Maryville NR 327 —Mental Health
Nursing Exam 2 With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. Which of the following is the priority nursing action when a client expresses active
suicidal intent with a specific plan?
A. Encourage the client to talk about feelings
B. Ask the client to sign a no-harm contract
C. Initiate one-to-one observation and ensure safety
D. Provide psychoeducation about coping skills
Rationale: Immediate safety is highest priority; one-to-one observation reduces risk
while further assessment and interventions occur.
2. A client with schizophrenia reports hearing voices telling them to harm themselves.
Which symptom is this an example of?
A. Negative symptom
B. Positive symptom
C. Avolition
D. Flat affect
Rationale: Hallucinations and delusions are positive symptoms — additions to
normal experience — common in schizophrenia.
3. A patient on haloperidol develops acute dystonia. The nurse should administer:
A. Lorazepam orally
B. IM benztropine or diphenhydramine
C. Start lithium therapy
D. Continue haloperidol and observe
, Rationale: Acute dystonia (muscle spasms) is an extrapyramidal side effect treated
promptly with anticholinergics like benztropine or diphenhydramine.
4. A client with major depressive disorder has started an SSRI one week ago and reports
increased agitation and suicidal thoughts. The nurse should:
A. Reassure the client this is normal and wait two more weeks
B. Perform a suicide risk assessment and notify the provider immediately
C. Stop the medication abruptly
D. Encourage the client to exercise to improve mood
Rationale: Early in antidepressant treatment, suicidal ideation can increase;
immediate assessment and provider notification are essential.
5. Which therapy focuses on identifying and reframing distorted automatic thoughts?
A. Psychoanalysis
B. Cognitive-behavioral therapy (CBT)
C. Electroconvulsive therapy (ECT)
D. Play therapy
Rationale: CBT targets maladaptive cognitions and behaviors, teaching skills to
restructure distorted thoughts.
6. A client in a manic phase of bipolar disorder is extremely talkative and pressured. The
best initial nursing intervention is to:
A. Encourage group activities
B. Provide stimulating games to distract energy
C. Offer a quiet environment and set clear limits
D. Administer PRN antidepressant
Rationale: During mania, reducing stimulation and setting limits helps maintain
safety and control escalating behavior.
7. Which is a sign of neuroleptic malignant syndrome (NMS)?
A. Bradycardia and hyponatremia
B. Extrapyramidal symptoms after one year of therapy
C. Hypersalivation and insomnia
D. High fever, muscle rigidity, and autonomic instability
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by
hyperthermia, rigidity, and autonomic dysfunction.
8. A client with generalized anxiety disorder asks how benzodiazepines work. The nurse
explains they:
A. Block dopamine receptors
B. Increase serotonin reuptake
C. Enhance GABA neurotransmission to produce calming effects
D. Act as MAO inhibitors
, Rationale: Benzodiazepines potentiate GABA, the main inhibitory neurotransmitter,
producing anxiolytic effects.
9. During a therapeutic group, a member monopolizes conversation. The group leader
should:
A. Ignore the behavior to avoid confrontation
B. Have the member leave the group
C. Gently redirect and invite others to share
D. End the session early
Rationale: A leader should manage group dynamics by redirecting to maintain
equal participation and therapeutic benefit.
10. Which is the best documentation after using seclusion for a violent patient?
A. “Secluded for safety.”
B. “Patient was aggressive; seclusion used.”
C. Describe behaviors leading to seclusion, time initiated, assessments,
interventions, and ongoing observations.
D. No documentation required if order obtained
Rationale: Thorough documentation of rationale, time, behavior, assessments, and
monitoring is legally and clinically required.
11. A 17-year-old with anorexia nervosa has a BMI of 15 and bradycardia. Priority nursing
concern is:
A. Addressing distorted body image
B. Monitoring cardiac status and preventing refeeding syndrome
C. Encouraging group therapy participation
D. Teaching relaxation techniques
Rationale: Severe malnutrition risks cardiac complications and refeeding syndrome;
physiological stabilization is priority.
12. Which med requires monitoring of serum levels and thyroid/renal function?
A. Fluoxetine
B. Haloperidol
C. Lithium
D. Lorazepam
Rationale: Lithium has a narrow therapeutic index and requires periodic level
checks and monitoring of renal and thyroid function.
13. A patient with PTSD experiences flashbacks and hypervigilance. Which intervention is
therapeutic?
