MENTAL HEALTH
NURSING EXAM 2
Psychiatric Nursing & DSM-5-TR
2026/2027 Edition
Clinical Judgment Review
100 Verified Questions with Detailed Rationales
EXAM SPECIFICATIONS
Time Allocation: 2.5 Hours
Total Questions: 100 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: 85% Required to Pass
Core Focus: DSM-5-TR, Therapeutic Communication, Psychopharmacology
Mental Health Nursing Exam 2 Prep 2026/2027 Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
This Mental Health Nursing Exam 2 Prep evaluates clinical judgment in psychiatric nursing using
DSM-5-TR criteria. Content covers mood disorders, anxiety, psychosis, substance use, personality
disorders, and therapeutic interventions per NCLEX-RN standards.
CONTENT DISTRIBUTION
• Mood Disorders (25%) — Depression, bipolar, suicide risk, antidepressants, mood stabilizers, ECT
• Anxiety & Trauma Disorders (20%) — GAD, panic, PTSD, phobias, anxiolytics, CBT techniques
• Psychotic Disorders (20%) — Schizophrenia, delusions, hallucinations, antipsychotics, safety
management
• Substance Use & Addiction (15%) — Withdrawal, detox, dual diagnosis, motivational interviewing,
relapse prevention
• Personality Disorders & Crisis (10%) — Borderline, antisocial, therapeutic communication,
de-escalation
• Legal/Ethical & Psychopharmacology (10%) — Involuntary commitment, restraints, medication
side effects, patient rights
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes a detailed rationale. Achieve 85% competency to demonstrate mastery.
STUDY STRATEGY
Master DSM-5-TR diagnostic criteria and nursing interventions. Practice therapeutic communication
techniques. Review psychotropic medication classes, side effects, and patient teaching.
CURRICULUM ALIGNMENT
Questions reflect 2026/2027 standards: DSM-5-TR, NCLEX-RN Test Plan Psychosocial Integrity,
ANA Psychiatric-Mental Health Nursing Standards, and QSEN competencies.
Mental Health Nursing Exam 2 Prep 2026/2027 Page 2
, SECTION I: Mood Disorders & Suicide Prevention
1. A patient with major depressive disorder states, 'I don't want to be here anymore.' The
nurse's priority action is:
✓ A. Ask if the patient has a suicide plan
B. Reassure the patient that things will get better
C. Leave the patient alone to rest
D. Notify the physician at the end of shift
Rationale: Direct assessment of suicide plan is the priority for safety. Reassurance is non-therapeutic.
Leaving patient alone is unsafe. Notification must be immediate, not delayed.
2. Which symptom is required for diagnosis of major depressive episode per DSM-5-TR?
A. Insomnia for 3 days
✓ B. Depressed mood or anhedonia for at least 2 weeks
C. Weight loss of 5 pounds
D. Occasional crying spells
Rationale: DSM-5-TR requires depressed mood or anhedonia plus 4 other symptoms for ≥2 weeks.
Insomnia, weight loss, and crying may occur but aren't sufficient alone.
3. A patient taking phenelzine (MAOI) should avoid which food?
A. Fresh vegetables
✓ B. Aged cheese
C. White bread
D. Apple juice
Rationale: MAOIs + tyramine-rich foods (aged cheese, cured meats, fermented products) can cause
hypertensive crisis. Fresh foods and bread are safe.
4. Lithium toxicity is most likely when the serum level exceeds:
A. 0.5 mEq/L
✓ B. 1.5 mEq/L
C. 2.5 mEq/L
D. 3.5 mEq/L
Rationale: Therapeutic range is 0.6-1.2 mEq/L. Levels >1.5 indicate toxicity: tremor, confusion, ataxia.
Severe toxicity >2.0 can cause seizures, coma.
