Mental Health Final Exam 2026–2027 | Rasmussen University |
Complete Study Guide & Practice Test | Verified Questions &
Answers
Prepare for the Rasmussen University Mental Health Final Exam with this comprehensive
practice test featuring verified questions, answers, and detailed explanations. This study guide
covers essential mental health nursing concepts including therapeutic communication,
psychiatric assessment, anxiety disorders, mood disorders, schizophrenia spectrum disorders,
substance use disorders, crisis intervention, psychopharmacology, and evidence-based nursing
care. Designed to reinforce key course concepts and improve exam readiness, the material
reflects the competencies and learning objectives commonly assessed throughout the Mental
Health nursing curriculum. Ideal for Rasmussen University nursing students seeking a reliable
resource to strengthen their understanding, build confidence, and achieve success on the final
examination.
1. A nurse is caring for a client who exhibits intense, unstable relationships,
impulsive behavior, and frequent self-harm gestures. The nurse should identify
that these findings are consistent with which of the following personality
disorders?
A. Antisocial personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Narcissistic personality disorder
Answer: B. Borderline personality disorder
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity and recurrent suicidal or self-harming behavior. Antisocial personality
disorder focuses more on disregard for the rights of others. Histrionic involves excessive
emotionality and attention-seeking. Narcissistic involves grandiosity and a lack of
empathy.
2. A nurse is assessing a client experiencing a severe panic attack. Which of the
following nursing interventions is the priority?
A. Teach the client deep-breathing relaxation techniques.
B. Instruct the client to identify their anxiety triggers.
C. Stay with the client and speak in short, simple sentences.
D. Administer a maintenance dose of an antidepressant.
Answer: C. Stay with the client and speak in short, simple sentences.
Rationale: During a severe or panic-level anxiety attack, the client's ability to process
information is severely impaired. The immediate safety and psychological priority is to
stay with the client to ensure safety and use calm, brief communication. Teaching new
coping skills or exploring triggers is impossible until the panic subsides.
, 3. A nurse is admitting a client who has anorexia nervosa. Which of the following
assessment findings should the nurse identify as a criteria for hospitalization?
A. Weight loss of 10% of total body weight
B. Serum potassium level of 2.8 mEq/L
C. Heart rate of 55 beats per minute
D. Blood pressure of 100/60 mm Hg
Answer: B. Serum potassium level of 2.8 mEq/L
Rationale: Severe electrolyte imbalances, such as a potassium level below 3.0 mEq/L,
represent an immediate, life-threatening medical emergency due to the risk of cardiac
arrhythmias. Weight loss greater than 25% to 30% of body weight, a heart rate below 40
bpm, and severe hypotension are typical criteria for admission.
4. A nurse is preparing to administer lithium carbonate to a client with bipolar
disorder. Which of the following laboratory values should the nurse review before
administering the medication?
A. Serum sodium level
B. Arterial blood gases
C. Serum calcium level
D. Total cholesterol
Answer: A. Serum sodium level
Rationale: Lithium is a salt, and its excretion is directly tied to renal function and sodium
levels. Renal tubules reabsorb lithium when sodium levels are low, which can rapidly
lead to toxic accumulation of lithium in the bloodstream.
5. A client diagnosed with schizophrenia states, "The government is tracking my
thoughts using the electrical outlets in my room." Which of the following
responses by the nurse is therapeutic?
A. "No one is tracking you. Electrical outlets only carry power."
B. "I know you believe that is happening, but I do not see any tracking equipment."
C. "Why do you think the government wants to monitor your thoughts?"
D. "Let's move your bed away from the outlets so you feel safer."
Answer: B. "I know you believe that is happening, but I do not see any tracking
equipment."
Rationale: This response validates the client's feelings without reinforcing or validating
the delusion. It presents reality gently. Arguing with the delusion (Option A) builds
defensiveness, asking "why" (Option C) is non-therapeutic, and altering the environment
to avoid the outlets (Option D) validates the false belief.
6. A nurse is monitoring a client who recently started taking haloperidol. The nurse
notes the client is experiencing severe muscle rigidity, a temperature of 103°F
(39.4°C), and diaphoresis. What complication should the nurse suspect?
