MENTAL HEALTH EXAM 3 LATEST 2025 ACTUAL AND DETAILED QUESTIONS AND
CORRECT ANSWERS WITH A BRIEF EXPLANATION.ALREADY GRADED A+
1.Which anticonvulsant mood stabilizer often prescribed for bipolar disorder carries a black box
warning that includes pancreatitis?
A) Ramelteon
B) Lamotrigine
C) Valproic acid
D) Carbamazepine
C. Valproic acid
Valproic acid (Depakene) is helpful in bipolar patients unresponsive to lithium. Black box
warnings for valproic acid include hepatotoxicity, tetratogenicity, and pancreatitis. Ramelteon is
a melatonin receptor agonist that works as a hypnotic. The use of lamotrigine may trigger a
severe allergic skin reaction called Stephens-Johnson syndrome (SJS). The use of carbamazepine
warrants a periodic complete blood count due to rare, but serious blood dyscrasias (e.g., aplastic
anemia and agranulocytosis).
2.Which side effects of lithium can be expected when the medication is at therapeutic levels?
A) Nausea and thirst
B) Ataxia and hypotension
C) Fine hand tremors and polyuria
D) Coarse hand tremors and gastrointestinal upset
C. Fine hand tremors and polyuria
Fine hand tremors and polyuria are present at therapeutic levels of lithium treatment. Nausea and
thirst are early signs of toxicity. Ataxia, hypotension, coarse hand tremors and gastrointestinal
upset are advanced signs of toxicity.
,3.How much time does it usually take for a crisis to self-resolve?
A) 1 to 10 days
B) 1 to 3 weeks
C) 4 to 6 weeks
D) 3 to 4 months
C. 4-6 weeks
At 4 to 6 weeks, the individual is making accommodations and adjustments to relieve anxiety,
and the crisis is no longer a crisis. These adjustments usually cannot be made in less time, but
taking 3 to 4 months would not be tolerable.
4.The client is being admitted for short-term effects of a stress event. What is the nurse likely to
find during the assessment?
A) Tachycardia
B) High blood lipid levels
C) Depression
D) heart disease
A. Tachycardia
Tachycardia is a short-term effect of a stressor. High blood pressure, depression, and heart
disease are long-term effects of stress.
5.The nurse is performing crisis intervention for a client who has been sexually assaulted. What
action should the nurse take first?
A) Ask the client what happened.
B) Assess the client for any suicidal intentions.
C) Learn the client's perception of the situation.
D) Assess the coping skills of the client.
D. Assess the client for any suicidal intentions.
A client experiencing crisis can develop suicidal behavior to escape from the situation. The nurse
should first asses the suicidal intentions of the client to promote the safety of the client. Aside
from asking details that pertain only to the client's health and safety, the nurse's priority
intervention should not be to ask the client what happened since this could unnecessarily
retraumatize the client. The client's perception of the situation and coping skills are assessed after
,assessing the suicidal intentions of the client, because the safety of the client is of greater
importance.
6.When a client complains of being "stressed out," the nurse understands that this label may
include what experiences? Select all that apply.
A) Sleeping through the night
B) Excessive appetite
C) Loss of interest in favorite activities
D) Headaches and back pain
E) Difficulty concentrating
B, C, D, E
Feeling "stressed out" is commonly associated with changes in appetite, loss of interest in
favorite activities, headaches and back pain, difficulty concentrating, and difficulty sleeping.
7.A client was admitted to a health care facility following a suicide attempt resulting from family
violence. After the crisis is resolved, what intervention should be given the highest priority?
A) Give the client an outpatient referral.
B) Refer the client to an inpatient psychiatric unit.
C) Identify the perpetrator and have him or her arrested.
D) Ask the client if they have suicidal ideations.
D. Ask the client if they have suicidal ideations.
The first step after the crisis resolution is to know about the lethality of the situation. For this, the
nurse needs to carefully question the client. If the client is looking forward to the future and has
no further suicidal plans, a referral to outpatient care can be done. If the client is still suicidal,
then a referral to a psychiatric unit can be done. The client's safety is the main concern. The
nurse should not be judgmental about the perpetrator.
8.A nurse observes that a client arguing with the hospital staff is tense and impatient. What
nursing diagnosis should the nurse add to the client's plan of care?
A) Ineffective impulse control
B) Risk for self-directed violence
C) Risk for stress overload
D) Ineffective coping
C. Risk for stress overload
Clients at risk for stress overload have feelings of anger, tension, and impatience. They
demonstrate negative actions such as arguing with and abusing others. Symptoms of ineffective
, impulse control are offensive body language such as rigid posture and clenching fists, a history
of violence, a history of substance abuse, and impulsivity. Symptoms of risk for self-directed
violence are suicidal ideation and feelings of worthlessness, hopelessness, and helplessness.
