Page 1 of 81
NSG 3450 MENTAL HEALTH EXAM 2 QUESTIONS LATEST EDITION 2026 –
2027 VERSION SOLVED QUESTIONS & ANSWERS
NSG 3450 Mental Health Exam 2 –Questions with Rationales
Summarized 10-Point Exam Coverage
Schizophrenia Spectrum and Other Psychotic Disorders – Positive/negative
symptoms, antipsychotic management, relapse prevention, community support.
Personality Disorders – Clusters A, B, C, therapeutic communication, boundary
setting, crisis management.
Substance Use and Addictive Disorders – Withdrawal, detoxification, relapse
prevention, dual diagnosis, 12-step programs.
Eating Disorders – Anorexia nervosa, bulimia nervosa, binge-eating disorder, refeeding
syndrome, family-based therapy.
Somatic Symptom and Dissociative Disorders – Illness anxiety, conversion disorder,
dissociative identity disorder, trauma-informed care.
Child and Adolescent Mental Health – Autism spectrum, ADHD, oppositional defiant
disorder, childhood depression, family interventions.
Neurocognitive Disorders – Delirium, dementia, Alzheimer's disease, Lewy body
dementia, safety and caregiver support.
Psychotherapy and Therapeutic Modalities – CBT, DBT, group therapy, family therapy,
milieu therapy, complementary therapies.
Community Mental Health and Rehabilitation – Assertive community treatment,
psychosocial rehabilitation, housing, employment support.
Special Populations – Older adults, LGBTQ+ individuals, veterans, homeless
populations, cultural and spiritual considerations.
SECTION 1: SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS
(Questions 1–30)
, Page 2 of 81
1. A nurse is assessing a patient who reports hearing voices that others do not hear
and believes the government is monitoring their thoughts. Which symptom
category do these experiences represent?
A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Mood symptoms
Correct Answer: B
Rationale: Hallucinations (hearing voices) and delusions (belief about government
monitoring) are positive symptoms of schizophrenia, which reflect an excess or
distortion of normal functions.
2. A nurse is caring for a patient with schizophrenia who lacks motivation, has flat
affect, and speaks very little. The nurse should recognize these as which type of
symptoms?
A) Positive symptoms
B) Negative symptoms
C) Disorganized symptoms
D) Affective symptoms
Correct Answer: B
Rationale: Negative symptoms include avolition (lack of motivation), blunted affect,
alogia (poverty of speech), and anhedonia. They reflect a decrease or loss of normal
functions.
3. A nurse is administering haloperidol to a patient with schizophrenia. Which
extrapyramidal side effect should the nurse monitor for during the first few days of
treatment?
A) Tardive dyskinesia
B) Acute dystonia
C) Weight gain
D) Sedation
Correct Answer: B
Rationale: Acute dystonia is an early-onset extrapyramidal side effect that can occur
within hours to days of starting typical antipsychotics like haloperidol. It involves
sudden muscle spasms, often of the neck or eyes.
4. A nurse is teaching a patient about clozapine. Which laboratory test is essential
to monitor for a life-threatening side effect of this medication?
A) Liver function tests
B) Complete blood count with differential
C) Renal function tests
D) Thyroid function tests
, Page 3 of 81
Correct Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis, a severe drop in
white blood cells. Regular complete blood count monitoring is required to detect this
potentially fatal side effect.
5. A nurse is caring for a patient with schizophrenia who is experiencing an acute
episode of psychosis. Which nursing intervention is the priority?
A) Encouraging the patient to attend group therapy.
B) Ensuring the patient's safety and reducing environmental stimulation.
C) Teaching the patient about medication side effects.
D) Discussing discharge plans with the family.
Correct Answer: B
Rationale: During acute psychosis, the patient's safety is the priority. Reducing
stimulation helps decrease agitation and prevents escalation of symptoms.
6. A nurse is communicating with a patient who is actively hallucinating. Which
nursing response is most therapeutic?
A) "There are no voices; you are just imagining them."
B) "I don't hear the voices, but I understand they are real to you. Let's focus on
something else."
C) "What are the voices telling you to do?"
D) "You need to ignore the voices and listen to me."
Correct Answer: B
Rationale: The nurse should acknowledge the patient's experience without reinforcing
the hallucination, then gently redirect to reality-based topics. Arguing or focusing on the
content of the hallucination can increase distress.
7. A nurse is assessing a patient with schizophrenia who suddenly stops speaking
mid-sentence and appears to be listening to something. The nurse should
recognize this as which symptom?
