SK298
Brain, Mind & Mental Health
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A 72‑year‑old with progressive memory loss, apathy, and
impaired executive function presents for evaluation. MRI shows
cortical atrophy most pronounced in the hippocampus and temporal
lobes.
Question: Which diagnosis is most consistent with this
presentation?
- A. Vascular dementia
- B. Alzheimer disease
- C. Frontotemporal dementia
- D. Normal pressure hydrocephalus
Answer: B. Alzheimer disease
Rationale: Hippocampal and temporal cortical atrophy with
progressive memory and executive decline is characteristic of
Alzheimer pathology.
2. Case: A 28‑year‑old presents with sudden onset of severe panic
symptoms, palpitations, derealization, and fear of losing control. No
medical cause is found.
Question: Which immediate nursing intervention is most
appropriate?
- A. Restrain the patient to prevent harm
- B. Provide a calm environment, breathing guidance, and
short‑acting benzodiazepine if severe and ordered
- C. Start long‑term SSRI immediately
- D. Discharge home with reassurance only
Answer: B. Provide a calm environment, breathing guidance, and
short‑acting benzodiazepine if severe and ordered
Rationale: Acute panic requires de‑escalation, breathing
techniques, and short‑term pharmacologic relief when indicated;
long‑term meds are not immediate therapy.
3. Case: A patient on clozapine reports fever, sore throat, and
malaise. CBC shows absolute neutrophil count (ANC) 400/µL.
2
, Question: What is the correct clinical action?
- A. Continue clozapine and observe
- B. Immediately discontinue clozapine and arrange urgent
hematology evaluation for agranulocytosis management
- C. Increase clozapine dose
- D. Switch to another antipsychotic without monitoring
Answer: B. Immediately discontinue clozapine and arrange urgent
hematology evaluation for agranulocytosis management
Rationale: Clozapine can cause life‑threatening agranulocytosis;
ANC <500 requires immediate cessation and urgent workup.
4. Case: A 45‑year‑old with major depressive disorder has partial
response to an SSRI. The psychiatrist considers augmentation with
atypical antipsychotic. Which risk must the nurse monitor closely?
- A. Hypoglycemia
- B. Extrapyramidal symptoms and metabolic syndrome
- C. Increased seizure threshold only
- D. Renal failure within 24 hours
Answer: B. Extrapyramidal symptoms and metabolic syndrome
Rationale: Atypical antipsychotics can cause EPS and metabolic
adverse effects (weight gain, dyslipidemia, hyperglycemia) requiring
monitoring.
5. Case: A patient with suspected bacterial meningitis is obtunded.
Empiric antibiotics are started. Which nursing priority supports
prevention of secondary brain injury?
- A. Maintain normothermia, monitor intracranial pressure signs,
and ensure adequate oxygenation and perfusion
- B. Allow hyperthermia to run its course
- C. Withhold fluids to reduce cerebral edema
- D. Avoid monitoring neurologic status to reduce stimulation
Answer: A. Maintain normothermia, monitor intracranial pressure
signs, and ensure adequate oxygenation and perfusion
Rationale: Preventing secondary injury requires temperature
3
Brain, Mind & Mental Health
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A 72‑year‑old with progressive memory loss, apathy, and
impaired executive function presents for evaluation. MRI shows
cortical atrophy most pronounced in the hippocampus and temporal
lobes.
Question: Which diagnosis is most consistent with this
presentation?
- A. Vascular dementia
- B. Alzheimer disease
- C. Frontotemporal dementia
- D. Normal pressure hydrocephalus
Answer: B. Alzheimer disease
Rationale: Hippocampal and temporal cortical atrophy with
progressive memory and executive decline is characteristic of
Alzheimer pathology.
2. Case: A 28‑year‑old presents with sudden onset of severe panic
symptoms, palpitations, derealization, and fear of losing control. No
medical cause is found.
Question: Which immediate nursing intervention is most
appropriate?
- A. Restrain the patient to prevent harm
- B. Provide a calm environment, breathing guidance, and
short‑acting benzodiazepine if severe and ordered
- C. Start long‑term SSRI immediately
- D. Discharge home with reassurance only
Answer: B. Provide a calm environment, breathing guidance, and
short‑acting benzodiazepine if severe and ordered
Rationale: Acute panic requires de‑escalation, breathing
techniques, and short‑term pharmacologic relief when indicated;
long‑term meds are not immediate therapy.
3. Case: A patient on clozapine reports fever, sore throat, and
malaise. CBC shows absolute neutrophil count (ANC) 400/µL.
2
, Question: What is the correct clinical action?
- A. Continue clozapine and observe
- B. Immediately discontinue clozapine and arrange urgent
hematology evaluation for agranulocytosis management
- C. Increase clozapine dose
- D. Switch to another antipsychotic without monitoring
Answer: B. Immediately discontinue clozapine and arrange urgent
hematology evaluation for agranulocytosis management
Rationale: Clozapine can cause life‑threatening agranulocytosis;
ANC <500 requires immediate cessation and urgent workup.
4. Case: A 45‑year‑old with major depressive disorder has partial
response to an SSRI. The psychiatrist considers augmentation with
atypical antipsychotic. Which risk must the nurse monitor closely?
- A. Hypoglycemia
- B. Extrapyramidal symptoms and metabolic syndrome
- C. Increased seizure threshold only
- D. Renal failure within 24 hours
Answer: B. Extrapyramidal symptoms and metabolic syndrome
Rationale: Atypical antipsychotics can cause EPS and metabolic
adverse effects (weight gain, dyslipidemia, hyperglycemia) requiring
monitoring.
5. Case: A patient with suspected bacterial meningitis is obtunded.
Empiric antibiotics are started. Which nursing priority supports
prevention of secondary brain injury?
- A. Maintain normothermia, monitor intracranial pressure signs,
and ensure adequate oxygenation and perfusion
- B. Allow hyperthermia to run its course
- C. Withhold fluids to reduce cerebral edema
- D. Avoid monitoring neurologic status to reduce stimulation
Answer: A. Maintain normothermia, monitor intracranial pressure
signs, and ensure adequate oxygenation and perfusion
Rationale: Preventing secondary injury requires temperature
3
