NUR180/NUR 180 Exam 3 V3 | Concepts
of Mental Health Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A patient with bipolar disorder is prescribed Lithium carbonate. Which serum lithium level
would the nurse identify as within the therapeutic range?
A. 0.6 to 1.2 mEq/L
B. 1.5 to 2.0 mEq/L
C. 0.2 to 0.5 mEq/L
D. 2.5 to 3.0 mEq/L
Correct Answer: A
Rationale: The therapeutic range for serum lithium is generally 0.6 to 1.2 mEq/L for
maintenance therapy. Lithium has a very narrow therapeutic index, meaning the difference
between a therapeutic and a toxic dose is small. Monitoring blood levels regularly is
essential to ensure safety and efficacy during treatment.
2. The nurse is caring for a patient experiencing a panic attack. Which nursing intervention is
the priority?
A. Stay with the patient and provide a calm, brief explanation of what is happening.
B. Leave the patient alone to provide a quiet environment.
,C. Ask the patient to describe the source of their anxiety in detail.
D. Encourage the patient to perform vigorous exercise to burn off energy.
Correct Answer: A
Rationale: During a panic attack, the nurse’s priority is to stay with the patient to provide
security and safety. Using short, simple sentences is effective because the patient’s ability
to process information is severely diminished. Leaving the patient alone can increase their
fear and lead to injury.
3. A patient is admitted with a diagnosis of Schizophrenia and is exhibiting ‘waxy flexibility.’
How would the nurse document this finding?
A. The patient is moving limbs in a jerky, uncontrollable manner.
B. The patient remains in whatever position they are placed by the nurse.
C. The patient shows extreme resistance to any movement.
D. The patient repeats every word the nurse says.
Correct Answer: B
Rationale: Waxy flexibility is a psychomotor symptom where the patient maintains a fixed
position for long periods. If the nurse moves the patient’s arm, the patient will keep it in
that exact position as if made of wax. This symptom is often associated with catatonic
schizophrenia.
, 4. Which side effect of a typical antipsychotic medication would the nurse immediately report
as a sign of Neuroleptic Malignant Syndrome (NMS)?
A. Dry mouth and blurred vision
B. Mild tremors and shuffling gait
C. Severe muscle rigidity and high fever
D. Weight gain and sedation
Correct Answer: C
Rationale: Neuroleptic Malignant Syndrome is a life-threatening emergency characterized
by muscular rigidity, hyperpyrexia (high fever), and autonomic instability. It is a rare but
serious reaction to dopamine-blocking drugs. Immediate medical intervention is required
to prevent organ failure or death.
5. A patient with Obsessive-Compulsive Disorder (OCD) spends two hours washing their
hands every morning. What is the most appropriate initial nursing intervention?
A. Lock the bathroom door so the patient cannot perform the ritual.
B. Tell the patient that their behavior is irrational and must stop.
C. Give the patient a task to do during the washing ritual to distract them.
D. Allow the patient enough time to complete the ritual initially.
Correct Answer: D
of Mental Health Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A patient with bipolar disorder is prescribed Lithium carbonate. Which serum lithium level
would the nurse identify as within the therapeutic range?
A. 0.6 to 1.2 mEq/L
B. 1.5 to 2.0 mEq/L
C. 0.2 to 0.5 mEq/L
D. 2.5 to 3.0 mEq/L
Correct Answer: A
Rationale: The therapeutic range for serum lithium is generally 0.6 to 1.2 mEq/L for
maintenance therapy. Lithium has a very narrow therapeutic index, meaning the difference
between a therapeutic and a toxic dose is small. Monitoring blood levels regularly is
essential to ensure safety and efficacy during treatment.
2. The nurse is caring for a patient experiencing a panic attack. Which nursing intervention is
the priority?
A. Stay with the patient and provide a calm, brief explanation of what is happening.
B. Leave the patient alone to provide a quiet environment.
,C. Ask the patient to describe the source of their anxiety in detail.
D. Encourage the patient to perform vigorous exercise to burn off energy.
Correct Answer: A
Rationale: During a panic attack, the nurse’s priority is to stay with the patient to provide
security and safety. Using short, simple sentences is effective because the patient’s ability
to process information is severely diminished. Leaving the patient alone can increase their
fear and lead to injury.
3. A patient is admitted with a diagnosis of Schizophrenia and is exhibiting ‘waxy flexibility.’
How would the nurse document this finding?
A. The patient is moving limbs in a jerky, uncontrollable manner.
B. The patient remains in whatever position they are placed by the nurse.
C. The patient shows extreme resistance to any movement.
D. The patient repeats every word the nurse says.
Correct Answer: B
Rationale: Waxy flexibility is a psychomotor symptom where the patient maintains a fixed
position for long periods. If the nurse moves the patient’s arm, the patient will keep it in
that exact position as if made of wax. This symptom is often associated with catatonic
schizophrenia.
, 4. Which side effect of a typical antipsychotic medication would the nurse immediately report
as a sign of Neuroleptic Malignant Syndrome (NMS)?
A. Dry mouth and blurred vision
B. Mild tremors and shuffling gait
C. Severe muscle rigidity and high fever
D. Weight gain and sedation
Correct Answer: C
Rationale: Neuroleptic Malignant Syndrome is a life-threatening emergency characterized
by muscular rigidity, hyperpyrexia (high fever), and autonomic instability. It is a rare but
serious reaction to dopamine-blocking drugs. Immediate medical intervention is required
to prevent organ failure or death.
5. A patient with Obsessive-Compulsive Disorder (OCD) spends two hours washing their
hands every morning. What is the most appropriate initial nursing intervention?
A. Lock the bathroom door so the patient cannot perform the ritual.
B. Tell the patient that their behavior is irrational and must stop.
C. Give the patient a task to do during the washing ritual to distract them.
D. Allow the patient enough time to complete the ritual initially.
Correct Answer: D
