NR 326 Mental Health Nursing Practice Final Exam 2026 |Chamberlain
College
1. A client with schizophrenia is experiencing auditory hallucinations. Which is
the most appropriate nursing intervention?
A. Tell the client that the voices are not real.
B. Leave the client alone to reduce environmental stimuli.
C. Ask the client directly, ‘What are the voices telling you?’
D. Argue with the client about the validity of the voices.
Answer: C
Rationale: Asking what the voices are saying is essential to assess for command
hallucinations that could lead to self-harm or violence.
2. Which laboratory value is most important to monitor for a client taking
Clozapine?
A. White blood cell (WBC) count
B. Blood urea nitrogen (BUN)
C. Serum potassium levels
D. Serum lithium levels
Answer: A
Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBCs,
requiring weekly or bi-weekly monitoring.
,3. A client is admitted for lithium toxicity. Which symptom would the nurse
expect to observe?
A. Hyperactivity and flight of ideas
B. Constipation and urinary retention
C. Coarse hand tremors and ataxia
D. Increased appetite and weight gain
Answer: C
Rationale: Coarse tremors, ataxia, blurred vision, and severe diarrhea are signs of lithium
toxicity (levels typically above 1.5 mEq/L).
4. A nurse is caring for a client with anorexia nervosa. Which finding is a priority
for the nurse to report?
A. Potassium level of 2.8 mEq/L
B. Fine, downy hair (lanugo) on the back
C. Amenorrhea
D. Weight 15% below ideal body weight
Answer: A
Rationale: Hypokalemia (low potassium) is a medical emergency that can lead to fatal
cardiac arrhythmias.
5. A client is experiencing a manic episode. Which meal choice is most
appropriate?
A. Spaghetti and meatballs with a salad
B. Soup and crackers
C. Steak, baked potato, and corn
D. A chicken wrap and an apple
Answer: D
Rationale: Clients in a manic state benefit from ‘finger foods’ that allow them to eat while
on the move due to high activity levels.
, 6. The nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS).
Which symptom is characteristic of this condition?
A. Severe muscle rigidity and high fever
B. Muscle flaccidity and diarrhea
C. Hypothermia and bradycardia
D. Increased salivation and hypotension
Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by high fever,
muscle rigidity, altered mental status, and autonomic instability.
7. Which defense mechanism is a client using when they state, ‘I only drink
because my spouse is so stressful to live with’?
A. Projection
B. Reaction formation
C. Displacement
D. Rationalization
Answer: D
Rationale: Rationalization involves justifying illogical or unreasonable ideas or feelings by
developing acceptable explanations.
8. A client with Borderline Personality Disorder is praising one nurse while
devaluing another. This is an example of:
A. Manipulation
B. Splitting
C. Sublimation
D. Narcissism
Answer: B
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image.
College
1. A client with schizophrenia is experiencing auditory hallucinations. Which is
the most appropriate nursing intervention?
A. Tell the client that the voices are not real.
B. Leave the client alone to reduce environmental stimuli.
C. Ask the client directly, ‘What are the voices telling you?’
D. Argue with the client about the validity of the voices.
Answer: C
Rationale: Asking what the voices are saying is essential to assess for command
hallucinations that could lead to self-harm or violence.
2. Which laboratory value is most important to monitor for a client taking
Clozapine?
A. White blood cell (WBC) count
B. Blood urea nitrogen (BUN)
C. Serum potassium levels
D. Serum lithium levels
Answer: A
Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBCs,
requiring weekly or bi-weekly monitoring.
,3. A client is admitted for lithium toxicity. Which symptom would the nurse
expect to observe?
A. Hyperactivity and flight of ideas
B. Constipation and urinary retention
C. Coarse hand tremors and ataxia
D. Increased appetite and weight gain
Answer: C
Rationale: Coarse tremors, ataxia, blurred vision, and severe diarrhea are signs of lithium
toxicity (levels typically above 1.5 mEq/L).
4. A nurse is caring for a client with anorexia nervosa. Which finding is a priority
for the nurse to report?
A. Potassium level of 2.8 mEq/L
B. Fine, downy hair (lanugo) on the back
C. Amenorrhea
D. Weight 15% below ideal body weight
Answer: A
Rationale: Hypokalemia (low potassium) is a medical emergency that can lead to fatal
cardiac arrhythmias.
5. A client is experiencing a manic episode. Which meal choice is most
appropriate?
A. Spaghetti and meatballs with a salad
B. Soup and crackers
C. Steak, baked potato, and corn
D. A chicken wrap and an apple
Answer: D
Rationale: Clients in a manic state benefit from ‘finger foods’ that allow them to eat while
on the move due to high activity levels.
, 6. The nurse is assessing a client for Neuroleptic Malignant Syndrome (NMS).
Which symptom is characteristic of this condition?
A. Severe muscle rigidity and high fever
B. Muscle flaccidity and diarrhea
C. Hypothermia and bradycardia
D. Increased salivation and hypotension
Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by high fever,
muscle rigidity, altered mental status, and autonomic instability.
7. Which defense mechanism is a client using when they state, ‘I only drink
because my spouse is so stressful to live with’?
A. Projection
B. Reaction formation
C. Displacement
D. Rationalization
Answer: D
Rationale: Rationalization involves justifying illogical or unreasonable ideas or feelings by
developing acceptable explanations.
8. A client with Borderline Personality Disorder is praising one nurse while
devaluing another. This is an example of:
A. Manipulation
B. Splitting
C. Sublimation
D. Narcissism
Answer: B
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image.
