RASMUSSEN MENTAL HEALTH EXAM 2 ACTUAL EXAM
2026/2027 | Latest Version | Complete Solution | Verified
Questions and Answers | Pass Guaranteed - A+ Graded
Section 1: Mood Disorders and Suicide (15 Questions)
Q1: A 28-year-old client is admitted to the inpatient psychiatric unit with a diagnosis of
major depressive disorder (MDD). The client has been taking sertraline 100mg daily for
6 weeks but reports continued depressed mood, anhedonia, and passive suicidal
ideation without plan. The client mentions "feeling more energetic" over the past 3 days
but still hopeless. Which nursing intervention is the PRIORITY?
A. Encourage increased participation in group therapy activities to boost mood
B. Implement suicide precautions and conduct a thorough reassessment of suicide risk
[CORRECT]
C. Contact the provider to request an immediate increase in sertraline dosage
D. Document the energy improvement as a positive response to antidepressant therapy
Correct Answer: B
Rationale: The emergence of energy alongside persistent hopelessness represents the
highest-risk period for suicide in depression treatment. This pattern indicates the client
may have increased physical capacity to act on suicidal thoughts while cognitive
symptoms (hopelessness) remain unchanged—a dangerous combination often
preceding suicide attempts. Antidepressants can increase energy before mood
improves, creating this vulnerability window. Priority nursing action is immediate suicide
precautions (1:1 or q15min checks, removal of means) and comprehensive
reassessment of ideation, plan, intent, and means. Option A is premature and potentially
dangerous without safety assessment. Option C requires provider notification but safety
,takes precedence over medication adjustment. Option D misinterprets the clinical
picture—energy without mood improvement is a warning sign, not treatment success.
Nurses must recognize that suicide risk often increases during the first weeks of
antidepressant treatment when psychomotor retardation lifts before mood stabilizes.
Q2: A client with bipolar I disorder, currently manic, is pacing the unit hallway, speaking
rapidly about starting a business empire, and has not slept in 48 hours. The client
becomes irritable when offered PRN haloperidol. Which therapeutic communication
response is MOST appropriate?
A. "You need to take this medication so you can calm down and get some sleep."
B. "I understand you have big plans. Let's discuss how rest might help you organize
those thoughts effectively." [CORRECT]
C. "Your behavior is disruptive to other clients. Please take the medication."
D. "If you don't take this medication, I'll have to call security."
Correct Answer: B
Rationale: This response validates the client's experience (reducing defensiveness)
while redirecting toward the therapeutic goal (rest/sleep) without power struggle. Manic
clients have impaired insight and grandiosity—confrontation (A, C, D) increases
agitation and potential violence. The nursing approach for acute mania uses calm,
simple, non-confrontational communication that acknowledges the client's feelings
while setting boundaries indirectly. Sleep deprivation exacerbates mania, making rest a
priority, but forcing medication creates resistance. Option B uses the technique of
"rolling with resistance"—joining with the client's goal (business success) to frame rest
as helpful to that goal rather than opposing it. Options A, C, and D use authoritarian or
confrontational approaches that escalate manic agitation and damage therapeutic
alliance.
,Q3: Which of the following are evidence-based nursing interventions for a client
admitted with severe major depressive disorder with psychotic features? (Select all that
apply)
A. Place the client in a private room with minimal stimulation to prevent sensory
overload
B. Assess and document psychotic symptoms, including delusions and hallucinations
[CORRECT]
C. Administer prescribed antipsychotic medication and monitor for side effects
[CORRECT]
D. Use simple, concrete communication and validate the client's emotional experience
[CORRECT]
E. Challenge delusional beliefs to help the client regain reality orientation
F. Encourage immediate participation in complex group activities to distract from
psychosis
Correct Answer: B, C, D
Rationale: For depression with psychotic features, nursing care addresses both mood
and psychosis. Assessment of psychotic symptoms (B) establishes baseline and
monitors treatment response. Antipsychotic administration (C) is essential—psychotic
depression requires combination therapy (antidepressant + antipsychotic or ECT).
