NFDN 2007 MENTAL HEALTH NURSING
COMPREHENSIVE FINAL EXAM PREP
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A patient with schizophrenia is started on clozapine. Which laboratory parameter must the
nurse monitor most closely during the first six months of treatment?
A. Serum creatinine and blood urea nitrogen
B. Liver function tests (ALT/AST)
C. Absolute neutrophil count (ANC)
D. Serum potassium levels
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis.
Regular monitoring of the Absolute Neutrophil Count (ANC) is mandatory to detect life-
threatening bone marrow suppression.
2. A client is admitted for major depressive disorder and is prescribed Phenelzine, an MAOI.
Which menu choice indicates the client understands the dietary restrictions?
A. Pepperoni pizza and a glass of red wine
B. Smoked salmon on a sourdough bagel
,C. Grilled chicken breast with steamed broccoli
D. Aged cheddar cheese and crackers
Answer: C
Conceptual Explanation: MAOIs require a low-tyramine diet to prevent hypertensive
crisis. Aged cheeses, smoked meats, pepperoni, and red wine are all high in tyramine, while
fresh chicken and vegetables are safe.
3. A nurse is caring for a client in the manic phase of bipolar disorder. Which intervention is
the priority for the safety of the client and others?
A. Encourage the client to participate in a group volleyball game
B. Decrease environmental stimuli and provide a quiet area
C. Provide the client with high-calorie finger foods
D. Strictly enforce a schedule for cognitive behavioral therapy
Answer: B
Conceptual Explanation: Reducing environmental stimuli is the priority to decrease
agitation and prevent escalation of manic behavior. High-calorie finger foods are important
for nutrition but decreasing stimuli is a primary safety/stabilization intervention.
4. A client on a psychiatric unit exhibits ‘splitting’ behavior, praising one nurse while
demeaning another. This is most characteristic of which personality disorder?
A. Antisocial Personality Disorder
, B. Narcissistic Personality Disorder
C. Borderline Personality Disorder
D. Avoidant Personality Disorder
Answer: C
Conceptual Explanation: Splitting—the inability to integrate the positive and negative
qualities of oneself or others into a cohesive image—is a classic defense mechanism used
by individuals with Borderline Personality Disorder.
5. Which assessment finding would most strongly suggest that a client is experiencing
Neuroleptic Malignant Syndrome (NMS)?
A. Fine hand tremors and mild sedation
B. Orthostatic hypotension and dry mouth
C. Acute dystonia and oculogyric crisis
D. Muscle rigidity and hyperpyrexia
Answer: D
Conceptual Explanation: NMS is a life-threatening emergency associated with
antipsychotic use. Its hallmarks include severe muscle rigidity, high fever (hyperpyrexia),
tachycardia, and autonomic instability.
COMPREHENSIVE FINAL EXAM PREP
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A patient with schizophrenia is started on clozapine. Which laboratory parameter must the
nurse monitor most closely during the first six months of treatment?
A. Serum creatinine and blood urea nitrogen
B. Liver function tests (ALT/AST)
C. Absolute neutrophil count (ANC)
D. Serum potassium levels
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis.
Regular monitoring of the Absolute Neutrophil Count (ANC) is mandatory to detect life-
threatening bone marrow suppression.
2. A client is admitted for major depressive disorder and is prescribed Phenelzine, an MAOI.
Which menu choice indicates the client understands the dietary restrictions?
A. Pepperoni pizza and a glass of red wine
B. Smoked salmon on a sourdough bagel
,C. Grilled chicken breast with steamed broccoli
D. Aged cheddar cheese and crackers
Answer: C
Conceptual Explanation: MAOIs require a low-tyramine diet to prevent hypertensive
crisis. Aged cheeses, smoked meats, pepperoni, and red wine are all high in tyramine, while
fresh chicken and vegetables are safe.
3. A nurse is caring for a client in the manic phase of bipolar disorder. Which intervention is
the priority for the safety of the client and others?
A. Encourage the client to participate in a group volleyball game
B. Decrease environmental stimuli and provide a quiet area
C. Provide the client with high-calorie finger foods
D. Strictly enforce a schedule for cognitive behavioral therapy
Answer: B
Conceptual Explanation: Reducing environmental stimuli is the priority to decrease
agitation and prevent escalation of manic behavior. High-calorie finger foods are important
for nutrition but decreasing stimuli is a primary safety/stabilization intervention.
4. A client on a psychiatric unit exhibits ‘splitting’ behavior, praising one nurse while
demeaning another. This is most characteristic of which personality disorder?
A. Antisocial Personality Disorder
, B. Narcissistic Personality Disorder
C. Borderline Personality Disorder
D. Avoidant Personality Disorder
Answer: C
Conceptual Explanation: Splitting—the inability to integrate the positive and negative
qualities of oneself or others into a cohesive image—is a classic defense mechanism used
by individuals with Borderline Personality Disorder.
5. Which assessment finding would most strongly suggest that a client is experiencing
Neuroleptic Malignant Syndrome (NMS)?
A. Fine hand tremors and mild sedation
B. Orthostatic hypotension and dry mouth
C. Acute dystonia and oculogyric crisis
D. Muscle rigidity and hyperpyrexia
Answer: D
Conceptual Explanation: NMS is a life-threatening emergency associated with
antipsychotic use. Its hallmarks include severe muscle rigidity, high fever (hyperpyrexia),
tachycardia, and autonomic instability.
