Mental Health Final Exam 2026–2028 | 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.
Question 1
A nurse is caring for a client who exhibits extreme suspicion, mistrust of others, and
constantly misinterprets benign remarks as malicious threats. The nurse should
recognize these behaviors as characteristic of which personality disorder?
A. Schizoid personality disorder
B. Paranoid personality disorder
C. Histrionic personality disorder
D. Antisocial personality disorder
Answer: B. Paranoid personality disorder
Rationale: Paranoid personality disorder is characterized by a pervasive, unwarranted
distrust and suspiciousness of others. Clients view the actions of others as deliberately
threatening or demeaning. Schizoid personality disorder involves social detachment and
restricted emotional expression. Histrionic personality disorder involves attention-
seeking behavior and excessive emotionality. Antisocial personality disorder involves a
disregard for, and violation of, the rights of others.
Question 2
,A nurse is assessing a client who has a lithium level of 1.8 mEq/L. Which of the
following findings should the nurse expect?
A. Deep sleep and increased appetite
B. Fine hand tremors and mild thirst
C. Constipation and urinary retention
D. Coarse hand tremors, vomiting, and diarrhea
Answer: D. Coarse hand tremors, vomiting, and diarrhea
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates moderate lithium toxicity. Symptoms of early to moderate toxicity include
coarse hand tremors, persistent gastrointestinal upset (vomiting, severe diarrhea),
blurred vision, and ataxia. Fine hand tremors and mild thirst are common, expected side
effects within the therapeutic range.
Question 3
A client is admitted to the psychiatric unit with a diagnosis of severe major depressive
disorder. Which of the following is the highest priority nursing intervention during the
initial 24 hours of admission?
A. Encouraging the client to attend group therapy sessions
B. Implementing a continuous, one-on-one safety observation protocol
C. Assisting the client to complete their daily hygiene routine
D. Teaching the client about the onset of antidepressant medications
Answer: B. Implementing a continuous, one-on-one safety observation protocol
Rationale: According to Maslow's Hierarchy of Needs and the nursing process, client
safety is always the highest priority. A client with severe major depressive disorder is at
a significantly high risk for suicide and self-harm. Implementing one-on-one safety
observation directly addresses the risk of suicide before focusing on secondary
psychosocial goals like group therapy or medication education.
Question 4
A nurse is caring for a client who is prescribed phenelzine, a monoamine oxidase
inhibitor (MAOI). Which of the following food choices chosen by the client indicates a
need for further teaching?
A. Fresh grilled chicken breast with white rice
B. Pepperoni pizza and a glass of red wine
,C. Scrambled eggs with sliced avocados
D. Oatmeal topped with fresh blueberries
Answer: B. Pepperoni pizza and a glass of red wine
Rationale: Phenelzine is an MAOI. Clients taking MAOIs must strictly avoid foods
containing high amounts of tyramine, such as aged cheeses (found on pepperoni
pizza), cured or processed meats (pepperoni), and red wine. Consuming tyramine while
on an MAOI can precipitate a severe, life-threatening hypertensive crisis. Fresh meats,
poultry, eggs, and most fresh fruits are safe.
Question 5
A client on an inpatient unit approaches the nurse's station shouting, "No one cares
about me! This whole place is a prison and you are all terrible!" Which of the following is
an example of a therapeutic communication response?
A. "Why do you feel the need to shout at us like that?"
B. "If you do not calm down right now, I will call security."
C. "It sounds like you are feeling incredibly frustrated and lonely right now."
D. "We are only trying to help you, so please do not say we are terrible."
Answer: C. "It sounds like you are feeling incredibly frustrated and lonely right
now."
Rationale: This response uses the therapeutic communication technique of reflecting
and validating the client's underlying feelings. It avoids being defensive or punitive.
Asking "why" is non-therapeutic and provokes defensiveness. Threatening security or
becoming defensive blocks further productive communication.
