100 PMH-BC Practice Questions with
Answers & Rationales WITH: ASSESSMENT
AND DIAGNOSIS COVERED ALREADY
GRADED A+
1. A nurse is conducting a mental status examination (MSE) on a client. Which component of
the MSE assesses the client's ability to think logically and make connections?
A. Appearance and behavior
B. Speech and language
C. Thought process
D. Insight and judgment
Answer: C
Rationale: Thought process refers to the way a client thinks and organizes their thoughts,
including the logical flow and coherence of ideas. It assesses whether the client has
circumstantial, tangential, or loose associations. Appearance and behavior (A) assess physical
presentation. Speech and language (B) assess rate, rhythm, and volume. Insight and judgment
(D) assess awareness of illness and decision-making ability.
2. A client presents with a flat affect, alogia, and avolition. These symptoms are most
characteristic of which type of symptoms in schizophrenia?
A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Affective symptoms
Answer: B
Rationale: Negative symptoms of schizophrenia include diminished emotional expression (flat
affect), alogia (poverty of speech), avolition (lack of motivation), anhedonia, and asociality.
Positive symptoms (A) include hallucinations and delusions. Cognitive symptoms (C) include
1
, impaired memory and executive function. Affective symptoms (D) include depression and
anxiety.
3. A nurse is assessing a client with major depressive disorder. Which finding would be most
concerning for imminent risk of suicide?
A. The client reports feeling sad and hopeless
B. The client has a specific plan for suicide and access to means
C. The client reports difficulty sleeping and poor appetite
D. The client has a history of previous suicide attempts
Answer: B
Rationale: A specific suicide plan with access to means is the most significant risk factor for
imminent suicide. While feelings of sadness (A), sleep disturbances (C), and history of attempts
(D) are important risk factors, a specific plan with means indicates immediate high risk and
requires urgent intervention.
4. A client reports auditory hallucinations commanding her to harm herself. The nurse's
priority intervention is:
A. Ask the client to describe the voices in detail
B. Implement one-to-one observation and ensure client safety
C. Administer an antipsychotic medication immediately
D. Encourage the client to ignore the voices
Answer: B
Rationale: The priority intervention for a client with command hallucinations to self-harm is to
ensure client safety through one-to-one observation and a safe environment. Asking for details
(A) may be therapeutic but is not the priority. Medication (C) may be needed but is not the
immediate intervention. Encouraging the client to ignore the voices (D) is not realistic or
therapeutic.
5. A nurse is assessing a client with bipolar disorder who is currently in a manic episode.
Which finding would the nurse expect?
A. Psychomotor retardation and hypersomnia
B. Grandiose delusions and decreased need for sleep
2
, C. Anhedonia and social withdrawal
D. Flat affect and alogia
Answer: B
Rationale: Manic episodes are characterized by grandiosity, decreased need for sleep,
pressured speech, flight of ideas, and increased goal-directed activity. Psychomotor retardation
and hypersomnia (A) are seen in depressive episodes. Anhedonia and social withdrawal (C) are
seen in depression. Flat affect and alogia (D) are negative symptoms of schizophrenia.
6. A client presents with a fear of social situations where they may be scrutinized by others.
They avoid parties, meetings, and eating in public. Which diagnosis is most consistent with
these symptoms?
A. Panic disorder
B. Social anxiety disorder (social phobia)
C. Agoraphobia
D. Generalized anxiety disorder
Answer: B
Rationale: Social anxiety disorder is characterized by marked fear or anxiety about social
situations where the individual may be scrutinized, leading to avoidance. Panic disorder (A)
involves recurrent unexpected panic attacks. Agoraphobia (C) involves fear of situations where
escape might be difficult. Generalized anxiety disorder (D) involves excessive worry about
multiple domains.
7. A nurse is assessing a client with post-traumatic stress disorder (PTSD). Which symptom is
characteristic of the "hyperarousal" cluster?
A. Recurrent, intrusive memories of the trauma
B. Avoidance of trauma-related stimuli
C. Hypervigilance and an exaggerated startle response
D. Negative alterations in cognition and mood
Answer: C
Rationale: The hyperarousal cluster of PTSD includes hypervigilance, exaggerated startle
response, sleep disturbances, irritability, and difficulty concentrating. Intrusive memories (A) are
part of the intrusion cluster. Avoidance (B) is the avoidance cluster. Negative alterations in
cognition and mood (D) are the negative alterations cluster.
3
, 8. A client is brought to the emergency department by police after being found wandering in
the street, disoriented, and unable to provide identifying information. The client's speech is
incoherent, and they appear to be responding to internal stimuli. Which is the priority nursing
action?
