Psychiatric-Mental Health Nursing Test Bank — Unit 1
Psychiatric-Mental Health Nursing
Comprehensive NCLEX-Style Test Bank
Based on OpenStax Psychiatric-Mental Health Nursing
(Puchkors, Saunders, & Sharp, 2024)
Each item includes the correct answer, a detailed rationale (including why distractors are incorrect), and a
textbook reference.
Page 1
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
Contents
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
Chapter 2: Fundamentals of Theories and Therapies
Chapter 3: Communication, Perception, and Assessment
Chapter 4: Neurobiology and Pharmacological Standards
Chapter 5: Therapeutic Settings
Chapter 6: Therapeutic Relationships
Chapter 7: Interprofessional Care
Chapter 8: Cultural Considerations
Chapter 9: Social and Emotional Concerns
Chapter 10: Legal and Ethical Guidelines
Chapter 11: Court Involvement
Chapter 12: Self-Determination and Advocacy
Chapter 13: Clinical Guidelines and Practice
Chapter 14: Neurocognitive Disorders
Chapter 15: Schizophrenia Spectrum Disorder and Other Psychotic Disorders
Chapter 16: Mood Disorders and Suicide
Chapter 17: Anxiety, OCD, and Trauma-Stressor Disorders
Chapter 18: Personality Disorders
Chapter 19: Substance Use and Misuse
Chapter 20: Eating Disorders
Chapter 21: Somatic Symptom Disorders
Chapter 22: Sexual Dysfunction and Gender Dysphoria
Chapter 25: Community Mental Health Treatment
Chapter 26: Adjuncts to Treatments
Chapter 27: Current Trends and Growing Needs
Chapter 28: Critical Thinking in Psychiatric-Mental Health Nursing
Page 2
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
UNIT 1: THEORIES, PRACTICE, AND TRENDS
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
16 Questions
1. Nurse Jon is caring for a client who reports occasional stress from everyday demands but continues to sleep well, maintain
relationships, and perform effectively at work. According to the mental health continuum, this client is best classified as
being in which category?
A. Mental illness
B. Well-being
C. Emotional problems or concerns
D. Serious mental illness
Correct Answer: B
Rationale: Well-being is the healthy end of the mental health continuum; individuals experience normal stress but cope
effectively with no impairment in daily functioning. Mental illness and serious mental illness both involve moderate-to-
severe functional impairment, and "emotional problems" reflects a transitional zone with some distress but not the sustained
effective coping described here.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 10–11 (Figure 1.2, Mental Health Continuum)
2. A nurse explains to a nursing student that the primary reason nurses gather subjective data (e.g., "Tell me more about how
you are feeling") rather than relying solely on objective data when evaluating an antidepressant’s effectiveness is which of
the following?
A. Objective data are unreliable in psychiatric nursing
B. Neurotransmitter levels cannot be directly measured, so the client’s reported experience is the primary indicator
of medication effect
C. Subjective data are easier to document in the medical record
D. Objective vital signs are not part of a psychiatric assessment
Correct Answer: B
Rationale: Unlike a measurable finding such as blood pressure or heart rate, neurotransmitter activity cannot be directly
assessed at the bedside. The nurse must rely on the client’s subjective report of mood, thought, and behavior, supplemented
by direct observation, to judge medication effectiveness. Objective data (vitals, labs) remain valuable but are not the primary
measure of a psychotropic medication’s effect.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 12–13
3. Which historical figure is credited with developing the theory of interpersonal relations and is known as the “mother of
psychiatric nursing”?
A. Effie Jane Taylor
B. Edward Cowles
C. Hildegard Peplau
D. Sigmund Freud
Correct Answer: C
Rationale: Hildegard Peplau rose to prominence in the 1950s with her theory of interpersonal relations, redefining the
psychiatric nurse’s role as a collaborative partner rather than a physician’s assistant. Cowles began the first psychiatric nurse
training program, and Taylor organized the first nurse-taught psychiatric nursing course, but neither is credited with this
theoretical framework.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 11 (History of Psychiatric Nursing)
Page 3
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
4. A community mental health nurse is completing an intake assessment on a 32-year-old pregnant client with depression
who declines to answer questions about alcohol and tobacco use. What is the nurse’s best rationale for continuing to pursue
this information?
