NR 325: Mental Health Nursing Final Exam
ACTUAL EXAM TEST BANK 230 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||NEWEST VERSION 2026/2027
QUESTION
A client with schizophrenia states, “The FBI is controlling my thoughts through the TV.” What is
the nurse’s best response?
A. “That is not true, the FBI is not controlling you.”
B. “Tell me more about what you are experiencing.”
C. “You should not believe those thoughts.”
D. “Let’s watch TV together to prove it’s safe.”
Correct Answer: B
Expert Rationale
This is a delusion associated with schizophrenia. The priority nursing approach is to
acknowledge the client’s experience without reinforcing or directly challenging the delusion.
Encouraging discussion helps assess severity while maintaining therapeutic communication.
Directly disputing beliefs can increase mistrust. Agreeing or validating the delusion reinforces
psychosis. Reality testing is done gently, not confrontationally.
QUESTION
A client with major depressive disorder states, “I have a plan to end my life tonight.” What is the
priority action?
A. Ask about family support
B. Initiate suicide precautions
C. Encourage journaling feelings
D. Leave the client alone to rest
Correct Answer: B
,Expert Rationale
A stated plan indicates high suicide risk requiring immediate safety interventions. Initiating
suicide precautions ensures constant observation and removal of harmful objects. Exploring
family support or journaling is not appropriate during acute risk. Leaving the client alone
increases danger. Safety always overrides therapeutic exploration in suicidal ideation.
QUESTION
Which finding indicates lithium toxicity?
A. Hand tremors and nausea
B. Serum level 2.0 mEq/L
C. Increased appetite
D. Mild thirst
Correct Answer: B
Expert Rationale
Therapeutic lithium range is 0.6–1.2 mEq/L. Levels above 1.5 indicate toxicity. A level of 2.0 is
life-threatening and may lead to seizures, renal failure, and arrhythmias. Mild tremor and thirst
are early side effects, not toxicity indicators. Immediate discontinuation and treatment are
required.
QUESTION
Which are symptoms of serotonin syndrome? Select all that apply.
A. Hyperreflexia
B. Fever
C. Bradycardia
D. Agitation
E. Muscle rigidity
Correct Answers: A, B, D, E
Expert Rationale
Serotonin syndrome is caused by excess serotonergic activity (often SSRIs + MAOIs). It presents
with autonomic instability, neuromuscular hyperactivity, and mental status changes.
Hyperreflexia, agitation, fever, and rigidity are key findings. Bradycardia is not typical;
tachycardia is expected.
,QUESTION
A client with panic disorder is having an acute attack. What is the priority intervention?
A. Teach relaxation techniques
B. Stay with the client and use calm reassurance
C. Encourage deep insight discussion
D. Ask client to describe triggers
Correct Answer: B
Expert Rationale
During an acute panic attack, the client is overwhelmed and cannot process complex
information. The priority is ensuring safety and providing calm presence. Teaching and
exploration are ineffective during acute anxiety. Simple reassurance helps reduce sympathetic
response.
QUESTION
Which behavior is most associated with antisocial personality disorder?
A. Excessive fear of abandonment
B. Manipulation and lack of remorse
C. Social withdrawal and flat affect
D. Perfectionism and control
Correct Answer: B
Expert Rationale
Antisocial Personality Disorder is characterized by disregard for rules, manipulation, deceit, and
lack of empathy or remorse. Fear of abandonment is seen in borderline personality disorder.
Social withdrawal is common in schizophrenia. Perfectionism is associated with obsessive-
compulsive personality traits.
QUESTION
A client on MAOIs should avoid which food?
A. Cheese
B. Rice
, C. Apples
D. Bread
Correct Answer: A
Expert Rationale
MAOIs interact with tyramine-rich foods such as aged cheese, causing hypertensive crisis due to
excessive catecholamine release. Symptoms include severe headache and hypertension. Other
foods listed are safe.
QUESTION
Which finding indicates improvement in schizophrenia negative symptoms?
A. Reduced hallucinations
B. Increased social interaction
C. Decreased delusions
D. Reduced paranoia
Correct Answer: B
Expert Rationale
Negative symptoms include social withdrawal, flat affect, and lack of motivation. Improvement
is seen when the client increases social engagement and participation. Positive symptoms
(hallucinations, delusions) are separate clinical features.
QUESTION
A client with bipolar mania is pacing, not sleeping, and speaking rapidly. What is the priority
nursing action?
