PNR 200/PNR200 Final Exam V2 | Mental
Health Nursing Q&A with Rationale | Fortis
College
1. A nurse is conducting a mental status examination on a client with depression. Which of
the following components should the nurse assess first to determine the client’s level of
consciousness?
A. Memory recall
B. Orientation to person, place, and time
C. Abstract thinking abilities
D. Judgment and insight
Correct Answer: B
Expert Explanation: Orientation is the fundamental component of assessing a client’s level
of consciousness and cognitive baseline. It determines if the client understands who they
are, where they are, and the current time. This assessment provides a foundation for
interpreting more complex cognitive functions like memory and judgment.
2. A nurse is caring for a client who has been admitted involuntarily to a mental health
facility. Which of the following rights does this client retain?
A. The right to refuse psychotropic medications
B. The right to leave the facility against medical advice
,C. The right to carry personal weapons
D. The right to ignore facility safety rules
Correct Answer: A
Expert Explanation: Involuntary admission does not automatically waive a client’s right to
refuse treatment or medication. Legal procedures must be followed to override this right,
such as a court order or a psychiatric emergency. Clients retain their civil liberties,
including the right to informed consent, even when hospitalized against their will.
3. Which therapeutic communication technique is the nurse using when they state, ‘You say
you feel overwhelmed, but you are smiling’?
A. Summarizing
B. Confrontation
C. Focusing
D. Reflecting
Correct Answer: B
Expert Explanation: Confrontation is used to point out discrepancies between a client’s
verbal statements and their non-verbal behaviors. This technique helps the client become
aware of inconsistent communications and encourages them to explore underlying feelings.
It should be used only after a therapeutic relationship has been established to avoid
defensiveness.
, 4. A nurse is caring for a client with Bipolar I Disorder who is experiencing acute mania. Which
of the following meal choices is most appropriate for this client?
A. Steak, baked potato, and a side salad
B. Chicken soup with crackers and hot tea
C. A cheeseburger and an apple
D. Spaghetti with meatballs and a breadstick
Correct Answer: C
Expert Explanation: Clients in a manic state often have high energy levels and cannot sit
still long enough to eat a full meal. Providing ‘finger foods’ like a cheeseburger allows the
client to consume calories while remaining mobile. This intervention supports nutritional
requirements without causing the frustration of being confined to a table.
5. A client is prescribed Lithium Carbonate for the treatment of Bipolar Disorder. The nurse
should instruct the client to monitor for which of the following signs of early toxicity?
A. Coarse hand tremors and ataxia
B. Nausea, vomiting, and fine hand tremors
C. Severe hypotension and seizures
D. Tinnitus and blurred vision
Correct Answer: B
Health Nursing Q&A with Rationale | Fortis
College
1. A nurse is conducting a mental status examination on a client with depression. Which of
the following components should the nurse assess first to determine the client’s level of
consciousness?
A. Memory recall
B. Orientation to person, place, and time
C. Abstract thinking abilities
D. Judgment and insight
Correct Answer: B
Expert Explanation: Orientation is the fundamental component of assessing a client’s level
of consciousness and cognitive baseline. It determines if the client understands who they
are, where they are, and the current time. This assessment provides a foundation for
interpreting more complex cognitive functions like memory and judgment.
2. A nurse is caring for a client who has been admitted involuntarily to a mental health
facility. Which of the following rights does this client retain?
A. The right to refuse psychotropic medications
B. The right to leave the facility against medical advice
,C. The right to carry personal weapons
D. The right to ignore facility safety rules
Correct Answer: A
Expert Explanation: Involuntary admission does not automatically waive a client’s right to
refuse treatment or medication. Legal procedures must be followed to override this right,
such as a court order or a psychiatric emergency. Clients retain their civil liberties,
including the right to informed consent, even when hospitalized against their will.
3. Which therapeutic communication technique is the nurse using when they state, ‘You say
you feel overwhelmed, but you are smiling’?
A. Summarizing
B. Confrontation
C. Focusing
D. Reflecting
Correct Answer: B
Expert Explanation: Confrontation is used to point out discrepancies between a client’s
verbal statements and their non-verbal behaviors. This technique helps the client become
aware of inconsistent communications and encourages them to explore underlying feelings.
It should be used only after a therapeutic relationship has been established to avoid
defensiveness.
, 4. A nurse is caring for a client with Bipolar I Disorder who is experiencing acute mania. Which
of the following meal choices is most appropriate for this client?
A. Steak, baked potato, and a side salad
B. Chicken soup with crackers and hot tea
C. A cheeseburger and an apple
D. Spaghetti with meatballs and a breadstick
Correct Answer: C
Expert Explanation: Clients in a manic state often have high energy levels and cannot sit
still long enough to eat a full meal. Providing ‘finger foods’ like a cheeseburger allows the
client to consume calories while remaining mobile. This intervention supports nutritional
requirements without causing the frustration of being confined to a table.
5. A client is prescribed Lithium Carbonate for the treatment of Bipolar Disorder. The nurse
should instruct the client to monitor for which of the following signs of early toxicity?
A. Coarse hand tremors and ataxia
B. Nausea, vomiting, and fine hand tremors
C. Severe hypotension and seizures
D. Tinnitus and blurred vision
Correct Answer: B
