NR 326 Mental Health Nursing Final Exam Practice 2026 |Chamberlain
College
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most therapeutic response?
A. “The voices are not real; you should try to ignore them.”
B. “Why do you think the voices are talking to you right now?”
C. “I don’t hear the voices, but I understand they are real to you.”
D. “What are the voices telling you to do?”
Answer: C
Rationale: Acknowledging the client’s experience without validating the hallucination as
reality is therapeutic and builds trust.
2. Which laboratory value must be monitored closely for a client prescribed
Clozapine?
A. Platelet count
B. White blood cell (WBC) count
C. Serum potassium
D. Blood urea nitrogen (BUN)
Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular monitoring of the
absolute neutrophil count and WBC.
,3. A client is admitted for Lithium toxicity. Which serum lithium level would the
nurse expect to see?
A. 0.8 mEq/L
B. 1.2 mEq/L
C. 2.1 mEq/L
D. 0.4 mEq/L
Answer: C
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L
are considered toxic.
4. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is
commonly expected?
A. Hypertension
B. Tachycardia
C. Hyperthermia
D. Lanugo
Answer: D
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for heat loss in clients
with severe malnutrition.
5. A client is experiencing a panic attack. What is the priority nursing
intervention?
A. Teach the client new coping skills.
B. Stay with the client and remain calm.
C. Leave the client alone to reduce stimulation.
D. Ask the client to explain what triggered the attack.
Answer: B
Rationale: During a panic attack, the priority is safety and reducing anxiety by providing a
calm, supportive presence.
, 6. Which defense mechanism is a client using when they redirect their anger at
their boss toward their spouse?
A. Sublimation
B. Displacement
C. Rationalization
D. Projection
Answer: B
Rationale: Displacement involves transferring emotions from a stressful situation to a less
threatening substitute.
7. A client with Bipolar Disorder is in a manic phase. Which meal is most
appropriate?
A. Spaghetti and meatballs
B. Soup and crackers
C. Chicken nuggets and an apple
D. Steak and a baked potato
Answer: C
Rationale: Clients in mania need high-calorie ‘finger foods’ that they can eat while moving
to maintain nutrition.
8. What is the primary goal of Milieu Therapy?
A. To provide one-on-one intensive psychotherapy.
B. To ensure the client remains sedated throughout the day.
C. To focus solely on pharmacological interventions.
D. To provide a structured, safe, and therapeutic environment.
Answer: D
Rationale: Milieu therapy manipulates the environment so that all aspects of the client’s
hospital experience are therapeutic.
College
1. A nurse is caring for a client with schizophrenia who is experiencing auditory
hallucinations. Which is the most therapeutic response?
A. “The voices are not real; you should try to ignore them.”
B. “Why do you think the voices are talking to you right now?”
C. “I don’t hear the voices, but I understand they are real to you.”
D. “What are the voices telling you to do?”
Answer: C
Rationale: Acknowledging the client’s experience without validating the hallucination as
reality is therapeutic and builds trust.
2. Which laboratory value must be monitored closely for a client prescribed
Clozapine?
A. Platelet count
B. White blood cell (WBC) count
C. Serum potassium
D. Blood urea nitrogen (BUN)
Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular monitoring of the
absolute neutrophil count and WBC.
,3. A client is admitted for Lithium toxicity. Which serum lithium level would the
nurse expect to see?
A. 0.8 mEq/L
B. 1.2 mEq/L
C. 2.1 mEq/L
D. 0.4 mEq/L
Answer: C
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L
are considered toxic.
4. A nurse is assessing a client with Anorexia Nervosa. Which physical finding is
commonly expected?
A. Hypertension
B. Tachycardia
C. Hyperthermia
D. Lanugo
Answer: D
Rationale: Lanugo (fine, downy hair) is a compensatory mechanism for heat loss in clients
with severe malnutrition.
5. A client is experiencing a panic attack. What is the priority nursing
intervention?
A. Teach the client new coping skills.
B. Stay with the client and remain calm.
C. Leave the client alone to reduce stimulation.
D. Ask the client to explain what triggered the attack.
Answer: B
Rationale: During a panic attack, the priority is safety and reducing anxiety by providing a
calm, supportive presence.
, 6. Which defense mechanism is a client using when they redirect their anger at
their boss toward their spouse?
A. Sublimation
B. Displacement
C. Rationalization
D. Projection
Answer: B
Rationale: Displacement involves transferring emotions from a stressful situation to a less
threatening substitute.
7. A client with Bipolar Disorder is in a manic phase. Which meal is most
appropriate?
A. Spaghetti and meatballs
B. Soup and crackers
C. Chicken nuggets and an apple
D. Steak and a baked potato
Answer: C
Rationale: Clients in mania need high-calorie ‘finger foods’ that they can eat while moving
to maintain nutrition.
8. What is the primary goal of Milieu Therapy?
A. To provide one-on-one intensive psychotherapy.
B. To ensure the client remains sedated throughout the day.
C. To focus solely on pharmacological interventions.
D. To provide a structured, safe, and therapeutic environment.
Answer: D
Rationale: Milieu therapy manipulates the environment so that all aspects of the client’s
hospital experience are therapeutic.