Symptoms of ineffective coping are poor problem-solving, poor cognitive functioning, and
difficulty in doing simple tasks such as eating, dressing, and other activities of daily living.
9.The high school nurse meets with small groups of students the day after a school bus accident
resulted in the death of five students. Which comment should the nurse use to begin the session?
A) "Sometimes life is not fair. Yesterday's tragedy is an example of just how unfair it can be."
B) "We're grateful that you are safe. Our discussion is to talk about feelings associated with
yesterday's tragedy."
C) "Thank you for coming today. As school leaders, we know it is very important to respond to
yesterday's tragedy."
D) "We've had a terrible loss. I also feel your pain. You need to talk about your feelings
associated with the event."
B. "We're grateful that you are safe. Our discussion is to talk about feelings associated with
yesterday's tragedy."
By indicating that the nurse leading the session and the school are glad the students are safe and
that the meeting's purpose is to talk about feelings associated with the tragedy, the nurse is
beginning the introductory phase of the critical incident stress debriefing process, so this is the
correct answer. Claiming that life is not fair does nothing to establish a safe environment and
clarify the goals of the debriefing, so this is an incorrect response. Indicating that the students
would need to respond to the tragedy fails to begin the meeting by establishing a safe place or a
clear objective for the meeting, so this is not the correct way to begin the meeting. Beginning
with feelings about the loss and the nurse's own pain doesn't start the session in a way that
creates safety and clarity, so this is not the correct response.
10.The nurse is assessing four psychiatric clients in the emergency department. Which client
needs crisis intervention?
A) The client complaining of inability to sleep for the past 2 days
B) The client who has been taking a new antidepressant for 1 week
C) The client with new onset hallucinations
D) The client who recently experienced the death of a spouse
C. The client with new onset hallucinations
Crisis care is appropriate for clients with acute psychosis, such as new onset hallucinations. A
client complaining of inability to sleep may be having anxiety or depression. Crisis intervention
in this situation is not warranted but further assessment is required. It will take approximately 3
to 4 weeks for antidepressant medications to become therapeutic for the client with depression. A
CORRECT ANSWERS WITH A BRIEF EXPLANATION.ALREADY GRADED A+
1.Which anticonvulsant mood stabilizer often prescribed for bipolar disorder carries a black box
warning that includes pancreatitis?
A) Ramelteon
B) Lamotrigine
C) Valproic acid
D) Carbamazepine
C. Valproic acid
Valproic acid (Depakene) is helpful in bipolar patients unresponsive to lithium. Black box
warnings for valproic acid include hepatotoxicity, tetratogenicity, and pancreatitis. Ramelteon is
a melatonin receptor agonist that works as a hypnotic. The use of lamotrigine may trigger a
severe allergic skin reaction called Stephens-Johnson syndrome (SJS). The use of carbamazepine
warrants a periodic complete blood count due to rare, but serious blood dyscrasias (e.g., aplastic
anemia and agranulocytosis).
2.Which side effects of lithium can be expected when the medication is at therapeutic levels?
A) Nausea and thirst
B) Ataxia and hypotension
C) Fine hand tremors and polyuria
D) Coarse hand tremors and gastrointestinal upset
C. Fine hand tremors and polyuria
Fine hand tremors and polyuria are present at therapeutic levels of lithium treatment. Nausea and
thirst are early signs of toxicity. Ataxia, hypotension, coarse hand tremors and gastrointestinal
upset are advanced signs of toxicity.
,3.How much time does it usually take for a crisis to self-resolve?
A) 1 to 10 days
B) 1 to 3 weeks
C) 4 to 6 weeks
D) 3 to 4 months
C. 4-6 weeks
At 4 to 6 weeks, the individual is making accommodations and adjustments to relieve anxiety,
and the crisis is no longer a crisis. These adjustments usually cannot be made in less time, but
taking 3 to 4 months would not be tolerable.
4.The client is being admitted for short-term effects of a stress event. What is the nurse likely to
find during the assessment?
A) Tachycardia
B) High blood lipid levels
C) Depression
D) heart disease
A. Tachycardia
Tachycardia is a short-term effect of a stressor. High blood pressure, depression, and heart
disease are long-term effects of stress.
5.The nurse is performing crisis intervention for a client who has been sexually assaulted. What
action should the nurse take first?