A) Thought blocking
B) Flight of ideas
C) Circumstantiality
D) Tangentiality
Correct Answer: A
Rationale: Thought blocking is an abrupt interruption in speech, often due to internal
stimuli such as hallucinations. The patient may resume speaking on a different topic
after the interruption.
8. A nurse is caring for a patient with schizophrenia who is refusing to take oral
antipsychotic medication. Which action by the nurse is most appropriate?
A) Hiding the medication in the patient's food.
B) Respecting the patient's refusal and notifying the prescriber.
, Page 4 of 81
C) Threatening the patient with restraints if they refuse.
D) Administering the medication by injection without consent.
Correct Answer: B
Rationale: Patients have the right to refuse medication. The nurse should respect the
refusal, document it, and notify the prescriber to discuss alternative treatment options.
9. A nurse is teaching a patient about the side effects of risperidone. Which
statement by the patient indicates a need for further teaching?
A) "I may experience weight gain while taking this medication."
B) "I should report any unusual muscle movements to my doctor."
C) "I can stop taking this medication if I feel better."
D) "This medication may cause drowsiness."
Correct Answer: C
Rationale: Antipsychotic medications should not be stopped abruptly, as this can
cause relapse or withdrawal symptoms. Patients should continue taking the medication
as prescribed.
10. A nurse is assessing a patient with schizophrenia who has been taking an
antipsychotic for several months and now reports involuntary lip smacking and
tongue movements. The nurse should recognize this as which condition?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Pseudoparkinsonism
Correct Answer: C
Rationale: Tardive dyskinesia is a late-onset extrapyramidal side effect characterized by
involuntary movements of the face, tongue, and limbs. It may be irreversible and
requires immediate reporting.
11. A nurse is caring for a patient with schizophrenia who is experiencing command
hallucinations. Which nursing action is the priority?
A) Encouraging the patient to participate in group activities.
B) Assessing the content of the hallucinations and ensuring safety.
C) Documenting the hallucinations and continuing routine care.
D) Telling the patient that the voices are not real.
Correct Answer: B
Rationale: Command hallucinations instruct the patient to perform certain actions,
which may include self-harm or harm to others. Assessing the content and ensuring
safety are the priority interventions.
12. A nurse is teaching a family about relapse prevention for a member with
schizophrenia. Which statement by a family member indicates correct
understanding?
NSG 3450 MENTAL HEALTH EXAM 2 QUESTIONS LATEST EDITION 2026 –
2027 VERSION SOLVED QUESTIONS & ANSWERS
NSG 3450 Mental Health Exam 2 –Questions with Rationales
Summarized 10-Point Exam Coverage
Schizophrenia Spectrum and Other Psychotic Disorders – Positive/negative
symptoms, antipsychotic management, relapse prevention, community support.
Personality Disorders – Clusters A, B, C, therapeutic communication, boundary
setting, crisis management.
Substance Use and Addictive Disorders – Withdrawal, detoxification, relapse
prevention, dual diagnosis, 12-step programs.
Eating Disorders – Anorexia nervosa, bulimia nervosa, binge-eating disorder, refeeding
syndrome, family-based therapy.
Somatic Symptom and Dissociative Disorders – Illness anxiety, conversion disorder,
dissociative identity disorder, trauma-informed care.
Child and Adolescent Mental Health – Autism spectrum, ADHD, oppositional defiant
disorder, childhood depression, family interventions.
Neurocognitive Disorders – Delirium, dementia, Alzheimer's disease, Lewy body
dementia, safety and caregiver support.
Psychotherapy and Therapeutic Modalities – CBT, DBT, group therapy, family therapy,
milieu therapy, complementary therapies.
Community Mental Health and Rehabilitation – Assertive community treatment,
psychosocial rehabilitation, housing, employment support.
Special Populations – Older adults, LGBTQ+ individuals, veterans, homeless
populations, cultural and spiritual considerations.
SECTION 1: SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS
(Questions 1–30)
, Page 2 of 81
1. A nurse is assessing a patient who reports hearing voices that others do not hear
and believes the government is monitoring their thoughts. Which symptom
category do these experiences represent?
A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Mood symptoms
Correct Answer: B
Rationale: Hallucinations (hearing voices) and delusions (belief about government
monitoring) are positive symptoms of schizophrenia, which reflect an excess or
distortion of normal functions.
2. A nurse is caring for a patient with schizophrenia who lacks motivation, has flat
affect, and speaks very little. The nurse should recognize these as which type of
symptoms?
