2026 ACTUAL EXAM| NUR 253 MENTAL HEALTH
EXAM 2 REVIEW WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
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A client prescribed lithium carbonate for bipolar disorder reports
vomiting, coarse hand tremors, and confusion. Which action should the
nurse take first?
a) Administer the next dose with food
b) Hold the medication and notify the provider
c) Encourage increased caffeine intake
d) Reassure the client the symptoms are temporary - Correct Answer - b)
Hold the medication and notify the provider
Vomiting, confusion, and coarse tremors are signs of lithium toxicity.
Lithium should be withheld immediately.
A nurse observes a client with schizophrenia suddenly stop talking and
stare at the wall during conversation. Which term best describes this
behavior?
a) Neologism
b) Echolalia
c) Thought blocking
d) Clang association - Correct Answer - c) Thought blocking
Thought blocking refers to abrupt interruption in thought processes
resulting in sudden silence.
pg. 1
,A client taking phenelzine for depression develops severe headache and
hypertension after eating pepperoni pizza. Which condition should the
nurse suspect?
a) Neuroleptic malignant syndrome
b) Serotonin syndrome
c) Hypertensive crisis
d) Anticholinergic toxicity - Correct Answer - c) Hypertensive crisis
MAOIs interact with tyramine-containing foods, causing hypertensive
crisis.
A client prescribed haloperidol develops muscle rigidity, fever,
diaphoresis, and altered consciousness. Which complication should the
nurse suspect?
a) Acute dystonia
b) Tardive dyskinesia
c) Neuroleptic malignant syndrome
d) Akathisia - Correct Answer - c) Neuroleptic malignant syndrome
NMS is a life-threatening reaction characterized by rigidity,
hyperthermia, autonomic instability, and altered mental status.
A nurse is planning care for a client admitted with anorexia nervosa
whose BMI is critically low. Which intervention takes priority?
a) Encourage journaling after meals
b) Monitor weight, electrolytes, and cardiac status
c) Allow the client to choose preferred meals only
d) Begin family therapy immediately - Correct Answer - b) Monitor
weight, electrolytes, and cardiac status
pg. 2
,Physiological stabilization is the first priority due to risk for
dysrhythmias and electrolyte imbalance.
A nurse is assessing a client who reports nightmares, hypervigilance, and
flashbacks after surviving a shooting. Which disorder is most likely?
a) Panic disorder
b) Dissociative disorder
c) Post-traumatic stress disorder
d) Cyclothymic disorder - Correct Answer - c) Post-traumatic stress
disorder
PTSD commonly includes flashbacks, hypervigilance, intrusive
memories, and sleep disturbances after trauma.
A client with schizophrenia begins smacking lips and making
involuntary tongue movements after long-term antipsychotic use. Which
adverse effect is suspected?
a) Tardive dyskinesia
b) Akinesia
c) Acute dystonia
d) Neuroleptic malignant syndrome - Correct Answer - a) Tardive
dyskinesia
Tardive dyskinesia involves potentially irreversible involuntary
movements after prolonged antipsychotic therapy.
A client in alcohol withdrawal becomes tremulous, diaphoretic, and
confused. Which medication does the nurse anticipate administering?
a) Lithium
pg. 3
, b) Lorazepam
c) Fluoxetine
d) Benztropine - Correct Answer - b) Lorazepam
Benzodiazepines are first-line medications for alcohol withdrawal
management.
A nurse is assessing suicide risk in a depressed client. Which finding
indicates the highest risk?
a) Lack of appetite
b) Insomnia
c) Specific suicide plan with available means
d) Feelings of hopelessness - Correct Answer - c) Specific suicide plan
with available means
A detailed plan with access to means significantly increases suicide risk.
A client prescribed clozapine develops fever and sore throat. Which
action should the nurse take?
a) Encourage fluids only
b) Administer acetaminophen
c) Notify the provider and obtain CBC results
d) Reassure the client this is expected - Correct Answer - c) Notify the
provider and obtain CBC results
Clozapine can cause agranulocytosis, requiring immediate evaluation.
A client suddenly develops neck spasms and upward eye deviation after
receiving fluphenazine. Which medication should the nurse anticipate?
pg. 4