A. Encourage avoidance to prevent triggers
B. Teach grounding techniques and provide consistent, safe environment
C. Provide psychoanalytic free association
Nursing Exam 2 With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
1. Which of the following is the priority nursing action when a client expresses active
suicidal intent with a specific plan?
A. Encourage the client to talk about feelings
B. Ask the client to sign a no-harm contract
C. Initiate one-to-one observation and ensure safety
D. Provide psychoeducation about coping skills
Rationale: Immediate safety is highest priority; one-to-one observation reduces risk
while further assessment and interventions occur.
2. A client with schizophrenia reports hearing voices telling them to harm themselves.
Which symptom is this an example of?
A. Negative symptom
B. Positive symptom
C. Avolition
D. Flat affect
Rationale: Hallucinations and delusions are positive symptoms — additions to
normal experience — common in schizophrenia.
3. A patient on haloperidol develops acute dystonia. The nurse should administer:
A. Lorazepam orally
B. IM benztropine or diphenhydramine
C. Start lithium therapy
D. Continue haloperidol and observe
, Rationale: Acute dystonia (muscle spasms) is an extrapyramidal side effect treated
promptly with anticholinergics like benztropine or diphenhydramine.
4. A client with major depressive disorder has started an SSRI one week ago and reports
increased agitation and suicidal thoughts. The nurse should:
A. Reassure the client this is normal and wait two more weeks
B. Perform a suicide risk assessment and notify the provider immediately
C. Stop the medication abruptly
D. Encourage the client to exercise to improve mood
Rationale: Early in antidepressant treatment, suicidal ideation can increase;
immediate assessment and provider notification are essential.
5. Which therapy focuses on identifying and reframing distorted automatic thoughts?
A. Psychoanalysis
B. Cognitive-behavioral therapy (CBT)
C. Electroconvulsive therapy (ECT)
D. Play therapy
Rationale: CBT targets maladaptive cognitions and behaviors, teaching skills to
restructure distorted thoughts.
6. A client in a manic phase of bipolar disorder is extremely talkative and pressured. The
best initial nursing intervention is to:
A. Encourage group activities
B. Provide stimulating games to distract energy
C. Offer a quiet environment and set clear limits
D. Administer PRN antidepressant
Rationale: During mania, reducing stimulation and setting limits helps maintain
safety and control escalating behavior.
7. Which is a sign of neuroleptic malignant syndrome (NMS)?
A. Bradycardia and hyponatremia
B. Extrapyramidal symptoms after one year of therapy
C. Hypersalivation and insomnia
D. High fever, muscle rigidity, and autonomic instability
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by
hyperthermia, rigidity, and autonomic dysfunction.
8. A client with generalized anxiety disorder asks how benzodiazepines work. The nurse
explains they:
A. Block dopamine receptors
B. Increase serotonin reuptake
C. Enhance GABA neurotransmission to produce calming effects
D. Act as MAO inhibitors
, Rationale: Benzodiazepines potentiate GABA, the main inhibitory neurotransmitter,
producing anxiolytic effects.
9. During a therapeutic group, a member monopolizes conversation. The group leader
should:
A. Ignore the behavior to avoid confrontation
B. Have the member leave the group
C. Gently redirect and invite others to share
D. End the session early
Rationale: A leader should manage group dynamics by redirecting to maintain
equal participation and therapeutic benefit.
10. Which is the best documentation after using seclusion for a violent patient?
A. “Secluded for safety.”
B. “Patient was aggressive; seclusion used.”
C. Describe behaviors leading to seclusion, time initiated, assessments,
interventions, and ongoing observations.
D. No documentation required if order obtained
Rationale: Thorough documentation of rationale, time, behavior, assessments, and
monitoring is legally and clinically required.
11. A 17-year-old with anorexia nervosa has a BMI of 15 and bradycardia. Priority nursing
concern is:
A. Addressing distorted body image
B. Monitoring cardiac status and preventing refeeding syndrome
C. Encouraging group therapy participation
D. Teaching relaxation techniques
Rationale: Severe malnutrition risks cardiac complications and refeeding syndrome;
physiological stabilization is priority.
12. Which med requires monitoring of serum levels and thyroid/renal function?
A. Fluoxetine
B. Haloperidol
C. Lithium
D. Lorazepam
Rationale: Lithium has a narrow therapeutic index and requires periodic level
checks and monitoring of renal and thyroid function.
13. A patient with PTSD experiences flashbacks and hypervigilance. Which intervention is
therapeutic?
A. Encourage avoidance to prevent triggers
B. Teach grounding techniques and provide consistent, safe environment
C. Provide psychoanalytic free association