A. It is optional and only affects billing documentation
B. Substance use during pregnancy is associated with significant fetal risks, including cognitive delays, low birth
weight, and neonatal complications
C. Tobacco and alcohol use are unrelated to mental health treatment planning
D. The information is only relevant after delivery
Correct Answer: B
Rationale: Maternal substance use is a documented risk factor for adverse fetal and neonatal outcomes (e.g., fetal alcohol
syndrome, ADHD, low birth weight, neonatal abstinence syndrome). This information directly affects the interdisciplinary
plan of care for both client and fetus, making it an essential, not optional, component of assessment.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 16–17 (Table 1.2, Effects of Maternal Drug Use)
5. Approximately what percentage of adults report experiencing adverse childhood experiences (ACEs) such as abuse,
neglect, or household dysfunction?
A. 19 percent
B. 39 percent
C. 61 percent
D. 85 percent
Correct Answer: C
Rationale: The chapter reports that an estimated 61 percent of adults have experienced early ACEs. This distinguishes ACE
prevalence from the statistic that roughly 19 percent of adults experience any mental illness in a given year—a commonly
confused figure on exams.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 18–19
6. A client sustained a traumatic brain injury (TBI) in a motor vehicle accident two years ago. The nurse recognizes this client
is at increased risk for which long-term outcome?
A. Complete resolution of psychiatric risk once physical healing occurs
B. Decreased risk of PTSD compared to the general population
C. Long-term psychiatric and functional effects, including risk of PTSD from the traumatic event and mental health
strain on family members
D. No relationship between TBI and psychiatric symptoms
Correct Answer: C
Rationale: TBI is identified as a physiological risk factor for mental illness that can cause lasting problems with cognition,
mood, and behavior, and can also increase PTSD symptoms and psychological strain on partners or family members caring
for the client.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 17
7. According to current evidence cited in the text, what duration and frequency of exercise is considered optimal for
supporting good mental health as a protective factor?
A. 15 minutes daily
B. 45 minutes, 3–5 days per week
C. 60 minutes, 7 days per week
D. 20 minutes, 1–2 days per week
Correct Answer: B
Rationale: Evidence cited in the chapter suggests 45 minutes of exercise, 3 to 5 days per week, is optimal for good mental
health, reducing symptoms such as depression through mechanisms including endorphin release. This is a frequently tested
specific figure distinguishing protective lifestyle interventions.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 20 (Internal Environment: Physiological)
Page 4
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
8. A client states, "I don't want anyone to know I'm getting treatment because I'm ashamed of being sick." This statement best
reflects which type of stigma?
A. Public stigma
B. Institutional stigma
C. Self-stigma
D. Affiliated (caregiver) stigma
Correct Answer: C
Rationale: Self-stigma involves internalized shame and negative attitudes a person holds about their own condition. Public
stigma refers to societal attitudes toward people with mental illness in general; institutional stigma involves systemic policies
limiting opportunity; affiliated stigma pertains to caregivers, not the client themselves.
Reference: Ch. 1.3 Mental Health Stigma, p. 23
9. A nurse notices she feels unexplained discomfort around clients who remind her of family members with substance use
disorder, even though she is not consciously aware of forming this judgment. This scenario best illustrates which concept?
A. Explicit bias
B. Implicit bias
C. Stereotyping
D. Institutional stigma
Correct Answer: B
Rationale: Implicit bias refers to prejudice that exists beyond a person’s conscious awareness or control, shaped by social
conditioning. Explicit bias, in contrast, involves attitudes the person is aware of and communicates openly. Stereotyping is a
generalized, prejudiced opinion about a group, and institutional stigma refers to systemic, organizational-level discrimination.
