NURS 230: MENTAL HEALTH
NURSING – FINAL EXAM (2026)
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section I: Multiple Choice (1–60)
1. A client with major depressive disorder states, “I feel like giving up.” Which nursing
response is most therapeutic?
• A) “Everyone feels sad sometimes. You’ll get over it.”
• B) “It sounds like you’re feeling hopeless. Tell me more about that.”
Rationale: Reflects feeling and encourages expression. Avoids false reassurance
or minimizing.
• C) “Why do you feel that way?”
• D) “You have so much to live for.”
2. The nurse is caring for a client with bipolar disorder, manic episode. Which meal
option is most appropriate?
• A) Protein shake and a sandwich
• B) High-calorie finger foods (e.g., granola bars, cheese cubes, smoothie)
Rationale: Manic clients have decreased attention and may not sit for meals.
Finger foods allow eating on the go while maintaining nutrition.
• C) Large plated dinner with knife and fork
• D) Low-fat, low-carbohydrate meal
,3. A client with schizophrenia tells the nurse, “The FBI is poisoning my food through
the TV.” This is an example of:
• A) Delusion of persecution
Rationale: False belief that others are trying to harm the client.
• B) Delusion of grandeur
• C) Thought insertion
• D) Ideas of reference
4. The nurse assesses a client with anorexia nervosa. Which finding requires
immediate medical intervention?
• A) Serum potassium 2.4 mEq/L
Rationale: Hypokalemia increases risk for cardiac arrhythmias and is a medical
emergency.
• B) BMI 17.5
• C) Lanugo on face and back
• D) Bradycardia 54 bpm
5. Which medication is considered first-line treatment for panic disorder?
• A) Haloperidol
• B) Sertraline (SSRI)
Rationale: SSRIs are first-line for panic disorder. Haloperidol is for psychosis;
clonazepam is for short-term use.
• C) Clonazepam (benzo)
• D) Bupropion
6. A client with borderline personality disorder threatens self-harm after a staff
change. The nurse’s priority action is:
• A) Ignore the behavior to avoid reinforcement
• B) Complete a suicide risk assessment
Rationale: All threats of self-harm must be taken seriously and assessed
immediately.
• C) Place the client in seclusion
• D) Call the provider for discharge
7. Which statement by a client with PTSD indicates successful cognitive reframing?
• A) “I can’t think about the accident at all.”
• B) “The accident was not my fault. I did what I could to survive.”
Rationale: Indicates reduced self-blame and distorted guilt.
• C) “I am safe only when I’m alone.”
• D) “Nightmares will never stop.”
, 8. The nurse is teaching a client starting lithium. Which sign of toxicity should be
reported immediately?
• A) Mild thirst
• B) Vomiting and coarse tremor
Rationale: Early toxicity signs include vomiting, diarrhea, ataxia, coarse tremor.
• C) Fine hand tremor
• D) Polyuria
9. A client with alcohol use disorder is prescribed disulfiram. Which statement
indicates understanding?
• A) “I can drink wine but not liquor.”
• B) “I must avoid all alcohol including mouthwash and vanilla extract.”
Rationale: Any alcohol exposure causes severe reaction (flushing, vomiting,
hypotension).
• C) “I should take it only when I feel like drinking.”
• D) “It will reduce my cravings for alcohol.”
10. Which defense mechanism is a client with obsessive-compulsive disorder using
when repeatedly checking the locked door?
• A) Denial
• B) Projection
• C) Undoing
Rationale: Performing a ritual to symbolically reverse or “undo” an obsessive
thought.
• D) Reaction formation
11. A client on haloperidol develops muscle rigidity, fever, and confusion. The nurse
suspects:
• A) Tardive dyskinesia
• B) Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, autonomic instability, and altered
mental status.
• C) EPS dystonia
• D) Serotonin syndrome
12. During a mental status exam, the nurse asks, “What does ‘a rolling stone gathers
no moss’ mean?” This assesses:
• A) Attention
• B) Memory
• C) Insight
NURSING – FINAL EXAM (2026)
QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section I: Multiple Choice (1–60)
1. A client with major depressive disorder states, “I feel like giving up.” Which nursing
response is most therapeutic?
