NUR 256 MENTAL HEALTH NURSING EXAM | QUESTIONS
AND ANSWERS | VERIFIED ANSWERS PLUS RATIONALES |
EXAM ALREADY GRADED A+ | LATEST EXAM
1. A nurse is establishing rapport with a newly admitted client. Which action demonstrates
therapeutic communication?
A. Offering personal advice
B. Asking open-ended questions
C. Changing the subject when the client cries
D. Giving false reassurance
Answer: B. Asking open-ended questions.
Rationale: Open-ended questions encourage expression of feelings and promote therapeutic
communication. Advice, avoidance, and false reassurance are non-therapeutic.
2. A client with generalized anxiety disorder reports constant worrying. Which
neurotransmitter imbalance is most associated with anxiety disorders?
A. Dopamine excess
B. Acetylcholine deficiency
C. GABA deficiency
D. Endorphin excess
Answer: C. GABA deficiency.
Rationale: Low gamma-aminobutyric acid (GABA) levels are linked to anxiety disorders because
GABA has inhibitory effects in the CNS.
3. A client with major depressive disorder states, “Life isn’t worth living.” What is the
nurse’s priority response?
A. “You shouldn’t feel that way.”
B. “Why do you think that?”
C. “Are you thinking about hurting yourself?”
D. “Everything will be okay.”
Answer: C. “Are you thinking about hurting yourself?”
Rationale: Directly assessing suicidal ideation is the priority. It does not increase risk and
ensures safety.
4. Which defense mechanism is demonstrated when a client blames others for personal
failures?
,A. Projection
B. Regression
C. Sublimation
D. Displacement
Answer: A. Projection.
Rationale: Projection involves attributing one’s own unacceptable feelings or behaviors to
others.
5. A client with schizophrenia reports hearing voices. The nurse’s best response is:
A. “Those voices are not real.”
B. “What are the voices telling you?”
C. “Ignore them.”
D. “That’s impossible.”
Answer: B. “What are the voices telling you?”
Rationale: This assesses for command hallucinations and maintains therapeutic communication
without reinforcing the hallucination.
6. Which medication is classified as a selective serotonin reuptake inhibitor (SSRI)?
A. Lithium
B. Fluoxetine
C. Haloperidol
D. Valproate
Answer: B. Fluoxetine.
Rationale: Fluoxetine is an SSRI used to treat depression and anxiety disorders.
7. A manic client is hyperverbal and intrusive. What is the priority nursing intervention?
A. Encourage group activities
B. Provide high-calorie finger foods
C. Allow unlimited stimulation
D. Discuss consequences of behavior
Answer: B. Provide high-calorie finger foods.
Rationale: Clients with mania burn high energy and may not sit for meals. Finger foods maintain
nutrition.
8. A client taking lithium should be monitored for which therapeutic serum level?
A. 0.2–0.4 mEq/L
B. 0.6–1.2 mEq/L
,C. 2–4 mEq/L
D. 5–7 mEq/L
Answer: B. 0.6–1.2 mEq/L.
Rationale: The therapeutic range for lithium is typically 0.6–1.2 mEq/L.
9. Which symptom is considered a negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Answer: C. Flat affect.
Rationale: Negative symptoms include flat affect, social withdrawal, and lack of motivation.
10. A client experiences a panic attack. What is the nurse’s priority action?
A. Leave the client alone
B. Encourage deep breathing
C. Provide detailed explanations
D. Ask about childhood trauma
Answer: B. Encourage deep breathing.
Rationale: During panic attacks, simple grounding techniques such as slow breathing reduce
anxiety.
11. Which is a common side effect of antipsychotic medications?
A. Hypertension
B. Hyperglycemia
C. Extrapyramidal symptoms
D. Hypokalemia
Answer: C. Extrapyramidal symptoms.
Rationale: EPS (e.g., dystonia, akathisia) are common with antipsychotic use.
12. A client diagnosed with PTSD reports flashbacks. Which intervention is most
appropriate?
A. Force discussion of trauma
B. Teach grounding techniques
C. Ignore the behavior
D. Encourage isolation
, Answer: B. Teach grounding techniques.
Rationale: Grounding techniques help clients return to present awareness during flashbacks.
13. Which statement reflects cognitive distortion in depression?
A. “Sometimes I feel sad.”
B. “Nothing ever works out for me.”
C. “I had a bad day.”
D. “I need rest.”
Answer: B. “Nothing ever works out for me.”
Rationale: Overgeneralization is a common cognitive distortion in depression.
14. Which is a priority nursing diagnosis for a client with anorexia nervosa?
A. Social isolation
B. Disturbed body image
C. Imbalanced nutrition: less than body requirements
D. Chronic low self-esteem
Answer: C. Imbalanced nutrition: less than body requirements.
Rationale: Physiological stability and nutrition are priority.
15. A client with borderline personality disorder demonstrates splitting. This behavior
involves:
A. Avoiding relationships
B. Viewing people as all good or all bad
C. Excessive dependence
D. Identity confusion
Answer: B. Viewing people as all good or all bad.
Rationale: Splitting is a defense mechanism involving extreme thinking.
16. Which intervention is appropriate for alcohol withdrawal?
A. Administer benzodiazepines
B. Give stimulants
C. Restrict fluids
D. Encourage caffeine
Answer: A. Administer benzodiazepines.
Rationale: Benzodiazepines prevent seizures and delirium tremens.
