COMPREHENSIVE PSYCHIATRIC-MENTAL
HEALTH NURSING VARCAROLIS, 9TH
EDITION (CHAPTERS 1–37)
Section I: Multiple Choice (60 Questions)
1. A nursing student is reviewing the concept of "mental health." Which statement best defines
mental health?
a) The absence of mental illness.
b) The ability to distinguish between right and wrong.
c) The successful performance of mental functions resulting in productive activities and adaptation.
d) The state of being emotionally stable regardless of environment.
<details> <summary><strong>Answer & Rationale</strong></summary> **c) The successful
performance of mental functions resulting in productive activities and adaptation.** *Rationale:*
Mental health is defined as the successful adaptation to stressors from the internal or external
environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent
with local and cultural norms. It is not merely the absence of illness. </details>
2. A client tells the nurse, "The FBI is stalking me because I have the secret code to the nuclear launch
system." The nurse documents this as:
a) Hallucination
b) Loose association
c) Delusion of grandeur
d) Delusion of persecution
<details> <summary><strong>Answer & Rationale</strong></summary> **d) Delusion of persecution**
*Rationale:* This is a fixed, false belief that one is being malevolently treated (stalked, harassed,
conspired against). A delusion of grandeur involves an exaggerated sense of importance or power. A
hallucination is a sensory perception without external stimuli. </details>
3. According to Erikson’s theory of psychosocial development, which stage is associated with the
primary task of developing a sense of trust?
a) Latency
b) Infancy
c) Adolescence
d) Young adulthood
,<details> <summary><strong>Answer & Rationale</strong></summary> **b) Infancy** *Rationale:*
Erikson’s first stage (Infancy, birth–18 months) is *Trust vs. Mistrust*. The infant develops trust when
needs are consistently met by a caregiver. </details>
4. A nurse is caring for a client with bipolar disorder who is experiencing acute mania. Which nursing
intervention takes priority?
a) Engaging the client in a competitive card game.
b) Encouraging the client to attend a group therapy session.
c) Providing high-calorie finger foods and fluids.
d) Placing the client in a private room with loud, stimulating music.
<details> <summary><strong>Answer & Rationale</strong></summary> **c) Providing high-calorie
finger foods and fluids.** *Rationale:* During acute mania, clients often refuse to sit down for meals
and expend massive amounts of energy. Safety and physiological needs are priority; they require high-
calorie, portable nutrition to prevent exhaustion and dehydration. Stimulation should be minimized, not
increased. </details>
5. Which neurotransmitter imbalance is most associated with Major Depressive Disorder?
a) Excess dopamine and acetylcholine
b) Deficiency of norepinephrine, serotonin, and dopamine
c) Excess gamma-aminobutyric acid (GABA)
d) Deficiency of histamine and epinephrine
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Deficiency of
norepinephrine, serotonin, and dopamine** *Rationale:* The monoamine hypothesis suggests that
depression is related to a deficiency in the availability of monoamines (norepinephrine, serotonin, and
dopamine) in the synaptic cleft. </details>
6. A client diagnosed with schizophrenia tells the nurse, "I am the son of the King of Mars." The
nurse’s most therapeutic response is:
a) "No, you are not. You are a client in a hospital."
b) "That sounds like a scary thought. Tell me more about Mars."
c) "You believe you are the son of the King of Mars?"
d) "Why do you think you are a king?"
<details> <summary><strong>Answer & Rationale</strong></summary> **c) "You believe you are the
son of the King of Mars?"** *Rationale:* This is a therapeutic technique called *making observations*
or *verbalizing the implied*. It acknowledges the client’s belief without reinforcing the delusion or
arguing with it. Arguing (A) challenges the client’s reality and damages rapport. Asking "why" (D)
encourages rationalization and is non-therapeutic. </details>
7. The nurse is administering a first dose of haloperidol (Haldol) to a client. Which side effect requires
immediate medical intervention?
a) Dry mouth
, b) Dystonic reaction
c) Weight gain
d) Sedation
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Dystonic reaction**
*Rationale:* Dystonic reactions (acute muscle spasms, e.g., oculogyric crisis, torticollis) are acute
extrapyramidal side effects (EPS) that can compromise the airway and require immediate treatment
with anticholinergic medications like benztropine (Cogentin). </details>
8. A client with borderline personality disorder (BPD) has been admitted for self-harm. The nurse
observes the client being extremely complimentary one moment and enraged the next. The nurse
recognizes this behavior as:
a) Splitting
b) Dissociation
c) Projection
d) Rationalization
<details> <summary><strong>Answer & Rationale</strong></summary> **a) Splitting** *Rationale:*
Splitting is a primitive defense mechanism common in BPD where the client views people or situations
as all good or all bad, unable to integrate contradictory qualities. This often leads to idealization and
devaluation of staff. </details>
9. A client is prescribed lorazepam (Ativan) for generalized anxiety disorder. What important patient
education should the nurse provide?
a) "This medication is safe to take with alcohol to enhance relaxation."
b) "You may experience a feeling of euphoria initially."
c) "Avoid abrupt discontinuation of this medication due to the risk of withdrawal seizures."
d) "This medication will cure your anxiety after two weeks."
<details> <summary><strong>Answer & Rationale</strong></summary> **c) "Avoid abrupt
discontinuation of this medication due to the risk of withdrawal seizures."** *Rationale:*
Benzodiazepines (lorazepam, alprazolam, clonazepam) cause physical dependence. Abrupt cessation can
lead to severe withdrawal symptoms, including seizures and life-threatening status epilepticus.
</details>
10. A client with Alzheimer’s disease begins to have difficulty with short-term memory. The nurse
understands this is due to the degeneration of which structure?
a) Brainstem
b) Hippocampus
c) Frontal lobe
d) Cerebellum
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Hippocampus**
*Rationale:* The hippocampus is the area of the brain primarily responsible for the consolidation of
HEALTH NURSING VARCAROLIS, 9TH
EDITION (CHAPTERS 1–37)
Section I: Multiple Choice (60 Questions)
1. A nursing student is reviewing the concept of "mental health." Which statement best defines
mental health?
a) The absence of mental illness.
b) The ability to distinguish between right and wrong.
c) The successful performance of mental functions resulting in productive activities and adaptation.
d) The state of being emotionally stable regardless of environment.
<details> <summary><strong>Answer & Rationale</strong></summary> **c) The successful
performance of mental functions resulting in productive activities and adaptation.** *Rationale:*
Mental health is defined as the successful adaptation to stressors from the internal or external
environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent
with local and cultural norms. It is not merely the absence of illness. </details>
2. A client tells the nurse, "The FBI is stalking me because I have the secret code to the nuclear launch
system." The nurse documents this as:
a) Hallucination
b) Loose association
c) Delusion of grandeur
d) Delusion of persecution
<details> <summary><strong>Answer & Rationale</strong></summary> **d) Delusion of persecution**
*Rationale:* This is a fixed, false belief that one is being malevolently treated (stalked, harassed,
conspired against). A delusion of grandeur involves an exaggerated sense of importance or power. A
hallucination is a sensory perception without external stimuli. </details>
3. According to Erikson’s theory of psychosocial development, which stage is associated with the
primary task of developing a sense of trust?
a) Latency
b) Infancy
c) Adolescence
d) Young adulthood
,<details> <summary><strong>Answer & Rationale</strong></summary> **b) Infancy** *Rationale:*
Erikson’s first stage (Infancy, birth–18 months) is *Trust vs. Mistrust*. The infant develops trust when
needs are consistently met by a caregiver. </details>
4. A nurse is caring for a client with bipolar disorder who is experiencing acute mania. Which nursing
intervention takes priority?
a) Engaging the client in a competitive card game.
b) Encouraging the client to attend a group therapy session.
c) Providing high-calorie finger foods and fluids.
d) Placing the client in a private room with loud, stimulating music.
