysis without anesthesia—which would be cruel and inaccurate.
Option C is incorrect because medications are given and clients are not simply shocked
without anesthesia. Short-term memory loss and confusion after treatment are common,
so remembering everything is unlikely, making option D inaccurate.
4. A client recently started light therapy for seasonal depression. Which statement
should the nurse recognize as most concerning?
A. “I feel a little jittery and have a mild headache after my sessions.”
B. “I feel much more awake in the morning and fall asleep earlier at night.”
C. “I feel extremely agitated and can’t stop pacing after using the light.”
D. “I’ve noticed my appetite improving.”
Correct Answer: C
Rationale: Mild jitteriness and headache are expected side effects of light therapy and are
usually manageable. Increased wakefulness and improved appetite can be signs of
treatment response. However, extreme agitation and pacing may indicate overstimulation
or a switch toward hypomania/mania in a vulnerable client and require prompt evaluation
and possible adjustment of treatment.
5. The nurse assesses a 19-year-old client with anorexia nervosa. Which finding is the
highest priority to report to the provider?
A. Fine, downy hair over the back and shoulders
B. Reports of feeling cold all the time
,C. BMI of 15 with heart rate 48 and temperature 95°F (35°C)
D. Distorted body image and fear of gaining weight
Correct Answer: C
Rationale: A BMI of 15 with bradycardia and hypothermia indicates severe anorexia and
risk for life-threatening complications such as cardiac dysrhythmias and metabolic
acidosis.
This requires immediate attention and likely hospitalization. Lanugo, cold intolerance,
distorted body image, and intense fear of weight gain are classic findings in anorexia but
are not as acutely life-threatening as the vital sign abnormalities.
6. A client with anorexia nervosa is being admitted. Which nursing diagnosis takes
priority?
A. Disturbed body image related to fear of weight gain
B. Risk for injury related to electrolyte imbalance
C. Social isolation related to preoccupation with weight
D. Chronic low self-esteem related to perfectionism
Correct Answer: B
Rationale: In anorexia, the highest priority is physiological safety. Severe malnutrition
leads to electrolyte imbalances (especially potassium), which can cause cardiac arrest.
Therefore, risk for injury related to electrolyte imbalance is the priority. Disturbed body
image, social isolation, and chronic low self-esteem are all important but are lower in
priority than life-threatening physical risks.
7. The nurse cares for a client with bulimia nervosa who has been bingeing and
purging. Which assessment finding is the most important to monitor?
A. Tooth enamel erosion and swollen parotid glands
B. Reports of feeling out of control while eating
C. Serum potassium level of 2.9 mEq/L
D. History of constipation and use of laxatives
Correct Answer: C
Rationale: A potassium level of 2.9 mEq/L is critically low and can cause life-
threatening cardiac dysrhythmias, especially in clients who purge through vomiting or
laxatives. Dental erosion and parotid swelling are classic physical findings but not
immediately life-
, threatening. Feelings of loss of control and laxative abuse are significant for treatment
planning but not as urgent as electrolyte imbalance.
8. Which clinical picture best differentiates bulimia nervosa from anorexia nervosa?
A. Severe underweight, lanugo, refusal to eat
B. Normal or slightly overweight body weight with dental erosion
C. Amenorrhea and constant feeling of cold
D. Primarily restrictive intake without purging behaviors
Correct Answer: B
Rationale: Clients with bulimia often maintain a normal or slightly increased weight but
have recurrent binge-and-purge episodes leading to dental erosion and enlarged parotid
glands. Severe underweight with lanugo, cold intolerance, amenorrhea, and purely
restrictive behavior patterns are more typical of anorexia. Restrictive intake without
compensatory purging also fits anorexia more than bulimia.
9. The nurse teaches a client with binge eating disorder about treatment. Which
statement indicates understanding?
A. “I’ll probably need to be hospitalized for a long time.”
B. “I may be prescribed Vyvanse along with therapy.”
C. “I’ll be started on diuretics to control my weight.”
D. “Inducing vomiting after I overeat will help prevent weight gain.”
Correct Answer: B
Rationale: Binge eating disorder is associated with obesity and recurrent episodes of
overeating without purging. Treatment often includes SSRIs, SNRIs, and lisdexamfetamine
(Vyvanse) along with psychotherapy. Long-term hospitalization is not typically indicated.
Diuretics and self-induced vomiting are unsafe and reinforce disordered patterns.
10. Which client presentation is most consistent with avoidant/restrictive food intake
disorder rather than anorexia nervosa?
A. Adolescent with low BMI, intense fear of gaining weight, and body image distortion
B. Child with very limited food preferences, low BMI, but no concern about body size