A) Ask the client what happened.
B) Assess the client for any suicidal intentions.
C) Learn the client's perception of the situation.
D) Assess the coping skills of the client.
D. Assess the client for any suicidal intentions.
A client experiencing crisis can develop suicidal behavior to escape from the situation. The nurse
should first asses the suicidal intentions of the client to promote the safety of the client. Aside
from asking details that pertain only to the client's health and safety, the nurse's priority
intervention should not be to ask the client what happened since this could unnecessarily
retraumatize the client. The client's perception of the situation and coping skills are assessed after
,assessing the suicidal intentions of the client, because the safety of the client is of greater
importance.
6.When a client complains of being "stressed out," the nurse understands that this label may
include what experiences? Select all that apply.
A) Sleeping through the night
B) Excessive appetite
C) Loss of interest in favorite activities
D) Headaches and back pain
E) Difficulty concentrating
B, C, D, E
Feeling "stressed out" is commonly associated with changes in appetite, loss of interest in
favorite activities, headaches and back pain, difficulty concentrating, and difficulty sleeping.
7.A client was admitted to a health care facility following a suicide attempt resulting from family
violence. After the crisis is resolved, what intervention should be given the highest priority?
A) Give the client an outpatient referral.
B) Refer the client to an inpatient psychiatric unit.
C) Identify the perpetrator and have him or her arrested.
D) Ask the client if they have suicidal ideations.
D. Ask the client if they have suicidal ideations.
The first step after the crisis resolution is to know about the lethality of the situation. For this, the
nurse needs to carefully question the client. If the client is looking forward to the future and has
no further suicidal plans, a referral to outpatient care can be done. If the client is still suicidal,
then a referral to a psychiatric unit can be done. The client's safety is the main concern. The
nurse should not be judgmental about the perpetrator.
8.A nurse observes that a client arguing with the hospital staff is tense and impatient. What
nursing diagnosis should the nurse add to the client's plan of care?
A) Ineffective impulse control
B) Risk for self-directed violence
C) Risk for stress overload
D) Ineffective coping
C. Risk for stress overload
Clients at risk for stress overload have feelings of anger, tension, and impatience. They
demonstrate negative actions such as arguing with and abusing others. Symptoms of ineffective
, impulse control are offensive body language such as rigid posture and clenching fists, a history
of violence, a history of substance abuse, and impulsivity. Symptoms of risk for self-directed
violence are suicidal ideation and feelings of worthlessness, hopelessness, and helplessness.
Symptoms of ineffective coping are poor problem-solving, poor cognitive functioning, and
difficulty in doing simple tasks such as eating, dressing, and other activities of daily living.
9.The high school nurse meets with small groups of students the day after a school bus accident
resulted in the death of five students. Which comment should the nurse use to begin the session?
A) "Sometimes life is not fair. Yesterday's tragedy is an example of just how unfair it can be."
B) "We're grateful that you are safe. Our discussion is to talk about feelings associated with
yesterday's tragedy."
C) "Thank you for coming today. As school leaders, we know it is very important to respond to
yesterday's tragedy."
D) "We've had a terrible loss. I also feel your pain. You need to talk about your feelings
associated with the event."
B. "We're grateful that you are safe. Our discussion is to talk about feelings associated with
yesterday's tragedy."
By indicating that the nurse leading the session and the school are glad the students are safe and
that the meeting's purpose is to talk about feelings associated with the tragedy, the nurse is
beginning the introductory phase of the critical incident stress debriefing process, so this is the
correct answer. Claiming that life is not fair does nothing to establish a safe environment and
clarify the goals of the debriefing, so this is an incorrect response. Indicating that the students
would need to respond to the tragedy fails to begin the meeting by establishing a safe place or a
clear objective for the meeting, so this is not the correct way to begin the meeting. Beginning
with feelings about the loss and the nurse's own pain doesn't start the session in a way that
creates safety and clarity, so this is not the correct response.
10.The nurse is assessing four psychiatric clients in the emergency department. Which client
needs crisis intervention?
A) The client complaining of inability to sleep for the past 2 days
B) The client who has been taking a new antidepressant for 1 week
C) The client with new onset hallucinations
D) The client who recently experienced the death of a spouse
C. The client with new onset hallucinations
Crisis care is appropriate for clients with acute psychosis, such as new onset hallucinations. A
client complaining of inability to sleep may be having anxiety or depression. Crisis intervention
in this situation is not warranted but further assessment is required. It will take approximately 3
to 4 weeks for antidepressant medications to become therapeutic for the client with depression. A
