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Mental Health Nursing Exam 2026: 300
Q&A with Rationales – PMH-BC &
NCLEX Prep
Q1
A patient diagnosed with schizophrenia tells the nurse, "The FBI is monitoring my
brain waves through satellite signals." Which nursing response is most therapeutic?
A) "That sounds frightening. Let's focus on something safe in this room."
B) "The FBI has no interest in monitoring you."
C) "Why do you think they would monitor you?"
D) "I don't hear the signals you're describing."
Correct Answer: A
Rationale: Option A validates the patient's emotional experience without reinforcing
the delusion, then redirects to the present reality. Option B argues with the delusion,
damaging trust. Option C encourages further elaboration of psychotic content. Option
D denies the patient's subjective reality without addressing the underlying fear.
Q2
A patient with major depressive disorder has been prescribed phenelzine (Nardil).
Which dietary item should the nurse instruct the patient to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) White rice
D) Boiled chicken
Correct Answer: B
Rationale: Phenelzine is an MAOI. Aged cheeses contain high tyramine levels, which
can precipitate a hypertensive crisis. Fresh fruits, rice, and plain meats are safe.
Q3
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A patient with borderline personality disorder exhibits splitting behavior by telling
the nurse, "You're the only one who understands me; the other nurses are cruel."
What is the nurse's best response?
A) "I'm glad you trust me."
B) "The other nurses are competent and caring professionals."
C) "It sounds like you have strong feelings. Let's discuss your concerns about the team."
D) "You shouldn't talk about your other nurses that way."
Correct Answer: C
Rationale: Option C addresses splitting by validating feelings while encouraging
reality testing and open communication. Option A reinforces idealization. Option B
dismisses feelings. Option D is judgmental and non-therapeutic.
Q4
A patient experiencing alcohol withdrawal is prescribed chlordiazepoxide (Librium).
The nurse understands that the primary purpose of this medication is to:
A) Reduce craving for alcohol
B) Prevent seizures and manage agitation
C) Block the euphoric effects of alcohol
D) Promote aversion to alcohol
Correct Answer: B
Rationale: Benzodiazepines like chlordiazepoxide are the mainstay of alcohol
withdrawal management because they cross-tolerate with alcohol and suppress CNS
hyperexcitability, preventing seizures and delirium tremens.
Q5
Which defense mechanism is most commonly used by a patient with obsessive-
compulsive disorder who repeatedly checks locked doors to manage anxiety?
A) Repression
B) Rationalization
C) Undoing
D) Projection
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Correct Answer: C
Rationale: Undoing is an unconscious attempt to reverse an unwanted thought
through ritualistic behavior. Checking locks counteracts the fear of harm.
Q6
A patient states, "I'm so worthless. My family would be better off if I were dead."
Which nursing action takes priority?
A) Ask the patient if they have a plan to harm themselves
B) Call the patient's family to inform them
C) Reassure the patient that they are not worthless
D) Distract the patient with a positive activity
Correct Answer: A
Rationale: The priority is to conduct a suicide risk assessment, including asking
directly about suicidal ideation, intent, plan, and means. This is mandatory and
immediate.
Q7
A nurse is caring for a patient with bipolar disorder experiencing acute mania. Which
environmental intervention is most appropriate?
A) Place the patient in a private room with minimal stimulation
B) Assign the patient to a group exercise session
C) Encourage competitive games to channel energy
D) Provide a high-stimulation environment to distract
Correct Answer: A
Rationale: Patients in acute mania are highly susceptible to sensory overload. A
private, quiet, low-stimulation environment reduces agitation and promotes sleep.
Q8
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Mental Health Nursing Exam 2026: 300
Q&A with Rationales – PMH-BC &
NCLEX Prep
Q1
A patient diagnosed with schizophrenia tells the nurse, "The FBI is monitoring my
brain waves through satellite signals." Which nursing response is most therapeutic?
A) "That sounds frightening. Let's focus on something safe in this room."
B) "The FBI has no interest in monitoring you."
C) "Why do you think they would monitor you?"
D) "I don't hear the signals you're describing."
Correct Answer: A
Rationale: Option A validates the patient's emotional experience without reinforcing
the delusion, then redirects to the present reality. Option B argues with the delusion,
damaging trust. Option C encourages further elaboration of psychotic content. Option
D denies the patient's subjective reality without addressing the underlying fear.
Q2
A patient with major depressive disorder has been prescribed phenelzine (Nardil).
Which dietary item should the nurse instruct the patient to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) White rice
D) Boiled chicken
Correct Answer: B
Rationale: Phenelzine is an MAOI. Aged cheeses contain high tyramine levels, which
can precipitate a hypertensive crisis. Fresh fruits, rice, and plain meats are safe.
Q3
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A patient with borderline personality disorder exhibits splitting behavior by telling
the nurse, "You're the only one who understands me; the other nurses are cruel."
What is the nurse's best response?
A) "I'm glad you trust me."
B) "The other nurses are competent and caring professionals."
C) "It sounds like you have strong feelings. Let's discuss your concerns about the team."
D) "You shouldn't talk about your other nurses that way."
Correct Answer: C
Rationale: Option C addresses splitting by validating feelings while encouraging
reality testing and open communication. Option A reinforces idealization. Option B
dismisses feelings. Option D is judgmental and non-therapeutic.
Q4
A patient experiencing alcohol withdrawal is prescribed chlordiazepoxide (Librium).
The nurse understands that the primary purpose of this medication is to:
A) Reduce craving for alcohol
B) Prevent seizures and manage agitation
C) Block the euphoric effects of alcohol
D) Promote aversion to alcohol
Correct Answer: B
Rationale: Benzodiazepines like chlordiazepoxide are the mainstay of alcohol
withdrawal management because they cross-tolerate with alcohol and suppress CNS
hyperexcitability, preventing seizures and delirium tremens.
Q5
Which defense mechanism is most commonly used by a patient with obsessive-
compulsive disorder who repeatedly checks locked doors to manage anxiety?
A) Repression
B) Rationalization
C) Undoing
D) Projection
, 4|Page
Correct Answer: C
Rationale: Undoing is an unconscious attempt to reverse an unwanted thought
through ritualistic behavior. Checking locks counteracts the fear of harm.
Q6
A patient states, "I'm so worthless. My family would be better off if I were dead."
Which nursing action takes priority?
A) Ask the patient if they have a plan to harm themselves
B) Call the patient's family to inform them
C) Reassure the patient that they are not worthless
D) Distract the patient with a positive activity
Correct Answer: A
Rationale: The priority is to conduct a suicide risk assessment, including asking
directly about suicidal ideation, intent, plan, and means. This is mandatory and
immediate.
Q7
A nurse is caring for a patient with bipolar disorder experiencing acute mania. Which
environmental intervention is most appropriate?
A) Place the patient in a private room with minimal stimulation
B) Assign the patient to a group exercise session
C) Encourage competitive games to channel energy
D) Provide a high-stimulation environment to distract
Correct Answer: A
Rationale: Patients in acute mania are highly susceptible to sensory overload. A
private, quiet, low-stimulation environment reduces agitation and promotes sleep.
Q8
