, Psychiatric Mental Health Nursing NCLEX® Review:
10th Edition Videbeck EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE - 1. Current Theories and Practice
- 2. Building the Nurse–Client Relationship - 3. Current
Social and Emotional Concerns - 4. Nursing Practice
for Psychiatric Disorders
1. A psychiatric-mental health nurse is evaluating a client newly admitted with acute major
depressive disorder who exhibits profound psychomotor retardation and mutism. Which initial
nursing intervention takes priority to ensure client safety and physiological integrity?
A. Administering prescribed oral antidepressant medications with apple juice to mask the bitter
taste.
B. Assessing hydration and nutritional status while implementing structured feeding
assistance protocols.
C. Engaging the client in open-ended exploratory dialogue to uncover underlying depressive
triggers.
D. Encouraging immediate participation in group occupational therapy to mitigate isolation.
CORRECT ANSWER : B
Rationale: Clients with profound psychomotor retardation and mutism are at severe risk for
dehydration, malnutrition, and physical exhaustion, making physiological stability the absolute
priority. Option B directly addresses immediate survival needs. Option A is premature and
unsafe for oral medication administration given the client's mutism and risk of aspiration.
Option C fails because a mute client cannot engage in complex verbal exploration. Option D
places an inappropriate physical and emotional demand on a client who is severely
incapacitated.
,2. A client diagnosed with schizophrenia is prescribed clozapine after failing two previous trials of
atypical antipsychotics. Which diagnostic monitoring schedule must the nurse strictly enforce to
prevent life-threatening hematological complications?
A. Monthly complete blood counts (CBC) with differential throughout the lifetime duration of
therapy.
B. Weekly absolute neutrophil counts (ANC) for the first 6 months, followed by biweekly
and monthly monitoring based on clinical guidelines.
C. Biweekly serum electrolyte panels and liver function tests for the entire duration of treatment.
D. Quarterly electrocardiograms and biweekly thyroid-stimulating hormone levels.
CORRECT ANSWER : B
Rationale: Clozapine carries a severe risk of agranulocytosis, requiring rigorous hematological
tracking via absolute neutrophil counts (ANC) starting weekly for the first 6 months, then
biweekly for the next 6 months, and monthly thereafter if stable. Option A is incorrect because
monitoring frequency is initially much more frequent than monthly. Option C and D reference
incorrect intervals and parameters that do not replace the mandated ANC protocol for
neutropenia monitoring.
3. A nurse is conducting a mental status examination on a client presenting to the emergency
department. The client states, "The government has implanted a microchip in my dental fillings
to broadcast my thoughts to the FBI." How should the nurse document and classify this specific
thought content alteration?
A. Loose associations characteristic of formal thought disorder.
B. A fixed, false belief categorized as a delusion of persecution and control.
C. Concrete thinking reflective of cognitive decline.
D. An auditory hallucination involving sensory misperception.
CORRECT ANSWER : B
Rationale: Believing that an external agency has implanted a device to monitor or control
thoughts is a classic definition of a paranoid delusion, specifically involving themes of
persecution and control. Option A refers to disorganized speech flow rather than content. Option
C denotes an inability to abstract, which is different from a systematized false belief. Option D is
incorrect because believing or thinking something is a delusion, whereas a hallucination
involves a false sensory perception (hearing, seeing, tasting, smelling, or feeling).
, 4. A psychiatric nurse is leading an interaction with a client experiencing severe anxiety. The client
paces rapidly and states, "I feel like I am completely losing my mind and going to die right now."
Which response by the nurse represents the most therapeutic initial approach?
A. "Let's sit together in this quiet corner; I am staying right here with you."
B. "Try to calm down and tell me logically why you think you are dying."
C. "You are completely safe in the hospital, and your fears are entirely irrational."
D. "Would you like me to teach you a complex progressive muscle relaxation technique right
now?"
CORRECT ANSWER : A
Rationale: During severe to panic levels of anxiety, clients cannot process complex
rationalizations or learn new skills. Providing a calm, safe physical presence and setting limits
on pacing by offering a quiet space provides containment and security. Option B demands
rational thought the client is incapable of producing. Option C invalidates the client's intense
subjective experience. Option D introduces teaching at a time when cognitive capacity is
severely impaired.
5. A client with borderline personality disorder is admitted following an episode of superficial wrist
scratching. The client alternately praises one staff member as "the only compassionate nurse
here" while viciously criticizing another as "cold, malicious, and incompetent." What defense
mechanism is this client primarily demonstrating?
A. Intellectualization
B. Splitting
C. Reaction formation
D. Projection
CORRECT ANSWER : B
Rationale: Splitting is a primary defense mechanism common in borderline personality disorder
where the individual views people, situations, or themselves as all good or all bad, unable to
integrate ambivalent qualities. Option A involves using excessive reasoning to block emotional
pain. Option C involves expressing the opposite of one's true feelings. Option D involves
attributing one's own unacceptable impulses to another person.
10th Edition Videbeck EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE - 1. Current Theories and Practice
- 2. Building the Nurse–Client Relationship - 3. Current
Social and Emotional Concerns - 4. Nursing Practice
for Psychiatric Disorders
1. A psychiatric-mental health nurse is evaluating a client newly admitted with acute major
depressive disorder who exhibits profound psychomotor retardation and mutism. Which initial
nursing intervention takes priority to ensure client safety and physiological integrity?
A. Administering prescribed oral antidepressant medications with apple juice to mask the bitter
taste.
B. Assessing hydration and nutritional status while implementing structured feeding
assistance protocols.
C. Engaging the client in open-ended exploratory dialogue to uncover underlying depressive
triggers.
D. Encouraging immediate participation in group occupational therapy to mitigate isolation.
CORRECT ANSWER : B
Rationale: Clients with profound psychomotor retardation and mutism are at severe risk for
dehydration, malnutrition, and physical exhaustion, making physiological stability the absolute
priority. Option B directly addresses immediate survival needs. Option A is premature and
unsafe for oral medication administration given the client's mutism and risk of aspiration.
Option C fails because a mute client cannot engage in complex verbal exploration. Option D
places an inappropriate physical and emotional demand on a client who is severely
incapacitated.
,2. A client diagnosed with schizophrenia is prescribed clozapine after failing two previous trials of
atypical antipsychotics. Which diagnostic monitoring schedule must the nurse strictly enforce to
prevent life-threatening hematological complications?
A. Monthly complete blood counts (CBC) with differential throughout the lifetime duration of
therapy.
B. Weekly absolute neutrophil counts (ANC) for the first 6 months, followed by biweekly
and monthly monitoring based on clinical guidelines.
C. Biweekly serum electrolyte panels and liver function tests for the entire duration of treatment.
D. Quarterly electrocardiograms and biweekly thyroid-stimulating hormone levels.
CORRECT ANSWER : B
Rationale: Clozapine carries a severe risk of agranulocytosis, requiring rigorous hematological
tracking via absolute neutrophil counts (ANC) starting weekly for the first 6 months, then
biweekly for the next 6 months, and monthly thereafter if stable. Option A is incorrect because
monitoring frequency is initially much more frequent than monthly. Option C and D reference
incorrect intervals and parameters that do not replace the mandated ANC protocol for
neutropenia monitoring.
3. A nurse is conducting a mental status examination on a client presenting to the emergency
department. The client states, "The government has implanted a microchip in my dental fillings
to broadcast my thoughts to the FBI." How should the nurse document and classify this specific
thought content alteration?
A. Loose associations characteristic of formal thought disorder.
B. A fixed, false belief categorized as a delusion of persecution and control.
C. Concrete thinking reflective of cognitive decline.
D. An auditory hallucination involving sensory misperception.
CORRECT ANSWER : B
Rationale: Believing that an external agency has implanted a device to monitor or control
thoughts is a classic definition of a paranoid delusion, specifically involving themes of
persecution and control. Option A refers to disorganized speech flow rather than content. Option
C denotes an inability to abstract, which is different from a systematized false belief. Option D is
incorrect because believing or thinking something is a delusion, whereas a hallucination
involves a false sensory perception (hearing, seeing, tasting, smelling, or feeling).
, 4. A psychiatric nurse is leading an interaction with a client experiencing severe anxiety. The client
paces rapidly and states, "I feel like I am completely losing my mind and going to die right now."
Which response by the nurse represents the most therapeutic initial approach?
A. "Let's sit together in this quiet corner; I am staying right here with you."
B. "Try to calm down and tell me logically why you think you are dying."
C. "You are completely safe in the hospital, and your fears are entirely irrational."
D. "Would you like me to teach you a complex progressive muscle relaxation technique right
now?"
CORRECT ANSWER : A
Rationale: During severe to panic levels of anxiety, clients cannot process complex
rationalizations or learn new skills. Providing a calm, safe physical presence and setting limits
on pacing by offering a quiet space provides containment and security. Option B demands
rational thought the client is incapable of producing. Option C invalidates the client's intense
subjective experience. Option D introduces teaching at a time when cognitive capacity is
severely impaired.
5. A client with borderline personality disorder is admitted following an episode of superficial wrist
scratching. The client alternately praises one staff member as "the only compassionate nurse
here" while viciously criticizing another as "cold, malicious, and incompetent." What defense
mechanism is this client primarily demonstrating?
A. Intellectualization
B. Splitting
C. Reaction formation
D. Projection
CORRECT ANSWER : B
Rationale: Splitting is a primary defense mechanism common in borderline personality disorder
where the individual views people, situations, or themselves as all good or all bad, unable to
integrate ambivalent qualities. Option A involves using excessive reasoning to block emotional
pain. Option C involves expressing the opposite of one's true feelings. Option D involves
attributing one's own unacceptable impulses to another person.
