Strayer University NUR 450 Final EXAM (pdf) | 2026/2027 |
Psychiatric Q&A | Psychiatric Nursing
1. A nurse is caring for a client who is experiencing a manic episode. Which
environmental intervention is most appropriate?
A) Provide a stimulating environment with many activities.
B) Place the client in a private room with decreased stimuli.
C) Encourage the client to participate in group therapy.
D) Allow the client to stay awake as long as desired.
Correct Answer: Place the client in a private room with decreased stimuli.
Rationale: Clients in a manic episode are highly stimulated and may become
overwhelmed. A quiet, low-stimulus environment helps reduce agitation and
promotes rest. Structured, calm activities are more appropriate than
stimulating ones.
2. Which defense mechanism is commonly used by clients who are
alcoholics?
A) Denial
B) Projection
C) Rationalization
D) Regression
Correct Answer: Denial
Rationale: Denial is a common defense mechanism used by individuals with
substance use disorders, including alcoholism. It involves refusing to
acknowledge the reality of the problem or its consequences.
,3. A client with generalized anxiety disorder is prescribed a benzodiazepine.
Which instruction should the nurse include in the teaching plan?
A) "This medication is safe to take with alcohol."
B) "You may experience drowsiness; avoid driving until you know how it
affects you."
C) "This medication is not habit-forming."
D) "You can stop taking this medication abruptly when you feel better."
Correct Answer: "You may experience drowsiness; avoid driving until you
know how it affects you."
Rationale: Benzodiazepines cause CNS depression, leading to drowsiness and
sedation. Clients should be advised to avoid driving or operating machinery
until they know how the medication affects them. Benzodiazepines are habit-
forming and should not be stopped abruptly.
4. The nurse is performing a mental status examination. Which component
assesses the client's ability to think abstractly?
A) Orientation
B) Memory
C) Judgment
D) Similarities and differences
Correct Answer: Similarities and differences
Rationale: Abstract thinking is assessed by asking the client to explain
similarities and differences (e.g., "How are an apple and an orange alike?").
Orientation assesses awareness of person, place, and time; memory
assesses recall; judgment assesses decision-making.
,5. Which of the following is a positive symptom of schizophrenia?
A) Flat affect
B) Hallucinations
C) Social withdrawal
D) Anhedonia
Correct Answer: Hallucinations
Rationale: Positive symptoms of schizophrenia are those that are added to
normal functioning and include hallucinations, delusions, and disorganized
thinking. Negative symptoms include flat affect, social withdrawal, and
anhedonia.
6. A client with borderline personality disorder is engaging in splitting
behavior. Which statement best describes splitting?
A) Seeing people as either all good or all bad.
B) Avoiding all interpersonal relationships.
C) Extreme dependence on others.
D) Manipulative behaviors.
Correct Answer: Seeing people as either all good or all bad.
Rationale: Splitting is a defense mechanism common in borderline
personality disorder in which the client views people and situations as either
all good or all bad. This can lead to unstable relationships and
idealization/devaluation.
7. The nurse is assessing a client for signs of major depressive disorder.
Which finding is most consistent with this diagnosis?
, A) Elevated mood and increased energy
B) Persistent sadness and anhedonia
C) Grandiose delusions
D) Pressured speech
Correct Answer: Persistent sadness and anhedonia
Rationale: Major depressive disorder is characterized by persistent sadness,
hopelessness, and anhedonia (loss of interest or pleasure in activities).
Elevated mood, grandiose delusions, and pressured speech are associated
with mania.
8. A client with schizophrenia is prescribed an antipsychotic medication.
Which side effect should the nurse monitor for?
A) Tardive dyskinesia
B) Weight loss
C) Hypertension
D) Bradycardia
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a potentially irreversible movement disorder
characterized by involuntary, repetitive movements of the face, tongue, and
extremities. It is a late-onset adverse effect of antipsychotic medications,
particularly typical antipsychotics.
9. Which neurotransmitter is believed to be dysfunctional in anxiety
disorders and functions as the body's natural antianxiety agent by reducing
cell excitability?
