### Mental Health Nursing Exam Cycle
2026 | NCLEX-Style Comprehensive Prep
Guide | Student Success Edition with
Practice Pack
**100 Questions with Verified Rationales**
---
**1. A client with major depressive disorder is started on fluoxetine. Which of the following statements
by the client indicates a need for further teaching?**
A) "It may take several weeks for this medication to work."
B) "I should avoid drinking alcohol while taking this medication."
C) "I can stop taking this medication as soon as I feel better."
D) "I should report any thoughts of suicide to my healthcare provider."
🎯CORRECT CHOICE: C
💡EXPLANATION: Antidepressants like fluoxetine (an SSRI) should not be stopped abruptly and require a
gradual taper under medical supervision to avoid withdrawal symptoms and relapse. It also takes 2-4
weeks for therapeutic effects to be seen, and patients should be monitored for suicidal ideation,
especially early in treatment.
**2. A nurse is caring for a client with bipolar disorder who is experiencing a manic episode. Which of
the following interventions is a priority?**
A) Encouraging the client to participate in group activities
B) Providing a structured, low-stimulation environment
C) Allowing the client to make all decisions regarding their care
D) Offering high-calorie snacks frequently
🎯CORRECT CHOICE: B
,💡EXPLANATION: During a manic episode, clients are highly distractible and may become easily
overstimulated. A structured, low-stimulation environment with a calm approach helps reduce agitation
and prevent escalation. Safety and providing clear, firm boundaries are priorities.
**3. A client with a diagnosis of schizophrenia is exhibiting auditory hallucinations. The client states,
"The voices are telling me that I am a bad person." What is the nurse's most therapeutic initial
response?**
A) "The voices are not real. You need to ignore them."
B) "I understand that the voices are telling you that you are a bad person, but I do not hear them."
C) "Why do you think the voices are saying that to you?"
D) "We need to increase your medication dose."
🎯CORRECT CHOICE: B
💡EXPLANATION: This response validates the client's experience without agreeing with the
hallucination. It distinguishes between the nurse's reality and the client's reality, which is a therapeutic
technique. It promotes trust and allows the client to feel understood.
**4. A nurse is assessing a client who is experiencing a panic attack. Which of the following physical
symptoms is the nurse most likely to observe?**
A) Bradycardia and hypotension
B) Hyperventilation and palpitations
C) Constricted pupils and decreased respiratory rate
D) Flaccid muscles and lethargy
🎯CORRECT CHOICE: B
💡EXPLANATION: Panic attacks are characterized by intense fear and autonomic arousal, leading to
symptoms such as palpitations, hyperventilation, chest pain, trembling, sweating, and a feeling of
impending doom. These symptoms are related to the sympathetic nervous system activation.
**5. A client has been diagnosed with post-traumatic stress disorder (PTSD) following a motor vehicle
accident. Which of the following is a hallmark symptom of this disorder?**
A) Persistent avoidance of anything associated with the traumatic event
B) Euphoric mood and grandiosity
C) Auditory hallucinations and disorganized speech
,D) Obsessive-compulsive behaviors
🎯CORRECT CHOICE: A
💡EXPLANATION: Avoidance is a core symptom of PTSD. Individuals with PTSD go to great lengths to
avoid reminders of the trauma, including thoughts, feelings, people, places, and activities. Other
symptoms include re-experiencing the trauma, hypervigilance, and negative alterations in mood and
cognition.
**6. A nurse is teaching a client with generalized anxiety disorder about relaxation techniques. Which of
the following is an example of a cognitive-behavioral technique used to manage anxiety?**
A) Deep breathing exercises
B) Progressive muscle relaxation
C) Guided imagery
D) Cognitive restructuring (challenging negative thoughts)
🎯CORRECT CHOICE: D
💡EXPLANATION: Cognitive restructuring is a core component of cognitive-behavioral therapy (CBT). It
involves identifying, challenging, and replacing negative, irrational, or distorted thoughts that contribute
to anxiety. Deep breathing, progressive muscle relaxation, and guided imagery are behavioral
techniques.
**7. A client with borderline personality disorder is engaging in self-harming behavior. The nurse's
priority intervention is to:**
A) Ignore the behavior to avoid reinforcing it
B) Establish a no-harm contract with the client
C) Ensure the client's physical safety by providing a safe environment
D) Confront the client about the manipulative nature of the behavior
🎯CORRECT CHOICE: C
💡EXPLANATION: The priority is always client safety. Ensuring a safe environment by removing harmful
objects and maintaining close observation is the immediate priority when a client is at risk of self-harm.
