PRN 1562/PRN1562 Exam 4 V2 | Principles
of Mental Health Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client who was admitted with major depressive disorder and reports
a sudden improvement in mood. Which action should the nurse take first?
A. Document the improvement and continue the current plan of care.
B. Inform the client that they will likely be discharged tomorrow.
C. Reduce the dosage of the client’s antidepressant medication.
D. Increase the frequency of suicide observation and checks.
Correct Answer: D
Expert Explanation: A sudden lift in mood in a severely depressed client often indicates
that the client has finally made a decision to complete suicide and feels a sense of relief. The
nurse must prioritize safety by increasing observation because the client now has the
energy to carry out a plan. This transition period is considered a high-risk time for self-
harm in psychiatric settings.
2. Which laboratory value is most critical for a nurse to monitor in a client taking Lithium
carbonate for bipolar disorder?
A. White blood cell count
B. Serum potassium level
,C. Blood glucose level
D. Serum sodium level
Correct Answer: D
Expert Explanation: Lithium is a salt, and its excretion is closely tied to sodium levels in
the body. If sodium levels drop, the kidneys will retain lithium instead of sodium, leading to
potentially fatal lithium toxicity. Patients must maintain a consistent intake of salt and
fluids to keep the serum lithium concentration within a therapeutic range.
3. A client with Borderline Personality Disorder (BPD) tells a nurse, ‘The night shift nurse is so
much better than you; she actually cares.’ This behavior is an example of which defense
mechanism?
A. Projection
B. Splitting
C. Rationalization
D. Reaction formation
Correct Answer: B
Expert Explanation: Splitting is a common defense mechanism in BPD where individuals
perceive people as either ‘all good’ or ‘all bad.’ By pitting staff members against each other,
the client attempts to manage their own anxiety and internal conflict. The nursing staff
should maintain consistent boundaries and use a team approach to prevent the client’s
manipulative behavior from causing conflict.
,4. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is most
characteristic of this condition?
A. Hypertension
B. Lanugo
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Expert Explanation: Lanugo is the growth of fine, downy hair on the face and back as a
compensatory mechanism to provide warmth to a malnourished body. Clients with
anorexia often exhibit bradycardia, hypotension, and hypothermia due to a slowed
metabolism and loss of body fat. Recognizing these physiological adaptations is crucial for
evaluating the severity of the client’s malnutrition.
5. A client taking Phenelzine (Nardil) for depression should be instructed to avoid which of
the following foods?
A. Aged cheddar cheese
B. Fresh apples
C. Grilled chicken breast
D. Boiled eggs
Correct Answer: A
, Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that requires a
low-tyramine diet to prevent a hypertensive crisis. Aged cheeses, cured meats, and
fermented products are high in tyramine and can cause a rapid, dangerous increase in
blood pressure. Education on dietary restrictions is the most vital component of patient
safety for those prescribed MAOIs.
6. A nurse is caring for a client in the manic phase of Bipolar Disorder. Which meal choice is
most appropriate for this client?
A. Steak and baked potato
B. Spaghetti and meatballs
C. Chicken nuggets and an apple
D. Soup and crackers
Correct Answer: C
Expert Explanation: During a manic episode, clients are often hyperactive and cannot sit
down long enough to eat a full meal. ‘Finger foods’ that are high in protein and calories
allow the client to eat while moving and maintain their nutritional status. This intervention
addresses the physical exhaustion and weight loss that can occur during prolonged periods
of mania.
7. A client is diagnosed with Antisocial Personality Disorder. Which behavior should the nurse
expect to observe?
A. Excessive need for approval
of Mental Health Nursing Q&A with
Rationale | Rasmussen University
1. A nurse is caring for a client who was admitted with major depressive disorder and reports
a sudden improvement in mood. Which action should the nurse take first?
A. Document the improvement and continue the current plan of care.
B. Inform the client that they will likely be discharged tomorrow.
C. Reduce the dosage of the client’s antidepressant medication.
D. Increase the frequency of suicide observation and checks.
Correct Answer: D
Expert Explanation: A sudden lift in mood in a severely depressed client often indicates
that the client has finally made a decision to complete suicide and feels a sense of relief. The
nurse must prioritize safety by increasing observation because the client now has the
energy to carry out a plan. This transition period is considered a high-risk time for self-
harm in psychiatric settings.
2. Which laboratory value is most critical for a nurse to monitor in a client taking Lithium
carbonate for bipolar disorder?
A. White blood cell count
B. Serum potassium level
,C. Blood glucose level
D. Serum sodium level
Correct Answer: D
Expert Explanation: Lithium is a salt, and its excretion is closely tied to sodium levels in
the body. If sodium levels drop, the kidneys will retain lithium instead of sodium, leading to
potentially fatal lithium toxicity. Patients must maintain a consistent intake of salt and
fluids to keep the serum lithium concentration within a therapeutic range.
3. A client with Borderline Personality Disorder (BPD) tells a nurse, ‘The night shift nurse is so
much better than you; she actually cares.’ This behavior is an example of which defense
mechanism?
A. Projection
B. Splitting
C. Rationalization
D. Reaction formation
Correct Answer: B
Expert Explanation: Splitting is a common defense mechanism in BPD where individuals
perceive people as either ‘all good’ or ‘all bad.’ By pitting staff members against each other,
the client attempts to manage their own anxiety and internal conflict. The nursing staff
should maintain consistent boundaries and use a team approach to prevent the client’s
manipulative behavior from causing conflict.
,4. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is most
characteristic of this condition?
A. Hypertension
B. Lanugo
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Expert Explanation: Lanugo is the growth of fine, downy hair on the face and back as a
compensatory mechanism to provide warmth to a malnourished body. Clients with
anorexia often exhibit bradycardia, hypotension, and hypothermia due to a slowed
metabolism and loss of body fat. Recognizing these physiological adaptations is crucial for
evaluating the severity of the client’s malnutrition.
5. A client taking Phenelzine (Nardil) for depression should be instructed to avoid which of
the following foods?
A. Aged cheddar cheese
B. Fresh apples
C. Grilled chicken breast
D. Boiled eggs
Correct Answer: A
, Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that requires a
low-tyramine diet to prevent a hypertensive crisis. Aged cheeses, cured meats, and
fermented products are high in tyramine and can cause a rapid, dangerous increase in
blood pressure. Education on dietary restrictions is the most vital component of patient
safety for those prescribed MAOIs.
6. A nurse is caring for a client in the manic phase of Bipolar Disorder. Which meal choice is
most appropriate for this client?
A. Steak and baked potato
B. Spaghetti and meatballs
C. Chicken nuggets and an apple
D. Soup and crackers
Correct Answer: C
Expert Explanation: During a manic episode, clients are often hyperactive and cannot sit
down long enough to eat a full meal. ‘Finger foods’ that are high in protein and calories
allow the client to eat while moving and maintain their nutritional status. This intervention
addresses the physical exhaustion and weight loss that can occur during prolonged periods
of mania.
7. A client is diagnosed with Antisocial Personality Disorder. Which behavior should the nurse
expect to observe?
A. Excessive need for approval