A) Positive symptoms
B) Negative symptoms
C) Disorganized symptoms
D) Affective symptoms
Correct Answer: B
Rationale: Negative symptoms include avolition (lack of motivation), blunted affect,
alogia (poverty of speech), and anhedonia. They reflect a decrease or loss of normal
functions.
3. A nurse is administering haloperidol to a patient with schizophrenia. Which
extrapyramidal side effect should the nurse monitor for during the first few days of
treatment?
A) Tardive dyskinesia
B) Acute dystonia
C) Weight gain
D) Sedation
Correct Answer: B
Rationale: Acute dystonia is an early-onset extrapyramidal side effect that can occur
within hours to days of starting typical antipsychotics like haloperidol. It involves
sudden muscle spasms, often of the neck or eyes.
4. A nurse is teaching a patient about clozapine. Which laboratory test is essential
to monitor for a life-threatening side effect of this medication?
A) Liver function tests
B) Complete blood count with differential
C) Renal function tests
D) Thyroid function tests
, Page 3 of 81
Correct Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis, a severe drop in
white blood cells. Regular complete blood count monitoring is required to detect this
potentially fatal side effect.
5. A nurse is caring for a patient with schizophrenia who is experiencing an acute
episode of psychosis. Which nursing intervention is the priority?
A) Encouraging the patient to attend group therapy.
B) Ensuring the patient's safety and reducing environmental stimulation.
C) Teaching the patient about medication side effects.
D) Discussing discharge plans with the family.
Correct Answer: B
Rationale: During acute psychosis, the patient's safety is the priority. Reducing
stimulation helps decrease agitation and prevents escalation of symptoms.
6. A nurse is communicating with a patient who is actively hallucinating. Which
nursing response is most therapeutic?
A) "There are no voices; you are just imagining them."
B) "I don't hear the voices, but I understand they are real to you. Let's focus on
something else."
C) "What are the voices telling you to do?"
D) "You need to ignore the voices and listen to me."
Correct Answer: B
Rationale: The nurse should acknowledge the patient's experience without reinforcing
the hallucination, then gently redirect to reality-based topics. Arguing or focusing on the
content of the hallucination can increase distress.
7. A nurse is assessing a patient with schizophrenia who suddenly stops speaking
mid-sentence and appears to be listening to something. The nurse should
recognize this as which symptom?
A) Thought blocking
B) Flight of ideas
C) Circumstantiality
D) Tangentiality
Correct Answer: A
Rationale: Thought blocking is an abrupt interruption in speech, often due to internal
stimuli such as hallucinations. The patient may resume speaking on a different topic
after the interruption.
8. A nurse is caring for a patient with schizophrenia who is refusing to take oral
antipsychotic medication. Which action by the nurse is most appropriate?
A) Hiding the medication in the patient's food.
B) Respecting the patient's refusal and notifying the prescriber.
, Page 4 of 81
C) Threatening the patient with restraints if they refuse.
D) Administering the medication by injection without consent.
Correct Answer: B
Rationale: Patients have the right to refuse medication. The nurse should respect the
refusal, document it, and notify the prescriber to discuss alternative treatment options.
9. A nurse is teaching a patient about the side effects of risperidone. Which
statement by the patient indicates a need for further teaching?
A) "I may experience weight gain while taking this medication."
B) "I should report any unusual muscle movements to my doctor."
C) "I can stop taking this medication if I feel better."
D) "This medication may cause drowsiness."
Correct Answer: C
Rationale: Antipsychotic medications should not be stopped abruptly, as this can
cause relapse or withdrawal symptoms. Patients should continue taking the medication
as prescribed.
10. A nurse is assessing a patient with schizophrenia who has been taking an
antipsychotic for several months and now reports involuntary lip smacking and
tongue movements. The nurse should recognize this as which condition?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Pseudoparkinsonism
Correct Answer: C
Rationale: Tardive dyskinesia is a late-onset extrapyramidal side effect characterized by
involuntary movements of the face, tongue, and limbs. It may be irreversible and
requires immediate reporting.
11. A nurse is caring for a patient with schizophrenia who is experiencing command
hallucinations. Which nursing action is the priority?
A) Encouraging the patient to participate in group activities.
B) Assessing the content of the hallucinations and ensuring safety.
C) Documenting the hallucinations and continuing routine care.
D) Telling the patient that the voices are not real.
Correct Answer: B
Rationale: Command hallucinations instruct the patient to perform certain actions,
which may include self-harm or harm to others. Assessing the content and ensuring
safety are the priority interventions.
12. A nurse is teaching a family about relapse prevention for a member with
schizophrenia. Which statement by a family member indicates correct
understanding?
