Psychiatric Nursing and Mental Health
Nursing Practice Exam questions and correct
answers– Updated 2026 (Graded A+) instant
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Subject: Mental Health Nursing
Subtopic: Therapeutic Communication
Question 1: A nurse is caring for a client recently diagnosed with major depressive disorder who
states, "Nothing in my life has any meaning anymore." Which response by the nurse
demonstrates the most therapeutic communication technique?
A) "You should focus on the positive aspects of your life."
B) "Why do you think your life has no meaning?"
C) "Tell me more about what has been making life feel meaningless."
D) "Many people with depression feel this way temporarily."
Correct Answer: C - Tell me more about what has been making life feel meaningless.
Rationale: Open-ended exploration facilitates therapeutic communication by encouraging the
client to elaborate on thoughts and feelings. Option A minimizes the client's feelings and offers
premature advice. Option B begins with "why," which may sound judgmental or provoke
defensiveness. Option D offers false reassurance and shifts focus away from the client's unique
experience. Exam questions frequently test the nurse's ability to use broad openings and
encourage expression rather than offering solutions.
Question 2: A hospitalized client with schizophrenia states, "The television announcer is sending
me secret messages." What is the nurse's best response?
A) "The television is not sending messages; you are mistaken."
B) "I understand that you believe the announcer is communicating with you, but I do not
perceive that."
C) "What specific messages are you receiving?"
D) "You should ignore the television."
Correct Answer: B - I understand that you believe the announcer is communicating with
you, but I do not perceive that.
Rationale: Presenting reality while acknowledging the client's experience is therapeutic. Option
A directly challenges the delusion and may increase defensiveness. Option C may reinforce the
delusion by encouraging detailed discussion of false beliefs. Option D dismisses the client's
,experience without exploring associated emotions. Nurses should validate feelings without
validating delusional content.
Question 3: Which nurse-client interaction best demonstrates the therapeutic use of silence?
A) Remaining silent after a client reveals suicidal thoughts, allowing time for elaboration
B) Avoiding conversation because the client appears withdrawn
C) Remaining silent to discourage discussion of distressing topics
D) Ending a conversation without explanation
Correct Answer: A - Remaining silent after a client reveals suicidal thoughts, allowing time
for elaboration
Rationale: Therapeutic silence gives clients time to process thoughts and continue sharing
sensitive information. Option B reflects avoidance. Option C suppresses communication. Option
D may damage trust. In psychiatric nursing, purposeful silence facilitates reflection and
emotional expression.
Subtopic: Mood Disorders
Question 4: A client diagnosed with major depressive disorder states, "Everyone would be better
off if I were dead." What is the nurse's priority action?
A) Reassure the client that treatment will improve symptoms
B) Assess the client for suicidal intent, plan, and means
C) Encourage participation in group therapy
D) Notify family members immediately
Correct Answer: B - Assess the client for suicidal intent, plan, and means
Rationale: Suicide risk assessment is the priority because the statement suggests possible
suicidal ideation. Option A provides reassurance without assessing risk. Option C may be
appropriate later but does not address immediate safety concerns. Option D may be necessary
depending on circumstances but is not the first action. Safety always takes precedence in
psychiatric nursing.
Question 5: A nurse is caring for a client experiencing acute mania. Which intervention is most
appropriate?
A) Encourage lengthy group discussions
B) Provide high-calorie finger foods and fluids
C) Restrict all physical activity
D) Assign multiple staff members to reinforce limits
,Correct Answer: B - Provide high-calorie finger foods and fluids
Rationale: Clients experiencing mania often have excessive psychomotor activity and difficulty
sitting long enough to eat. Finger foods support adequate nutrition. Option A may overstimulate
the client. Option C is unrealistic and unnecessary. Option D may contribute to inconsistent
limit-setting. Consistent structure and meeting physiologic needs are priorities.
Question 6: A client taking lithium for bipolar disorder reports nausea, coarse tremors, and
confusion. Which nursing action is most appropriate?
A) Administer the next dose with food
B) Document findings as expected adverse effects
C) Hold the medication and notify the healthcare provider
D) Encourage increased caffeine intake
Correct Answer: C - Hold the medication and notify the healthcare provider
Rationale: Nausea, coarse tremors, and confusion may indicate lithium toxicity. Option A is
insufficient because toxicity is potentially life-threatening. Option B is incorrect because these
findings are not expected mild side effects. Option D may worsen symptoms. Early recognition of
lithium toxicity is essential.
Subtopic: Anxiety Disorders
Question 7: A client experiencing a panic attack is hyperventilating and pacing. What should the
nurse do first?