17. A client expresses anger toward the nurse. The nurse should:
AND ANSWERS | VERIFIED ANSWERS PLUS RATIONALES |
EXAM ALREADY GRADED A+ | LATEST EXAM
1. A nurse is establishing rapport with a newly admitted client. Which action demonstrates
therapeutic communication?
A. Offering personal advice
B. Asking open-ended questions
C. Changing the subject when the client cries
D. Giving false reassurance
Answer: B. Asking open-ended questions.
Rationale: Open-ended questions encourage expression of feelings and promote therapeutic
communication. Advice, avoidance, and false reassurance are non-therapeutic.
2. A client with generalized anxiety disorder reports constant worrying. Which
neurotransmitter imbalance is most associated with anxiety disorders?
A. Dopamine excess
B. Acetylcholine deficiency
C. GABA deficiency
D. Endorphin excess
Answer: C. GABA deficiency.
Rationale: Low gamma-aminobutyric acid (GABA) levels are linked to anxiety disorders because
GABA has inhibitory effects in the CNS.
3. A client with major depressive disorder states, “Life isn’t worth living.” What is the
nurse’s priority response?
A. “You shouldn’t feel that way.”
B. “Why do you think that?”
C. “Are you thinking about hurting yourself?”
D. “Everything will be okay.”
Answer: C. “Are you thinking about hurting yourself?”
Rationale: Directly assessing suicidal ideation is the priority. It does not increase risk and
ensures safety.
4. Which defense mechanism is demonstrated when a client blames others for personal
failures?
,A. Projection
B. Regression
C. Sublimation
D. Displacement
Answer: A. Projection.
Rationale: Projection involves attributing one’s own unacceptable feelings or behaviors to
others.
5. A client with schizophrenia reports hearing voices. The nurse’s best response is:
A. “Those voices are not real.”
B. “What are the voices telling you?”
C. “Ignore them.”
D. “That’s impossible.”
Answer: B. “What are the voices telling you?”
Rationale: This assesses for command hallucinations and maintains therapeutic communication
without reinforcing the hallucination.
6. Which medication is classified as a selective serotonin reuptake inhibitor (SSRI)?
A. Lithium
B. Fluoxetine
C. Haloperidol
D. Valproate
Answer: B. Fluoxetine.
Rationale: Fluoxetine is an SSRI used to treat depression and anxiety disorders.
7. A manic client is hyperverbal and intrusive. What is the priority nursing intervention?
A. Encourage group activities
B. Provide high-calorie finger foods
C. Allow unlimited stimulation
D. Discuss consequences of behavior
Answer: B. Provide high-calorie finger foods.
Rationale: Clients with mania burn high energy and may not sit for meals. Finger foods maintain
nutrition.
8. A client taking lithium should be monitored for which therapeutic serum level?
A. 0.2–0.4 mEq/L
B. 0.6–1.2 mEq/L
,C. 2–4 mEq/L
D. 5–7 mEq/L
Answer: B. 0.6–1.2 mEq/L.
Rationale: The therapeutic range for lithium is typically 0.6–1.2 mEq/L.
9. Which symptom is considered a negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
Answer: C. Flat affect.
Rationale: Negative symptoms include flat affect, social withdrawal, and lack of motivation.
10. A client experiences a panic attack. What is the nurse’s priority action?
A. Leave the client alone
B. Encourage deep breathing
C. Provide detailed explanations
D. Ask about childhood trauma
Answer: B. Encourage deep breathing.
Rationale: During panic attacks, simple grounding techniques such as slow breathing reduce
anxiety.
11. Which is a common side effect of antipsychotic medications?
A. Hypertension
B. Hyperglycemia
C. Extrapyramidal symptoms
D. Hypokalemia
Answer: C. Extrapyramidal symptoms.
Rationale: EPS (e.g., dystonia, akathisia) are common with antipsychotic use.
12. A client diagnosed with PTSD reports flashbacks. Which intervention is most
appropriate?
A. Force discussion of trauma
B. Teach grounding techniques
C. Ignore the behavior
D. Encourage isolation
, Answer: B. Teach grounding techniques.
Rationale: Grounding techniques help clients return to present awareness during flashbacks.
13. Which statement reflects cognitive distortion in depression?
A. “Sometimes I feel sad.”
B. “Nothing ever works out for me.”
C. “I had a bad day.”
D. “I need rest.”
Answer: B. “Nothing ever works out for me.”
Rationale: Overgeneralization is a common cognitive distortion in depression.
14. Which is a priority nursing diagnosis for a client with anorexia nervosa?
A. Social isolation
B. Disturbed body image
C. Imbalanced nutrition: less than body requirements
D. Chronic low self-esteem
Answer: C. Imbalanced nutrition: less than body requirements.
Rationale: Physiological stability and nutrition are priority.
15. A client with borderline personality disorder demonstrates splitting. This behavior
involves:
A. Avoiding relationships
B. Viewing people as all good or all bad
C. Excessive dependence
D. Identity confusion
Answer: B. Viewing people as all good or all bad.
Rationale: Splitting is a defense mechanism involving extreme thinking.
16. Which intervention is appropriate for alcohol withdrawal?
A. Administer benzodiazepines
B. Give stimulants
C. Restrict fluids
D. Encourage caffeine
Answer: A. Administer benzodiazepines.
Rationale: Benzodiazepines prevent seizures and delirium tremens.
17. A client expresses anger toward the nurse. The nurse should:
