NR 326 Mental Health Nursing Comprehensive Exam Study Guide
2026 |Chamberlain College
1. A nurse is communicating with a client who has a substance use disorder.
Which of the following statements by the nurse is an example of therapeutic
communication?
A. Why do you continue to use drugs when you know they are bad for you?
B. You should really think about how your family feels when you use.
C. Tell me more about the situations that trigger your urge to use.
D. I think you would feel much better if you just stopped using today.
Answer: C
Rationale: Open-ended questions allow the client to express thoughts and feelings without
judgment, fostering a therapeutic alliance.
2. A client taking Lithium Carbonate for Bipolar Disorder has a serum level of 1.4
mEq/L. Which of the following is the most appropriate nursing action?
A. Administer the next dose as scheduled.
B. Observe for signs of early lithium toxicity.
C. Increase the client’s sodium intake immediately.
D. Prepare for emergency hemodialysis.
Answer: B
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.4 is near the
toxic threshold, so monitoring for toxicity is essential.
,3. Which of the following findings is a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions of grandeur
C. Flat affect
D. Echolalia
Answer: C
Rationale: Negative symptoms involve the absence of things that should be there, such as
flat affect, anhedonia, and social withdrawal.
4. A client is prescribed Phenelzine (an MAOI). Which food choice should the
nurse instruct the client to avoid?
A. Fresh chicken
B. Potatoes
C. Apples
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs interact with tyramine-rich foods like aged cheese, which can lead to a
hypertensive crisis.
5. A nurse is caring for a client experiencing a manic episode. Which of the
following is the priority nursing intervention?
A. Encourage the client to join a group volleyball game.
B. Ask the client to explain their racing thoughts.
C. Provide high-calorie finger foods.
D. Administer a sedative and place the client in seclusion.
Answer: C
Rationale: Clients in mania are often too active to sit down for meals; finger foods provide
necessary nutrition while allowing movement.
, 6. A client with Depression starts to show a sudden increase in energy and
improved mood after two weeks on SSRIs. What is the nurse’s priority concern?
A. The medication is working effectively.
B. The client is ready for discharge.
C. The client is developing mania.
D. The client is at increased risk for suicide.
Answer: D
Rationale: A sudden lift in mood often provides the energy needed to carry out a suicide
plan.
7. A nurse is assessing a client for Serotonin Syndrome. Which of the following
symptoms should the nurse expect?
A. Hypothermia and bradycardia
B. Constipation and urinary retention
C. Muscle rigidity and high fever
D. Bradypnea and hypotension
Answer: C
Rationale: Serotonin Syndrome is characterized by mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities like rigidity and fever.
8. Which physical finding is most characteristic of Anorexia Nervosa?
A. Hyperkalemia
B. Tachycardia
C. Lanugo
D. High blood pressure
Answer: C
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for the body to retain
heat when there is a lack of body fat.
2026 |Chamberlain College
1. A nurse is communicating with a client who has a substance use disorder.
Which of the following statements by the nurse is an example of therapeutic
communication?
A. Why do you continue to use drugs when you know they are bad for you?
B. You should really think about how your family feels when you use.
C. Tell me more about the situations that trigger your urge to use.
D. I think you would feel much better if you just stopped using today.
Answer: C
Rationale: Open-ended questions allow the client to express thoughts and feelings without
judgment, fostering a therapeutic alliance.
2. A client taking Lithium Carbonate for Bipolar Disorder has a serum level of 1.4
mEq/L. Which of the following is the most appropriate nursing action?
A. Administer the next dose as scheduled.
B. Observe for signs of early lithium toxicity.
C. Increase the client’s sodium intake immediately.
D. Prepare for emergency hemodialysis.
Answer: B
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.4 is near the
toxic threshold, so monitoring for toxicity is essential.
,3. Which of the following findings is a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions of grandeur
C. Flat affect
D. Echolalia
Answer: C
Rationale: Negative symptoms involve the absence of things that should be there, such as
flat affect, anhedonia, and social withdrawal.
4. A client is prescribed Phenelzine (an MAOI). Which food choice should the
nurse instruct the client to avoid?
A. Fresh chicken
B. Potatoes
C. Apples
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs interact with tyramine-rich foods like aged cheese, which can lead to a
hypertensive crisis.
5. A nurse is caring for a client experiencing a manic episode. Which of the
following is the priority nursing intervention?
A. Encourage the client to join a group volleyball game.
B. Ask the client to explain their racing thoughts.
C. Provide high-calorie finger foods.
D. Administer a sedative and place the client in seclusion.
Answer: C
Rationale: Clients in mania are often too active to sit down for meals; finger foods provide
necessary nutrition while allowing movement.
, 6. A client with Depression starts to show a sudden increase in energy and
improved mood after two weeks on SSRIs. What is the nurse’s priority concern?
A. The medication is working effectively.
B. The client is ready for discharge.
C. The client is developing mania.
D. The client is at increased risk for suicide.
Answer: D
Rationale: A sudden lift in mood often provides the energy needed to carry out a suicide
plan.
7. A nurse is assessing a client for Serotonin Syndrome. Which of the following
symptoms should the nurse expect?
A. Hypothermia and bradycardia
B. Constipation and urinary retention
C. Muscle rigidity and high fever
D. Bradypnea and hypotension
Answer: C
Rationale: Serotonin Syndrome is characterized by mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities like rigidity and fever.
8. Which physical finding is most characteristic of Anorexia Nervosa?
A. Hyperkalemia
B. Tachycardia
C. Lanugo
D. High blood pressure
Answer: C
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for the body to retain
heat when there is a lack of body fat.
