NFDN 2007 MENTAL HEALTH EXAM 3 -
ADVANCED NURSING PRACTICE
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A patient with Bipolar I Disorder is in the acute phase of mania. Which meal choice is most
appropriate for the nurse to provide?
A. A plate of spaghetti and meatballs with a side salad.
B. Chicken nuggets and an apple.
C. Beef and vegetable stew with a roll.
D. A bowl of vegetable soup and crackers.
Answer: B
Conceptual Explanation: Patients in acute mania exhibit psychomotor agitation and
cannot sit long enough to eat. Finger foods like chicken nuggets and fruit allow them to
maintain caloric intake while moving.
2. A client is prescribed Phenelzine (Nardil) for treatment-resistant depression. Which
statement by the client indicates a need for further teaching?
A. I can take over-the-counter cold medicine if I get a sniffle.
B. I will avoid aged cheeses and cured meats.
,C. I will wait 14 days after stopping this med before starting another antidepressant.
D. I need to monitor my blood pressure regularly.
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Taking OTC cold medications containing
pseudoephedrine can lead to a hypertensive crisis. Dietary restrictions (tyramine) and
washout periods are necessary.
3. A nurse is assessing a client with Borderline Personality Disorder. Which behavior is the
nurse most likely to observe?
A. Alternating between extreme idealization and devaluation of others.
B. Excessive emotionality and attention-seeking behavior.
C. Social isolation and lack of interest in relationships.
D. Rigid adherence to rules and perfectionism.
Answer: A
Conceptual Explanation: Splitting is a hallmark defense mechanism of Borderline
Personality Disorder, where the client sees people as all good or all bad.
4. A patient taking Lithium Carbonate for Bipolar Disorder reports blurred vision and a coarse
hand tremor. The lithium level is 2.1 mEq/L. What is the priority nursing action?
A. Administer the next scheduled dose and recheck the level in 4 hours.
B. Document the findings as common side effects of lithium therapy.
, C. Advise the patient to increase their fluid intake to flush the medication.
D. Hold the medication and notify the healthcare provider immediately.
Answer: D
Conceptual Explanation: A lithium level of 2.1 mEq/L indicates moderate to severe
toxicity. Coarse tremors and blurred vision are signs of advanced toxicity. The drug must be
held.
5. Which assessment finding is a priority for a client admitted with Anorexia Nervosa?
A. Presence of lanugo on the back and arms.
B. Body weight 25% below ideal body weight.
C. Potassium level of 2.8 mEq/L.
D. Amenorrhea for the past six months.
Answer: C
Conceptual Explanation: While all findings are characteristic of Anorexia, a potassium
level of 2.8 mEq/L is critically low and poses an immediate risk for cardiac arrhythmias
and death.
6. A client is experiencing alcohol withdrawal delirium (Delirium Tremens). Which medication
should the nurse anticipate administering first?
A. Disulfiram (Antabuse)
B. Naltrexone (ReVia)
ADVANCED NURSING PRACTICE
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A patient with Bipolar I Disorder is in the acute phase of mania. Which meal choice is most
appropriate for the nurse to provide?
A. A plate of spaghetti and meatballs with a side salad.
B. Chicken nuggets and an apple.
C. Beef and vegetable stew with a roll.
D. A bowl of vegetable soup and crackers.
Answer: B
Conceptual Explanation: Patients in acute mania exhibit psychomotor agitation and
cannot sit long enough to eat. Finger foods like chicken nuggets and fruit allow them to
maintain caloric intake while moving.
2. A client is prescribed Phenelzine (Nardil) for treatment-resistant depression. Which
statement by the client indicates a need for further teaching?
A. I can take over-the-counter cold medicine if I get a sniffle.
B. I will avoid aged cheeses and cured meats.
,C. I will wait 14 days after stopping this med before starting another antidepressant.
D. I need to monitor my blood pressure regularly.
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Taking OTC cold medications containing
pseudoephedrine can lead to a hypertensive crisis. Dietary restrictions (tyramine) and
washout periods are necessary.
3. A nurse is assessing a client with Borderline Personality Disorder. Which behavior is the
nurse most likely to observe?
A. Alternating between extreme idealization and devaluation of others.
B. Excessive emotionality and attention-seeking behavior.
C. Social isolation and lack of interest in relationships.
D. Rigid adherence to rules and perfectionism.
Answer: A
Conceptual Explanation: Splitting is a hallmark defense mechanism of Borderline
Personality Disorder, where the client sees people as all good or all bad.
4. A patient taking Lithium Carbonate for Bipolar Disorder reports blurred vision and a coarse
hand tremor. The lithium level is 2.1 mEq/L. What is the priority nursing action?
A. Administer the next scheduled dose and recheck the level in 4 hours.
B. Document the findings as common side effects of lithium therapy.
, C. Advise the patient to increase their fluid intake to flush the medication.
D. Hold the medication and notify the healthcare provider immediately.
Answer: D
Conceptual Explanation: A lithium level of 2.1 mEq/L indicates moderate to severe
toxicity. Coarse tremors and blurred vision are signs of advanced toxicity. The drug must be
held.
5. Which assessment finding is a priority for a client admitted with Anorexia Nervosa?
A. Presence of lanugo on the back and arms.
B. Body weight 25% below ideal body weight.
C. Potassium level of 2.8 mEq/L.
D. Amenorrhea for the past six months.
Answer: C
Conceptual Explanation: While all findings are characteristic of Anorexia, a potassium
level of 2.8 mEq/L is critically low and poses an immediate risk for cardiac arrhythmias
and death.
6. A client is experiencing alcohol withdrawal delirium (Delirium Tremens). Which medication
should the nurse anticipate administering first?
A. Disulfiram (Antabuse)
B. Naltrexone (ReVia)