A. Acute dystonia
B. Tardive dyskinesia
,C. Neuroleptic malignant syndrome (NMS)
D. Agranulocytosis
Answer: C. Neuroleptic malignant syndrome (NMS)
Rationale: NMS is a life-threatening, idiosyncratic reaction to antipsychotic drugs. Major
clinical signs include severe muscle rigidity ("lead-pipe"), hyperpyrexia (high fever),
autonomic instability (diaphoresis, tachycardia), and altered mental status.
7. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the
following medications should the nurse expect to administer to manage acute
withdrawal symptoms?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Naltrexone
Answer: B. Lorazepam
Rationale: Benzodiazepines like lorazepam are the first-line treatment for acute alcohol
withdrawal. They prevent seizures, stabilize vital signs, and reduce tremors by
mimicking the calming effects of alcohol on the central nervous system. Disulfiram and
naltrexone are used for long-term sobriety maintenance.
8. A nurse is completing an admission assessment for a client who has major
depressive disorder. Which of the following clinical findings is the priority for the
nurse to investigate?
A. Insomnia and early morning awakening
B. Anorexia and recent weight loss
C. Poor hygiene and unkempt appearance
D. Statements regarding feelings of worthlessness
Answer: D. Statements regarding feelings of worthlessness
Rationale: While all listed options are classic symptoms of depression, statements of
worthlessness are closely linked to suicidal ideation and intent. The nurse's immediate
priority is assessing safety and determining if the client has a plan to harm themselves.
9. A nurse is teaching a client who has a new prescription for phenelzine, an MAOI
antidepressant. Which of the following foods should the nurse instruct the client
to avoid?
A. Aged cheddar cheese
B. Fresh apples
C. Whole milk
D. Grilled chicken breast
Answer: A. Aged cheddar cheese
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Clients taking MAOIs
must avoid foods high in tyramine, such as aged cheeses, cured meats, and red wine,
to prevent a life-threatening hypertensive crisis.
, 10. A client is admitted following a motor vehicle crash. The client cannot remember
any details surrounding the accident but is otherwise completely oriented. The
nurse should recognize this as which defense mechanism?
A. Suppression
B. Repression
C. Denial
D. Displacement
Answer: B. Repression
Rationale: Repression is an unconscious defense mechanism where the mind blocks
painful, traumatic, or unacceptable thoughts, feelings, or memories from conscious
awareness. Suppression is a conscious, deliberate effort to defer thinking about a
stressor.
11. A nurse is planning care for a client who has obsessive-compulsive disorder
(OCD) and performs handwashing rituals for 45 minutes every morning. Which
action should the nurse take initially?
A. Lock the bathroom door to prevent the client from washing their hands.
B. Give the client a strict 5-minute time limit to complete the ritual.
C. Allow the client enough time in the schedule to complete the ritual.
D. Tell the client their skin will break down if they keep washing.
Answer: C. Allow the client enough time in the schedule to complete the ritual.
Rationale: At the beginning of treatment, attempting to abruptly stop or severely limit a
compulsive ritual will cause the client's anxiety to skyrocket to unmanageable levels.
The nurse should initially allow time for the ritual while gradually working on anxiety
reduction techniques and structured limits later.
12. A nurse is reinforcing teaching with a client who is scheduled for
electroconvulsive therapy (ECT). Which of the following adverse effects should
the nurse include as a common, temporary expectation?
A. Long-term permanent memory loss
B. Immediate, severe visual hallucinations
C. Temporary short-term memory loss and confusion
D. Permanent loss of fine motor skills
Answer: C. Temporary short-term memory loss and confusion
Rationale: The most common side effects observed immediately following ECT are
transient confusion, disorientation, and short-term retrograde memory loss. These
symptoms typically resolve within a few weeks after completing the treatments.
13. A client on an inpatient psychiatric unit tells the nurse, "I am the real President of
the United States, and everyone here is a secret service agent." The nurse
replies, "You are a client here at the hospital, and I am your nurse." What
therapeutic communication technique is the nurse using?