<details> <summary><strong>Answer & Rationale</strong></summary> **c) Providing high-calorie
finger foods and fluids.** *Rationale:* During acute mania, clients often refuse to sit down for meals
and expend massive amounts of energy. Safety and physiological needs are priority; they require high-
calorie, portable nutrition to prevent exhaustion and dehydration. Stimulation should be minimized, not
increased. </details>
5. Which neurotransmitter imbalance is most associated with Major Depressive Disorder?
a) Excess dopamine and acetylcholine
b) Deficiency of norepinephrine, serotonin, and dopamine
c) Excess gamma-aminobutyric acid (GABA)
d) Deficiency of histamine and epinephrine
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Deficiency of
norepinephrine, serotonin, and dopamine** *Rationale:* The monoamine hypothesis suggests that
depression is related to a deficiency in the availability of monoamines (norepinephrine, serotonin, and
dopamine) in the synaptic cleft. </details>
6. A client diagnosed with schizophrenia tells the nurse, "I am the son of the King of Mars." The
nurse’s most therapeutic response is:
a) "No, you are not. You are a client in a hospital."
b) "That sounds like a scary thought. Tell me more about Mars."
c) "You believe you are the son of the King of Mars?"
d) "Why do you think you are a king?"
<details> <summary><strong>Answer & Rationale</strong></summary> **c) "You believe you are the
son of the King of Mars?"** *Rationale:* This is a therapeutic technique called *making observations*
or *verbalizing the implied*. It acknowledges the client’s belief without reinforcing the delusion or
arguing with it. Arguing (A) challenges the client’s reality and damages rapport. Asking "why" (D)
encourages rationalization and is non-therapeutic. </details>
7. The nurse is administering a first dose of haloperidol (Haldol) to a client. Which side effect requires
immediate medical intervention?
a) Dry mouth
, b) Dystonic reaction
c) Weight gain
d) Sedation
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Dystonic reaction**
*Rationale:* Dystonic reactions (acute muscle spasms, e.g., oculogyric crisis, torticollis) are acute
extrapyramidal side effects (EPS) that can compromise the airway and require immediate treatment
with anticholinergic medications like benztropine (Cogentin). </details>
8. A client with borderline personality disorder (BPD) has been admitted for self-harm. The nurse
observes the client being extremely complimentary one moment and enraged the next. The nurse
recognizes this behavior as:
a) Splitting
b) Dissociation
c) Projection
d) Rationalization
<details> <summary><strong>Answer & Rationale</strong></summary> **a) Splitting** *Rationale:*
Splitting is a primitive defense mechanism common in BPD where the client views people or situations
as all good or all bad, unable to integrate contradictory qualities. This often leads to idealization and
devaluation of staff. </details>
9. A client is prescribed lorazepam (Ativan) for generalized anxiety disorder. What important patient
education should the nurse provide?
a) "This medication is safe to take with alcohol to enhance relaxation."
b) "You may experience a feeling of euphoria initially."
c) "Avoid abrupt discontinuation of this medication due to the risk of withdrawal seizures."
d) "This medication will cure your anxiety after two weeks."
<details> <summary><strong>Answer & Rationale</strong></summary> **c) "Avoid abrupt
discontinuation of this medication due to the risk of withdrawal seizures."** *Rationale:*
Benzodiazepines (lorazepam, alprazolam, clonazepam) cause physical dependence. Abrupt cessation can
lead to severe withdrawal symptoms, including seizures and life-threatening status epilepticus.
</details>
10. A client with Alzheimer’s disease begins to have difficulty with short-term memory. The nurse
understands this is due to the degeneration of which structure?
a) Brainstem
b) Hippocampus
c) Frontal lobe
d) Cerebellum
<details> <summary><strong>Answer & Rationale</strong></summary> **b) Hippocampus**
*Rationale:* The hippocampus is the area of the brain primarily responsible for the consolidation of