Reference: Ch. 1.3 Mental Health Stigma, p. 24
10. Place the five stages of the psychiatric-mental health recovery model in the correct sequence.
A. Education, starting treatment, finding new meaning, making a change, sticking with recovery
B. Starting treatment, mental illness education, making a change, finding new meaning, sticking with recovery
C. Making a change, starting treatment, sticking with recovery, education, finding new meaning
D. Sticking with recovery, starting treatment, education, making a change, finding new meaning
Correct Answer: B
Rationale: The correct sequence is: (1) starting treatment, when the person recognizes the need for help; (2) mental illness
education; (3) making a change to lifestyle, environment, or relationships; (4) finding new meaning through positive
experiences; and (5) sticking with recovery through ongoing treatment planning. While recovery is nonlinear overall, this is
the model’s intended progression.
Reference: Ch. 1.4 Mental Health Recovery and Wellness, p. 29 (Figure 1.7)
11. Which principle of the recovery model reflects the idea that setbacks are an expected part of the process, and growth
continues through learning from those setbacks rather than viewing them as failure?
A. Strengths-based
B. Nonlinear
C. Self-direction
D. Responsibility
Correct Answer: B
Rationale: The nonlinear principle explicitly states that recovery is not a straight path and may involve setbacks, with
continued growth occurring through learning from them. Strengths-based focuses on building on existing capabilities, self-
direction emphasizes client-led decision-making, and responsibility emphasizes client ownership of the recovery path—all
distinct principles.
Reference: Ch. 1.4 Mental Health Recovery and Wellness, p. 28 (Ten Principles of Recovery)
12. The Wellness Recovery Action Plan (WRAP) is best described as which type of intervention?
Page 5
Psychiatric-Mental Health Nursing
Comprehensive NCLEX-Style Test Bank
Based on OpenStax Psychiatric-Mental Health Nursing
(Puchkors, Saunders, & Sharp, 2024)
Each item includes the correct answer, a detailed rationale (including why distractors are incorrect), and a
textbook reference.
Page 1
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
Contents
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
Chapter 2: Fundamentals of Theories and Therapies
Chapter 3: Communication, Perception, and Assessment
Chapter 4: Neurobiology and Pharmacological Standards
Chapter 5: Therapeutic Settings
Chapter 6: Therapeutic Relationships
Chapter 7: Interprofessional Care
Chapter 8: Cultural Considerations
Chapter 9: Social and Emotional Concerns
Chapter 10: Legal and Ethical Guidelines
Chapter 11: Court Involvement
Chapter 12: Self-Determination and Advocacy
Chapter 13: Clinical Guidelines and Practice
Chapter 14: Neurocognitive Disorders
Chapter 15: Schizophrenia Spectrum Disorder and Other Psychotic Disorders
Chapter 16: Mood Disorders and Suicide
Chapter 17: Anxiety, OCD, and Trauma-Stressor Disorders
Chapter 18: Personality Disorders
Chapter 19: Substance Use and Misuse
Chapter 20: Eating Disorders
Chapter 21: Somatic Symptom Disorders
Chapter 22: Sexual Dysfunction and Gender Dysphoria
Chapter 25: Community Mental Health Treatment
Chapter 26: Adjuncts to Treatments
Chapter 27: Current Trends and Growing Needs
Chapter 28: Critical Thinking in Psychiatric-Mental Health Nursing
Page 2
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
UNIT 1: THEORIES, PRACTICE, AND TRENDS
Chapter 1: Foundations of Psychiatric-Mental Health Nursing
16 Questions
1. Nurse Jon is caring for a client who reports occasional stress from everyday demands but continues to sleep well, maintain
relationships, and perform effectively at work. According to the mental health continuum, this client is best classified as
being in which category?