A. Reflecting
B. Presenting reality
Complete Study Guide & Practice Test | Verified Questions &
Answers
Prepare for the Rasmussen University Mental Health Final Exam with this comprehensive
practice test featuring verified questions, answers, and detailed explanations. This study guide
covers essential mental health nursing concepts including therapeutic communication,
psychiatric assessment, anxiety disorders, mood disorders, schizophrenia spectrum disorders,
substance use disorders, crisis intervention, psychopharmacology, and evidence-based nursing
care. Designed to reinforce key course concepts and improve exam readiness, the material
reflects the competencies and learning objectives commonly assessed throughout the Mental
Health nursing curriculum. Ideal for Rasmussen University nursing students seeking a reliable
resource to strengthen their understanding, build confidence, and achieve success on the final
examination.
1. A nurse is caring for a client who exhibits intense, unstable relationships,
impulsive behavior, and frequent self-harm gestures. The nurse should identify
that these findings are consistent with which of the following personality
disorders?
A. Antisocial personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Narcissistic personality disorder
Answer: B. Borderline personality disorder
Rationale: Borderline personality disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity and recurrent suicidal or self-harming behavior. Antisocial personality
disorder focuses more on disregard for the rights of others. Histrionic involves excessive
emotionality and attention-seeking. Narcissistic involves grandiosity and a lack of
empathy.
2. A nurse is assessing a client experiencing a severe panic attack. Which of the
following nursing interventions is the priority?
A. Teach the client deep-breathing relaxation techniques.
B. Instruct the client to identify their anxiety triggers.
C. Stay with the client and speak in short, simple sentences.
D. Administer a maintenance dose of an antidepressant.
Answer: C. Stay with the client and speak in short, simple sentences.
Rationale: During a severe or panic-level anxiety attack, the client's ability to process
information is severely impaired. The immediate safety and psychological priority is to
stay with the client to ensure safety and use calm, brief communication. Teaching new
coping skills or exploring triggers is impossible until the panic subsides.
, 3. A nurse is admitting a client who has anorexia nervosa. Which of the following
assessment findings should the nurse identify as a criteria for hospitalization?
A. Weight loss of 10% of total body weight
B. Serum potassium level of 2.8 mEq/L
C. Heart rate of 55 beats per minute
D. Blood pressure of 100/60 mm Hg
Answer: B. Serum potassium level of 2.8 mEq/L
Rationale: Severe electrolyte imbalances, such as a potassium level below 3.0 mEq/L,
represent an immediate, life-threatening medical emergency due to the risk of cardiac
arrhythmias. Weight loss greater than 25% to 30% of body weight, a heart rate below 40
bpm, and severe hypotension are typical criteria for admission.
4. A nurse is preparing to administer lithium carbonate to a client with bipolar
disorder. Which of the following laboratory values should the nurse review before
administering the medication?
A. Serum sodium level
B. Arterial blood gases
C. Serum calcium level
D. Total cholesterol
Answer: A. Serum sodium level
Rationale: Lithium is a salt, and its excretion is directly tied to renal function and sodium
levels. Renal tubules reabsorb lithium when sodium levels are low, which can rapidly
lead to toxic accumulation of lithium in the bloodstream.
5. A client diagnosed with schizophrenia states, "The government is tracking my
thoughts using the electrical outlets in my room." Which of the following
responses by the nurse is therapeutic?
A. "No one is tracking you. Electrical outlets only carry power."
B. "I know you believe that is happening, but I do not see any tracking equipment."
C. "Why do you think the government wants to monitor your thoughts?"
D. "Let's move your bed away from the outlets so you feel safer."
Answer: B. "I know you believe that is happening, but I do not see any tracking
equipment."
Rationale: This response validates the client's feelings without reinforcing or validating
the delusion. It presents reality gently. Arguing with the delusion (Option A) builds
defensiveness, asking "why" (Option C) is non-therapeutic, and altering the environment
to avoid the outlets (Option D) validates the false belief.
6. A nurse is monitoring a client who recently started taking haloperidol. The nurse
notes the client is experiencing severe muscle rigidity, a temperature of 103°F
(39.4°C), and diaphoresis. What complication should the nurse suspect?