Question 6
A nurse is admitting an older adult client who lost his spouse of 50 years three months
ago. The client states, "I just can't seem to find any purpose in life anymore. I don't see
why I should keep going." According to Erikson's stages of development, which crisis is
this client experiencing?
A. Generativity vs. Stagnation
B. Identity vs. Role Confusion
C. Intimacy vs. Isolation
D. Integrity vs. Despair
, Answer: D. Integrity vs. Despair
Rationale: This client is an older adult experiencing Erikson's developmental stage of
Integrity vs. Despair. During late adulthood, individuals look back on their lives and
attempt to find meaning and fulfillment. Facing the loss of a spouse and feeling a lack of
purpose reflects a struggle with despair. Generativity vs. Stagnation occurs in middle
adulthood.
Question 7
A nurse is caring for a client with schizophrenia who states, "The government has
implanted a microchip in my tooth to broadcast my thoughts to the news." How should
the nurse respond?
A. "That is impossible; the government does not have that kind of technology."
B. "I understand that you believe that is happening, but I do not see any evidence of a
chip."
C. "Why do you think the government is choosing to target you specifically?"
D. "Let's look closely at your tooth in the mirror to prove to you it isn't there."
Answer: B. "I understand that you believe that is happening, but I do not see any
evidence of a chip."
Rationale: When communicating with a client experiencing a delusion, the nurse should
validate the client's feelings without reinforcing the false belief or directly arguing with it.
Proposing reality-testing or presenting a neutral disagreement ("I do not see any
evidence") helps anchor the client without escalating agitation. Arguing, challenging, or
asking "why" will strengthen the delusion.
Question 8
A client experiencing a panic attack is hyperventilating, sweating, and pacing rapidly
around the room. Which action should the nurse take first?
A. Administer a scheduled daily dose of an SSRI antidepressant
B. Escort the client to a large, crowded dayroom to distract them
C. Instruct the client to sit down and guide them through deep, slow breaths
D. Leave the client alone for a few minutes so they can calm down in private
Answer: C. Instruct the client to sit down and guide them through deep, slow
breaths
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.
Question 1
A nurse is caring for a client who exhibits extreme suspicion, mistrust of others, and
constantly misinterprets benign remarks as malicious threats. The nurse should
recognize these behaviors as characteristic of which personality disorder?
A. Schizoid personality disorder
B. Paranoid personality disorder
C. Histrionic personality disorder
D. Antisocial personality disorder
Answer: B. Paranoid personality disorder
Rationale: Paranoid personality disorder is characterized by a pervasive, unwarranted
distrust and suspiciousness of others. Clients view the actions of others as deliberately
threatening or demeaning. Schizoid personality disorder involves social detachment and
restricted emotional expression. Histrionic personality disorder involves attention-
seeking behavior and excessive emotionality. Antisocial personality disorder involves a
disregard for, and violation of, the rights of others.
Question 2
,A nurse is assessing a client who has a lithium level of 1.8 mEq/L. Which of the
following findings should the nurse expect?
A. Deep sleep and increased appetite
B. Fine hand tremors and mild thirst
C. Constipation and urinary retention
D. Coarse hand tremors, vomiting, and diarrhea
Answer: D. Coarse hand tremors, vomiting, and diarrhea
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L
indicates moderate lithium toxicity. Symptoms of early to moderate toxicity include
coarse hand tremors, persistent gastrointestinal upset (vomiting, severe diarrhea),
blurred vision, and ataxia. Fine hand tremors and mild thirst are common, expected side
effects within the therapeutic range.
Question 3
A client is admitted to the psychiatric unit with a diagnosis of severe major depressive
disorder. Which of the following is the highest priority nursing intervention during the
initial 24 hours of admission?
A. Encouraging the client to attend group therapy sessions
B. Implementing a continuous, one-on-one safety observation protocol
C. Assisting the client to complete their daily hygiene routine
D. Teaching the client about the onset of antidepressant medications
Answer: B. Implementing a continuous, one-on-one safety observation protocol
Rationale: According to Maslow's Hierarchy of Needs and the nursing process, client
safety is always the highest priority. A client with severe major depressive disorder is at
a significantly high risk for suicide and self-harm. Implementing one-on-one safety
observation directly addresses the risk of suicide before focusing on secondary
psychosocial goals like group therapy or medication education.
