NR 326 Mental Health Nursing Exam 8 Study Guide 2026
|Chamberlain College
1. A client with bipolar disorder is prescribed Lithium. What is the therapeutic
serum range for this medication during the maintenance phase?
A. 0.2 to 0.5 mEq/L
B. 1.5 to 2.0 mEq/L
C. 0.6 to 1.2 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: C
Rationale: The therapeutic maintenance range for Lithium is typically 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
2. Which assessment finding is most indicative of Serotonin Syndrome in a client
taking an SSRI?
A. Bradycardia and hypotension
B. Weight gain and drowsiness
C. Urinary retention and constipation
D. Muscle rigidity, hyperreflexia, and fever
Answer: D
Rationale: Serotonin syndrome is characterized by mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities such as hyperreflexia and rigidity.
,3. A client is starting Phenelzine (Nardil), an MAOI. Which food item should the
nurse instruct the client to avoid?
A. Fresh green salad
B. Cottage cheese
C. Pepperoni pizza
D. Grilled chicken
Answer: C
Rationale: MAOIs require a low-tyramine diet to prevent hypertensive crisis. Pepperoni is
a cured meat high in tyramine.
4. Which medication is most likely to be prescribed for a client experiencing
acute extrapyramidal symptoms (EPS) from antipsychotics?
A. Lithium
B. Donepezil
C. Benztropine
D. Fluoxetine
Answer: C
Rationale: Benztropine is an anticholinergic medication used to treat EPS, such as
pseudoparkinsonism and dystonia.
5. A client with schizophrenia is experiencing auditory hallucinations. What is
the priority nursing intervention?
A. Tell the client that the voices are not real
B. Ask the client what the voices are saying
C. Leave the client alone to rest
D. Play loud music to drown out the voices
Answer: B
Rationale: The nurse should first determine if the voices are command hallucinations that
might instruct the client to harm themselves or others.
, 6. A nurse is caring for a client with Borderline Personality Disorder. The client
states, ‘You are the only nurse who understands me; the others are mean.’ This
is an example of:
A. Splitting
B. Rationalization
C. Projection
D. Reaction formation
Answer: A
Rationale: Splitting is a defense mechanism common in BPD where the individual
perceives individuals as all good or all bad.
7. What is the most serious side effect associated with the use of Clozapine?
A. Agranulocytosis
B. Weight gain
C. Dry mouth
D. Photosensitivity
Answer: A
Rationale: Clozapine can cause agranulocytosis, a severe reduction in white blood cell
count, requiring frequent blood monitoring.
8. A client in a manic phase of bipolar disorder is pacing the halls and talking
rapidly. Which snack is most appropriate for the nurse to provide?
A. A sandwich and a banana
B. A bowl of soup
C. Spaghetti and meatballs
D. Ice cream in a dish
Answer: A
Rationale: Clients in mania benefit from ‘finger foods’ that can be eaten while moving, as
they often cannot sit still to eat a full meal.
|Chamberlain College
1. A client with bipolar disorder is prescribed Lithium. What is the therapeutic
serum range for this medication during the maintenance phase?
A. 0.2 to 0.5 mEq/L
B. 1.5 to 2.0 mEq/L
C. 0.6 to 1.2 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: C
Rationale: The therapeutic maintenance range for Lithium is typically 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
2. Which assessment finding is most indicative of Serotonin Syndrome in a client
taking an SSRI?
A. Bradycardia and hypotension
B. Weight gain and drowsiness
C. Urinary retention and constipation
D. Muscle rigidity, hyperreflexia, and fever
Answer: D
Rationale: Serotonin syndrome is characterized by mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities such as hyperreflexia and rigidity.
,3. A client is starting Phenelzine (Nardil), an MAOI. Which food item should the
nurse instruct the client to avoid?
A. Fresh green salad
B. Cottage cheese
C. Pepperoni pizza
D. Grilled chicken
Answer: C
Rationale: MAOIs require a low-tyramine diet to prevent hypertensive crisis. Pepperoni is
a cured meat high in tyramine.
4. Which medication is most likely to be prescribed for a client experiencing
acute extrapyramidal symptoms (EPS) from antipsychotics?
A. Lithium
B. Donepezil
C. Benztropine
D. Fluoxetine
Answer: C
Rationale: Benztropine is an anticholinergic medication used to treat EPS, such as
pseudoparkinsonism and dystonia.
5. A client with schizophrenia is experiencing auditory hallucinations. What is
the priority nursing intervention?
A. Tell the client that the voices are not real
B. Ask the client what the voices are saying
C. Leave the client alone to rest
D. Play loud music to drown out the voices
Answer: B
Rationale: The nurse should first determine if the voices are command hallucinations that
might instruct the client to harm themselves or others.
, 6. A nurse is caring for a client with Borderline Personality Disorder. The client
states, ‘You are the only nurse who understands me; the others are mean.’ This
is an example of:
A. Splitting
B. Rationalization
C. Projection
D. Reaction formation
Answer: A
Rationale: Splitting is a defense mechanism common in BPD where the individual
perceives individuals as all good or all bad.
7. What is the most serious side effect associated with the use of Clozapine?
A. Agranulocytosis
B. Weight gain
C. Dry mouth
D. Photosensitivity
Answer: A
Rationale: Clozapine can cause agranulocytosis, a severe reduction in white blood cell
count, requiring frequent blood monitoring.
8. A client in a manic phase of bipolar disorder is pacing the halls and talking
rapidly. Which snack is most appropriate for the nurse to provide?
A. A sandwich and a banana
B. A bowl of soup
C. Spaghetti and meatballs
D. Ice cream in a dish
Answer: A
Rationale: Clients in mania benefit from ‘finger foods’ that can be eaten while moving, as
they often cannot sit still to eat a full meal.
