NSRG 126 Final Exam V2 | NSRG 126 Mental Health
Nursing | Actual Q&A with Rationale (NSRG126
Final Exam) | Ivy Tech
1. A patient with bipolar disorder is prescribed lithium carbonate. Which of the following
laboratory values should the nurse prioritize for monitoring to ensure safety and therapeutic
efficacy?
A. Serum lithium levels
B. Serum potassium levels
C. Liver function tests
D. Fast glucose levels
Correct Answer: A
Explanation: Lithium has a very narrow therapeutic index, typically between 0.6 and 1.2
mEq/L. Regular monitoring is essential to prevent toxicity, which can occur at levels above
1.5 mEq/L. The nurse must assess these levels frequently during the initiation of therapy
and periodically thereafter to ensure the patient remains within the safe range.
2. A nurse is communicating with a client who is experiencing a manic episode. Which of the
following communication techniques are most appropriate for this client? (Select all that
apply or choose the best single approach provided).
A. Engaging in long, detailed discussions about their feelings
B. Using calm, short, and concise explanations
,C. Using a joking manner to de-escalate the situation
D. Allowing the client to lead the conversation entirely
E. Providing complex choices for daily activities
Correct Answer: B
Explanation: Clients in a manic state have a decreased attention span and are easily
overstimulated by complex information. Short and concise communication helps the client
process information without becoming more agitated. This approach maintains
professional boundaries and provides the structure the client needs during an acute
episode.
3. Which clinical manifestation is considered a negative symptom of schizophrenia?
A. Flat affect
B. Delusions of grandeur
C. Disorganized speech
D. Auditory hallucinations
Correct Answer: A
Explanation: Negative symptoms of schizophrenia refer to the absence or diminution of
normal functions, such as emotional expression. Flat affect, alogia, and avolition are classic
examples of these deficits. In contrast, hallucinations and delusions are positive symptoms,
representing an excess or distortion of normal functioning.
, 4. A client is prescribed phenelzine for depression. The nurse must instruct the client to avoid
which of the following foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Chicken and white rice
C. Aged cheeses and smoked meats
D. Cottage cheese and milk
Correct Answer: C
Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that interacts
dangerously with tyramine-rich foods. Ingesting tyramine while on an MAOI can cause a
massive release of norepinephrine, leading to severe hypertension. The nurse must provide
a comprehensive list of prohibited foods, including sauerkraut, draft beer, and fermented
products.
5. During an intake assessment, a client reveals they have been hearing voices telling them to
harm themselves. What is the nurse’s priority action?
A. Document the finding in the medical record
B. Assess the client for a specific plan and lethality
C. Ask the client why they think the voices are talking to them
D. Administer an as-needed dose of an antipsychotic
Correct Answer: B
Nursing | Actual Q&A with Rationale (NSRG126
Final Exam) | Ivy Tech
1. A patient with bipolar disorder is prescribed lithium carbonate. Which of the following
laboratory values should the nurse prioritize for monitoring to ensure safety and therapeutic
efficacy?
A. Serum lithium levels
B. Serum potassium levels
C. Liver function tests
D. Fast glucose levels
Correct Answer: A
Explanation: Lithium has a very narrow therapeutic index, typically between 0.6 and 1.2
mEq/L. Regular monitoring is essential to prevent toxicity, which can occur at levels above
1.5 mEq/L. The nurse must assess these levels frequently during the initiation of therapy
and periodically thereafter to ensure the patient remains within the safe range.
2. A nurse is communicating with a client who is experiencing a manic episode. Which of the
following communication techniques are most appropriate for this client? (Select all that
apply or choose the best single approach provided).
A. Engaging in long, detailed discussions about their feelings
B. Using calm, short, and concise explanations
,C. Using a joking manner to de-escalate the situation
D. Allowing the client to lead the conversation entirely
E. Providing complex choices for daily activities
Correct Answer: B
Explanation: Clients in a manic state have a decreased attention span and are easily
overstimulated by complex information. Short and concise communication helps the client
process information without becoming more agitated. This approach maintains
professional boundaries and provides the structure the client needs during an acute
episode.
3. Which clinical manifestation is considered a negative symptom of schizophrenia?
A. Flat affect
B. Delusions of grandeur
C. Disorganized speech
D. Auditory hallucinations
Correct Answer: A
Explanation: Negative symptoms of schizophrenia refer to the absence or diminution of
normal functions, such as emotional expression. Flat affect, alogia, and avolition are classic
examples of these deficits. In contrast, hallucinations and delusions are positive symptoms,
representing an excess or distortion of normal functioning.
, 4. A client is prescribed phenelzine for depression. The nurse must instruct the client to avoid
which of the following foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Chicken and white rice
C. Aged cheeses and smoked meats
D. Cottage cheese and milk
Correct Answer: C
Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that interacts
dangerously with tyramine-rich foods. Ingesting tyramine while on an MAOI can cause a
massive release of norepinephrine, leading to severe hypertension. The nurse must provide
a comprehensive list of prohibited foods, including sauerkraut, draft beer, and fermented
products.
5. During an intake assessment, a client reveals they have been hearing voices telling them to
harm themselves. What is the nurse’s priority action?
A. Document the finding in the medical record
B. Assess the client for a specific plan and lethality
C. Ask the client why they think the voices are talking to them
D. Administer an as-needed dose of an antipsychotic
Correct Answer: B
