# NR 326 Mental Health Nursing Final Examination
## Comprehensive Psychiatric Nursing Review | 100 NCLEX-Style
Questions with Rationales
### Updated 2026 | Therapeutic Communication & Clinical Judgment
---
**Question 1**
A nurse is caring for a patient diagnosed with major depressive disorder. Which statement by the
patient indicates a risk for suicide?
A. "I feel so tired all the time."
B. "I just want to go to sleep and never wake up."
C. "I don't enjoy doing anything anymore."
D. "I have trouble concentrating at work."
💫ANSWER✔️✔️: B. "I just want to go to sleep and never wake up."
💫RATIONALE✔️✔️: Statements indicating suicidal ideation require immediate intervention and safety
assessment.
---
**Question 2**
A patient with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through the television."
Which type of delusion is the patient demonstrating?
A. Grandiose delusion
B. Persecutory delusion
C. Somatic delusion
D. Referential delusion
,💫ANSWER✔️✔️: B. Persecutory delusion
💫RATIONALE✔️✔️: Persecutory delusions involve beliefs of being targeted or harassed by others.
---
**Question 3**
The nurse is establishing a therapeutic relationship with a patient. Which statement is an example of a
therapeutic communication technique?
A. "I understand exactly how you feel."
B. "You should try to think more positively."
C. "Tell me more about what happened that upset you."
D. "Everything will be fine, don't worry."
💫ANSWER✔️✔️: C. "Tell me more about what happened that upset you."
💫RATIONALE✔️✔️: Using open-ended questions encourages the patient to explore feelings.
---
**Question 4**
A patient with bipolar disorder in the manic phase is exhibiting grandiosity. Which nursing intervention
is most appropriate?
A. Allow the patient to lead group activities
B. Provide challenging intellectual tasks
C. Set firm, consistent limits on behavior
D. Encourage the patient to express grandiose ideas
💫ANSWER✔️✔️: C. Set firm, consistent limits on behavior
💫RATIONALE✔️✔️: Setting limits ensures patient safety and provides structure during mania.
,---
**Question 5**
The nurse is assessing a patient with generalized anxiety disorder. Which finding is most consistent with
this diagnosis?
A. Excessive worry about multiple events for 6 months
B. Panic attacks occurring weekly
C. Intrusive thoughts about contamination
D. Fear of social situations
💫ANSWER✔️✔️: A. Excessive worry about multiple events for 6 months
💫RATIONALE✔️✔️: GAD is characterized by excessive, uncontrollable worry lasting at least 6 months.
---
**Question 6**
A patient diagnosed with borderline personality disorder is expressing feelings of emptiness and
threatening self-harm. The nurse's priority action is:
A. Place the patient in seclusion
B. Initiate a no-suicide contract
C. Maintain continuous observation and safety monitoring
D. Administer PRN antipsychotic medication
💫ANSWER✔️✔️: C. Maintain continuous observation and safety monitoring
💫RATIONALE✔️✔️: Safety is the priority; patients at risk of self-harm require continuous observation.
---
**Question 7**
, The nurse is caring for a patient experiencing alcohol withdrawal. Which finding should the nurse assess
first?
A. Tremors
B. Diaphoresis
C. Seizure activity
D. Nausea and vomiting
💫ANSWER✔️✔️: C. Seizure activity
💫RATIONALE✔️✔️: Seizures are a life-threatening complication of alcohol withdrawal requiring
immediate intervention.
---
**Question 8**
A patient with post-traumatic stress disorder is having flashbacks. Which nursing intervention is most
appropriate?
A. Ask the patient to describe the flashback in detail
B. Use grounding techniques such as naming objects in the room
C. Encourage the patient to talk about the trauma
D. Administer antipsychotic medication immediately
💫ANSWER✔️✔️: B. Use grounding techniques such as naming objects in the room
💫RATIONALE✔️✔️: Grounding techniques help the patient reorient to the present reality.
---
**Question 9**
The nurse is assessing a patient with obsessive-compulsive disorder. Which behavior is consistent with
this diagnosis?