5. The best indicator that a depressed patient is improving is:
A. Patient states 'I feel better'
✓ B. Increased energy and engagement in activities
C. Sleeping 12 hours daily
D. Decreased appetite
Mental Health Nursing Exam 2 Prep 2026/2027 Page 3
NURSING EXAM 2
Psychiatric Nursing & DSM-5-TR
2026/2027 Edition
Clinical Judgment Review
100 Verified Questions with Detailed Rationales
EXAM SPECIFICATIONS
Time Allocation: 2.5 Hours
Total Questions: 100 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: 85% Required to Pass
Core Focus: DSM-5-TR, Therapeutic Communication, Psychopharmacology
Mental Health Nursing Exam 2 Prep 2026/2027 Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
This Mental Health Nursing Exam 2 Prep evaluates clinical judgment in psychiatric nursing using
DSM-5-TR criteria. Content covers mood disorders, anxiety, psychosis, substance use, personality
disorders, and therapeutic interventions per NCLEX-RN standards.
CONTENT DISTRIBUTION
• Mood Disorders (25%) — Depression, bipolar, suicide risk, antidepressants, mood stabilizers, ECT
• Anxiety & Trauma Disorders (20%) — GAD, panic, PTSD, phobias, anxiolytics, CBT techniques
• Psychotic Disorders (20%) — Schizophrenia, delusions, hallucinations, antipsychotics, safety
management
• Substance Use & Addiction (15%) — Withdrawal, detox, dual diagnosis, motivational interviewing,
relapse prevention
• Personality Disorders & Crisis (10%) — Borderline, antisocial, therapeutic communication,
de-escalation
• Legal/Ethical & Psychopharmacology (10%) — Involuntary commitment, restraints, medication
side effects, patient rights
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes a detailed rationale. Achieve 85% competency to demonstrate mastery.
STUDY STRATEGY
Master DSM-5-TR diagnostic criteria and nursing interventions. Practice therapeutic communication
techniques. Review psychotropic medication classes, side effects, and patient teaching.
CURRICULUM ALIGNMENT
Questions reflect 2026/2027 standards: DSM-5-TR, NCLEX-RN Test Plan Psychosocial Integrity,
ANA Psychiatric-Mental Health Nursing Standards, and QSEN competencies.
Mental Health Nursing Exam 2 Prep 2026/2027 Page 2
, SECTION I: Mood Disorders & Suicide Prevention
1. A patient with major depressive disorder states, 'I don't want to be here anymore.' The
nurse's priority action is:
✓ A. Ask if the patient has a suicide plan
B. Reassure the patient that things will get better
C. Leave the patient alone to rest
D. Notify the physician at the end of shift
Rationale: Direct assessment of suicide plan is the priority for safety. Reassurance is non-therapeutic.
Leaving patient alone is unsafe. Notification must be immediate, not delayed.
2. Which symptom is required for diagnosis of major depressive episode per DSM-5-TR?
A. Insomnia for 3 days
✓ B. Depressed mood or anhedonia for at least 2 weeks
C. Weight loss of 5 pounds
D. Occasional crying spells
Rationale: DSM-5-TR requires depressed mood or anhedonia plus 4 other symptoms for ≥2 weeks.
Insomnia, weight loss, and crying may occur but aren't sufficient alone.
3. A patient taking phenelzine (MAOI) should avoid which food?
A. Fresh vegetables
✓ B. Aged cheese
C. White bread
D. Apple juice
Rationale: MAOIs + tyramine-rich foods (aged cheese, cured meats, fermented products) can cause
hypertensive crisis. Fresh foods and bread are safe.
4. Lithium toxicity is most likely when the serum level exceeds:
A. 0.5 mEq/L
✓ B. 1.5 mEq/L
C. 2.5 mEq/L
D. 3.5 mEq/L
Rationale: Therapeutic range is 0.6-1.2 mEq/L. Levels >1.5 indicate toxicity: tremor, confusion, ataxia.
Severe toxicity >2.0 can cause seizures, coma.
5. The best indicator that a depressed patient is improving is:
A. Patient states 'I feel better'
✓ B. Increased energy and engagement in activities
C. Sleeping 12 hours daily
D. Decreased appetite
Mental Health Nursing Exam 2 Prep 2026/2027 Page 3
