NR 326 Mental Health Nursing Final Exam Practice 2026 |Chamberlain
College
1. A nurse is assessing a client who has been taking lithium carbonate for the
treatment of bipolar disorder. Which of the following findings should the nurse
identify as an early sign of lithium toxicity?
A. Severe hypotension
B. Confusion and slurred speech
C. Fine hand tremors and nausea
D. Polyuria and dehydration
Answer: C
Rationale: Early signs of lithium toxicity typically include fine hand tremors, nausea,
vomiting, and diarrhea. Severe confusion and slurred speech are advanced signs.
2. A nurse is caring for a client who has schizophrenia and is experiencing
command hallucinations. Which of the following actions is the nurse’s priority?
A. Discuss the client’s delusions
B. Administer an antipsychotic medication
C. Encourage the client to listen to music
D. Ask the client what the voices are saying
Answer: D
Rationale: The nurse’s priority is safety. Asking the client what the voices are saying helps
determine if the client is being commanded to hurt themselves or others.
,3. A nurse is planning care for a client who has anorexia nervosa. Which of the
following interventions should the nurse include?
A. Observe the client for 60 minutes after meals
B. Set a weight gain goal of 5 lbs per week
C. Allow the client to exercise for 1 hour after meals
D. Provide the client with low-calorie food choices
Answer: A
Rationale: Clients with anorexia nervosa should be observed for 60 minutes after meals to
prevent purging or hiding food.
4. A client is prescribed phenelzine, an MAOI. Which of the following foods
should the nurse instruct the client to avoid?
A. Cottage cheese
B. Smoked salami
C. Fresh apples
D. Grilled chicken
Answer: B
Rationale: MAOIs interact with tyramine-rich foods, such as aged meats (salami), cheeses,
and red wine, which can cause a hypertensive crisis.
5. A nurse is providing teaching to a client who has a new prescription for
clozapine. Which of the following laboratory tests should the nurse emphasize
as necessary?
A. Liver function tests
B. Serum creatinine
C. Thyroid stimulating hormone
D. White blood cell (WBC) count
Answer: D
, Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBCs.
Weekly or bi-weekly monitoring is required.
6. Which of the following defense mechanisms is a client using when they state,
‘I only drink because my spouse is so demanding’?
A. Rationalization
B. Displacement
C. Projection
D. Denial
Answer: A
Rationale: Rationalization involves justifying illogical or unreasonable ideas or feelings by
developing acceptable explanations.
7. A nurse is caring for a client in a manic phase of bipolar disorder. Which of the
following meal choices is most appropriate?
A. Chicken soup and crackers
B. Steak and a baked potato
C. Spaghetti with meatballs
D. A cheeseburger and an apple
Answer: D
Rationale: Clients in a manic state benefit from high-calorie ‘finger foods’ that can be eaten
while they are moving around.
8. A nurse is assessing a client for alcohol withdrawal. Which of the following is
a common early sign of withdrawal?
A. Bradycardia
B. Coarse tremors of the hands
C. Hypotension
D. Increased appetite
Answer: B
College
1. A nurse is assessing a client who has been taking lithium carbonate for the
treatment of bipolar disorder. Which of the following findings should the nurse
identify as an early sign of lithium toxicity?
A. Severe hypotension
B. Confusion and slurred speech
C. Fine hand tremors and nausea
D. Polyuria and dehydration
Answer: C
Rationale: Early signs of lithium toxicity typically include fine hand tremors, nausea,
vomiting, and diarrhea. Severe confusion and slurred speech are advanced signs.
2. A nurse is caring for a client who has schizophrenia and is experiencing
command hallucinations. Which of the following actions is the nurse’s priority?
A. Discuss the client’s delusions
B. Administer an antipsychotic medication
C. Encourage the client to listen to music
D. Ask the client what the voices are saying
Answer: D
Rationale: The nurse’s priority is safety. Asking the client what the voices are saying helps
determine if the client is being commanded to hurt themselves or others.
,3. A nurse is planning care for a client who has anorexia nervosa. Which of the
following interventions should the nurse include?
A. Observe the client for 60 minutes after meals
B. Set a weight gain goal of 5 lbs per week
C. Allow the client to exercise for 1 hour after meals
D. Provide the client with low-calorie food choices
Answer: A
Rationale: Clients with anorexia nervosa should be observed for 60 minutes after meals to
prevent purging or hiding food.
4. A client is prescribed phenelzine, an MAOI. Which of the following foods
should the nurse instruct the client to avoid?
A. Cottage cheese
B. Smoked salami
C. Fresh apples
D. Grilled chicken
Answer: B
Rationale: MAOIs interact with tyramine-rich foods, such as aged meats (salami), cheeses,
and red wine, which can cause a hypertensive crisis.
5. A nurse is providing teaching to a client who has a new prescription for
clozapine. Which of the following laboratory tests should the nurse emphasize
as necessary?
A. Liver function tests
B. Serum creatinine
C. Thyroid stimulating hormone
D. White blood cell (WBC) count
Answer: D
, Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBCs.
Weekly or bi-weekly monitoring is required.
6. Which of the following defense mechanisms is a client using when they state,
‘I only drink because my spouse is so demanding’?
A. Rationalization
B. Displacement
C. Projection
D. Denial
Answer: A
Rationale: Rationalization involves justifying illogical or unreasonable ideas or feelings by
developing acceptable explanations.
7. A nurse is caring for a client in a manic phase of bipolar disorder. Which of the
following meal choices is most appropriate?
A. Chicken soup and crackers
B. Steak and a baked potato
C. Spaghetti with meatballs
D. A cheeseburger and an apple
Answer: D
Rationale: Clients in a manic state benefit from high-calorie ‘finger foods’ that can be eaten
while they are moving around.
8. A nurse is assessing a client for alcohol withdrawal. Which of the following is
a common early sign of withdrawal?
A. Bradycardia
B. Coarse tremors of the hands
C. Hypotension
D. Increased appetite
Answer: B
