NURS 222 Mental Health Nursing Comprehensive Final Exam 2026
|WCU
1. A client is prescribed phenelzine for treatment-resistant depression. Which
menu choice indicates the client understands the necessary dietary restrictions?
A. Pepperoni pizza with extra cheese
B. Grilled chicken breast with steamed broccoli
C. Smoked salmon on a whole-grain bagel
D. Soy sauce glazed tofu with bean sprouts
Answer: B
Rationale: Phenelzine is an MAOI that requires a low-tyramine diet to prevent
hypertensive crisis. Aged meats, smoked fish, and soy products are high in tyramine, while
fresh chicken and vegetables are safe.
2. A patient with schizophrenia is experiencing auditory hallucinations. What is
the most appropriate initial nursing intervention?
A. Leave the client alone to reduce environmental stimuli.
B. Tell the client that the voices are not real.
C. Ask the client, ‘What are the voices telling you?’
D. Play loud music to drown out the internal voices.
Answer: C
Rationale: The nurse’s priority is to assess the content of hallucinations, especially
command hallucinations, to ensure the safety of the client and others.
,3. A client with bipolar I disorder is in a manic phase and is moving rapidly
around the unit. Which snack is most appropriate?
A. A bowl of vegetable soup
B. A turkey and cheese wrap
C. A dish of vanilla ice cream
D. A steak and potato dinner
Answer: B
Rationale: Clients in a manic state often cannot sit down to eat; ‘finger foods’ that are high
in protein and calories allow them to eat while moving.
4. Which laboratory value is most critical for a nurse to monitor in a client taking
clozapine?
A. Serum sodium levels
B. Blood urea nitrogen (BUN)
C. Absolute neutrophil count (ANC)
D. Creatinine kinase (CK)
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis; therefore, regular monitoring of the
ANC is mandatory to prevent life-threatening infections.
5. A nurse observes a client with OCD washing their hands for the tenth time in
an hour. What is the nurse’s best action?
A. Allow the client to finish washing their hands.
B. Lock the bathroom door to prevent further washing.
C. Explain the physical damage handwashing causes to the skin.
D. Tell the client they must go to a group therapy session immediately.
Answer: A
Rationale: Initially, the nurse should allow the ritual to be completed to avoid increasing
the client’s anxiety. Therapy involves gradual reduction of the rituals.
, 6. A client being treated for depression with sertraline presents with
hyperreflexia, tachycardia, and diaphoresis. What does the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anticholinergic toxicity
D. Tardive dyskinesia
Answer: A
Rationale: Serotonin syndrome is a potentially fatal reaction to SSRIs characterized by
mental status changes, autonomic hyperactivity, and neuromuscular abnormalities.
7. What is the therapeutic serum lithium level range for a client in the
maintenance phase of bipolar disorder?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The standard therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
8. A client with Borderline Personality Disorder is praising one nurse while
devaluing another. This defense mechanism is known as:
A. Projective identification
B. Undoing
C. Reaction formation
D. Splitting
Answer: D
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image, resulting in all-or-nothing thinking.
|WCU
1. A client is prescribed phenelzine for treatment-resistant depression. Which
menu choice indicates the client understands the necessary dietary restrictions?
A. Pepperoni pizza with extra cheese
B. Grilled chicken breast with steamed broccoli
C. Smoked salmon on a whole-grain bagel
D. Soy sauce glazed tofu with bean sprouts
Answer: B
Rationale: Phenelzine is an MAOI that requires a low-tyramine diet to prevent
hypertensive crisis. Aged meats, smoked fish, and soy products are high in tyramine, while
fresh chicken and vegetables are safe.
2. A patient with schizophrenia is experiencing auditory hallucinations. What is
the most appropriate initial nursing intervention?
A. Leave the client alone to reduce environmental stimuli.
B. Tell the client that the voices are not real.
C. Ask the client, ‘What are the voices telling you?’
D. Play loud music to drown out the internal voices.
Answer: C
Rationale: The nurse’s priority is to assess the content of hallucinations, especially
command hallucinations, to ensure the safety of the client and others.
,3. A client with bipolar I disorder is in a manic phase and is moving rapidly
around the unit. Which snack is most appropriate?
A. A bowl of vegetable soup
B. A turkey and cheese wrap
C. A dish of vanilla ice cream
D. A steak and potato dinner
Answer: B
Rationale: Clients in a manic state often cannot sit down to eat; ‘finger foods’ that are high
in protein and calories allow them to eat while moving.
4. Which laboratory value is most critical for a nurse to monitor in a client taking
clozapine?
A. Serum sodium levels
B. Blood urea nitrogen (BUN)
C. Absolute neutrophil count (ANC)
D. Creatinine kinase (CK)
Answer: C
Rationale: Clozapine carries a risk of agranulocytosis; therefore, regular monitoring of the
ANC is mandatory to prevent life-threatening infections.
5. A nurse observes a client with OCD washing their hands for the tenth time in
an hour. What is the nurse’s best action?
A. Allow the client to finish washing their hands.
B. Lock the bathroom door to prevent further washing.
C. Explain the physical damage handwashing causes to the skin.
D. Tell the client they must go to a group therapy session immediately.
Answer: A
Rationale: Initially, the nurse should allow the ritual to be completed to avoid increasing
the client’s anxiety. Therapy involves gradual reduction of the rituals.
, 6. A client being treated for depression with sertraline presents with
hyperreflexia, tachycardia, and diaphoresis. What does the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anticholinergic toxicity
D. Tardive dyskinesia
Answer: A
Rationale: Serotonin syndrome is a potentially fatal reaction to SSRIs characterized by
mental status changes, autonomic hyperactivity, and neuromuscular abnormalities.
7. What is the therapeutic serum lithium level range for a client in the
maintenance phase of bipolar disorder?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The standard therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
8. A client with Borderline Personality Disorder is praising one nurse while
devaluing another. This defense mechanism is known as:
A. Projective identification
B. Undoing
C. Reaction formation
D. Splitting
Answer: D
Rationale: Splitting is the inability to integrate positive and negative qualities of oneself or
others into a cohesive image, resulting in all-or-nothing thinking.