Simple, concrete communication (D) accommodates cognitive impairment from
depression and psychosis while validation builds rapport. Private rooms with minimal
stimulation (A) are inappropriate—depressed clients need social engagement and
structured activity, not isolation. Challenging delusions (E) is non-therapeutic; instead,
nurses should neither confirm nor deny delusions but focus on emotional content ("That
sounds frightening"). Complex activities (F) overwhelm cognitively impaired clients. The
combination of pharmacologic management and supportive, structured psychosocial
care optimizes outcomes for psychotic depression.
, Q4: A client with treatment-resistant depression is scheduled for electroconvulsive
therapy (ECT). Which pre-procedure nursing intervention is ESSENTIAL?
A. Ensure the client has been NPO for 8 hours prior to the procedure [CORRECT]
B. Administer a benzodiazepine to reduce pre-procedure anxiety
C. Instruct the client to continue all antidepressant medications until after ECT
D. Apply restraints to the client before transport to the treatment room
Correct Answer: A
Rationale: NPO status (A) is mandatory for ECT due to general anesthesia
administration—aspiration risk is the primary safety concern. Clients must be NPO for
6-8 hours (solids) and 2 hours (clear liquids) prior. Benzodiazepines (B) are typically
held before ECT as they increase seizure threshold and reduce treatment efficacy.
Antidepressants (C) are often tapered or held prior to ECT depending on protocol and
medication type (MAOIs require specific timing). Restraints (D) are unnecessary and
inappropriate—ECT involves anesthesia and muscle relaxants; physical restraints are
not part of standard care. Essential nursing responsibilities include NPO verification,
medication reconciliation (holding medications affecting seizure threshold),
pre-procedure assessment, and post-procedure monitoring for confusion, headache,
and memory effects.
Q5: A 19-year-old college student is brought to the emergency department by campus
security after being found on the roof of a dormitory stating "I can fly." The student has
not slept in 72 hours, has spent $3,000 on artwork in 2 days, and believes they are the
chosen one to solve world hunger. Which medication would the provider MOST likely
prescribe for acute management?
A. Lithium carbonate
B. Valproic acid
C. Aripiprazole [CORRECT]
2026/2027 | Latest Version | Complete Solution | Verified
Questions and Answers | Pass Guaranteed - A+ Graded
Section 1: Mood Disorders and Suicide (15 Questions)
Q1: A 28-year-old client is admitted to the inpatient psychiatric unit with a diagnosis of
major depressive disorder (MDD). The client has been taking sertraline 100mg daily for
6 weeks but reports continued depressed mood, anhedonia, and passive suicidal
ideation without plan. The client mentions "feeling more energetic" over the past 3 days
but still hopeless. Which nursing intervention is the PRIORITY?
A. Encourage increased participation in group therapy activities to boost mood
B. Implement suicide precautions and conduct a thorough reassessment of suicide risk
[CORRECT]
C. Contact the provider to request an immediate increase in sertraline dosage
D. Document the energy improvement as a positive response to antidepressant therapy
Correct Answer: B
Rationale: The emergence of energy alongside persistent hopelessness represents the
highest-risk period for suicide in depression treatment. This pattern indicates the client
may have increased physical capacity to act on suicidal thoughts while cognitive
symptoms (hopelessness) remain unchanged—a dangerous combination often
preceding suicide attempts. Antidepressants can increase energy before mood
improves, creating this vulnerability window. Priority nursing action is immediate suicide
precautions (1:1 or q15min checks, removal of means) and comprehensive
reassessment of ideation, plan, intent, and means. Option A is premature and potentially
dangerous without safety assessment. Option C requires provider notification but safety
,takes precedence over medication adjustment. Option D misinterprets the clinical
picture—energy without mood improvement is a warning sign, not treatment success.
Nurses must recognize that suicide risk often increases during the first weeks of
antidepressant treatment when psychomotor retardation lifts before mood stabilizes.
Q2: A client with bipolar I disorder, currently manic, is pacing the unit hallway, speaking
rapidly about starting a business empire, and has not slept in 48 hours. The client
becomes irritable when offered PRN haloperidol. Which therapeutic communication
response is MOST appropriate?