A) Explore underlying stressors immediately
B) Remain with the client and speak in a calm, concise manner
C) Encourage the client to join group activities
D) Explain the physiologic basis of anxiety
Correct Answer: B - Remain with the client and speak in a calm, concise manner
Rationale: During a panic attack, the priority is reducing anxiety and ensuring safety. Calm
presence and simple communication are therapeutic. Option A requires a lower anxiety level.
Option C may increase distress. Option D is ineffective during severe anxiety because cognitive
processing is impaired.
Question 8: Which finding is most characteristic of generalized anxiety disorder?
A) Recurrent intrusive memories following trauma
B) Excessive, persistent worry about multiple life circumstances
, C) Periodic episodes of elevated mood and grandiosity
D) Repetitive compulsions performed to reduce obsessions
Correct Answer: B - Excessive, persistent worry about multiple life circumstances
Rationale: Generalized anxiety disorder involves chronic, excessive worry across numerous
domains. Option A describes post-traumatic stress disorder. Option C is characteristic of bipolar
disorder. Option D describes obsessive-compulsive disorder.
Question 9: A client with severe anxiety repeatedly asks the same question despite receiving an
answer. What is the nurse's best response?
A) Ignore further questioning
B) Provide concise, repeated answers using a calm tone
C) Instruct the client to stop asking repetitive questions
D) Encourage independent problem-solving immediately
Correct Answer: B - Provide concise, repeated answers using a calm tone
Rationale: Severe anxiety impairs concentration and information processing. Repetition and
calm communication are therapeutic. Ignoring or criticizing the client increases anxiety.
Independent problem-solving may be unrealistic until anxiety decreases.
Subtopic: Schizophrenia Spectrum Disorders
Question 10: Which assessment finding is considered a negative symptom of schizophrenia?
A) Auditory hallucinations
B) Delusions of persecution
C) Flat affect
D) Disorganized speech
Correct Answer: C - Flat affect
Rationale: Negative symptoms reflect deficits in normal functioning and include flat affect,
avolition, and anhedonia. Hallucinations, delusions, and disorganized speech are positive
symptoms. Distinguishing positive from negative symptoms is commonly tested in psychiatric
nursing exams.
Question 11: A client with schizophrenia is responding to internal stimuli. Which observation
best supports this conclusion?
A) The client is pacing the hallway
B) The client is laughing and talking when alone
Nursing Practice Exam questions and correct
answers– Updated 2026 (Graded A+) instant
download pdf
Subject: Mental Health Nursing
Subtopic: Therapeutic Communication
Question 1: A nurse is caring for a client recently diagnosed with major depressive disorder who
states, "Nothing in my life has any meaning anymore." Which response by the nurse
demonstrates the most therapeutic communication technique?
A) "You should focus on the positive aspects of your life."
B) "Why do you think your life has no meaning?"
C) "Tell me more about what has been making life feel meaningless."
D) "Many people with depression feel this way temporarily."
Correct Answer: C - Tell me more about what has been making life feel meaningless.
Rationale: Open-ended exploration facilitates therapeutic communication by encouraging the
client to elaborate on thoughts and feelings. Option A minimizes the client's feelings and offers
premature advice. Option B begins with "why," which may sound judgmental or provoke
defensiveness. Option D offers false reassurance and shifts focus away from the client's unique
experience. Exam questions frequently test the nurse's ability to use broad openings and
encourage expression rather than offering solutions.
Question 2: A hospitalized client with schizophrenia states, "The television announcer is sending
me secret messages." What is the nurse's best response?
A) "The television is not sending messages; you are mistaken."
B) "I understand that you believe the announcer is communicating with you, but I do not
perceive that."
C) "What specific messages are you receiving?"
D) "You should ignore the television."
Correct Answer: B - I understand that you believe the announcer is communicating with
you, but I do not perceive that.
Rationale: Presenting reality while acknowledging the client's experience is therapeutic. Option
A directly challenges the delusion and may increase defensiveness. Option C may reinforce the
delusion by encouraging detailed discussion of false beliefs. Option D dismisses the client's
,experience without exploring associated emotions. Nurses should validate feelings without
validating delusional content.
Question 3: Which nurse-client interaction best demonstrates the therapeutic use of silence?
A) Remaining silent after a client reveals suicidal thoughts, allowing time for elaboration
B) Avoiding conversation because the client appears withdrawn
C) Remaining silent to discourage discussion of distressing topics
D) Ending a conversation without explanation
Correct Answer: A - Remaining silent after a client reveals suicidal thoughts, allowing time
for elaboration
Rationale: Therapeutic silence gives clients time to process thoughts and continue sharing
sensitive information. Option B reflects avoidance. Option C suppresses communication. Option
D may damage trust. In psychiatric nursing, purposeful silence facilitates reflection and
emotional expression.
