NR 326 Mental Health Nursing Exam 4 Practice 2026 |Chamberlain
College
1. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is
most characteristic of this disorder?
A. Hypertension
B. Tachycardia
C. Hyperthermia
D. Lanugo
Answer: D
Rationale: Lanugo, which is fine, downy hair, grows on the face and back of patients with
Anorexia Nervosa as a compensatory mechanism to provide insulation due to lack of body
fat.
2. A client with Bulimia Nervosa is found to have calluses on the knuckles of her
hands. What is this finding called?
A. Trousseau’s sign
B. Cullen’s sign
C. Chvostek’s sign
D. Russell’s sign
Answer: D
Rationale: Russell’s sign refers to the calluses or scars on the knuckles or dorsal hand from
self-induced vomiting.
,3. When does alcohol withdrawal delirium (Delirium Tremens) typically peak
after the cessation of heavy drinking?
A. 1 to 2 hours
B. 6 to 12 hours
C. 48 to 72 hours
D. 24 to 36 hours
Answer: C
Rationale: Alcohol withdrawal delirium usually peaks between 48 and 72 hours after the
last drink and is a medical emergency.
4. A child is prescribed Methylphenidate (Ritalin) for ADHD. Which side effect
should the nurse instruct the parents to monitor for?
A. Increased appetite
B. Insomnia
C. Weight gain
D. Somnolence
Answer: B
Rationale: Methylphenidate is a stimulant. Common side effects include insomnia,
restlessness, and decreased appetite/weight loss.
5. A client with Borderline Personality Disorder frequently shifts from idealizing
the nurse to devaluing them. What defense mechanism is this?
A. Projection
B. Splitting
C. Reaction Formation
D. Undoing
Answer: B
Rationale: Splitting is a characteristic defense mechanism in Borderline Personality
Disorder where people or situations are viewed as all good or all bad.
, 6. Which nutritional deficiency is responsible for Wernicke’s Encephalopathy in
clients with chronic alcohol use?
A. Vitamin B12
B. Vitamin C
C. Vitamin B1 (Thiamine)
D. Folic Acid
Answer: C
Rationale: Wernicke’s Encephalopathy is caused by a deficiency in Thiamine (B1), often
seen in chronic alcoholism due to poor nutrition.
7. A client is admitted with pinpoint pupils, respiratory depression, and stupor.
Which medication should the nurse anticipate administering?
A. Flumazenil
B. Naloxone
C. Methadone
D. Diazepam
Answer: B
Rationale: Pinpoint pupils and respiratory depression indicate an opioid overdose;
Naloxone (Narcan) is the antagonist used for reversal.
8. A 14-year-old is diagnosed with Conduct Disorder. Which behavior is most
consistent with this diagnosis?
A. Occasional argumentativeness with parents
B. Difficulty paying attention in class
C. Cruelty to animals and property destruction
D. Fear of being away from home
Answer: C
Rationale: Conduct Disorder involves persistent violation of others’ rights, including
aggression, theft, and cruelty to animals.
College
1. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is
most characteristic of this disorder?
A. Hypertension
B. Tachycardia
C. Hyperthermia
D. Lanugo
Answer: D
Rationale: Lanugo, which is fine, downy hair, grows on the face and back of patients with
Anorexia Nervosa as a compensatory mechanism to provide insulation due to lack of body
fat.
2. A client with Bulimia Nervosa is found to have calluses on the knuckles of her
hands. What is this finding called?
A. Trousseau’s sign
B. Cullen’s sign
C. Chvostek’s sign
D. Russell’s sign
Answer: D
Rationale: Russell’s sign refers to the calluses or scars on the knuckles or dorsal hand from
self-induced vomiting.
,3. When does alcohol withdrawal delirium (Delirium Tremens) typically peak
after the cessation of heavy drinking?
A. 1 to 2 hours
B. 6 to 12 hours
C. 48 to 72 hours
D. 24 to 36 hours
Answer: C
Rationale: Alcohol withdrawal delirium usually peaks between 48 and 72 hours after the
last drink and is a medical emergency.
4. A child is prescribed Methylphenidate (Ritalin) for ADHD. Which side effect
should the nurse instruct the parents to monitor for?
A. Increased appetite
B. Insomnia
C. Weight gain
D. Somnolence
Answer: B
Rationale: Methylphenidate is a stimulant. Common side effects include insomnia,
restlessness, and decreased appetite/weight loss.
5. A client with Borderline Personality Disorder frequently shifts from idealizing
the nurse to devaluing them. What defense mechanism is this?
A. Projection
B. Splitting
C. Reaction Formation
D. Undoing
Answer: B
Rationale: Splitting is a characteristic defense mechanism in Borderline Personality
Disorder where people or situations are viewed as all good or all bad.
, 6. Which nutritional deficiency is responsible for Wernicke’s Encephalopathy in
clients with chronic alcohol use?
A. Vitamin B12
B. Vitamin C
C. Vitamin B1 (Thiamine)
D. Folic Acid
Answer: C
Rationale: Wernicke’s Encephalopathy is caused by a deficiency in Thiamine (B1), often
seen in chronic alcoholism due to poor nutrition.
7. A client is admitted with pinpoint pupils, respiratory depression, and stupor.
Which medication should the nurse anticipate administering?
A. Flumazenil
B. Naloxone
C. Methadone
D. Diazepam
Answer: B
Rationale: Pinpoint pupils and respiratory depression indicate an opioid overdose;
Naloxone (Narcan) is the antagonist used for reversal.
8. A 14-year-old is diagnosed with Conduct Disorder. Which behavior is most
consistent with this diagnosis?
A. Occasional argumentativeness with parents
B. Difficulty paying attention in class
C. Cruelty to animals and property destruction
D. Fear of being away from home
Answer: C
Rationale: Conduct Disorder involves persistent violation of others’ rights, including
aggression, theft, and cruelty to animals.