A. "You need to take this medication so you can calm down and get some sleep."
B. "I understand you have big plans. Let's discuss how rest might help you organize
those thoughts effectively." [CORRECT]
C. "Your behavior is disruptive to other clients. Please take the medication."
D. "If you don't take this medication, I'll have to call security."
Correct Answer: B
Rationale: This response validates the client's experience (reducing defensiveness)
while redirecting toward the therapeutic goal (rest/sleep) without power struggle. Manic
clients have impaired insight and grandiosity—confrontation (A, C, D) increases
agitation and potential violence. The nursing approach for acute mania uses calm,
simple, non-confrontational communication that acknowledges the client's feelings
while setting boundaries indirectly. Sleep deprivation exacerbates mania, making rest a
priority, but forcing medication creates resistance. Option B uses the technique of
"rolling with resistance"—joining with the client's goal (business success) to frame rest
as helpful to that goal rather than opposing it. Options A, C, and D use authoritarian or
confrontational approaches that escalate manic agitation and damage therapeutic
alliance.
,Q3: Which of the following are evidence-based nursing interventions for a client
admitted with severe major depressive disorder with psychotic features? (Select all that
apply)
A. Place the client in a private room with minimal stimulation to prevent sensory
overload
B. Assess and document psychotic symptoms, including delusions and hallucinations
[CORRECT]
C. Administer prescribed antipsychotic medication and monitor for side effects
[CORRECT]
D. Use simple, concrete communication and validate the client's emotional experience
[CORRECT]
E. Challenge delusional beliefs to help the client regain reality orientation
F. Encourage immediate participation in complex group activities to distract from
psychosis
Correct Answer: B, C, D
Rationale: For depression with psychotic features, nursing care addresses both mood
and psychosis. Assessment of psychotic symptoms (B) establishes baseline and
monitors treatment response. Antipsychotic administration (C) is essential—psychotic
depression requires combination therapy (antidepressant + antipsychotic or ECT).
Simple, concrete communication (D) accommodates cognitive impairment from
depression and psychosis while validation builds rapport. Private rooms with minimal
stimulation (A) are inappropriate—depressed clients need social engagement and
structured activity, not isolation. Challenging delusions (E) is non-therapeutic; instead,
nurses should neither confirm nor deny delusions but focus on emotional content ("That
sounds frightening"). Complex activities (F) overwhelm cognitively impaired clients. The
combination of pharmacologic management and supportive, structured psychosocial
care optimizes outcomes for psychotic depression.
, Q4: A client with treatment-resistant depression is scheduled for electroconvulsive
therapy (ECT). Which pre-procedure nursing intervention is ESSENTIAL?
A. Ensure the client has been NPO for 8 hours prior to the procedure [CORRECT]
B. Administer a benzodiazepine to reduce pre-procedure anxiety
C. Instruct the client to continue all antidepressant medications until after ECT
D. Apply restraints to the client before transport to the treatment room
Correct Answer: A
Rationale: NPO status (A) is mandatory for ECT due to general anesthesia
administration—aspiration risk is the primary safety concern. Clients must be NPO for
6-8 hours (solids) and 2 hours (clear liquids) prior. Benzodiazepines (B) are typically
held before ECT as they increase seizure threshold and reduce treatment efficacy.
Antidepressants (C) are often tapered or held prior to ECT depending on protocol and
medication type (MAOIs require specific timing). Restraints (D) are unnecessary and
inappropriate—ECT involves anesthesia and muscle relaxants; physical restraints are
not part of standard care. Essential nursing responsibilities include NPO verification,
medication reconciliation (holding medications affecting seizure threshold),
pre-procedure assessment, and post-procedure monitoring for confusion, headache,
and memory effects.
Q5: A 19-year-old college student is brought to the emergency department by campus
security after being found on the roof of a dormitory stating "I can fly." The student has
not slept in 72 hours, has spent $3,000 on artwork in 2 days, and believes they are the
chosen one to solve world hunger. Which medication would the provider MOST likely
prescribe for acute management?
A. Lithium carbonate
B. Valproic acid
C. Aripiprazole [CORRECT]