A. Encourage group therapy
B. Provide low-stimulation environment
C. Confront inappropriate behavior
D. Encourage journaling
Correct Answer: B
Expert Rationale
Manic clients are overstimulated and require a calm, structured environment to reduce
ACTUAL EXAM TEST BANK 230 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||NEWEST VERSION 2026/2027
QUESTION
A client with schizophrenia states, “The FBI is controlling my thoughts through the TV.” What is
the nurse’s best response?
A. “That is not true, the FBI is not controlling you.”
B. “Tell me more about what you are experiencing.”
C. “You should not believe those thoughts.”
D. “Let’s watch TV together to prove it’s safe.”
Correct Answer: B
Expert Rationale
This is a delusion associated with schizophrenia. The priority nursing approach is to
acknowledge the client’s experience without reinforcing or directly challenging the delusion.
Encouraging discussion helps assess severity while maintaining therapeutic communication.
Directly disputing beliefs can increase mistrust. Agreeing or validating the delusion reinforces
psychosis. Reality testing is done gently, not confrontationally.
QUESTION
A client with major depressive disorder states, “I have a plan to end my life tonight.” What is the
priority action?
A. Ask about family support
B. Initiate suicide precautions
C. Encourage journaling feelings
D. Leave the client alone to rest
Correct Answer: B
,Expert Rationale
A stated plan indicates high suicide risk requiring immediate safety interventions. Initiating
suicide precautions ensures constant observation and removal of harmful objects. Exploring
family support or journaling is not appropriate during acute risk. Leaving the client alone
increases danger. Safety always overrides therapeutic exploration in suicidal ideation.
QUESTION
Which finding indicates lithium toxicity?
A. Hand tremors and nausea
B. Serum level 2.0 mEq/L
C. Increased appetite
D. Mild thirst
Correct Answer: B
Expert Rationale
Therapeutic lithium range is 0.6–1.2 mEq/L. Levels above 1.5 indicate toxicity. A level of 2.0 is
life-threatening and may lead to seizures, renal failure, and arrhythmias. Mild tremor and thirst
are early side effects, not toxicity indicators. Immediate discontinuation and treatment are
required.
QUESTION
Which are symptoms of serotonin syndrome? Select all that apply.
A. Hyperreflexia
B. Fever
C. Bradycardia
D. Agitation
E. Muscle rigidity
Correct Answers: A, B, D, E
Expert Rationale
Serotonin syndrome is caused by excess serotonergic activity (often SSRIs + MAOIs). It presents
with autonomic instability, neuromuscular hyperactivity, and mental status changes.
Hyperreflexia, agitation, fever, and rigidity are key findings. Bradycardia is not typical;
tachycardia is expected.
,QUESTION
A client with panic disorder is having an acute attack. What is the priority intervention?
A. Teach relaxation techniques
B. Stay with the client and use calm reassurance
C. Encourage deep insight discussion
D. Ask client to describe triggers
Correct Answer: B
Expert Rationale
During an acute panic attack, the client is overwhelmed and cannot process complex
information. The priority is ensuring safety and providing calm presence. Teaching and
exploration are ineffective during acute anxiety. Simple reassurance helps reduce sympathetic
response.
QUESTION
Which behavior is most associated with antisocial personality disorder?
A. Excessive fear of abandonment
B. Manipulation and lack of remorse
C. Social withdrawal and flat affect
D. Perfectionism and control
Correct Answer: B
Expert Rationale
Antisocial Personality Disorder is characterized by disregard for rules, manipulation, deceit, and
lack of empathy or remorse. Fear of abandonment is seen in borderline personality disorder.
Social withdrawal is common in schizophrenia. Perfectionism is associated with obsessive-
compulsive personality traits.
QUESTION
A client on MAOIs should avoid which food?
A. Cheese
B. Rice
, C. Apples
D. Bread
Correct Answer: A
Expert Rationale
MAOIs interact with tyramine-rich foods such as aged cheese, causing hypertensive crisis due to
excessive catecholamine release. Symptoms include severe headache and hypertension. Other
foods listed are safe.
QUESTION
Which finding indicates improvement in schizophrenia negative symptoms?
A. Reduced hallucinations
B. Increased social interaction
C. Decreased delusions
D. Reduced paranoia
Correct Answer: B
Expert Rationale
Negative symptoms include social withdrawal, flat affect, and lack of motivation. Improvement
is seen when the client increases social engagement and participation. Positive symptoms
(hallucinations, delusions) are separate clinical features.
QUESTION
A client with bipolar mania is pacing, not sleeping, and speaking rapidly. What is the priority
nursing action?
A. Encourage group therapy
B. Provide low-stimulation environment
C. Confront inappropriate behavior
D. Encourage journaling
Correct Answer: B
Expert Rationale
Manic clients are overstimulated and require a calm, structured environment to reduce
