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I have only encountered this name twice (the Spanish singer Montserrat Caballé and the British actress Montserrat Lombard) but already I am liking it!
How about:
Montserrat Elisabeth
Montserrat Helen

Actually, I kinda like the name. About the middle names: Clare and
Fiera might do.

I'm sure I've seen that name on a map before... I don't think I'd use it on an actual person.

Like a lot of European place names, I find it to be pretentious, like the parents are trying too hard to prove how sophisticated they are, so yes it is pretty bad.

I know someone named Montserrat. I don't really like it, but it's not all that bad. The only thing is, that girl is teased often by being called "Monster rat."

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Montserrat Evelyn
Montserrat Genevieve
Montserrat Sophia
Montserrat Beatriz
Montserrat Avis

I like it, too!

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Montserrat Alexandra
Montserrat Joanne
Montserrat Maria or Montserrat Marie
Montserrat Lilianne
Montserrat Josephine

I'm a big fan of Montserrat, but I'd only use it in Spain.

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Montserrat Serene
Montserrat Sofia
Montserrat Anastasia
Montserrat Olivia
Montserrat Zoe
Montserrat Lily
Montserrat Vivianna
Montserrat Viola
Montserrat Zorana