A. Repeatedly checking if the door is locked
## Comprehensive Psychiatric Nursing Review | 100 NCLEX-Style
Questions with Rationales
### Updated 2026 | Therapeutic Communication & Clinical Judgment
---
**Question 1**
A nurse is caring for a patient diagnosed with major depressive disorder. Which statement by the
patient indicates a risk for suicide?
A. "I feel so tired all the time."
B. "I just want to go to sleep and never wake up."
C. "I don't enjoy doing anything anymore."
D. "I have trouble concentrating at work."
💫ANSWER✔️✔️: B. "I just want to go to sleep and never wake up."
💫RATIONALE✔️✔️: Statements indicating suicidal ideation require immediate intervention and safety
assessment.
---
**Question 2**
A patient with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through the television."
Which type of delusion is the patient demonstrating?
A. Grandiose delusion
B. Persecutory delusion
C. Somatic delusion
D. Referential delusion
,💫ANSWER✔️✔️: B. Persecutory delusion
💫RATIONALE✔️✔️: Persecutory delusions involve beliefs of being targeted or harassed by others.
---
**Question 3**
The nurse is establishing a therapeutic relationship with a patient. Which statement is an example of a
therapeutic communication technique?
A. "I understand exactly how you feel."
B. "You should try to think more positively."
C. "Tell me more about what happened that upset you."
D. "Everything will be fine, don't worry."
💫ANSWER✔️✔️: C. "Tell me more about what happened that upset you."
💫RATIONALE✔️✔️: Using open-ended questions encourages the patient to explore feelings.
---
**Question 4**
A patient with bipolar disorder in the manic phase is exhibiting grandiosity. Which nursing intervention
is most appropriate?
A. Allow the patient to lead group activities
B. Provide challenging intellectual tasks
C. Set firm, consistent limits on behavior
D. Encourage the patient to express grandiose ideas
💫ANSWER✔️✔️: C. Set firm, consistent limits on behavior
💫RATIONALE✔️✔️: Setting limits ensures patient safety and provides structure during mania.
,---
**Question 5**
The nurse is assessing a patient with generalized anxiety disorder. Which finding is most consistent with
this diagnosis?
A. Excessive worry about multiple events for 6 months
B. Panic attacks occurring weekly
C. Intrusive thoughts about contamination
D. Fear of social situations
💫ANSWER✔️✔️: A. Excessive worry about multiple events for 6 months
💫RATIONALE✔️✔️: GAD is characterized by excessive, uncontrollable worry lasting at least 6 months.
---
**Question 6**
A patient diagnosed with borderline personality disorder is expressing feelings of emptiness and
threatening self-harm. The nurse's priority action is:
A. Place the patient in seclusion
B. Initiate a no-suicide contract
C. Maintain continuous observation and safety monitoring
D. Administer PRN antipsychotic medication
💫ANSWER✔️✔️: C. Maintain continuous observation and safety monitoring
💫RATIONALE✔️✔️: Safety is the priority; patients at risk of self-harm require continuous observation.
---
**Question 7**
, The nurse is caring for a patient experiencing alcohol withdrawal. Which finding should the nurse assess
first?
A. Tremors
B. Diaphoresis
C. Seizure activity
D. Nausea and vomiting
💫ANSWER✔️✔️: C. Seizure activity
💫RATIONALE✔️✔️: Seizures are a life-threatening complication of alcohol withdrawal requiring
immediate intervention.
---
**Question 8**
A patient with post-traumatic stress disorder is having flashbacks. Which nursing intervention is most
appropriate?
A. Ask the patient to describe the flashback in detail
B. Use grounding techniques such as naming objects in the room
C. Encourage the patient to talk about the trauma
D. Administer antipsychotic medication immediately
💫ANSWER✔️✔️: B. Use grounding techniques such as naming objects in the room
💫RATIONALE✔️✔️: Grounding techniques help the patient reorient to the present reality.
---
**Question 9**
The nurse is assessing a patient with obsessive-compulsive disorder. Which behavior is consistent with
this diagnosis?
A. Repeatedly checking if the door is locked
