NURS 222 | Mental Health/Psychiatric Nursing Final Exam Prep 2026
|WCU
1. A client with schizophrenia is experiencing auditory hallucinations and tells
the nurse, “The voices are telling me I am a bad person.” Which response by the
nurse is most therapeutic?
A. “I believe the voices are real to you, but I do not hear them.”
B. “The voices are not real, so you should try to ignore them.”
C. “I don’t hear any voices; you are safe here with me.”
D. “Why do you think the voices are saying you are a bad person?”
Answer: A
Rationale: Acknowledge the client’s experience without validating the hallucination as
reality (presenting reality). Avoiding ‘why’ questions and dismissing the experience is
crucial.
2. A client is admitted to the psychiatric unit with a diagnosis of Borderline
Personality Disorder. The nurse observes the client praising one staff member
while criticizing another. Which defense mechanism is being used?
A. Reaction Formation
B. Projective Identification
C. Splitting
D. Undoing
Answer: C
Rationale: Splitting is a common defense mechanism in BPD where the individual views
others as all good or all bad, often causing conflict among staff.
,3. The nurse is caring for a client prescribed Phenelzine for depression. Which
food item should the nurse instruct the client to avoid?
A. Fresh green salad with vinaigrette
B. Hard-boiled eggs
C. Grilled chicken breast
D. Aged cheddar cheese and pepperoni
Answer: D
Rationale: Phenelzine is an MAOI. Consumption of tyramine-rich foods (aged cheeses,
cured meats) can lead to a hypertensive crisis.
4. A client exhibiting signs of Lithium toxicity has a serum level of 2.2 mEq/L.
Which clinical manifestation should the nurse expect to observe?
A. Giddiness, blurred vision, and seizures
B. Fine hand tremors and nausea
C. Mild thirst and polyuria
D. Increased appetite and weight gain
Answer: A
Rationale: Serum levels above 2.0 mEq/L represent severe toxicity, characterized by
neurological symptoms like seizures, ataxia, and blurred vision.
5. During an intake assessment, a client with Major Depressive Disorder reports
having no energy to shower or eat. The nurse documents this finding as:
A. Anhedonia
B. Anergia
C. Avolition
D. Alogia
Answer: B
Rationale: Anergia refers to a lack of energy, common in depression. Anhedonia is the
inability to feel pleasure.
, 6. A nurse is caring for a client experiencing a panic attack. Which intervention is
the priority?
A. Stay with the client and provide a calm, quiet environment.
B. Administer an immediate dose of an SSRI.
C. Teach the client deep breathing techniques for future use.
D. Ask the client to identify the trigger of the panic.
Answer: A
Rationale: Safety and presence are priorities during a panic attack. The client cannot learn
new techniques or process ‘why’ questions during peak anxiety.
7. Which assessment finding in a client taking Haloperidol requires immediate
intervention by the nurse?
A. Dry mouth and constipation
B. Blurred vision and photosensitivity
C. A shuffling gait and drooling
D. Temperature of 103°F (39.4°C) and muscle rigidity
Answer: D
Rationale: These are hallmark signs of Neuroleptic Malignant Syndrome (NMS), a life-
threatening complication of antipsychotic medications.
8. A client who has undergone a total hip replacement is now 48 hours post-op
and becomes agitated, tachycardic, and reports seeing ‘bugs’ on the wall. Which
condition is most likely?
A. Alcohol withdrawal delirium
B. Dementia with Lewy bodies
C. Postoperative psychosis
D. Major Depressive Disorder with psychotic features
Answer: A
|WCU
1. A client with schizophrenia is experiencing auditory hallucinations and tells
the nurse, “The voices are telling me I am a bad person.” Which response by the
nurse is most therapeutic?
A. “I believe the voices are real to you, but I do not hear them.”
B. “The voices are not real, so you should try to ignore them.”
C. “I don’t hear any voices; you are safe here with me.”
D. “Why do you think the voices are saying you are a bad person?”
Answer: A
Rationale: Acknowledge the client’s experience without validating the hallucination as
reality (presenting reality). Avoiding ‘why’ questions and dismissing the experience is
crucial.
2. A client is admitted to the psychiatric unit with a diagnosis of Borderline
Personality Disorder. The nurse observes the client praising one staff member
while criticizing another. Which defense mechanism is being used?
A. Reaction Formation
B. Projective Identification
C. Splitting
D. Undoing
Answer: C
Rationale: Splitting is a common defense mechanism in BPD where the individual views
others as all good or all bad, often causing conflict among staff.
,3. The nurse is caring for a client prescribed Phenelzine for depression. Which
food item should the nurse instruct the client to avoid?
A. Fresh green salad with vinaigrette
B. Hard-boiled eggs
C. Grilled chicken breast
D. Aged cheddar cheese and pepperoni
Answer: D
Rationale: Phenelzine is an MAOI. Consumption of tyramine-rich foods (aged cheeses,
cured meats) can lead to a hypertensive crisis.
4. A client exhibiting signs of Lithium toxicity has a serum level of 2.2 mEq/L.
Which clinical manifestation should the nurse expect to observe?
A. Giddiness, blurred vision, and seizures
B. Fine hand tremors and nausea
C. Mild thirst and polyuria
D. Increased appetite and weight gain
Answer: A
Rationale: Serum levels above 2.0 mEq/L represent severe toxicity, characterized by
neurological symptoms like seizures, ataxia, and blurred vision.
5. During an intake assessment, a client with Major Depressive Disorder reports
having no energy to shower or eat. The nurse documents this finding as:
A. Anhedonia
B. Anergia
C. Avolition
D. Alogia
Answer: B
Rationale: Anergia refers to a lack of energy, common in depression. Anhedonia is the
inability to feel pleasure.
, 6. A nurse is caring for a client experiencing a panic attack. Which intervention is
the priority?
A. Stay with the client and provide a calm, quiet environment.
B. Administer an immediate dose of an SSRI.
C. Teach the client deep breathing techniques for future use.
D. Ask the client to identify the trigger of the panic.
Answer: A
Rationale: Safety and presence are priorities during a panic attack. The client cannot learn
new techniques or process ‘why’ questions during peak anxiety.
7. Which assessment finding in a client taking Haloperidol requires immediate
intervention by the nurse?
A. Dry mouth and constipation
B. Blurred vision and photosensitivity
C. A shuffling gait and drooling
D. Temperature of 103°F (39.4°C) and muscle rigidity
Answer: D
Rationale: These are hallmark signs of Neuroleptic Malignant Syndrome (NMS), a life-
threatening complication of antipsychotic medications.
8. A client who has undergone a total hip replacement is now 48 hours post-op
and becomes agitated, tachycardic, and reports seeing ‘bugs’ on the wall. Which
condition is most likely?
A. Alcohol withdrawal delirium
B. Dementia with Lewy bodies
C. Postoperative psychosis
D. Major Depressive Disorder with psychotic features
Answer: A
