NUR 2459 MENTAL AND BEHAVIORAL
HEALTH NURSING - EXAM 2
COMPREHENSIVE STUDY GUIDE
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A patient diagnosed with Bipolar I Disorder is prescribed Lithium Carbonate. The nurse
notes the patient’s serum lithium level is 1.6 mEq/L and the patient is experiencing coarse
hand tremors and mental confusion. What is the priority nursing action?
A. Administer the next scheduled dose as these are expected side effects.
B. Encourage the patient to increase fluid intake to 4 liters per day.
C. Withhold the medication and notify the healthcare provider immediately.
D. Request a stat ECG to monitor for cardiac arrhythmias.
Answer: C
Conceptual Explanation: A lithium level of 1.6 mEq/L indicates early lithium toxicity
(therapeutic range is 0.6-1.2 mEq/L). Coarse tremors and confusion are signs of advanced
toxicity; the drug must be held and the provider notified.
,2. A nurse is providing discharge teaching for a client starting Phenelzine (Nardil). Which food
item should the nurse instruct the client to avoid?
A. Fresh chicken breast
B. Cottage cheese
C. Pepperoni pizza
D. Green beans
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Cured meats like pepperoni contain high
levels of tyramine, which can lead to a hypertensive crisis in patients taking MAOIs.
3. A client with Borderline Personality Disorder (BPD) tells the night shift nurse, ‘The day shift
nurse is wonderful and kind, but you are mean and insensitive.’ The nurse recognizes this as
which defense mechanism?
A. Projection
B. Rationalization
C. Reaction Formation
D. Splitting
Answer: D
, Conceptual Explanation: Splitting is a hallmark of BPD where the individual perceives
people or situations as either all good or all bad, unable to integrate positive and negative
qualities.
4. Which clinical manifestation is characteristic of a client experiencing a Panic Level of
anxiety?
A. Narrowed perceptual field and selective inattention.
B. Distorted perceptions and loss of rational thought.
C. Heightened senses and increased problem-solving ability.
D. Increased focus on the details of the environment.
Answer: B
Conceptual Explanation: At the panic level, the individual loses touch with reality,
experiences distorted perceptions, and is unable to communicate or function effectively.
5. A patient is prescribed Lamotrigine (Lamictal) for mood stabilization. The nurse should
instruct the patient to immediately report which potential adverse effect?
A. A skin rash
B. Increased appetite
C. Dry mouth
D. Mild sedation
Answer: A
HEALTH NURSING - EXAM 2
COMPREHENSIVE STUDY GUIDE
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A patient diagnosed with Bipolar I Disorder is prescribed Lithium Carbonate. The nurse
notes the patient’s serum lithium level is 1.6 mEq/L and the patient is experiencing coarse
hand tremors and mental confusion. What is the priority nursing action?
A. Administer the next scheduled dose as these are expected side effects.
B. Encourage the patient to increase fluid intake to 4 liters per day.
C. Withhold the medication and notify the healthcare provider immediately.
D. Request a stat ECG to monitor for cardiac arrhythmias.
Answer: C
Conceptual Explanation: A lithium level of 1.6 mEq/L indicates early lithium toxicity
(therapeutic range is 0.6-1.2 mEq/L). Coarse tremors and confusion are signs of advanced
toxicity; the drug must be held and the provider notified.
,2. A nurse is providing discharge teaching for a client starting Phenelzine (Nardil). Which food
item should the nurse instruct the client to avoid?
A. Fresh chicken breast
B. Cottage cheese
C. Pepperoni pizza
D. Green beans
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Cured meats like pepperoni contain high
levels of tyramine, which can lead to a hypertensive crisis in patients taking MAOIs.
3. A client with Borderline Personality Disorder (BPD) tells the night shift nurse, ‘The day shift
nurse is wonderful and kind, but you are mean and insensitive.’ The nurse recognizes this as
which defense mechanism?
A. Projection
B. Rationalization
C. Reaction Formation
D. Splitting
Answer: D
, Conceptual Explanation: Splitting is a hallmark of BPD where the individual perceives
people or situations as either all good or all bad, unable to integrate positive and negative
qualities.
4. Which clinical manifestation is characteristic of a client experiencing a Panic Level of
anxiety?
A. Narrowed perceptual field and selective inattention.
B. Distorted perceptions and loss of rational thought.
C. Heightened senses and increased problem-solving ability.
D. Increased focus on the details of the environment.
Answer: B
Conceptual Explanation: At the panic level, the individual loses touch with reality,
experiences distorted perceptions, and is unable to communicate or function effectively.
5. A patient is prescribed Lamotrigine (Lamictal) for mood stabilization. The nurse should
instruct the patient to immediately report which potential adverse effect?
A. A skin rash
B. Increased appetite
C. Dry mouth
D. Mild sedation
Answer: A
