NSG 3450 MENTAL HEALTH NURSING EXAM
AND CORRECT ANSWERS WITH RATIONALES
NEW 2026-2027 UPDATE GALEN
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for clients with acute and chronic mental health disorders
2 Evaluate psychopharmacologic and psychotherapeutic interventions using current evidence and safety
principles
3 Integrate legal, ethical, and cultural considerations into mental health nursing practice
4 NSG 3450 Mental Health Nursing Exam and Correct Answers with Rationales New 2026
5 2027 Update Galen
6 Foundations of Mental Health Nursing
7 Applied Mental Health Nursing
8 Advanced Mental Health Nursing
9 Mental Health Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from NSG 3450
Mental Health Nursing Exam and Correct Answers with Rationales New 2026-2027 Update Galen,
with the strongest emphasis placed on Apply the nursing process to prioritize care for clients with
acute and chronic mental health disorders, Evaluate psychopharmacologic and psychotherapeutic
interventions using current evidence and safety principles, Integrate legal, ethical and and cultural
considerations into mental health nursing practice. Every item follows the wording style and level of
reasoning you meet in the real paper, and each one is paired with a clear rationale so the correct
choice is never a guess. Work through the set at your own pace, mark the questions that slow you
down, then come back to them until the reasoning feels automatic. Learners who revise this way
walk into the exam room recognising the pattern behind the questions instead of meeting them for
the first time. Keep going - steady, honest practice is what turns a difficult paper into a comfortable
pass.
Page 1
,Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with schizophrenia is prescribed clozapine. Which laboratory monitoring
parameter is most critical to obtain at baseline and weekly for the first six months?
A. Serum creatinine
B. Absolute neutrophil count CORRECT
C. Liver function tests
D. Fasting blood glucose
RATIONALE: Clozapine carries a risk of severe neutropenia/agranulocytosis, requiring baseline
and weekly ANC monitoring for six months, then biweekly. While metabolic and hepatic effects
occur, ANC is the priority due to life-threatening infection risk. Creatinine and glucose are not the
primary mandated monitoring parameters.
Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client experiencing a panic attack is admitted to the emergency department.
Which nursing intervention should be implemented first?
A. Teach diaphragmatic breathing techniques
B. Administer prescribed lorazepam immediately
C. Stay with the client and use short, simple sentences CORRECT
D. Encourage the client to identify the source of anxiety
RATIONALE: During a panic attack, the client's ability to process information is severely
impaired; the nurse should remain present and use brief, clear communication to reduce
stimulation and promote safety. Medication may be given but is not the first psychosocial
intervention. Teaching and insight-oriented approaches are ineffective until anxiety decreases.
Page 2
,Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with bipolar disorder is prescribed lithium carbonate. Which statement by
the client indicates a need for further teaching?
A. I will maintain a consistent sodium intake.
B. I will take the medication with food to reduce stomach upset.
C. I will double my dose if I miss one. CORRECT
D. I will report excessive urination or thirst.
RATIONALE: Doubling a missed dose of lithium can lead to toxicity; clients should never double
doses. Consistent sodium intake, taking with food, and reporting polyuria/polydipsia are correct
self-management strategies. Lithium has a narrow therapeutic index, so dose accuracy is critical.
Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A nurse is assessing a client with anorexia nervosa. Which finding would be most
concerning for refeeding syndrome?
A. Heart rate 52 bpm
B. Serum phosphorus 1.2 mg/dL CORRECT
C. BMI 16.5
D. Potassium 4.0 mEq/L
RATIONALE: Refeeding syndrome is characterized by hypophosphatemia, which can lead to
cardiac and respiratory failure. Bradycardia and low BMI are common in anorexia but not specific
to refeeding syndrome. A normal potassium does not indicate refeeding syndrome; potassium
may also drop, but phosphorus is the hallmark.
Page 3
, Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with alcohol use disorder is experiencing acute withdrawal. Which
medication is considered first-line for managing withdrawal symptoms and
preventing seizures?
A. Haloperidol
B. Lorazepam CORRECT
C. Naltrexone
D. Disulfiram
RATIONALE: Benzodiazepines such as lorazepam are first-line for alcohol withdrawal because
they enhance GABA activity and prevent seizures and delirium tremens. Haloperidol may lower
seizure threshold. Naltrexone and disulfiram are used for maintenance, not acute withdrawal.
Q6 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A nurse is caring for a client with borderline personality disorder who engages in
self-mutilation. Which nursing approach is most therapeutic?
A. Set firm limits on manipulative behavior
B. Rotate staff assignments to prevent splitting
C. Encourage the client to express feelings verbally CORRECT
D. Allow the client to choose a favorite nurse for support
RATIONALE: Verbal expression of feelings is a healthier alternative to self-harm and is a key
therapeutic goal. Limit-setting is important but should be done in a non-punitive manner. Rotating
staff can worsen abandonment fears; allowing a favorite nurse can reinforce splitting.
