NSG 316 MENTAL HEALTH NURSING PRACTICE EXAM
(2025/2026) QUESTIONS – PSYCHIATRIC NURSING
SCENARIOS WITH ANSWERS AND RATIONALES
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin
decanoate) is being discharged in the morning. A repeat dose of medication is scheduled
for 20 days after discharge. The client tells the nurse that he is going on vacation in the
Bahamas and will return in 18 days. Which statement by the client indications a need for
health testing?
a. Two weeks after I return from my tropical island vacation, I will go to the clinic to get my
Prolixin injections.
b. While I'm on vacation and when I return, I will not eat or drink anything that contains
alcohol.
c. I will notify the HCP if I have a sore throat or flu-like symptoms.
d. I will continue to take my benztropine mesylate (Cogentin) everyday.
A. Two weeks after I return from my tropical island vacation, I will go to the clinic to get my
Prolixin injections.
Photosensitivity is a side effect of Proxilin and a vacation in the Bahamas (with its tropical
island clean up climate) increases the client's chance of experiencing this side effect. He
should be instructed to avoid direct sun (A) and wear sunscreen. (B,C, and d) include
accurate knowledge. Alcohol acts synergistically with Proxlin (B). (C) lists signs of
agranulcytosis which is also a side effect of Prolixin. In order to avoid extrapyramidal
symptoms (EPS) and anticholinergic drugs such as Cogentin that are often prescribed
prophylactically with Prolixin.
,A male client is admitted to the mental health unit because he was feeling depressed
about the loss of his wife and job. The client has a hx of alcohol dependency and admits
that he was drinking alcohol 12 hours ago. Vitals are: T: 100° F, P: 100, and BP: 142/100 The
nurse plans to give the client lorazepam (Ativan) based on which priority nursing diagnosis?
a. Risk for injury r/t suicidal ideation
b. Risk for injury r/t alcohol detoxification
c. Knowledge deficit r/t ineffective coping
d. Health seeking behaviors r/t personal crisis
B. Risk for injury r/t alcohol detoxification.
The most important nursing diagnosis is r/t alcohol detoxification (B) because the client
has elevated vitals, a sign of alcohol detoxification. Maintaining client safety r/t (A) should
be addressed after giving the client Ativan for elevated vitals secondary to alcohol
withdrawal. (C and D) can be addressed when immediate needs for safety are met.
A 25 y/o F client has been particularly restless and the nurse finds her trying to leave the
psych unit. She tells the nurse, "Please let me go! I must leave because the secret police
are after me." Which response is best for the nurse to make?
a. No one is after you, you're safe here.
b. You'll feel better after you have rested.
c. I know you must feel lonely and frightened.
d. Come with me to your room and I will sit with you.
D. Come with me to your room and I will sit with you.
(D) is the best response because it offers support without judgment or demands. (A) is
arguing with the client's delusion. (B) is offering false reassurance. (C) is a violation of
,therapeutic communication in that the nurse is telling the client how she feels (frightened
and lonely) rather than allowing the client to describe her own feelings. Hallucinating
and/or delusional clients are not capable of discussing their feelings, particularly when
they perceive a crisis.
The community health nurse talks to a male client who has bipolar disorder. The client
explains that he sleeps 4-5 hours a night and is working with his partner to start two new
businesses and build an empire. The client stopped taking his medications several days
ago. What nursing problem has the highest priority?
a. Excessive work activity.
b. Decreased need for sleep.
c. Medication management.
d. Inflated self-esteem
C. Medication management.
The most important nursing problem is medication management © because compliance
with the medication regimen will help prevent hospitalization. The client is also exhibiting
signs of (A, B, and C); however, these problems don't have the priority of medication
management.
A woman brings her 48 y/o husband to the outpatient psych unit and describes his behavior
to the admitting nurse. She states that he has been sleepwalking, can't remember who he
is, and exhibits multiple personalities. The nurse knows that these behaviors are often
associated with
a. dissociative disorder
b. obsessive-compulsive disorder
, c. panic disorder
d. post-traumatic stress syndrome
A. dissociative disorder
Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional
conflict from one's consciousness, which is the definition of a dissociative disorder (A). (B)
is characterized by persistent, recurrent intrusive thoughts or urges (obsessions) that are
unwilled and cannot be ignored, and provoke impulsive acts (compulsions) such as
handwashing. (C) is an acute attack of anxiety characterized by personality disorganization.
(D) is re-experiencing a psychologically terrifying or distressing event that is outside the
usual range of human experience, such as war, rape, etc.
A 45 y/o M client tells the nurse that he used to believe that he was Jesus Christ, but now he
knows he is not. Which response is best for the nurse to make?
a. Did you really believe you were Jesus Christ?
b. I think you're getting well.
c. Others have had similar thoughts when under stress.
d. Why did you think you were Jesus Christ?
C. Others have had similar thoughts when under stress.
(C) offers support by assuring the client that others have suffered as he has (also the
principle on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an
inappropriate judgment. You may have narrowed your choices to (C and D). However, you
should eliminate (D) because it is a "why" question, and the client doesn't know why!
