NGN NCLEX-RN
MENTAL HEALTH
Exam Elaborations Questions &
Answers
2026
,A patient with Bipolar I Disorder is admitted in a state of acute mania. Which nursing
intervention is the highest priority for this patient's safety and well-regulated care? A)
Engaging the patient in a group competitive sport, B) Providing high-calorie finger foods,
C) Encouraging the patient to lead a community meeting, D) Requesting the patient to write
a detailed life history.
Answer: B. Rationale: Manic patients are often too distracted or hyperactive to sit for
meals. Providing portable, high-calorie finger foods prevents weight loss and exhaustion
while the patient is in constant motion.
True or False: In a patient experiencing Alcohol Withdrawal, the nurse should expect to see
a decrease in blood pressure and heart rate during the first 24 hours.
Answer: False. Rationale: Alcohol is a CNS depressant. Withdrawal results in CNS
rebound hyperactivity, characterized by tachycardia, hypertension, tremors, and
diaphoresis.
A patient on Clozapine therapy presents with a sore throat, fever, and malaise. The nurse
knows that the most critical laboratory value to check is the ____.
Answer: Absolute Neutrophil Count (ANC). Rationale: Clozapine carries a black box
warning for agranulocytosis, a severe drop in white blood cells that leaves the patient
vulnerable to life-threatening infections.
The nurse is caring for a patient with Borderline Personality Disorder who alternates
between overvaluing and undervaluing staff members. The nurse identifies this defense
mechanism as: A) Projection, B) Splitting, C) Reaction Formation, D) Sublimation.
Answer: B. Rationale: Splitting is the inability to integrate positive and negative qualities of
others into a cohesive image, leading the patient to view people as either "all good" or "all
bad."
True or False: ECT (Electroconvulsive Therapy) is contraindicated for patients who have an
increased intracranial pressure.
Answer: True. Rationale: ECT causes a transient increase in cerebral blood flow and
intracranial pressure, which can lead to brain herniation in patients who already have
elevated ICP.
A patient is admitted with Anorexia Nervosa. During the first week of nutritional
rehabilitation, the nurse should monitor for heart failure and peripheral edema, which are
markers of ____.
2
, Answer: Refeeding Syndrome. Rationale: Rapid nutritional replenishment in a starved
patient leads to massive insulin release and shifts in electrolytes like phosphorus and
magnesium, which can cause cardiac collapse.
The nurse is assessing a patient for "Negative Symptoms" of Schizophrenia. Which of the
following is considered a negative symptom? A) Auditory hallucinations, B) Delusions of
grandeur, C) Anhedonia, D) Tangentiality.
Answer: C. Rationale: Negative symptoms involve a loss or deficit in normal functioning,
such as anhedonia (inability to feel pleasure), alogia, and flat affect. A, B, and D are
positive symptoms.
True or False: Wernicke’s Encephalopathy is a reversible condition caused by a deficiency
in Vitamin B1 (Thiamine), often seen in chronic alcohol use.
Answer: True. Rationale: Acute thiamine deficiency causes biochemical lesions in the
central nervous system. If not treated promptly with thiamine, it can progress to the
irreversible Korsakoff’s Psychosis.
A patient with a history of trauma reports feeling as though they are "outside their own
body," watching their life like a movie. The nurse documents this as ____.
Answer: Depersonalization. Rationale: Depersonalization is a dissociative symptom where
the individual feels a sense of unreality or detachment from their own body or mental
processes.
Which electrolyte abnormality is the nurse most likely to see in a patient who engages in
frequent self-induced vomiting for Bulimia Nervosa? A) Hyperkalemia, B) Hypokalemia,
C) Hypernatremia, D) Hypocalcemia.
Answer: B. Rationale: Chronic vomiting leads to the loss of hydrochloric acid and
potassium, as well as renal compensation for metabolic alkalosis, both of which deplete
serum potassium.
True or False: A nurse has a "Duty to Warn" if a patient reveals a specific plan to harm an
identifiable third party during a therapy session.
Answer: True. Rationale: Based on the Tarasoff ruling, the legal obligation to protect a
third party from harm overrides the patient's right to confidentiality.
A patient with Obsessive-Compulsive Disorder spends two hours each morning checking
the door locks. When the nurse attempts to interrupt the ritual to take the patient to a group
meeting, the patient is likely to experience ____.
Answer: Severe anxiety (or panic). Rationale: Rituals in OCD are performed to neutralize
or prevent the anxiety caused by obsessive thoughts. Inhibiting the ritual causes the anxiety
to escalate.