Page 4
AND CORRECT ANSWERS WITH RATIONALES
NEW 2026-2027 UPDATE GALEN
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for clients with acute and chronic mental health disorders
2 Evaluate psychopharmacologic and psychotherapeutic interventions using current evidence and safety
principles
3 Integrate legal, ethical, and cultural considerations into mental health nursing practice
4 NSG 3450 Mental Health Nursing Exam and Correct Answers with Rationales New 2026
5 2027 Update Galen
6 Foundations of Mental Health Nursing
7 Applied Mental Health Nursing
8 Advanced Mental Health Nursing
9 Mental Health Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from NSG 3450
Mental Health Nursing Exam and Correct Answers with Rationales New 2026-2027 Update Galen,
with the strongest emphasis placed on Apply the nursing process to prioritize care for clients with
acute and chronic mental health disorders, Evaluate psychopharmacologic and psychotherapeutic
interventions using current evidence and safety principles, Integrate legal, ethical and and cultural
considerations into mental health nursing practice. Every item follows the wording style and level of
reasoning you meet in the real paper, and each one is paired with a clear rationale so the correct
choice is never a guess. Work through the set at your own pace, mark the questions that slow you
down, then come back to them until the reasoning feels automatic. Learners who revise this way
walk into the exam room recognising the pattern behind the questions instead of meeting them for
the first time. Keep going - steady, honest practice is what turns a difficult paper into a comfortable
pass.
Page 1
,Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with schizophrenia is prescribed clozapine. Which laboratory monitoring
parameter is most critical to obtain at baseline and weekly for the first six months?
A. Serum creatinine
B. Absolute neutrophil count CORRECT
C. Liver function tests
D. Fasting blood glucose
RATIONALE: Clozapine carries a risk of severe neutropenia/agranulocytosis, requiring baseline
and weekly ANC monitoring for six months, then biweekly. While metabolic and hepatic effects
occur, ANC is the priority due to life-threatening infection risk. Creatinine and glucose are not the
primary mandated monitoring parameters.
Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client experiencing a panic attack is admitted to the emergency department.
Which nursing intervention should be implemented first?
A. Teach diaphragmatic breathing techniques
B. Administer prescribed lorazepam immediately
C. Stay with the client and use short, simple sentences CORRECT
D. Encourage the client to identify the source of anxiety
RATIONALE: During a panic attack, the client's ability to process information is severely
impaired; the nurse should remain present and use brief, clear communication to reduce
stimulation and promote safety. Medication may be given but is not the first psychosocial
intervention. Teaching and insight-oriented approaches are ineffective until anxiety decreases.
Page 2
,Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with bipolar disorder is prescribed lithium carbonate. Which statement by
the client indicates a need for further teaching?
A. I will maintain a consistent sodium intake.
B. I will take the medication with food to reduce stomach upset.
C. I will double my dose if I miss one. CORRECT
D. I will report excessive urination or thirst.
RATIONALE: Doubling a missed dose of lithium can lead to toxicity; clients should never double
doses. Consistent sodium intake, taking with food, and reporting polyuria/polydipsia are correct
self-management strategies. Lithium has a narrow therapeutic index, so dose accuracy is critical.
Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A nurse is assessing a client with anorexia nervosa. Which finding would be most
concerning for refeeding syndrome?
A. Heart rate 52 bpm
B. Serum phosphorus 1.2 mg/dL CORRECT
C. BMI 16.5
D. Potassium 4.0 mEq/L
RATIONALE: Refeeding syndrome is characterized by hypophosphatemia, which can lead to
cardiac and respiratory failure. Bradycardia and low BMI are common in anorexia but not specific
to refeeding syndrome. A normal potassium does not indicate refeeding syndrome; potassium
may also drop, but phosphorus is the hallmark.
Page 3
, Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A client with alcohol use disorder is experiencing acute withdrawal. Which
medication is considered first-line for managing withdrawal symptoms and
preventing seizures?
A. Haloperidol
B. Lorazepam CORRECT
C. Naltrexone
D. Disulfiram
RATIONALE: Benzodiazepines such as lorazepam are first-line for alcohol withdrawal because
they enhance GABA activity and prevent seizures and delirium tremens. Haloperidol may lower
seizure threshold. Naltrexone and disulfiram are used for maintenance, not acute withdrawal.
Q6 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR CLIENTS WITH ACUTE AND
CHRONIC MENTAL HEALTH DISORDERS
A nurse is caring for a client with borderline personality disorder who engages in
self-mutilation. Which nursing approach is most therapeutic?
A. Set firm limits on manipulative behavior
B. Rotate staff assignments to prevent splitting
C. Encourage the client to express feelings verbally CORRECT
D. Allow the client to choose a favorite nurse for support
RATIONALE: Verbal expression of feelings is a healthier alternative to self-harm and is a key
therapeutic goal. Limit-setting is important but should be done in a non-punitive manner. Rotating
staff can worsen abandonment fears; allowing a favorite nurse can reinforce splitting.
Page 4