A. Acute dystonia
B. Tardive dyskinesia
,C. Neuroleptic malignant syndrome (NMS)
D. Agranulocytosis
Answer: C. Neuroleptic malignant syndrome (NMS)
Rationale: NMS is a life-threatening, idiosyncratic reaction to antipsychotic drugs. Major
clinical signs include severe muscle rigidity ("lead-pipe"), hyperpyrexia (high fever),
autonomic instability (diaphoresis, tachycardia), and altered mental status.
7. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the
following medications should the nurse expect to administer to manage acute
withdrawal symptoms?
A. Disulfiram
B. Lorazepam
C. Methadone
D. Naltrexone
Answer: B. Lorazepam
Rationale: Benzodiazepines like lorazepam are the first-line treatment for acute alcohol
withdrawal. They prevent seizures, stabilize vital signs, and reduce tremors by
mimicking the calming effects of alcohol on the central nervous system. Disulfiram and
naltrexone are used for long-term sobriety maintenance.
8. A nurse is completing an admission assessment for a client who has major
depressive disorder. Which of the following clinical findings is the priority for the
nurse to investigate?
A. Insomnia and early morning awakening
B. Anorexia and recent weight loss
C. Poor hygiene and unkempt appearance
D. Statements regarding feelings of worthlessness
Answer: D. Statements regarding feelings of worthlessness
Rationale: While all listed options are classic symptoms of depression, statements of
worthlessness are closely linked to suicidal ideation and intent. The nurse's immediate
priority is assessing safety and determining if the client has a plan to harm themselves.
9. A nurse is teaching a client who has a new prescription for phenelzine, an MAOI
antidepressant. Which of the following foods should the nurse instruct the client
to avoid?
A. Aged cheddar cheese
B. Fresh apples
C. Whole milk
D. Grilled chicken breast
Answer: A. Aged cheddar cheese
Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). Clients taking MAOIs
must avoid foods high in tyramine, such as aged cheeses, cured meats, and red wine,
to prevent a life-threatening hypertensive crisis.
, 10. A client is admitted following a motor vehicle crash. The client cannot remember
any details surrounding the accident but is otherwise completely oriented. The
nurse should recognize this as which defense mechanism?
A. Suppression
B. Repression
C. Denial
D. Displacement
Answer: B. Repression
Rationale: Repression is an unconscious defense mechanism where the mind blocks
painful, traumatic, or unacceptable thoughts, feelings, or memories from conscious
awareness. Suppression is a conscious, deliberate effort to defer thinking about a
stressor.
11. A nurse is planning care for a client who has obsessive-compulsive disorder
(OCD) and performs handwashing rituals for 45 minutes every morning. Which
action should the nurse take initially?
A. Lock the bathroom door to prevent the client from washing their hands.
B. Give the client a strict 5-minute time limit to complete the ritual.
C. Allow the client enough time in the schedule to complete the ritual.
D. Tell the client their skin will break down if they keep washing.
Answer: C. Allow the client enough time in the schedule to complete the ritual.
Rationale: At the beginning of treatment, attempting to abruptly stop or severely limit a
compulsive ritual will cause the client's anxiety to skyrocket to unmanageable levels.
The nurse should initially allow time for the ritual while gradually working on anxiety
reduction techniques and structured limits later.
12. A nurse is reinforcing teaching with a client who is scheduled for
electroconvulsive therapy (ECT). Which of the following adverse effects should
the nurse include as a common, temporary expectation?
A. Long-term permanent memory loss
B. Immediate, severe visual hallucinations
C. Temporary short-term memory loss and confusion
D. Permanent loss of fine motor skills
Answer: C. Temporary short-term memory loss and confusion
Rationale: The most common side effects observed immediately following ECT are
transient confusion, disorientation, and short-term retrograde memory loss. These
symptoms typically resolve within a few weeks after completing the treatments.
13. A client on an inpatient psychiatric unit tells the nurse, "I am the real President of
the United States, and everyone here is a secret service agent." The nurse
replies, "You are a client here at the hospital, and I am your nurse." What
therapeutic communication technique is the nurse using?
A. Reflecting
B. Presenting reality
