NUR180/NUR 180 Exam 2 V2 | Concepts of
Mental Health Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for a patient experiencing a panic attack. Which intervention should the
nurse prioritize first?
A. Teach the patient deep breathing exercises.
B. Stay with the patient and provide a calm presence.
C. Administer an ordered PRN antidepressant.
D. Ask the patient to explain what triggered the attack.
Correct Answer: B
Rationale: Safety and a sense of security are the primary nursing priorities during a panic
attack. Staying with the patient reduces the fear of being alone and ensures the nurse can
monitor vital signs and safety. Teaching new coping skills like deep breathing is not
effective until the acute anxiety level has decreased.
2. A patient with obsessive-compulsive disorder (OCD) is late for breakfast because of a
ritualistic hand-washing routine. How should the nurse respond?
A. Block the patient from the sink to ensure they eat on time.
B. Tell the patient that their hand-washing is irrational.
,C. Inform the patient that they will lose their breakfast privilege.
D. Provide the patient extra time at the beginning of the day for rituals.
Correct Answer: D
Rationale: Initially, the nurse should allow the patient time to perform rituals to prevent
overwhelming anxiety. Forcing a patient to stop a ritual abruptly can lead to panic and a
breakdown in the therapeutic relationship. Over time, the treatment plan will include
gradually limiting the time spent on rituals while introducing new coping mechanisms.
3. A nurse is monitoring a patient who began taking Lithium carbonate for bipolar disorder
one week ago. Which finding is the most critical to report?
A. Fine hand tremors and mild thirst.
B. Persistent diarrhea and muscle weakness.
C. Polyuria and a metallic taste in the mouth.
D. Weight gain of 2 pounds in one week.
Correct Answer: B
Rationale: Persistent diarrhea, vomiting, and muscle weakness are early signs of lithium
toxicity. These symptoms indicate that the lithium level may be exceeding the therapeutic
range of 0.6 to 1.2 mEq/L. The nurse must recognize these signs early to prevent more
severe neurological complications or renal failure.
, 4. A patient diagnosed with schizophrenia says, ‘The government is tracking my thoughts
through the television.’ Which response by the nurse is therapeutic?
A. ‘The government does not have the technology to do that.’
B. ‘Why would the government want to track your thoughts?’
C. ‘That sounds very frightening for you to believe.’
D. ‘I believe you, tell me more about how they are doing it.’
Correct Answer: C
Rationale: The nurse should acknowledge the patient’s feelings without validating the
delusion. By saying ‘That sounds frightening,’ the nurse focuses on the emotional
experience of the patient. Directly challenging the delusion or ‘playing along’ with it are
both non-therapeutic and can hinder the recovery process.
5. A patient in the manic phase of bipolar disorder is pacing the halls and speaking loudly.
What is the best snack to offer this patient?
A. A bowl of vegetable soup.
B. A container of chocolate pudding.
C. A chicken wrap or finger foods.
D. A steak and potato dinner.
Correct Answer: C
Mental Health Nursing for the Practical
Nurse Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for a patient experiencing a panic attack. Which intervention should the
nurse prioritize first?
A. Teach the patient deep breathing exercises.
B. Stay with the patient and provide a calm presence.
C. Administer an ordered PRN antidepressant.
D. Ask the patient to explain what triggered the attack.
Correct Answer: B
Rationale: Safety and a sense of security are the primary nursing priorities during a panic
attack. Staying with the patient reduces the fear of being alone and ensures the nurse can
monitor vital signs and safety. Teaching new coping skills like deep breathing is not
effective until the acute anxiety level has decreased.
2. A patient with obsessive-compulsive disorder (OCD) is late for breakfast because of a
ritualistic hand-washing routine. How should the nurse respond?
A. Block the patient from the sink to ensure they eat on time.
B. Tell the patient that their hand-washing is irrational.
,C. Inform the patient that they will lose their breakfast privilege.
D. Provide the patient extra time at the beginning of the day for rituals.
Correct Answer: D
Rationale: Initially, the nurse should allow the patient time to perform rituals to prevent
overwhelming anxiety. Forcing a patient to stop a ritual abruptly can lead to panic and a
breakdown in the therapeutic relationship. Over time, the treatment plan will include
gradually limiting the time spent on rituals while introducing new coping mechanisms.
3. A nurse is monitoring a patient who began taking Lithium carbonate for bipolar disorder
one week ago. Which finding is the most critical to report?
A. Fine hand tremors and mild thirst.
B. Persistent diarrhea and muscle weakness.
C. Polyuria and a metallic taste in the mouth.
D. Weight gain of 2 pounds in one week.
Correct Answer: B
Rationale: Persistent diarrhea, vomiting, and muscle weakness are early signs of lithium
toxicity. These symptoms indicate that the lithium level may be exceeding the therapeutic
range of 0.6 to 1.2 mEq/L. The nurse must recognize these signs early to prevent more
severe neurological complications or renal failure.
, 4. A patient diagnosed with schizophrenia says, ‘The government is tracking my thoughts
through the television.’ Which response by the nurse is therapeutic?
A. ‘The government does not have the technology to do that.’
B. ‘Why would the government want to track your thoughts?’
C. ‘That sounds very frightening for you to believe.’
D. ‘I believe you, tell me more about how they are doing it.’
Correct Answer: C
Rationale: The nurse should acknowledge the patient’s feelings without validating the
delusion. By saying ‘That sounds frightening,’ the nurse focuses on the emotional
experience of the patient. Directly challenging the delusion or ‘playing along’ with it are
both non-therapeutic and can hinder the recovery process.
5. A patient in the manic phase of bipolar disorder is pacing the halls and speaking loudly.
What is the best snack to offer this patient?
A. A bowl of vegetable soup.
B. A container of chocolate pudding.
C. A chicken wrap or finger foods.
D. A steak and potato dinner.
Correct Answer: C
