NR 326 Mental Health Nursing Exam 6 Study Guide 2026
|Chamberlain College
1. A nurse is caring for a client with Borderline Personality Disorder who is
‘splitting’ the staff. Which nursing intervention is most appropriate?
A. Hold a staff meeting to ensure a consistent approach
B. Allow the client to choose their primary nurse
C. Avoid setting limits to prevent agitation
D. Grant the client’s requests to build rapport
Answer: A
Rationale: Splitting is a defense mechanism where the client views others as all good or all
bad. Consistent limits and a unified staff approach are essential to prevent manipulation
and maintain the therapeutic milieu.
2. Which laboratory value should the nurse monitor most closely for a client
receiving Lithium Carbonate?
A. Serum Glucose
B. Hemoglobin A1C
C. Serum Sodium
D. Prothrombin Time
Answer: C
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels. Hyponatremia
can lead to decreased lithium excretion and toxicity.
,3. A client is experiencing a manic episode. Which meal choice is most
appropriate for this client?
A. A bowl of hot vegetable soup
B. Chicken fingers and an apple
C. Steak with a side of mashed potatoes
D. Spaghetti and meatballs
Answer: B
Rationale: Clients in a manic phase often cannot sit still for long periods. Finger foods are
high in protein and calories and allow the client to eat while moving.
4. A client diagnosed with Schizophrenia tells the nurse, ‘The FBI is monitoring
my thoughts through the television.’ How should the nurse respond?
A. ‘The FBI does not have the technology to do that.’
B. ‘That sounds very frightening for you.’
C. ‘Why would the FBI want to monitor you?’
D. ‘I don’t see any FBI agents in the room.’
Answer: B
Rationale: The nurse should acknowledge the client’s feelings (empathy) without
validating the delusion or arguing with the logic.
5. Which finding is most indicative of a client experiencing Lithium toxicity?
A. Mild thirst
B. Fine hand tremors
C. Coarse tremors and ataxia
D. Increased appetite
Answer: C
Rationale: While fine tremors are a common side effect, coarse tremors, ataxia, and severe
gastrointestinal upset are signs of advanced lithium toxicity.
, 6. A client is admitted for Alcohol Withdrawal. Which medication is most likely
to be prescribed to prevent seizures?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Fluoxetine
Answer: B
Rationale: Benzodiazepines like Lorazepam are the gold standard for managing alcohol
withdrawal symptoms and preventing seizures or delirium tremens.
7. A nurse is assessing a client with Anorexia Nervosa. Which physical finding
should the nurse expect?
A. Lanugo
B. Hypertension
C. Tachycardia
D. Hyperthermia
Answer: A
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for heat loss in clients
with severe malnutrition and low body fat.
8. A client is prescribed Clozapine. Which laboratory result would require the
nurse to withhold the medication?
A. Creatinine of 1.0 mg/dL
B. Platelet count of 150,000/mm3
C. BUN of 15 mg/dL
D. WBC count of 2,000/mm3
Answer: D
Rationale: Clozapine carries a risk of agranulocytosis. A WBC count below 3,000/mm3 or
an ANC below 1,500/mm3 requires immediate cessation of the drug.
|Chamberlain College
1. A nurse is caring for a client with Borderline Personality Disorder who is
‘splitting’ the staff. Which nursing intervention is most appropriate?
A. Hold a staff meeting to ensure a consistent approach
B. Allow the client to choose their primary nurse
C. Avoid setting limits to prevent agitation
D. Grant the client’s requests to build rapport
Answer: A
Rationale: Splitting is a defense mechanism where the client views others as all good or all
bad. Consistent limits and a unified staff approach are essential to prevent manipulation
and maintain the therapeutic milieu.
2. Which laboratory value should the nurse monitor most closely for a client
receiving Lithium Carbonate?
A. Serum Glucose
B. Hemoglobin A1C
C. Serum Sodium
D. Prothrombin Time
Answer: C
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels. Hyponatremia
can lead to decreased lithium excretion and toxicity.
,3. A client is experiencing a manic episode. Which meal choice is most
appropriate for this client?
A. A bowl of hot vegetable soup
B. Chicken fingers and an apple
C. Steak with a side of mashed potatoes
D. Spaghetti and meatballs
Answer: B
Rationale: Clients in a manic phase often cannot sit still for long periods. Finger foods are
high in protein and calories and allow the client to eat while moving.
4. A client diagnosed with Schizophrenia tells the nurse, ‘The FBI is monitoring
my thoughts through the television.’ How should the nurse respond?
A. ‘The FBI does not have the technology to do that.’
B. ‘That sounds very frightening for you.’
C. ‘Why would the FBI want to monitor you?’
D. ‘I don’t see any FBI agents in the room.’
Answer: B
Rationale: The nurse should acknowledge the client’s feelings (empathy) without
validating the delusion or arguing with the logic.
5. Which finding is most indicative of a client experiencing Lithium toxicity?
A. Mild thirst
B. Fine hand tremors
C. Coarse tremors and ataxia
D. Increased appetite
Answer: C
Rationale: While fine tremors are a common side effect, coarse tremors, ataxia, and severe
gastrointestinal upset are signs of advanced lithium toxicity.
, 6. A client is admitted for Alcohol Withdrawal. Which medication is most likely
to be prescribed to prevent seizures?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Fluoxetine
Answer: B
Rationale: Benzodiazepines like Lorazepam are the gold standard for managing alcohol
withdrawal symptoms and preventing seizures or delirium tremens.
7. A nurse is assessing a client with Anorexia Nervosa. Which physical finding
should the nurse expect?
A. Lanugo
B. Hypertension
C. Tachycardia
D. Hyperthermia
Answer: A
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for heat loss in clients
with severe malnutrition and low body fat.
8. A client is prescribed Clozapine. Which laboratory result would require the
nurse to withhold the medication?
A. Creatinine of 1.0 mg/dL
B. Platelet count of 150,000/mm3
C. BUN of 15 mg/dL
D. WBC count of 2,000/mm3
Answer: D
Rationale: Clozapine carries a risk of agranulocytosis. A WBC count below 3,000/mm3 or
an ANC below 1,500/mm3 requires immediate cessation of the drug.