A. Mental illness
B. Well-being
C. Emotional problems or concerns
D. Serious mental illness
Correct Answer: B
Rationale: Well-being is the healthy end of the mental health continuum; individuals experience normal stress but cope
effectively with no impairment in daily functioning. Mental illness and serious mental illness both involve moderate-to-
severe functional impairment, and "emotional problems" reflects a transitional zone with some distress but not the sustained
effective coping described here.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 10–11 (Figure 1.2, Mental Health Continuum)
2. A nurse explains to a nursing student that the primary reason nurses gather subjective data (e.g., "Tell me more about how
you are feeling") rather than relying solely on objective data when evaluating an antidepressant’s effectiveness is which of
the following?
A. Objective data are unreliable in psychiatric nursing
B. Neurotransmitter levels cannot be directly measured, so the client’s reported experience is the primary indicator
of medication effect
C. Subjective data are easier to document in the medical record
D. Objective vital signs are not part of a psychiatric assessment
Correct Answer: B
Rationale: Unlike a measurable finding such as blood pressure or heart rate, neurotransmitter activity cannot be directly
assessed at the bedside. The nurse must rely on the client’s subjective report of mood, thought, and behavior, supplemented
by direct observation, to judge medication effectiveness. Objective data (vitals, labs) remain valuable but are not the primary
measure of a psychotropic medication’s effect.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 12–13
3. Which historical figure is credited with developing the theory of interpersonal relations and is known as the “mother of
psychiatric nursing”?
A. Effie Jane Taylor
B. Edward Cowles
C. Hildegard Peplau
D. Sigmund Freud
Correct Answer: C
Rationale: Hildegard Peplau rose to prominence in the 1950s with her theory of interpersonal relations, redefining the
psychiatric nurse’s role as a collaborative partner rather than a physician’s assistant. Cowles began the first psychiatric nurse
training program, and Taylor organized the first nurse-taught psychiatric nursing course, but neither is credited with this
theoretical framework.
Reference: Ch. 1.1 Mental Health and Mental Illness, p. 11 (History of Psychiatric Nursing)
Page 3
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
4. A community mental health nurse is completing an intake assessment on a 32-year-old pregnant client with depression
who declines to answer questions about alcohol and tobacco use. What is the nurse’s best rationale for continuing to pursue
this information?
A. It is optional and only affects billing documentation
B. Substance use during pregnancy is associated with significant fetal risks, including cognitive delays, low birth
weight, and neonatal complications
C. Tobacco and alcohol use are unrelated to mental health treatment planning
D. The information is only relevant after delivery
Correct Answer: B
Rationale: Maternal substance use is a documented risk factor for adverse fetal and neonatal outcomes (e.g., fetal alcohol
syndrome, ADHD, low birth weight, neonatal abstinence syndrome). This information directly affects the interdisciplinary
plan of care for both client and fetus, making it an essential, not optional, component of assessment.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 16–17 (Table 1.2, Effects of Maternal Drug Use)
5. Approximately what percentage of adults report experiencing adverse childhood experiences (ACEs) such as abuse,
neglect, or household dysfunction?
A. 19 percent
B. 39 percent
C. 61 percent
D. 85 percent
Correct Answer: C
Rationale: The chapter reports that an estimated 61 percent of adults have experienced early ACEs. This distinguishes ACE
prevalence from the statistic that roughly 19 percent of adults experience any mental illness in a given year—a commonly
confused figure on exams.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 18–19
6. A client sustained a traumatic brain injury (TBI) in a motor vehicle accident two years ago. The nurse recognizes this client
is at increased risk for which long-term outcome?