(2025/2026) QUESTIONS – PSYCHIATRIC NURSING
SCENARIOS WITH ANSWERS AND RATIONALES
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin
decanoate) is being discharged in the morning. A repeat dose of medication is scheduled
for 20 days after discharge. The client tells the nurse that he is going on vacation in the
Bahamas and will return in 18 days. Which statement by the client indications a need for
health testing?
a. Two weeks after I return from my tropical island vacation, I will go to the clinic to get my
Prolixin injections.
b. While I'm on vacation and when I return, I will not eat or drink anything that contains
alcohol.
c. I will notify the HCP if I have a sore throat or flu-like symptoms.
d. I will continue to take my benztropine mesylate (Cogentin) everyday.
A. Two weeks after I return from my tropical island vacation, I will go to the clinic to get my
Prolixin injections.
Photosensitivity is a side effect of Proxilin and a vacation in the Bahamas (with its tropical
island clean up climate) increases the client's chance of experiencing this side effect. He
should be instructed to avoid direct sun (A) and wear sunscreen. (B,C, and d) include
accurate knowledge. Alcohol acts synergistically with Proxlin (B). (C) lists signs of
agranulcytosis which is also a side effect of Prolixin. In order to avoid extrapyramidal
symptoms (EPS) and anticholinergic drugs such as Cogentin that are often prescribed
prophylactically with Prolixin.
,A male client is admitted to the mental health unit because he was feeling depressed
about the loss of his wife and job. The client has a hx of alcohol dependency and admits
that he was drinking alcohol 12 hours ago. Vitals are: T: 100° F, P: 100, and BP: 142/100 The
nurse plans to give the client lorazepam (Ativan) based on which priority nursing diagnosis?
a. Risk for injury r/t suicidal ideation
b. Risk for injury r/t alcohol detoxification
c. Knowledge deficit r/t ineffective coping
d. Health seeking behaviors r/t personal crisis
B. Risk for injury r/t alcohol detoxification.
The most important nursing diagnosis is r/t alcohol detoxification (B) because the client
has elevated vitals, a sign of alcohol detoxification. Maintaining client safety r/t (A) should
be addressed after giving the client Ativan for elevated vitals secondary to alcohol
withdrawal. (C and D) can be addressed when immediate needs for safety are met.
A 25 y/o F client has been particularly restless and the nurse finds her trying to leave the
psych unit. She tells the nurse, "Please let me go! I must leave because the secret police
are after me." Which response is best for the nurse to make?
a. No one is after you, you're safe here.
b. You'll feel better after you have rested.
c. I know you must feel lonely and frightened.
d. Come with me to your room and I will sit with you.
D. Come with me to your room and I will sit with you.
(D) is the best response because it offers support without judgment or demands. (A) is
arguing with the client's delusion. (B) is offering false reassurance. (C) is a violation of
,therapeutic communication in that the nurse is telling the client how she feels (frightened
and lonely) rather than allowing the client to describe her own feelings. Hallucinating
and/or delusional clients are not capable of discussing their feelings, particularly when
they perceive a crisis.
The community health nurse talks to a male client who has bipolar disorder. The client
explains that he sleeps 4-5 hours a night and is working with his partner to start two new
businesses and build an empire. The client stopped taking his medications several days
ago. What nursing problem has the highest priority?
a. Excessive work activity.
b. Decreased need for sleep.
c. Medication management.
d. Inflated self-esteem
C. Medication management.
The most important nursing problem is medication management © because compliance
with the medication regimen will help prevent hospitalization. The client is also exhibiting
signs of (A, B, and C); however, these problems don't have the priority of medication
management.
A woman brings her 48 y/o husband to the outpatient psych unit and describes his behavior
to the admitting nurse. She states that he has been sleepwalking, can't remember who he
is, and exhibits multiple personalities. The nurse knows that these behaviors are often
associated with
a. dissociative disorder
b. obsessive-compulsive disorder
, c. panic disorder
d. post-traumatic stress syndrome
A. dissociative disorder
Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional
conflict from one's consciousness, which is the definition of a dissociative disorder (A). (B)
is characterized by persistent, recurrent intrusive thoughts or urges (obsessions) that are
unwilled and cannot be ignored, and provoke impulsive acts (compulsions) such as
handwashing. (C) is an acute attack of anxiety characterized by personality disorganization.
(D) is re-experiencing a psychologically terrifying or distressing event that is outside the
usual range of human experience, such as war, rape, etc.
A 45 y/o M client tells the nurse that he used to believe that he was Jesus Christ, but now he
knows he is not. Which response is best for the nurse to make?
a. Did you really believe you were Jesus Christ?
b. I think you're getting well.
c. Others have had similar thoughts when under stress.
d. Why did you think you were Jesus Christ?
C. Others have had similar thoughts when under stress.
(C) offers support by assuring the client that others have suffered as he has (also the
principle on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an
inappropriate judgment. You may have narrowed your choices to (C and D). However, you
should eliminate (D) because it is a "why" question, and the client doesn't know why!
