Nur 253 Mental Health Exam 4 Complete Exam Review Questions With Correct Answers & Detailed Explanations

NUR 253 MENTAL HEALTH EXAM 4 COMPLETE EXAM REVIEW QUESTIONS WITH CORRECT ANSWERS & DETAILED EXPLANATIONS 1. A client with bipolar disorder is experiencing acute mania. Which nursing intervention is most appropriate during this phase? A) Encourage participation in group therapy sessions B) Provide a structured environment with minimal stimulation C) Allow the client to make all decisions regarding daily activities D) Assign the client to a private room with windows facing the courtyard Correct Answer: B) Provide a structured environment with minimal stimulation Explanation: During acute mania, clients experience heightened sensory input and decreased ability to filter stimuli. A structured environment with minimal stimulation reduces anxiety, prevents overstimulation, and helps maintain safety. Group therapy (A) would be overstimulating. Allowing full decision-making (C) is inappropriate as judgment is impaired. A private room with windows (D) may provide distracting stimuli. ________________________________________ 2. A client diagnosed with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through satellites." Which response by the nurse is most therapeutic? A) "That sounds frightening. Tell me more about what you're experiencing." B) "The FBI doesn't monitor people's thoughts. That's not possible." C) "Why do you think the FBI would be interested in you?" D) "Have you taken your antipsychotic medication today?" Correct Answer: A) "That sounds frightening. Tell me more about what you're experiencing." Explanation: This response acknowledges the client's feelings without validating the delusion. It uses therapeutic communication by exploring the client's experience. Option B challenges the delusion directly, which may increase defensiveness. Option C asks "why," which encourages rationalization of delusional content. Option D changes the subject and implies the delusion is due to missed medication. ________________________________________ 3. A client with major depressive disorder has been prescribed phenelzine (Nardil). Which food item should the nurse instruct the client to avoid? A) Apples B) Aged cheese C) Bananas D) Rice Correct Answer: B) Aged cheese Explanation: Phenelzine is an MAOI (monoamine oxidase inhibitor). Aged cheese contains tyramine, which can cause a hypertensive crisis when combined with MAOIs. Other foods to avoid include aged meats, fermented foods, and red wine. Apples (A), bananas (C), and rice (D) are safe to consume in moderation. ________________________________________ 4. The nurse is assessing a client with alcohol use disorder who is experiencing withdrawal. Which symptom would require immediate medical intervention? A) Diaphoresis B) Tremors C) Seizure activity D) Nausea Correct Answer: C) Seizure activity Explanation: Seizure activity during alcohol withdrawal is a medical emergency that can progress to status epilepticus or delirium tremens. Diaphoresis (A), tremors (B), and nausea (D) are common withdrawal symptoms that require monitoring but do not typically necessitate immediate emergency intervention. ________________________________________ 5. Which benzodiazepine is most commonly used for the management of alcohol withdrawal symptoms? A) Alprazolam (Xanax) B) Lorazepam (Ativan) C) Clonazepam (Klonopin) D) Diazepam (Valium) Correct Answer: D) Diazepam (Valium) Explanation: Diazepam is the most commonly used benzodiazepine for alcohol withdrawal due to its long half-life, which provides a smooth taper and reduces breakthrough symptoms. While lorazepam (B) is also used, diazepam is preferred in many clinical settings. Alprazolam (A) has a short half-life and is less suitable. Clonazepam (C) is used for seizure disorders and panic disorder. ________________________________________ 6. A client with borderline personality disorder frequently engages in self-harming behaviors. Which nursing intervention is a priority? A) Place the client in seclusion when self-harm is threatened B) Maintain a no-harm contract with the client C) Conduct frequent and regular safety checks D) Remove all sharp objects from the client's environment Correct Answer: C) Conduct frequent and regular safety checks Explanation: Frequent and regular safety checks are the priority intervention to ensure client safety and prevent self-harm. Seclusion (A) should only be used as a last resort. No-harm contracts (B) have limited effectiveness in borderline personality disorder. Removing sharp objects (D) is part of environmental safety but does not replace the need for ongoing observation. ________________________________________ 7. The nurse is caring for a client with anorexia nervosa. Which laboratory finding is most concerning? A) Serum potassium of 3.2 mEq/L B) Serum sodium of 138 mEq/L C) Serum glucose of 90 mg/dL D) Serum calcium of 9.5 mg/dL Correct Answer: A) Serum potassium of 3.2 mEq/L Explanation: Hypokalemia (potassium 3.5 mEq/L) in anorexia nervosa is concerning due to risk of cardiac arrhythmias and sudden death. The normal potassium range is 3.5-5.0 mEq/L. Sodium of 138 (B) is normal (135-145). Glucose of 90 (C) is normal (70-100). Calcium of 9.5 (D) is normal (8.5-10.5). ________________________________________ 8. A client taking lithium carbonate has a serum lithium level of 1.8 mEq/L. Which symptom would the nurse expect to observe? A) Fine hand tremors B) Polydipsia C) Severe diarrhea and vomiting D) Mild nausea Correct Answer: C) Severe diarrhea and vomiting Explanation: A lithium level of 1.8 mEq/L is in the toxic range (therapeutic range is 0.6-1.2 mEq/L). At toxic levels, clients experience severe gastrointestinal symptoms including diarrhea and vomiting. Fine hand tremors (A) and mild nausea (D) occur at therapeutic levels. Polydipsia (B) is a common side effect but not specific to toxicity. ________________________________________ 9. A client with post-traumatic stress disorder (PTSD) reports frequent nightmares and flashbacks. Which medication is FDA-approved specifically for this condition? A) Sertraline (Zoloft) B) Bupropion (Wellbutrin) C) Quetiapine (Seroquel) D) Olanzapine (Zyprexa) Correct Answer: A) Sertraline (Zoloft) Explanation: Sertraline and paroxetine are the two SSRIs FDA-approved for PTSD treatment. Bupropion (B) is used for depression and smoking cessation. Quetiapine (C) and Olanzapine (D) are atypical antipsychotics used as adjunctive treatments but are not FDA-approved as first-line monotherapy for PTSD. ________________________________________ 10. During a mental status examination, the nurse asks the client to interpret the proverb "People in glass houses shouldn't throw stones." The client responds, "They might break the glass and get cut." This response indicates which type of thinking? A) Concrete thinking B) Abstract thinking C) Magical thinking D) Loosening of associations Correct Answer: A) Concrete thinking Explanation: Concrete thinking is the inability to understand abstract concepts or metaphors; the client interprets the proverb literally. Abstract thinking (B) would involve understanding the figurative meaning about not criticizing others. Magical thinking (C) involves believing thoughts can influence events. Loosening of associations (D) involves rapid shifting between unrelated topics.