A. Complete resolution of psychiatric risk once physical healing occurs
B. Decreased risk of PTSD compared to the general population
C. Long-term psychiatric and functional effects, including risk of PTSD from the traumatic event and mental health
strain on family members
D. No relationship between TBI and psychiatric symptoms
Correct Answer: C
Rationale: TBI is identified as a physiological risk factor for mental illness that can cause lasting problems with cognition,
mood, and behavior, and can also increase PTSD symptoms and psychological strain on partners or family members caring
for the client.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 17
7. According to current evidence cited in the text, what duration and frequency of exercise is considered optimal for
supporting good mental health as a protective factor?
A. 15 minutes daily
B. 45 minutes, 3–5 days per week
C. 60 minutes, 7 days per week
D. 20 minutes, 1–2 days per week
Correct Answer: B
Rationale: Evidence cited in the chapter suggests 45 minutes of exercise, 3 to 5 days per week, is optimal for good mental
health, reducing symptoms such as depression through mechanisms including endorphin release. This is a frequently tested
specific figure distinguishing protective lifestyle interventions.
Reference: Ch. 1.2 Risk and Protective Factors of Mental Health, p. 20 (Internal Environment: Physiological)
Page 4
, Psychiatric-Mental Health Nursing Test Bank — Unit 1
8. A client states, "I don't want anyone to know I'm getting treatment because I'm ashamed of being sick." This statement best
reflects which type of stigma?
A. Public stigma
B. Institutional stigma
C. Self-stigma
D. Affiliated (caregiver) stigma
Correct Answer: C
Rationale: Self-stigma involves internalized shame and negative attitudes a person holds about their own condition. Public
stigma refers to societal attitudes toward people with mental illness in general; institutional stigma involves systemic policies
limiting opportunity; affiliated stigma pertains to caregivers, not the client themselves.
Reference: Ch. 1.3 Mental Health Stigma, p. 23
9. A nurse notices she feels unexplained discomfort around clients who remind her of family members with substance use
disorder, even though she is not consciously aware of forming this judgment. This scenario best illustrates which concept?
A. Explicit bias
B. Implicit bias
C. Stereotyping
D. Institutional stigma
Correct Answer: B
Rationale: Implicit bias refers to prejudice that exists beyond a person’s conscious awareness or control, shaped by social
conditioning. Explicit bias, in contrast, involves attitudes the person is aware of and communicates openly. Stereotyping is a
generalized, prejudiced opinion about a group, and institutional stigma refers to systemic, organizational-level discrimination.
Reference: Ch. 1.3 Mental Health Stigma, p. 24
10. Place the five stages of the psychiatric-mental health recovery model in the correct sequence.
A. Education, starting treatment, finding new meaning, making a change, sticking with recovery
B. Starting treatment, mental illness education, making a change, finding new meaning, sticking with recovery
C. Making a change, starting treatment, sticking with recovery, education, finding new meaning
D. Sticking with recovery, starting treatment, education, making a change, finding new meaning
Correct Answer: B
Rationale: The correct sequence is: (1) starting treatment, when the person recognizes the need for help; (2) mental illness
education; (3) making a change to lifestyle, environment, or relationships; (4) finding new meaning through positive
experiences; and (5) sticking with recovery through ongoing treatment planning. While recovery is nonlinear overall, this is
the model’s intended progression.
Reference: Ch. 1.4 Mental Health Recovery and Wellness, p. 29 (Figure 1.7)
11. Which principle of the recovery model reflects the idea that setbacks are an expected part of the process, and growth
continues through learning from those setbacks rather than viewing them as failure?
A. Strengths-based
B. Nonlinear
C. Self-direction
D. Responsibility
Correct Answer: B
Rationale: The nonlinear principle explicitly states that recovery is not a straight path and may involve setbacks, with
continued growth occurring through learning from them. Strengths-based focuses on building on existing capabilities, self-
direction emphasizes client-led decision-making, and responsibility emphasizes client ownership of the recovery path—all
distinct principles.
Reference: Ch. 1.4 Mental Health Recovery and Wellness, p. 28 (Ten Principles of Recovery)
12. The Wellness Recovery Action Plan (WRAP) is best described as which type of intervention?
Page 5