Subtopic: Mood Disorders
Question 4: A client diagnosed with major depressive disorder states, "Everyone would be better
off if I were dead." What is the nurse's priority action?
A) Reassure the client that treatment will improve symptoms
B) Assess the client for suicidal intent, plan, and means
C) Encourage participation in group therapy
D) Notify family members immediately
Correct Answer: B - Assess the client for suicidal intent, plan, and means
Rationale: Suicide risk assessment is the priority because the statement suggests possible
suicidal ideation. Option A provides reassurance without assessing risk. Option C may be
appropriate later but does not address immediate safety concerns. Option D may be necessary
depending on circumstances but is not the first action. Safety always takes precedence in
psychiatric nursing.
Question 5: A nurse is caring for a client experiencing acute mania. Which intervention is most
appropriate?
A) Encourage lengthy group discussions
B) Provide high-calorie finger foods and fluids
C) Restrict all physical activity
D) Assign multiple staff members to reinforce limits
,Correct Answer: B - Provide high-calorie finger foods and fluids
Rationale: Clients experiencing mania often have excessive psychomotor activity and difficulty
sitting long enough to eat. Finger foods support adequate nutrition. Option A may overstimulate
the client. Option C is unrealistic and unnecessary. Option D may contribute to inconsistent
limit-setting. Consistent structure and meeting physiologic needs are priorities.
Question 6: A client taking lithium for bipolar disorder reports nausea, coarse tremors, and
confusion. Which nursing action is most appropriate?
A) Administer the next dose with food
B) Document findings as expected adverse effects
C) Hold the medication and notify the healthcare provider
D) Encourage increased caffeine intake
Correct Answer: C - Hold the medication and notify the healthcare provider
Rationale: Nausea, coarse tremors, and confusion may indicate lithium toxicity. Option A is
insufficient because toxicity is potentially life-threatening. Option B is incorrect because these
findings are not expected mild side effects. Option D may worsen symptoms. Early recognition of
lithium toxicity is essential.
Subtopic: Anxiety Disorders
Question 7: A client experiencing a panic attack is hyperventilating and pacing. What should the
nurse do first?
A) Explore underlying stressors immediately
B) Remain with the client and speak in a calm, concise manner
C) Encourage the client to join group activities
D) Explain the physiologic basis of anxiety
Correct Answer: B - Remain with the client and speak in a calm, concise manner
Rationale: During a panic attack, the priority is reducing anxiety and ensuring safety. Calm
presence and simple communication are therapeutic. Option A requires a lower anxiety level.
Option C may increase distress. Option D is ineffective during severe anxiety because cognitive
processing is impaired.
Question 8: Which finding is most characteristic of generalized anxiety disorder?
A) Recurrent intrusive memories following trauma
B) Excessive, persistent worry about multiple life circumstances
, C) Periodic episodes of elevated mood and grandiosity
D) Repetitive compulsions performed to reduce obsessions
Correct Answer: B - Excessive, persistent worry about multiple life circumstances
Rationale: Generalized anxiety disorder involves chronic, excessive worry across numerous
domains. Option A describes post-traumatic stress disorder. Option C is characteristic of bipolar
disorder. Option D describes obsessive-compulsive disorder.
Question 9: A client with severe anxiety repeatedly asks the same question despite receiving an
answer. What is the nurse's best response?
A) Ignore further questioning
B) Provide concise, repeated answers using a calm tone
C) Instruct the client to stop asking repetitive questions
D) Encourage independent problem-solving immediately
Correct Answer: B - Provide concise, repeated answers using a calm tone
Rationale: Severe anxiety impairs concentration and information processing. Repetition and
calm communication are therapeutic. Ignoring or criticizing the client increases anxiety.
Independent problem-solving may be unrealistic until anxiety decreases.
Subtopic: Schizophrenia Spectrum Disorders
Question 10: Which assessment finding is considered a negative symptom of schizophrenia?
A) Auditory hallucinations
B) Delusions of persecution
C) Flat affect
D) Disorganized speech
Correct Answer: C - Flat affect
Rationale: Negative symptoms reflect deficits in normal functioning and include flat affect,
avolition, and anhedonia. Hallucinations, delusions, and disorganized speech are positive
symptoms. Distinguishing positive from negative symptoms is commonly tested in psychiatric
nursing exams.
Question 11: A client with schizophrenia is responding to internal stimuli. Which observation
best supports this conclusion?
A) The client is pacing the hallway
B) The client is laughing and talking when alone