This precedes any therapeutic communication or interventions.
**8. A nurse is assessing a client with alcohol use disorder who is experiencing withdrawal. Which of the
following findings is a sign of severe alcohol withdrawal that requires immediate medical attention?**
, A) Tremors and insomnia
B) Nausea and vomiting
C) Seizures and delirium tremens
D) Anxiety and restlessness
🎯CORRECT CHOICE: C
💡EXPLANATION: Seizures and delirium tremens (DTs) are life-threatening complications of severe
alcohol withdrawal. DTs include severe confusion, hallucinations, agitation, fever, and autonomic
instability. These require immediate medical intervention, including pharmacological management.
**9. A client is prescribed lorazepam for generalized anxiety disorder. Which of the following is an
important teaching point about benzodiazepines?**
A) They are safe for long-term use without any risk of dependence
B) They should be taken with high-fat meals to enhance absorption
C) They can cause physical and psychological dependence, and should be used short-term
D) They have no significant side effects
🎯CORRECT CHOICE: C
💡EXPLANATION: Benzodiazepines like lorazepam are effective for acute anxiety but carry a high risk of
physical and psychological dependence. They are generally recommended for short-term use. Tolerance
can develop, and withdrawal symptoms can occur upon discontinuation.
**10. A nurse is caring for a client with obsessive-compulsive disorder (OCD) who has a ritual of
checking the door lock 10 times before leaving the house. Which of the following nursing interventions
is most appropriate?**
A) Allowing the client ample time to complete the ritual to reduce anxiety
B) Telling the client to stop the ritual and that they are being irrational
C) Assisting the client to gradually reduce the frequency of the ritual
D) Ignoring the ritual to avoid reinforcing the behavior
🎯CORRECT CHOICE: C
💡EXPLANATION: The goal of treatment for OCD is to reduce the frequency and intensity of rituals. A
graduated approach, such as response prevention (gradually reducing the number of times the client
performs the ritual), is the most therapeutic. This is done in conjunction with cognitive therapy and
support.
2026 | NCLEX-Style Comprehensive Prep
Guide | Student Success Edition with
Practice Pack
**100 Questions with Verified Rationales**
---
**1. A client with major depressive disorder is started on fluoxetine. Which of the following statements
by the client indicates a need for further teaching?**
A) "It may take several weeks for this medication to work."
B) "I should avoid drinking alcohol while taking this medication."
C) "I can stop taking this medication as soon as I feel better."
D) "I should report any thoughts of suicide to my healthcare provider."
🎯CORRECT CHOICE: C
💡EXPLANATION: Antidepressants like fluoxetine (an SSRI) should not be stopped abruptly and require a
gradual taper under medical supervision to avoid withdrawal symptoms and relapse. It also takes 2-4
weeks for therapeutic effects to be seen, and patients should be monitored for suicidal ideation,
especially early in treatment.
**2. A nurse is caring for a client with bipolar disorder who is experiencing a manic episode. Which of
the following interventions is a priority?**
A) Encouraging the client to participate in group activities
B) Providing a structured, low-stimulation environment
C) Allowing the client to make all decisions regarding their care
D) Offering high-calorie snacks frequently
🎯CORRECT CHOICE: B
,💡EXPLANATION: During a manic episode, clients are highly distractible and may become easily
overstimulated. A structured, low-stimulation environment with a calm approach helps reduce agitation
and prevent escalation. Safety and providing clear, firm boundaries are priorities.
**3. A client with a diagnosis of schizophrenia is exhibiting auditory hallucinations. The client states,
"The voices are telling me that I am a bad person." What is the nurse's most therapeutic initial
response?**
A) "The voices are not real. You need to ignore them."
B) "I understand that the voices are telling you that you are a bad person, but I do not hear them."
C) "Why do you think the voices are saying that to you?"
D) "We need to increase your medication dose."
🎯CORRECT CHOICE: B
💡EXPLANATION: This response validates the client's experience without agreeing with the
hallucination. It distinguishes between the nurse's reality and the client's reality, which is a therapeutic
technique. It promotes trust and allows the client to feel understood.
