NURS 222: Mental Health/Psychiatric Nursing Comprehensive Exam
2026 |WCU
1. A nurse is caring for a client who is experiencing a crisis. Which of the
following actions should the nurse prioritize during the initial assessment?
A. Identifying the client’s previous coping mechanisms
B. Exploring the client’s childhood developmental stages
C. Assessing the client’s potential for self-harm or violence
D. Teaching the client relaxation techniques
Answer: C
Rationale: Safety is the priority in crisis intervention. Assessing for suicidal or homicidal
ideation is the first step before moving to coping mechanisms or therapy.
2. A client is prescribed Clozapine for treatment-resistant schizophrenia. Which
laboratory value is most critical for the nurse to monitor?
A. Serum potassium levels
B. White blood cell (WBC) count
C. Blood urea nitrogen (BUN)
D. Serum creatinine
Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, a potentially fatal drop in WBC
count. Weekly or bi-weekly monitoring of the absolute neutrophil count (ANC) is
mandatory.
,3. According to Peplau’s theory of interpersonal relations, in which phase does
the nurse help the client identify problems and set goals?
A. Working phase
B. Orientation phase
C. Termination phase
D. Identification phase
Answer: B
Rationale: The orientation phase involves defining the problem, establishing trust, and
setting the parameters of the relationship and goals.
4. A client experiencing a manic episode is pacing the halls and speaking rapidly.
Which of the following nursing interventions is most appropriate?
A. Encourage the client to join a group therapy session
B. Provide the client with high-calorie ‘finger foods’
C. Ask the client to sit still and explain their feelings
D. Administer a sedative immediately
Answer: B
Rationale: Clients in a manic state often cannot sit still for meals. High-calorie finger foods
allow them to maintain nutrition while remaining active.
5. Which legal principle applies when a nurse provides a client with information
about their right to refuse treatment?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the client’s right to make their own decisions about their
medical care, including the right to refuse medication or treatment.
, 6. A client is admitted involuntarily to a psychiatric unit. Which of the following
rights does the client retain?
A. The right to refuse psychotropic medications
B. The right to leave the hospital at any time
C. The right to carry personal weapons
D. The right to bypass all hospital safety searches
Answer: A
Rationale: Involuntary admission does not automatically waive the right to refuse
treatment, including medications, unless there is a court order or an immediate emergency.
7. A nurse is caring for a client who is taking Phenelzine (an MAOI). Which food
choice indicates the client needs further teaching?
A. Grilled chicken and steamed broccoli
B. Pepperoni pizza and a glass of red wine
C. Fresh apples and sliced oranges
D. Hard-boiled eggs and toast
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (like aged meats, cheeses, and red
wine), which can lead to a hypertensive crisis.
8. A client manifests muscle rigidity, a high fever (104°F), and autonomic
instability after starting Haloperidol. What is the nurse’s priority action?
A. Administer Benztropine IM
B. Increase the dosage as the symptoms suggest worsening psychosis
C. Apply a cooling blanket and stop the medication
D. Place the client in a quiet, dark room
Answer: C
Rationale: These are symptoms of Neuroleptic Malignant Syndrome (NMS), a medical
emergency. The medication must be stopped immediately, and the client cooled.
2026 |WCU
1. A nurse is caring for a client who is experiencing a crisis. Which of the
following actions should the nurse prioritize during the initial assessment?
A. Identifying the client’s previous coping mechanisms
B. Exploring the client’s childhood developmental stages
C. Assessing the client’s potential for self-harm or violence
D. Teaching the client relaxation techniques
Answer: C
Rationale: Safety is the priority in crisis intervention. Assessing for suicidal or homicidal
ideation is the first step before moving to coping mechanisms or therapy.
2. A client is prescribed Clozapine for treatment-resistant schizophrenia. Which
laboratory value is most critical for the nurse to monitor?
A. Serum potassium levels
B. White blood cell (WBC) count
C. Blood urea nitrogen (BUN)
D. Serum creatinine
Answer: B
Rationale: Clozapine carries a risk of agranulocytosis, a potentially fatal drop in WBC
count. Weekly or bi-weekly monitoring of the absolute neutrophil count (ANC) is
mandatory.
,3. According to Peplau’s theory of interpersonal relations, in which phase does
the nurse help the client identify problems and set goals?
A. Working phase
B. Orientation phase
C. Termination phase
D. Identification phase
Answer: B
Rationale: The orientation phase involves defining the problem, establishing trust, and
setting the parameters of the relationship and goals.
4. A client experiencing a manic episode is pacing the halls and speaking rapidly.
Which of the following nursing interventions is most appropriate?
A. Encourage the client to join a group therapy session
B. Provide the client with high-calorie ‘finger foods’
C. Ask the client to sit still and explain their feelings
D. Administer a sedative immediately
Answer: B
Rationale: Clients in a manic state often cannot sit still for meals. High-calorie finger foods
allow them to maintain nutrition while remaining active.
5. Which legal principle applies when a nurse provides a client with information
about their right to refuse treatment?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the client’s right to make their own decisions about their
medical care, including the right to refuse medication or treatment.
, 6. A client is admitted involuntarily to a psychiatric unit. Which of the following
rights does the client retain?
A. The right to refuse psychotropic medications
B. The right to leave the hospital at any time
C. The right to carry personal weapons
D. The right to bypass all hospital safety searches
Answer: A
Rationale: Involuntary admission does not automatically waive the right to refuse
treatment, including medications, unless there is a court order or an immediate emergency.
7. A nurse is caring for a client who is taking Phenelzine (an MAOI). Which food
choice indicates the client needs further teaching?
A. Grilled chicken and steamed broccoli
B. Pepperoni pizza and a glass of red wine
C. Fresh apples and sliced oranges
D. Hard-boiled eggs and toast
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (like aged meats, cheeses, and red
wine), which can lead to a hypertensive crisis.
8. A client manifests muscle rigidity, a high fever (104°F), and autonomic
instability after starting Haloperidol. What is the nurse’s priority action?
A. Administer Benztropine IM
B. Increase the dosage as the symptoms suggest worsening psychosis
C. Apply a cooling blanket and stop the medication
D. Place the client in a quiet, dark room
Answer: C
Rationale: These are symptoms of Neuroleptic Malignant Syndrome (NMS), a medical
emergency. The medication must be stopped immediately, and the client cooled.