Question 4
A nurse is caring for a client who is prescribed phenelzine, a monoamine oxidase
inhibitor (MAOI). Which of the following food choices chosen by the client indicates a
need for further teaching?
A. Fresh grilled chicken breast with white rice
B. Pepperoni pizza and a glass of red wine
,C. Scrambled eggs with sliced avocados
D. Oatmeal topped with fresh blueberries
Answer: B. Pepperoni pizza and a glass of red wine
Rationale: Phenelzine is an MAOI. Clients taking MAOIs must strictly avoid foods
containing high amounts of tyramine, such as aged cheeses (found on pepperoni
pizza), cured or processed meats (pepperoni), and red wine. Consuming tyramine while
on an MAOI can precipitate a severe, life-threatening hypertensive crisis. Fresh meats,
poultry, eggs, and most fresh fruits are safe.
Question 5
A client on an inpatient unit approaches the nurse's station shouting, "No one cares
about me! This whole place is a prison and you are all terrible!" Which of the following is
an example of a therapeutic communication response?
A. "Why do you feel the need to shout at us like that?"
B. "If you do not calm down right now, I will call security."
C. "It sounds like you are feeling incredibly frustrated and lonely right now."
D. "We are only trying to help you, so please do not say we are terrible."
Answer: C. "It sounds like you are feeling incredibly frustrated and lonely right
now."
Rationale: This response uses the therapeutic communication technique of reflecting
and validating the client's underlying feelings. It avoids being defensive or punitive.
Asking "why" is non-therapeutic and provokes defensiveness. Threatening security or
becoming defensive blocks further productive communication.
Question 6
A nurse is admitting an older adult client who lost his spouse of 50 years three months
ago. The client states, "I just can't seem to find any purpose in life anymore. I don't see
why I should keep going." According to Erikson's stages of development, which crisis is
this client experiencing?
A. Generativity vs. Stagnation
B. Identity vs. Role Confusion
C. Intimacy vs. Isolation
D. Integrity vs. Despair
, Answer: D. Integrity vs. Despair
Rationale: This client is an older adult experiencing Erikson's developmental stage of
Integrity vs. Despair. During late adulthood, individuals look back on their lives and
attempt to find meaning and fulfillment. Facing the loss of a spouse and feeling a lack of
purpose reflects a struggle with despair. Generativity vs. Stagnation occurs in middle
adulthood.
Question 7
A nurse is caring for a client with schizophrenia who states, "The government has
implanted a microchip in my tooth to broadcast my thoughts to the news." How should
the nurse respond?
A. "That is impossible; the government does not have that kind of technology."
B. "I understand that you believe that is happening, but I do not see any evidence of a
chip."
C. "Why do you think the government is choosing to target you specifically?"
D. "Let's look closely at your tooth in the mirror to prove to you it isn't there."
Answer: B. "I understand that you believe that is happening, but I do not see any
evidence of a chip."
Rationale: When communicating with a client experiencing a delusion, the nurse should
validate the client's feelings without reinforcing the false belief or directly arguing with it.
Proposing reality-testing or presenting a neutral disagreement ("I do not see any
evidence") helps anchor the client without escalating agitation. Arguing, challenging, or
asking "why" will strengthen the delusion.
Question 8
A client experiencing a panic attack is hyperventilating, sweating, and pacing rapidly
around the room. Which action should the nurse take first?
A. Administer a scheduled daily dose of an SSRI antidepressant
B. Escort the client to a large, crowded dayroom to distract them
C. Instruct the client to sit down and guide them through deep, slow breaths
D. Leave the client alone for a few minutes so they can calm down in private
Answer: C. Instruct the client to sit down and guide them through deep, slow
breaths