**4. A nurse is assessing a client who is experiencing a panic attack. Which of the following physical
symptoms is the nurse most likely to observe?**
A) Bradycardia and hypotension
B) Hyperventilation and palpitations
C) Constricted pupils and decreased respiratory rate
D) Flaccid muscles and lethargy
🎯CORRECT CHOICE: B
💡EXPLANATION: Panic attacks are characterized by intense fear and autonomic arousal, leading to
symptoms such as palpitations, hyperventilation, chest pain, trembling, sweating, and a feeling of
impending doom. These symptoms are related to the sympathetic nervous system activation.
**5. A client has been diagnosed with post-traumatic stress disorder (PTSD) following a motor vehicle
accident. Which of the following is a hallmark symptom of this disorder?**
A) Persistent avoidance of anything associated with the traumatic event
B) Euphoric mood and grandiosity
C) Auditory hallucinations and disorganized speech
,D) Obsessive-compulsive behaviors
🎯CORRECT CHOICE: A
💡EXPLANATION: Avoidance is a core symptom of PTSD. Individuals with PTSD go to great lengths to
avoid reminders of the trauma, including thoughts, feelings, people, places, and activities. Other
symptoms include re-experiencing the trauma, hypervigilance, and negative alterations in mood and
cognition.
**6. A nurse is teaching a client with generalized anxiety disorder about relaxation techniques. Which of
the following is an example of a cognitive-behavioral technique used to manage anxiety?**
A) Deep breathing exercises
B) Progressive muscle relaxation
C) Guided imagery
D) Cognitive restructuring (challenging negative thoughts)
🎯CORRECT CHOICE: D
💡EXPLANATION: Cognitive restructuring is a core component of cognitive-behavioral therapy (CBT). It
involves identifying, challenging, and replacing negative, irrational, or distorted thoughts that contribute
to anxiety. Deep breathing, progressive muscle relaxation, and guided imagery are behavioral
techniques.
**7. A client with borderline personality disorder is engaging in self-harming behavior. The nurse's
priority intervention is to:**
A) Ignore the behavior to avoid reinforcing it
B) Establish a no-harm contract with the client
C) Ensure the client's physical safety by providing a safe environment
D) Confront the client about the manipulative nature of the behavior
🎯CORRECT CHOICE: C
💡EXPLANATION: The priority is always client safety. Ensuring a safe environment by removing harmful
objects and maintaining close observation is the immediate priority when a client is at risk of self-harm.
This precedes any therapeutic communication or interventions.
**8. A nurse is assessing a client with alcohol use disorder who is experiencing withdrawal. Which of the
following findings is a sign of severe alcohol withdrawal that requires immediate medical attention?**
, A) Tremors and insomnia
B) Nausea and vomiting
C) Seizures and delirium tremens
D) Anxiety and restlessness
🎯CORRECT CHOICE: C
💡EXPLANATION: Seizures and delirium tremens (DTs) are life-threatening complications of severe
alcohol withdrawal. DTs include severe confusion, hallucinations, agitation, fever, and autonomic
instability. These require immediate medical intervention, including pharmacological management.
**9. A client is prescribed lorazepam for generalized anxiety disorder. Which of the following is an
important teaching point about benzodiazepines?**
A) They are safe for long-term use without any risk of dependence
B) They should be taken with high-fat meals to enhance absorption
C) They can cause physical and psychological dependence, and should be used short-term
D) They have no significant side effects
🎯CORRECT CHOICE: C
💡EXPLANATION: Benzodiazepines like lorazepam are effective for acute anxiety but carry a high risk of
physical and psychological dependence. They are generally recommended for short-term use. Tolerance
can develop, and withdrawal symptoms can occur upon discontinuation.
**10. A nurse is caring for a client with obsessive-compulsive disorder (OCD) who has a ritual of
checking the door lock 10 times before leaving the house. Which of the following nursing interventions
is most appropriate?**
A) Allowing the client ample time to complete the ritual to reduce anxiety
B) Telling the client to stop the ritual and that they are being irrational
C) Assisting the client to gradually reduce the frequency of the ritual
D) Ignoring the ritual to avoid reinforcing the behavior
🎯CORRECT CHOICE: C
💡EXPLANATION: The goal of treatment for OCD is to reduce the frequency and intensity of rituals. A
graduated approach, such as response prevention (gradually reducing the number of times the client
performs the ritual), is the most therapeutic. This is done in conjunction with cognitive therapy and
support.
