PRN 1562/PRN1562 Exam 4 V3 | Principles
of Mental Health Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client with Borderline Personality Disorder who is using ‘splitting’
behavior. Which action should the nurse take?
A. Allow the client to choose which nurse provides care.
B. Provide the client with extra attention to build trust.
C. Ignore the behavior to avoid reinforcing it.
D. Hold a staff meeting to ensure a consistent approach.
Correct Answer: D
Expert Explanation: Splitting is a common defense mechanism where the client views
individuals as either all good or all bad. By holding a staff meeting, the nursing team can
maintain consistency and prevent the client from playing staff members against each other.
Consistency is the primary intervention when managing the manipulative behaviors
associated with Cluster B personality disorders.
2. Which clinical manifestation should the nurse expect to find in a client diagnosed with
Anorexia Nervosa?
A. Tachycardia and hypertension.
B. Fine, downy hair (lanugo) on the back and face.
,C. Moist, warm skin with rapid capillary refill.
D. Elevated potassium and sodium levels.
Correct Answer: B
Expert Explanation: Lanugo is a physiological response to extreme weight loss and
malnutrition as the body attempts to provide insulation. Clients with Anorexia Nervosa
typically exhibit bradycardia and hypotension rather than tachycardia. Electrolyte
imbalances in these clients usually manifest as hypokalemia rather than elevated levels.
3. A client is admitted with Delirium. The nurse understands that which of the following is a
key characteristic of this condition?
A. The onset is slow and progressive over years.
B. The condition is usually irreversible and permanent.
C. It is characterized by a sudden change in level of consciousness.
D. Memory loss is the only primary symptom observed.
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid, acute onset of confusion and
fluctuating levels of consciousness. Unlike dementia, delirium is often reversible once the
underlying medical cause, such as infection or toxicity, is treated. Nurses must monitor for
changes in orientation and attention to identify delirium early.
, 4. The nurse is assessing a child with ADHD. Which of the following behaviors is most
characteristic of this diagnosis?
A. Extreme shyness and withdrawal in social settings.
B. Difficulty waiting for turns and interrupting others.
C. Repetitive motor movements and hand flapping.
D. Total lack of interest in any physical activity.
Correct Answer: B
Expert Explanation: ADHD involves a persistent pattern of inattention, hyperactivity, and
impulsivity that interferes with functioning. Difficulty waiting for turns and interrupting
others are classic signs of the impulsivity component of the disorder. Treatment often
involves a combination of behavioral therapy and stimulant medications like
methylphenidate.
5. A client with Antisocial Personality Disorder is being treated on an inpatient unit. Which
intervention is most appropriate?
A. Encourage the client to lead group therapy sessions.
B. Set clear, firm limits on behavior and expectations.
C. Provide flexible rules to accommodate the client’s needs.
D. Offer frequent praise to boost the client’s low self-esteem.
Correct Answer: B
of Mental Health Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client with Borderline Personality Disorder who is using ‘splitting’
behavior. Which action should the nurse take?
A. Allow the client to choose which nurse provides care.
B. Provide the client with extra attention to build trust.
C. Ignore the behavior to avoid reinforcing it.
D. Hold a staff meeting to ensure a consistent approach.
Correct Answer: D
Expert Explanation: Splitting is a common defense mechanism where the client views
individuals as either all good or all bad. By holding a staff meeting, the nursing team can
maintain consistency and prevent the client from playing staff members against each other.
Consistency is the primary intervention when managing the manipulative behaviors
associated with Cluster B personality disorders.
2. Which clinical manifestation should the nurse expect to find in a client diagnosed with
Anorexia Nervosa?
A. Tachycardia and hypertension.
B. Fine, downy hair (lanugo) on the back and face.
,C. Moist, warm skin with rapid capillary refill.
D. Elevated potassium and sodium levels.
Correct Answer: B
Expert Explanation: Lanugo is a physiological response to extreme weight loss and
malnutrition as the body attempts to provide insulation. Clients with Anorexia Nervosa
typically exhibit bradycardia and hypotension rather than tachycardia. Electrolyte
imbalances in these clients usually manifest as hypokalemia rather than elevated levels.
3. A client is admitted with Delirium. The nurse understands that which of the following is a
key characteristic of this condition?
A. The onset is slow and progressive over years.
B. The condition is usually irreversible and permanent.
C. It is characterized by a sudden change in level of consciousness.
D. Memory loss is the only primary symptom observed.
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid, acute onset of confusion and
fluctuating levels of consciousness. Unlike dementia, delirium is often reversible once the
underlying medical cause, such as infection or toxicity, is treated. Nurses must monitor for
changes in orientation and attention to identify delirium early.
, 4. The nurse is assessing a child with ADHD. Which of the following behaviors is most
characteristic of this diagnosis?
A. Extreme shyness and withdrawal in social settings.
B. Difficulty waiting for turns and interrupting others.
C. Repetitive motor movements and hand flapping.
D. Total lack of interest in any physical activity.
Correct Answer: B
Expert Explanation: ADHD involves a persistent pattern of inattention, hyperactivity, and
impulsivity that interferes with functioning. Difficulty waiting for turns and interrupting
others are classic signs of the impulsivity component of the disorder. Treatment often
involves a combination of behavioral therapy and stimulant medications like
methylphenidate.
5. A client with Antisocial Personality Disorder is being treated on an inpatient unit. Which
intervention is most appropriate?
A. Encourage the client to lead group therapy sessions.
B. Set clear, firm limits on behavior and expectations.
C. Provide flexible rules to accommodate the client’s needs.
D. Offer frequent praise to boost the client’s low self-esteem.
Correct Answer: B