3
MENTAL HEALTH
Exam Elaborations Questions &
Answers
2026
,A patient with Bipolar I Disorder is admitted in a state of acute mania. Which nursing
intervention is the highest priority for this patient's safety and well-regulated care? A)
Engaging the patient in a group competitive sport, B) Providing high-calorie finger foods,
C) Encouraging the patient to lead a community meeting, D) Requesting the patient to write
a detailed life history.
Answer: B. Rationale: Manic patients are often too distracted or hyperactive to sit for
meals. Providing portable, high-calorie finger foods prevents weight loss and exhaustion
while the patient is in constant motion.
True or False: In a patient experiencing Alcohol Withdrawal, the nurse should expect to see
a decrease in blood pressure and heart rate during the first 24 hours.
Answer: False. Rationale: Alcohol is a CNS depressant. Withdrawal results in CNS
rebound hyperactivity, characterized by tachycardia, hypertension, tremors, and
diaphoresis.
A patient on Clozapine therapy presents with a sore throat, fever, and malaise. The nurse
knows that the most critical laboratory value to check is the ____.
Answer: Absolute Neutrophil Count (ANC). Rationale: Clozapine carries a black box
warning for agranulocytosis, a severe drop in white blood cells that leaves the patient
vulnerable to life-threatening infections.
The nurse is caring for a patient with Borderline Personality Disorder who alternates
between overvaluing and undervaluing staff members. The nurse identifies this defense
mechanism as: A) Projection, B) Splitting, C) Reaction Formation, D) Sublimation.
Answer: B. Rationale: Splitting is the inability to integrate positive and negative qualities of
others into a cohesive image, leading the patient to view people as either "all good" or "all
bad."
True or False: ECT (Electroconvulsive Therapy) is contraindicated for patients who have an
increased intracranial pressure.
Answer: True. Rationale: ECT causes a transient increase in cerebral blood flow and
intracranial pressure, which can lead to brain herniation in patients who already have
elevated ICP.
A patient is admitted with Anorexia Nervosa. During the first week of nutritional
rehabilitation, the nurse should monitor for heart failure and peripheral edema, which are
markers of ____.
2
, Answer: Refeeding Syndrome. Rationale: Rapid nutritional replenishment in a starved
patient leads to massive insulin release and shifts in electrolytes like phosphorus and
magnesium, which can cause cardiac collapse.
The nurse is assessing a patient for "Negative Symptoms" of Schizophrenia. Which of the
following is considered a negative symptom? A) Auditory hallucinations, B) Delusions of
grandeur, C) Anhedonia, D) Tangentiality.
Answer: C. Rationale: Negative symptoms involve a loss or deficit in normal functioning,
such as anhedonia (inability to feel pleasure), alogia, and flat affect. A, B, and D are
positive symptoms.
True or False: Wernicke’s Encephalopathy is a reversible condition caused by a deficiency
in Vitamin B1 (Thiamine), often seen in chronic alcohol use.
Answer: True. Rationale: Acute thiamine deficiency causes biochemical lesions in the
central nervous system. If not treated promptly with thiamine, it can progress to the
irreversible Korsakoff’s Psychosis.
A patient with a history of trauma reports feeling as though they are "outside their own
body," watching their life like a movie. The nurse documents this as ____.
Answer: Depersonalization. Rationale: Depersonalization is a dissociative symptom where
the individual feels a sense of unreality or detachment from their own body or mental
processes.
Which electrolyte abnormality is the nurse most likely to see in a patient who engages in
frequent self-induced vomiting for Bulimia Nervosa? A) Hyperkalemia, B) Hypokalemia,
C) Hypernatremia, D) Hypocalcemia.
Answer: B. Rationale: Chronic vomiting leads to the loss of hydrochloric acid and
potassium, as well as renal compensation for metabolic alkalosis, both of which deplete
serum potassium.
True or False: A nurse has a "Duty to Warn" if a patient reveals a specific plan to harm an
identifiable third party during a therapy session.
Answer: True. Rationale: Based on the Tarasoff ruling, the legal obligation to protect a
third party from harm overrides the patient's right to confidentiality.
A patient with Obsessive-Compulsive Disorder spends two hours each morning checking
the door locks. When the nurse attempts to interrupt the ritual to take the patient to a group
meeting, the patient is likely to experience ____.
Answer: Severe anxiety (or panic). Rationale: Rituals in OCD are performed to neutralize
or prevent the anxiety caused by obsessive thoughts. Inhibiting the ritual causes the anxiety
to escalate.
3