A) Dopamine
Psychiatric Q&A | Psychiatric Nursing
1. A nurse is caring for a client who is experiencing a manic episode. Which
environmental intervention is most appropriate?
A) Provide a stimulating environment with many activities.
B) Place the client in a private room with decreased stimuli.
C) Encourage the client to participate in group therapy.
D) Allow the client to stay awake as long as desired.
Correct Answer: Place the client in a private room with decreased stimuli.
Rationale: Clients in a manic episode are highly stimulated and may become
overwhelmed. A quiet, low-stimulus environment helps reduce agitation and
promotes rest. Structured, calm activities are more appropriate than
stimulating ones.
2. Which defense mechanism is commonly used by clients who are
alcoholics?
A) Denial
B) Projection
C) Rationalization
D) Regression
Correct Answer: Denial
Rationale: Denial is a common defense mechanism used by individuals with
substance use disorders, including alcoholism. It involves refusing to
acknowledge the reality of the problem or its consequences.
,3. A client with generalized anxiety disorder is prescribed a benzodiazepine.
Which instruction should the nurse include in the teaching plan?
A) "This medication is safe to take with alcohol."
B) "You may experience drowsiness; avoid driving until you know how it
affects you."
C) "This medication is not habit-forming."
D) "You can stop taking this medication abruptly when you feel better."
Correct Answer: "You may experience drowsiness; avoid driving until you
know how it affects you."
Rationale: Benzodiazepines cause CNS depression, leading to drowsiness and
sedation. Clients should be advised to avoid driving or operating machinery
until they know how the medication affects them. Benzodiazepines are habit-
forming and should not be stopped abruptly.
4. The nurse is performing a mental status examination. Which component
assesses the client's ability to think abstractly?
A) Orientation
B) Memory
C) Judgment
D) Similarities and differences
Correct Answer: Similarities and differences
Rationale: Abstract thinking is assessed by asking the client to explain
similarities and differences (e.g., "How are an apple and an orange alike?").
Orientation assesses awareness of person, place, and time; memory
assesses recall; judgment assesses decision-making.
,5. Which of the following is a positive symptom of schizophrenia?
A) Flat affect
B) Hallucinations
C) Social withdrawal
D) Anhedonia
Correct Answer: Hallucinations
Rationale: Positive symptoms of schizophrenia are those that are added to
normal functioning and include hallucinations, delusions, and disorganized
thinking. Negative symptoms include flat affect, social withdrawal, and
anhedonia.
6. A client with borderline personality disorder is engaging in splitting
behavior. Which statement best describes splitting?
A) Seeing people as either all good or all bad.
B) Avoiding all interpersonal relationships.
C) Extreme dependence on others.
D) Manipulative behaviors.
Correct Answer: Seeing people as either all good or all bad.
Rationale: Splitting is a defense mechanism common in borderline
personality disorder in which the client views people and situations as either
all good or all bad. This can lead to unstable relationships and
idealization/devaluation.
7. The nurse is assessing a client for signs of major depressive disorder.
Which finding is most consistent with this diagnosis?
, A) Elevated mood and increased energy
B) Persistent sadness and anhedonia
C) Grandiose delusions
D) Pressured speech
Correct Answer: Persistent sadness and anhedonia
Rationale: Major depressive disorder is characterized by persistent sadness,
hopelessness, and anhedonia (loss of interest or pleasure in activities).
Elevated mood, grandiose delusions, and pressured speech are associated
with mania.
8. A client with schizophrenia is prescribed an antipsychotic medication.
Which side effect should the nurse monitor for?
A) Tardive dyskinesia
B) Weight loss
C) Hypertension
D) Bradycardia
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a potentially irreversible movement disorder
characterized by involuntary, repetitive movements of the face, tongue, and
extremities. It is a late-onset adverse effect of antipsychotic medications,
particularly typical antipsychotics.
9. Which neurotransmitter is believed to be dysfunctional in anxiety
disorders and functions as the body's natural antianxiety agent by reducing
cell excitability?
A) Dopamine
