NR 326 EXAM REVIEW QUESTIONS
WITH CORRECT ANSWERS 2026/2027
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory value requires the
nurse to withhold the medication and contact the provider immediately?
A. Absolute neutrophil count (ANC) of 900/mm3
B. White blood cell count of 4,500/mm3
C. Platelet count of 150,000/mm3
D. Blood glucose level of 110 mg/dL
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis. An ANC below
1,000/mm3 is a critical value requiring immediate cessation of the drug and monitoring for
infection.
2. A nurse is caring for a client with Bipolar I Disorder experiencing acute mania. Which meal
choice is most appropriate for this client?
A. Beef and vegetable stew with a side salad
B. A bowl of vegetable soup and crackers
,C. Spaghetti bolognese with garlic bread
D. Chicken nuggets, an apple, and a carton of milk
Answer: D
Conceptual Explanation: Clients in acute mania have high energy and low attention spans;
‘finger foods’ that are high in protein and calories allow them to eat while moving.
3. Which assessment finding is most indicative of Neuroleptic Malignant Syndrome (NMS) in a
patient taking Haloperidol?
A. Excessive salivation and drooling
B. Severe muscle rigidity and hyperpyrexia
C. Muscle flaccidity and hypotension
D. Involuntary tongue protrusion and lip smacking
Answer: B
Conceptual Explanation: NMS is a medical emergency characterized by ‘lead pipe’ muscle
rigidity, very high fever (hyperpyrexia), tachycardia, and fluctuations in blood pressure.
4. A client is receiving Lithium Carbonate for the treatment of Bipolar Disorder. The nurse
should instruct the client to maintain a consistent intake of which substance?
A. Vitamin K
B. Tyramine
C. Potassium
, D. Sodium
Answer: D
Conceptual Explanation: Lithium is a salt; if sodium levels drop (e.g., through sweating or
low intake), the kidneys conserve lithium, leading to toxic levels.
5. A nurse observes a client with Obsessive-Compulsive Disorder (OCD) repeatedly washing
their hands. What is the primary purpose of this ritualistic behavior?
A. To gain attention from the nursing staff
B. To maintain physical cleanliness
C. To reduce overwhelming anxiety
D. To exert control over the environment
Answer: C
Conceptual Explanation: Rituals in OCD are performed to neutralize or reduce the intense
anxiety caused by obsessive thoughts.
6. A client being treated with Phenelzine (an MAOI) complains of a sudden, throbbing
headache and stiff neck. What is the nurse’s priority action?
A. Administer a PRN dose of acetaminophen
B. Instruct the client to lie down in a dark room
C. Assess the client’s blood pressure
D. Check the client’s temperature
WITH CORRECT ANSWERS 2026/2027
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory value requires the
nurse to withhold the medication and contact the provider immediately?
A. Absolute neutrophil count (ANC) of 900/mm3
B. White blood cell count of 4,500/mm3
C. Platelet count of 150,000/mm3
D. Blood glucose level of 110 mg/dL
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis. An ANC below
1,000/mm3 is a critical value requiring immediate cessation of the drug and monitoring for
infection.
2. A nurse is caring for a client with Bipolar I Disorder experiencing acute mania. Which meal
choice is most appropriate for this client?
A. Beef and vegetable stew with a side salad
B. A bowl of vegetable soup and crackers
,C. Spaghetti bolognese with garlic bread
D. Chicken nuggets, an apple, and a carton of milk
Answer: D
Conceptual Explanation: Clients in acute mania have high energy and low attention spans;
‘finger foods’ that are high in protein and calories allow them to eat while moving.
3. Which assessment finding is most indicative of Neuroleptic Malignant Syndrome (NMS) in a
patient taking Haloperidol?
A. Excessive salivation and drooling
B. Severe muscle rigidity and hyperpyrexia
C. Muscle flaccidity and hypotension
D. Involuntary tongue protrusion and lip smacking
Answer: B
Conceptual Explanation: NMS is a medical emergency characterized by ‘lead pipe’ muscle
rigidity, very high fever (hyperpyrexia), tachycardia, and fluctuations in blood pressure.
4. A client is receiving Lithium Carbonate for the treatment of Bipolar Disorder. The nurse
should instruct the client to maintain a consistent intake of which substance?
A. Vitamin K
B. Tyramine
C. Potassium
, D. Sodium
Answer: D
Conceptual Explanation: Lithium is a salt; if sodium levels drop (e.g., through sweating or
low intake), the kidneys conserve lithium, leading to toxic levels.
5. A nurse observes a client with Obsessive-Compulsive Disorder (OCD) repeatedly washing
their hands. What is the primary purpose of this ritualistic behavior?
A. To gain attention from the nursing staff
B. To maintain physical cleanliness
C. To reduce overwhelming anxiety
D. To exert control over the environment
Answer: C
Conceptual Explanation: Rituals in OCD are performed to neutralize or reduce the intense
anxiety caused by obsessive thoughts.
6. A client being treated with Phenelzine (an MAOI) complains of a sudden, throbbing
headache and stiff neck. What is the nurse’s priority action?
A. Administer a PRN dose of acetaminophen
B. Instruct the client to lie down in a dark room
C. Assess the client’s blood pressure
D. Check the client’s temperature
