NSG 3450 Final Exam V2 | NSG 3450 Mental Health
Guide | Actual Q&A with Rationale (NSG3450 Final
Exam) | Galen College of Nursing
1. A nurse is assessing a client who has a new prescription for lithium carbonate. Which of the
following findings should the nurse identify as an early indication of lithium toxicity?
A. Fine hand tremors
B. Persistent gastrointestinal upset
C. Polyuria
D. Muscle hyperirritability
Correct Answer: B
Explanation: Persistent gastrointestinal upset, such as nausea, vomiting, or diarrhea, is an
early sign of lithium toxicity that requires immediate attention. Fine hand tremors and
polyuria are common expected side effects at therapeutic levels rather than signs of
toxicity. Muscle hyperirritability is a late sign of severe toxicity typically seen at levels
above 2.0 mEq/L.
2. A client diagnosed with schizophrenia is experiencing auditory hallucinations and tells the
nurse, ‘I hear voices telling me I am evil.’ Which response by the nurse is therapeutic?
A. Why do you think the voices are saying that to you?
B. I don’t hear any voices, but I believe you are hearing them.
,C. You should try to ignore the voices and focus on the group activity.
D. The voices are not real; they are just part of your illness.
Correct Answer: B
Explanation: This response acknowledges the client’s perception while maintaining the
nurse’s reality, a technique known as ‘presenting reality.’ It validates the client’s experience
without agreeing that the voices exist. Dismissing the voices or asking ‘why’ can increase
the client’s anxiety and defensiveness.
3. A nurse in an acute mental health facility is caring for a client who is in the manic phase of
bipolar disorder. Which of the following activities is most appropriate for this client?
A. Walking with the nurse on the grounds
B. Attending a 45-minute group therapy session
C. Participating in a competitive game of volleyball
D. Reading a complex novel in the library
Correct Answer: A
Explanation: Clients in a manic state require physical activity to expend energy but should
avoid high-stimulation or competitive environments. Walking with the nurse provides a
low-stimulus outlet for physical energy while maintaining safety and supervision. Complex
tasks or long group sessions are often impossible due to the client’s short attention span
and distractibility.
, 4. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Teach the client abdominal breathing exercises
B. Administer PRN lorazepam
C. Ask the client to describe what triggered the attack
D. Stay with the client and remain calm
Correct Answer: D
Explanation: During a panic attack, the priority is the safety and security of the client.
Staying with the client provides reassurance and ensures they are not alone during a
frightening experience. Teaching or deep processing cannot occur until the level of anxiety
has decreased from the panic stage.
5. A client is prescribed phenelzine for the treatment of depression. The nurse should instruct
the client to avoid which of the following foods?
A. Cottage cheese
B. Fresh chicken
C. Pepperoni pizza
D. Apples
Correct Answer: C
Guide | Actual Q&A with Rationale (NSG3450 Final
Exam) | Galen College of Nursing
1. A nurse is assessing a client who has a new prescription for lithium carbonate. Which of the
following findings should the nurse identify as an early indication of lithium toxicity?
A. Fine hand tremors
B. Persistent gastrointestinal upset
C. Polyuria
D. Muscle hyperirritability
Correct Answer: B
Explanation: Persistent gastrointestinal upset, such as nausea, vomiting, or diarrhea, is an
early sign of lithium toxicity that requires immediate attention. Fine hand tremors and
polyuria are common expected side effects at therapeutic levels rather than signs of
toxicity. Muscle hyperirritability is a late sign of severe toxicity typically seen at levels
above 2.0 mEq/L.
2. A client diagnosed with schizophrenia is experiencing auditory hallucinations and tells the
nurse, ‘I hear voices telling me I am evil.’ Which response by the nurse is therapeutic?
A. Why do you think the voices are saying that to you?
B. I don’t hear any voices, but I believe you are hearing them.
,C. You should try to ignore the voices and focus on the group activity.
D. The voices are not real; they are just part of your illness.
Correct Answer: B
Explanation: This response acknowledges the client’s perception while maintaining the
nurse’s reality, a technique known as ‘presenting reality.’ It validates the client’s experience
without agreeing that the voices exist. Dismissing the voices or asking ‘why’ can increase
the client’s anxiety and defensiveness.
3. A nurse in an acute mental health facility is caring for a client who is in the manic phase of
bipolar disorder. Which of the following activities is most appropriate for this client?
A. Walking with the nurse on the grounds
B. Attending a 45-minute group therapy session
C. Participating in a competitive game of volleyball
D. Reading a complex novel in the library
Correct Answer: A
Explanation: Clients in a manic state require physical activity to expend energy but should
avoid high-stimulation or competitive environments. Walking with the nurse provides a
low-stimulus outlet for physical energy while maintaining safety and supervision. Complex
tasks or long group sessions are often impossible due to the client’s short attention span
and distractibility.
, 4. A nurse is caring for a client who is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Teach the client abdominal breathing exercises
B. Administer PRN lorazepam
C. Ask the client to describe what triggered the attack
D. Stay with the client and remain calm
Correct Answer: D
Explanation: During a panic attack, the priority is the safety and security of the client.
Staying with the client provides reassurance and ensures they are not alone during a
frightening experience. Teaching or deep processing cannot occur until the level of anxiety
has decreased from the panic stage.
5. A client is prescribed phenelzine for the treatment of depression. The nurse should instruct
the client to avoid which of the following foods?
A. Cottage cheese
B. Fresh chicken
C. Pepperoni pizza
D. Apples
Correct Answer: C
