NURS 222: Mental Health/Psychiatric Nursing Exam 4 Review 2026
|WCU
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory result
must the nurse monitor most closely to prevent a potentially fatal
complication?
A. Serum creatinine and BUN levels
B. Absolute Neutrophil Count (ANC)
C. Alanine aminotransferase (ALT)
D. Glycosylated hemoglobin (HbA1c)
Answer: B
Rationale: Clozapine carries a high risk for agranulocytosis. A baseline ANC and regular
monitoring are mandatory to ensure the patient’s white blood cell count remains within a
safe range to prevent life-threatening infections.
2. A nurse is caring for a client experiencing alcohol withdrawal. Which
medication should the nurse anticipate administering to prevent the
progression to delirium tremens?
A. Methadone
B. Disulfiram
C. Naloxone
D. Chlordiazepoxide
Answer: D
Rationale: Benzodiazepines like Chlordiazepoxide are the first-line treatment for alcohol
withdrawal to stabilize vital signs and prevent seizures or delirium tremens.
,3. A client diagnosed with Borderline Personality Disorder (BPD) tells a day-shift
nurse that the night-shift nurse was ‘mean and incompetent,’ but the day-shift
nurse is ‘the only one who understands.’ This is an example of:
A. Reaction formation
B. Splitting
C. Intellectualization
D. Projection
Answer: B
Rationale: Splitting is a primitive defense mechanism common in BPD where the
individual views others as all good or all bad, unable to integrate positive and negative
qualities.
4. A patient taking Haloperidol presents with a high fever, muscle rigidity,
tachycardia, and altered consciousness. What is the priority nursing action?
A. Stop the medication and notify the provider for suspected Neuroleptic Malignant Syndrome
B. Administer a dose of Benztropine immediately
C. Encourage oral fluids to lower the temperature
D. Reassure the patient this is a common extrapyramidal side effect
Answer: A
Rationale: These symptoms are hallmark signs of Neuroleptic Malignant Syndrome (NMS),
a medical emergency requiring immediate cessation of the antipsychotic and supportive
care.
, 5. A client with Anorexia Nervosa is being admitted to an inpatient unit. Which
assessment finding would indicate a need for immediate medical stabilization?
A. Potassium level of 2.8 mEq/L
B. Presence of lanugo on the back
C. Body Mass Index (BMI) of 17.5
D. Amenorrhea for three consecutive cycles
Answer: A
Rationale: Hypokalemia (2.8 mEq/L) poses a severe risk for cardiac arrhythmias and
death, requiring immediate medical intervention over the other chronic symptoms of
anorexia.
6. A patient with Alzheimer’s disease is experiencing ‘sundowning.’ Which
intervention should the nurse include in the care plan?
A. Minimize environmental stimuli and provide a calm atmosphere in the late afternoon
B. Schedule vigorous exercise late in the evening to promote sleep
C. Turn on bright lights at night to reduce fear of the dark
D. Limit daytime naps to no more than 3 hours
Answer: A
Rationale: Sundowning is managed by reducing noise and activity levels as evening
approaches to prevent overstimulation and agitation.
7. A nurse is assessing a client for antisocial personality disorder. Which
characteristic is the nurse likely to observe?
A. Extreme sensitivity to rejection
B. Preoccupation with details and rules
C. Lack of remorse or guilt for hurting others
D. Excessive emotionality and attention-seeking
Answer: C
|WCU
1. A patient with schizophrenia is prescribed Clozapine. Which laboratory result
must the nurse monitor most closely to prevent a potentially fatal
complication?
A. Serum creatinine and BUN levels
B. Absolute Neutrophil Count (ANC)
C. Alanine aminotransferase (ALT)
D. Glycosylated hemoglobin (HbA1c)
Answer: B
Rationale: Clozapine carries a high risk for agranulocytosis. A baseline ANC and regular
monitoring are mandatory to ensure the patient’s white blood cell count remains within a
safe range to prevent life-threatening infections.
2. A nurse is caring for a client experiencing alcohol withdrawal. Which
medication should the nurse anticipate administering to prevent the
progression to delirium tremens?
A. Methadone
B. Disulfiram
C. Naloxone
D. Chlordiazepoxide
Answer: D
Rationale: Benzodiazepines like Chlordiazepoxide are the first-line treatment for alcohol
withdrawal to stabilize vital signs and prevent seizures or delirium tremens.
,3. A client diagnosed with Borderline Personality Disorder (BPD) tells a day-shift
nurse that the night-shift nurse was ‘mean and incompetent,’ but the day-shift
nurse is ‘the only one who understands.’ This is an example of:
A. Reaction formation
B. Splitting
C. Intellectualization
D. Projection
Answer: B
Rationale: Splitting is a primitive defense mechanism common in BPD where the
individual views others as all good or all bad, unable to integrate positive and negative
qualities.
4. A patient taking Haloperidol presents with a high fever, muscle rigidity,
tachycardia, and altered consciousness. What is the priority nursing action?
A. Stop the medication and notify the provider for suspected Neuroleptic Malignant Syndrome
B. Administer a dose of Benztropine immediately
C. Encourage oral fluids to lower the temperature
D. Reassure the patient this is a common extrapyramidal side effect
Answer: A
Rationale: These symptoms are hallmark signs of Neuroleptic Malignant Syndrome (NMS),
a medical emergency requiring immediate cessation of the antipsychotic and supportive
care.
, 5. A client with Anorexia Nervosa is being admitted to an inpatient unit. Which
assessment finding would indicate a need for immediate medical stabilization?
A. Potassium level of 2.8 mEq/L
B. Presence of lanugo on the back
C. Body Mass Index (BMI) of 17.5
D. Amenorrhea for three consecutive cycles
Answer: A
Rationale: Hypokalemia (2.8 mEq/L) poses a severe risk for cardiac arrhythmias and
death, requiring immediate medical intervention over the other chronic symptoms of
anorexia.
6. A patient with Alzheimer’s disease is experiencing ‘sundowning.’ Which
intervention should the nurse include in the care plan?
A. Minimize environmental stimuli and provide a calm atmosphere in the late afternoon
B. Schedule vigorous exercise late in the evening to promote sleep
C. Turn on bright lights at night to reduce fear of the dark
D. Limit daytime naps to no more than 3 hours
Answer: A
Rationale: Sundowning is managed by reducing noise and activity levels as evening
approaches to prevent overstimulation and agitation.
7. A nurse is assessing a client for antisocial personality disorder. Which
characteristic is the nurse likely to observe?
A. Extreme sensitivity to rejection
B. Preoccupation with details and rules
C. Lack of remorse or guilt for hurting others
D. Excessive emotionality and attention-seeking
Answer: C
