NUR 253 EXAM 2 MENTAL HEALTH
() QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING
1. A patient taking Lithium Carbonate for Bipolar I Disorder presents with a coarse hand
tremor, mental confusion, and an EEG showing generalized slowing. The nurse notes the
patient’s serum lithium level is 2.1 mEq/L. Which action is the clinical priority?
A. Administer the next scheduled dose of Lithium as prescribed.
B. Withhold the medication and prepare for gastric lavage or urea administration.
C. Request an immediate order for hemodialysis.
D. Instruct the patient to increase sodium and water intake immediately.
Answer: B
Conceptual Explanation: Serum lithium levels between 2.0 and 2.5 mEq/L indicate severe
toxicity. Priority interventions include withholding the drug and promoting excretion via
gastric lavage or drugs like urea or mannitol. Hemodialysis is typically reserved for levels
above 2.5 mEq/L.
,2. A client diagnosed with Schizophrenia is prescribed Haloperidol. Two days later, the nurse
observes the client has a high fever, muscle rigidity, tachycardia, and a fluctuating blood
pressure. What is the nurse’s first action?
A. Administer Benztropine (Cogentin) intramuscularly.
B. Apply cooling blankets to reduce the hyperpyrexia.
C. Hold the Haloperidol and notify the provider immediately.
D. Reassure the client that these are common extrapyramidal side effects.
Answer: C
Conceptual Explanation: The symptoms describe Neuroleptic Malignant Syndrome
(NMS), a life-threatening medical emergency. The first priority is to stop the causative
antipsychotic medication and alert the medical team.
3. A patient with Borderline Personality Disorder is observed being extremely complimentary
toward one nurse while being overtly hostile and demeaning toward another. This behavior is
an example of which defense mechanism?
A. Reaction Formation
B. Sublimation
C. Projective Identification
D. Splitting
Answer: D
, Conceptual Explanation: Splitting is the inability to integrate positive and negative
qualities of oneself or others into a cohesive image, leading the individual to view people as
either ‘all good’ or ‘all bad.’
4. During the assessment of a client with Anorexia Nervosa, the nurse notes the presence of
fine, downy hair on the client’s back and arms. How should the nurse document this finding?
A. Hirsutism
B. Lanugo
C. Alopecia
D. Acanthosis nigricans
Answer: B
Conceptual Explanation: Lanugo is the growth of fine, downy hair on the face and back,
which is a physiological response to malnutrition and the body’s attempt to maintain heat
in the absence of subcutaneous fat.
5. A client is starting Phenelzine (Nardil) for treatment-resistant depression. Which menu
choice indicates the client understands the dietary restrictions?
A. Grilled chicken breast, steamed broccoli, and a fresh apple
B. Pepperoni pizza and a glass of red wine
C. Smoked salmon on a bagel with cream cheese
D. Liver and onions with a side of fava beans
() QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING
1. A patient taking Lithium Carbonate for Bipolar I Disorder presents with a coarse hand
tremor, mental confusion, and an EEG showing generalized slowing. The nurse notes the
patient’s serum lithium level is 2.1 mEq/L. Which action is the clinical priority?
A. Administer the next scheduled dose of Lithium as prescribed.
B. Withhold the medication and prepare for gastric lavage or urea administration.
C. Request an immediate order for hemodialysis.
D. Instruct the patient to increase sodium and water intake immediately.
Answer: B
Conceptual Explanation: Serum lithium levels between 2.0 and 2.5 mEq/L indicate severe
toxicity. Priority interventions include withholding the drug and promoting excretion via
gastric lavage or drugs like urea or mannitol. Hemodialysis is typically reserved for levels
above 2.5 mEq/L.
,2. A client diagnosed with Schizophrenia is prescribed Haloperidol. Two days later, the nurse
observes the client has a high fever, muscle rigidity, tachycardia, and a fluctuating blood
pressure. What is the nurse’s first action?
A. Administer Benztropine (Cogentin) intramuscularly.
B. Apply cooling blankets to reduce the hyperpyrexia.
C. Hold the Haloperidol and notify the provider immediately.
D. Reassure the client that these are common extrapyramidal side effects.
Answer: C
Conceptual Explanation: The symptoms describe Neuroleptic Malignant Syndrome
(NMS), a life-threatening medical emergency. The first priority is to stop the causative
antipsychotic medication and alert the medical team.
3. A patient with Borderline Personality Disorder is observed being extremely complimentary
toward one nurse while being overtly hostile and demeaning toward another. This behavior is
an example of which defense mechanism?
A. Reaction Formation
B. Sublimation
C. Projective Identification
D. Splitting
Answer: D
, Conceptual Explanation: Splitting is the inability to integrate positive and negative
qualities of oneself or others into a cohesive image, leading the individual to view people as
either ‘all good’ or ‘all bad.’
4. During the assessment of a client with Anorexia Nervosa, the nurse notes the presence of
fine, downy hair on the client’s back and arms. How should the nurse document this finding?
A. Hirsutism
B. Lanugo
C. Alopecia
D. Acanthosis nigricans
Answer: B
Conceptual Explanation: Lanugo is the growth of fine, downy hair on the face and back,
which is a physiological response to malnutrition and the body’s attempt to maintain heat
in the absence of subcutaneous fat.
5. A client is starting Phenelzine (Nardil) for treatment-resistant depression. Which menu
choice indicates the client understands the dietary restrictions?
A. Grilled chicken breast, steamed broccoli, and a fresh apple
B. Pepperoni pizza and a glass of red wine
C. Smoked salmon on a bagel with cream cheese
D. Liver and onions with a side of fava beans