• A) “Everyone feels sad sometimes. You’ll get over it.”
• B) “It sounds like you’re feeling hopeless. Tell me more about that.”
Rationale: Reflects feeling and encourages expression. Avoids false reassurance
or minimizing.
• C) “Why do you feel that way?”
• D) “You have so much to live for.”
2. The nurse is caring for a client with bipolar disorder, manic episode. Which meal
option is most appropriate?
• A) Protein shake and a sandwich
• B) High-calorie finger foods (e.g., granola bars, cheese cubes, smoothie)
Rationale: Manic clients have decreased attention and may not sit for meals.
Finger foods allow eating on the go while maintaining nutrition.
• C) Large plated dinner with knife and fork
• D) Low-fat, low-carbohydrate meal
,3. A client with schizophrenia tells the nurse, “The FBI is poisoning my food through
the TV.” This is an example of:
• A) Delusion of persecution
Rationale: False belief that others are trying to harm the client.
• B) Delusion of grandeur
• C) Thought insertion
• D) Ideas of reference
4. The nurse assesses a client with anorexia nervosa. Which finding requires
immediate medical intervention?
• A) Serum potassium 2.4 mEq/L
Rationale: Hypokalemia increases risk for cardiac arrhythmias and is a medical
emergency.
• B) BMI 17.5
• C) Lanugo on face and back
• D) Bradycardia 54 bpm
5. Which medication is considered first-line treatment for panic disorder?
• A) Haloperidol
• B) Sertraline (SSRI)
Rationale: SSRIs are first-line for panic disorder. Haloperidol is for psychosis;
clonazepam is for short-term use.
• C) Clonazepam (benzo)
• D) Bupropion
6. A client with borderline personality disorder threatens self-harm after a staff
change. The nurse’s priority action is:
• A) Ignore the behavior to avoid reinforcement
• B) Complete a suicide risk assessment
Rationale: All threats of self-harm must be taken seriously and assessed
immediately.
• C) Place the client in seclusion
• D) Call the provider for discharge
7. Which statement by a client with PTSD indicates successful cognitive reframing?
• A) “I can’t think about the accident at all.”
• B) “The accident was not my fault. I did what I could to survive.”
Rationale: Indicates reduced self-blame and distorted guilt.
• C) “I am safe only when I’m alone.”
• D) “Nightmares will never stop.”
, 8. The nurse is teaching a client starting lithium. Which sign of toxicity should be
reported immediately?
• A) Mild thirst
• B) Vomiting and coarse tremor
Rationale: Early toxicity signs include vomiting, diarrhea, ataxia, coarse tremor.
• C) Fine hand tremor
• D) Polyuria
9. A client with alcohol use disorder is prescribed disulfiram. Which statement
indicates understanding?
• A) “I can drink wine but not liquor.”
• B) “I must avoid all alcohol including mouthwash and vanilla extract.”
Rationale: Any alcohol exposure causes severe reaction (flushing, vomiting,
hypotension).
• C) “I should take it only when I feel like drinking.”
• D) “It will reduce my cravings for alcohol.”
10. Which defense mechanism is a client with obsessive-compulsive disorder using
when repeatedly checking the locked door?
• A) Denial
• B) Projection
• C) Undoing
Rationale: Performing a ritual to symbolically reverse or “undo” an obsessive
thought.
• D) Reaction formation
11. A client on haloperidol develops muscle rigidity, fever, and confusion. The nurse
suspects:
• A) Tardive dyskinesia
• B) Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, autonomic instability, and altered
mental status.
• C) EPS dystonia
• D) Serotonin syndrome
12. During a mental status exam, the nurse asks, “What does ‘a rolling stone gathers
no moss’ mean?” This assesses:
• A) Attention
• B) Memory
• C) Insight
