NUR 384 Exam 1 – Mental Health Nursing (2026)
Concordia University | Practice Questions &
Rationales
1. A nurse is assessing a client who has recently experienced a
severe trauma. The client states, "I just don't want to talk about
it. Everything is fine." Which defense mechanism is the client
using?
A) Projection
B) Denial
C) Displacement
D) Rationalization
Answer: B) Denial
Rationale: Denial is an unconscious defense mechanism where
a person refuses to acknowledge the reality of a stressful or
traumatic event. Stating "everything is fine" and refusing to
discuss the trauma is a classic example of denial.
2. A client is prescribed phenelzine (Nardil), an MAOI, for
depression. The nurse provides dietary education. Which food
selection indicates that the client understands the teaching?
,A) Aged cheddar cheese and crackers
B) Smoked salmon and cream cheese
C) Grilled chicken breast and steamed rice
D) Pepperoni pizza and a draft beer
Answer: C) Grilled chicken breast and steamed rice
Rationale: MAOIs interact with tyramine-rich foods, which can
precipitate a life-threatening hypertensive crisis. Foods to avoid
include aged cheeses, smoked/cured meats, fermented foods,
and certain beers. Chicken and rice are safe choices.
3. A psychiatric nurse is using therapeutic communication with
a newly admitted client. Which of the following nursing
responses is an example of "exploring"?
A) "I notice you look down when you talk about your mother."
B) "Can you tell me more about what happened when you left
home?"
C) "Don't worry, everything is going to be fine."
D) "You should try to focus on getting better."
Answer: B) "Can you tell me more about what happened when
you left home?"
,Rationale: Exploring is a therapeutic technique used to gather
more information and encourage the client to elaborate on an
important topic. Option A is an observation, Option C is giving
false reassurance, and Option D is giving advice (both non-
therapeutic).
4. A client experiencing acute mania is pacing the unit, speaking
rapidly, and interrupting others. What is the nurse's priority
intervention?
A) Administer a PRN antipsychotic medication.
B) Place the client in seclusion.
C) Move the client to a quiet, low-stimulation environment.
D) Ignore the behavior to avoid escalating the client.
Answer: C) Move the client to a quiet, low-stimulation
environment
Rationale: During acute mania, the client is highly distractible
and reacts poorly to environmental stimuli. The least restrictive,
priority intervention is to decrease stimulation. Seclusion or
medication may be needed later if the client becomes a danger,
but reducing stimuli is the first step.
, 5. A nurse is caring for a client with generalized anxiety disorder
(GAD) who is prescribed buspirone. The nurse should teach the
client that this medication:
A) Can cause physical dependence and must be tapered off
slowly.
B) Has a delayed onset of action and may take 2 to 4 weeks to
work.
C) Should be taken only when feeling acutely anxious.
D) Will cause significant sedation and drowsiness.
Answer: B) Has a delayed onset of action and may take 2 to 4
weeks to work.
Rationale: Unlike benzodiazepines, buspirone is non-addictive
and does not cause significant sedation. However, it does not
provide immediate relief; it takes 2 to 4 weeks to reach
therapeutic effectiveness and must be taken on a scheduled
basis.
6. Which statement by a client taking fluoxetine (Prozac) for
major depressive disorder indicates a need for further
teaching?
A) "I might not feel better for a couple of weeks."
Concordia University | Practice Questions &
Rationales
1. A nurse is assessing a client who has recently experienced a
severe trauma. The client states, "I just don't want to talk about
it. Everything is fine." Which defense mechanism is the client
using?
A) Projection
B) Denial
C) Displacement
D) Rationalization
Answer: B) Denial
Rationale: Denial is an unconscious defense mechanism where
a person refuses to acknowledge the reality of a stressful or
traumatic event. Stating "everything is fine" and refusing to
discuss the trauma is a classic example of denial.
2. A client is prescribed phenelzine (Nardil), an MAOI, for
depression. The nurse provides dietary education. Which food
selection indicates that the client understands the teaching?
,A) Aged cheddar cheese and crackers
B) Smoked salmon and cream cheese
C) Grilled chicken breast and steamed rice
D) Pepperoni pizza and a draft beer
Answer: C) Grilled chicken breast and steamed rice
Rationale: MAOIs interact with tyramine-rich foods, which can
precipitate a life-threatening hypertensive crisis. Foods to avoid
include aged cheeses, smoked/cured meats, fermented foods,
and certain beers. Chicken and rice are safe choices.
3. A psychiatric nurse is using therapeutic communication with
a newly admitted client. Which of the following nursing
responses is an example of "exploring"?
A) "I notice you look down when you talk about your mother."
B) "Can you tell me more about what happened when you left
home?"
C) "Don't worry, everything is going to be fine."
D) "You should try to focus on getting better."
Answer: B) "Can you tell me more about what happened when
you left home?"
,Rationale: Exploring is a therapeutic technique used to gather
more information and encourage the client to elaborate on an
important topic. Option A is an observation, Option C is giving
false reassurance, and Option D is giving advice (both non-
therapeutic).
4. A client experiencing acute mania is pacing the unit, speaking
rapidly, and interrupting others. What is the nurse's priority
intervention?
A) Administer a PRN antipsychotic medication.
B) Place the client in seclusion.
C) Move the client to a quiet, low-stimulation environment.
D) Ignore the behavior to avoid escalating the client.
Answer: C) Move the client to a quiet, low-stimulation
environment
Rationale: During acute mania, the client is highly distractible
and reacts poorly to environmental stimuli. The least restrictive,
priority intervention is to decrease stimulation. Seclusion or
medication may be needed later if the client becomes a danger,
but reducing stimuli is the first step.
, 5. A nurse is caring for a client with generalized anxiety disorder
(GAD) who is prescribed buspirone. The nurse should teach the
client that this medication:
A) Can cause physical dependence and must be tapered off
slowly.
B) Has a delayed onset of action and may take 2 to 4 weeks to
work.
C) Should be taken only when feeling acutely anxious.
D) Will cause significant sedation and drowsiness.
Answer: B) Has a delayed onset of action and may take 2 to 4
weeks to work.
Rationale: Unlike benzodiazepines, buspirone is non-addictive
and does not cause significant sedation. However, it does not
provide immediate relief; it takes 2 to 4 weeks to reach
therapeutic effectiveness and must be taken on a scheduled
basis.
6. Which statement by a client taking fluoxetine (Prozac) for
major depressive disorder indicates a need for further
teaching?
A) "I might not feel better for a couple of weeks."
