NUR 2459 MENTAL HEALTH NURSING
COMPREHENSIVE EXAM REVIEW
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A client diagnosed with schizophrenia is experiencing auditory hallucinations and tells the
nurse, ‘The voices are telling me to hurt myself.’ Which is the priority nursing intervention?
A. Ask the client what the voices are saying to validate their experience.
B. Administer a PRN dose of an antipsychotic medication immediately.
C. Place the client on one-to-one observation to ensure safety.
D. Tell the client that the voices are not real and they are safe.
Answer: C
Conceptual Explanation: Safety is the priority. Command hallucinations that direct a
client to harm themselves or others require immediate safety measures, such as one-to-one
observation.
2. A client is being started on Lithium carbonate for bipolar disorder. The nurse should
instruct the client to maintain a consistent intake of which substance?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Answer: A
Conceptual Explanation: Lithium is a salt, and its excretion is closely tied to sodium
levels. If sodium intake drops, the kidneys retain lithium, leading to toxicity.
3. Which physical symptom would a nurse most likely observe in a client experiencing a panic
level of anxiety?
A. Dilated pupils and severe tremors
B. Increased focus on detail
C. Slightly elevated heart rate
D. Dry mouth and butterflies in the stomach
Answer: A
Conceptual Explanation: At the panic level, the body’s ‘fight or flight’ response is at its
peak, resulting in dilated pupils, severe tremors, and potential dissociation.
4. A client is receiving Phenelzine (Nardil). Which menu choice indicates the client
understands the dietary restrictions for this medication?
A. Grilled chicken breast with steamed broccoli
B. Pepperoni pizza with extra cheese
C. Smoked salmon and cream cheese bagel
, D. Avocado toast with a side of soy sauce
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Clients must avoid tyramine-rich foods
(aged cheeses, cured meats, fermented products, soy) to prevent a hypertensive crisis.
5. A client with borderline personality disorder is using ‘splitting’ behavior. How is this most
likely manifested on the unit?
A. The client refuses to participate in any group activities.
B. The client attempts to harm themselves to get attention.
C. The client tells the night nurse that the day nurse is incompetent and cruel.
D. The client mimics the behavior of the lead psychiatrist.
Answer: C
Conceptual Explanation: Splitting is a primitive defense mechanism where the client
views individuals as all good or all bad, often pitting staff members against each other.
6. The nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS). Which
symptoms are most characteristic of this condition?
A. Hypotension, bradycardia, and muscle flaccidity
B. Hyperpyrexia, muscle rigidity, and autonomic instability
C. Urticaria, respiratory distress, and angioedema
D. Blurred vision, dry mouth, and urinary retention
COMPREHENSIVE EXAM REVIEW
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A client diagnosed with schizophrenia is experiencing auditory hallucinations and tells the
nurse, ‘The voices are telling me to hurt myself.’ Which is the priority nursing intervention?
A. Ask the client what the voices are saying to validate their experience.
B. Administer a PRN dose of an antipsychotic medication immediately.
C. Place the client on one-to-one observation to ensure safety.
D. Tell the client that the voices are not real and they are safe.
Answer: C
Conceptual Explanation: Safety is the priority. Command hallucinations that direct a
client to harm themselves or others require immediate safety measures, such as one-to-one
observation.
2. A client is being started on Lithium carbonate for bipolar disorder. The nurse should
instruct the client to maintain a consistent intake of which substance?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Answer: A
Conceptual Explanation: Lithium is a salt, and its excretion is closely tied to sodium
levels. If sodium intake drops, the kidneys retain lithium, leading to toxicity.
3. Which physical symptom would a nurse most likely observe in a client experiencing a panic
level of anxiety?
A. Dilated pupils and severe tremors
B. Increased focus on detail
C. Slightly elevated heart rate
D. Dry mouth and butterflies in the stomach
Answer: A
Conceptual Explanation: At the panic level, the body’s ‘fight or flight’ response is at its
peak, resulting in dilated pupils, severe tremors, and potential dissociation.
4. A client is receiving Phenelzine (Nardil). Which menu choice indicates the client
understands the dietary restrictions for this medication?
A. Grilled chicken breast with steamed broccoli
B. Pepperoni pizza with extra cheese
C. Smoked salmon and cream cheese bagel
, D. Avocado toast with a side of soy sauce
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Clients must avoid tyramine-rich foods
(aged cheeses, cured meats, fermented products, soy) to prevent a hypertensive crisis.
5. A client with borderline personality disorder is using ‘splitting’ behavior. How is this most
likely manifested on the unit?
A. The client refuses to participate in any group activities.
B. The client attempts to harm themselves to get attention.
C. The client tells the night nurse that the day nurse is incompetent and cruel.
D. The client mimics the behavior of the lead psychiatrist.
Answer: C
Conceptual Explanation: Splitting is a primitive defense mechanism where the client
views individuals as all good or all bad, often pitting staff members against each other.
6. The nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS). Which
symptoms are most characteristic of this condition?
A. Hypotension, bradycardia, and muscle flaccidity
B. Hyperpyrexia, muscle rigidity, and autonomic instability
C. Urticaria, respiratory distress, and angioedema
D. Blurred vision, dry mouth, and urinary retention