A. Obtain a complete psychiatric history
B. Perform a physical assessment and obtain vital signs
C. Administer an antipsychotic medication
D. Place the client in seclusion
Answer: B
Rationale: The priority is to rule out medical causes of the acute mental status change. A
physical assessment, vital signs, and laboratory work (e.g., glucose, electrolytes, toxicology
screen) are essential to identify potential medical emergencies (e.g., hypoglycemia, infection,
substance intoxication). Obtaining a psychiatric history (A) is important but not the priority.
Medication (C) and seclusion (D) should not be the first interventions without a medical
evaluation.
9. A nurse is using the CAGE questionnaire to screen a client for alcohol use disorder. Which
question is part of the CAGE screening tool?
A. "Have you ever felt you should cut down on your drinking?"
B. "How many drinks do you have on a typical day?"
C. "Have you ever experienced withdrawal symptoms?"
D. "Do you drink alcohol to cope with stress?"
Answer: A
Rationale: The CAGE questionnaire consists of four questions: Cut down, Annoyed, Guilty,
and Eye-opener. "Have you ever felt you should cut down on your drinking?" is the "Cut down"
question. Quantity of drinks (B), withdrawal symptoms (C), and coping (D) are not part of the
CAGE tool.
10. A client with borderline personality disorder is admitted following a self-harm incident.
The nurse should prioritize which assessment?
A. History of childhood trauma
B. Current risk for suicide and self-harm
4
Answers & Rationales WITH: ASSESSMENT
AND DIAGNOSIS COVERED ALREADY
GRADED A+
1. A nurse is conducting a mental status examination (MSE) on a client. Which component of
the MSE assesses the client's ability to think logically and make connections?
A. Appearance and behavior
B. Speech and language
C. Thought process
D. Insight and judgment
Answer: C
Rationale: Thought process refers to the way a client thinks and organizes their thoughts,
including the logical flow and coherence of ideas. It assesses whether the client has
circumstantial, tangential, or loose associations. Appearance and behavior (A) assess physical
presentation. Speech and language (B) assess rate, rhythm, and volume. Insight and judgment
(D) assess awareness of illness and decision-making ability.
2. A client presents with a flat affect, alogia, and avolition. These symptoms are most
characteristic of which type of symptoms in schizophrenia?
A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Affective symptoms
Answer: B
Rationale: Negative symptoms of schizophrenia include diminished emotional expression (flat
affect), alogia (poverty of speech), avolition (lack of motivation), anhedonia, and asociality.
Positive symptoms (A) include hallucinations and delusions. Cognitive symptoms (C) include
1
, impaired memory and executive function. Affective symptoms (D) include depression and
anxiety.
3. A nurse is assessing a client with major depressive disorder. Which finding would be most
concerning for imminent risk of suicide?
A. The client reports feeling sad and hopeless
B. The client has a specific plan for suicide and access to means
C. The client reports difficulty sleeping and poor appetite
D. The client has a history of previous suicide attempts
Answer: B
Rationale: A specific suicide plan with access to means is the most significant risk factor for
imminent suicide. While feelings of sadness (A), sleep disturbances (C), and history of attempts
(D) are important risk factors, a specific plan with means indicates immediate high risk and
requires urgent intervention.
4. A client reports auditory hallucinations commanding her to harm herself. The nurse's
priority intervention is:
A. Ask the client to describe the voices in detail
B. Implement one-to-one observation and ensure client safety
C. Administer an antipsychotic medication immediately
D. Encourage the client to ignore the voices
Answer: B
Rationale: The priority intervention for a client with command hallucinations to self-harm is to
ensure client safety through one-to-one observation and a safe environment. Asking for details
(A) may be therapeutic but is not the priority. Medication (C) may be needed but is not the
immediate intervention. Encouraging the client to ignore the voices (D) is not realistic or
therapeutic.
5. A nurse is assessing a client with bipolar disorder who is currently in a manic episode.
Which finding would the nurse expect?
A. Psychomotor retardation and hypersomnia
B. Grandiose delusions and decreased need for sleep
2
, C. Anhedonia and social withdrawal
D. Flat affect and alogia
Answer: B
Rationale: Manic episodes are characterized by grandiosity, decreased need for sleep,
pressured speech, flight of ideas, and increased goal-directed activity. Psychomotor retardation
and hypersomnia (A) are seen in depressive episodes. Anhedonia and social withdrawal (C) are
seen in depression. Flat affect and alogia (D) are negative symptoms of schizophrenia.
6. A client presents with a fear of social situations where they may be scrutinized by others.
They avoid parties, meetings, and eating in public. Which diagnosis is most consistent with
these symptoms?
A. Panic disorder
B. Social anxiety disorder (social phobia)
C. Agoraphobia
D. Generalized anxiety disorder
Answer: B
Rationale: Social anxiety disorder is characterized by marked fear or anxiety about social
situations where the individual may be scrutinized, leading to avoidance. Panic disorder (A)
involves recurrent unexpected panic attacks. Agoraphobia (C) involves fear of situations where
escape might be difficult. Generalized anxiety disorder (D) involves excessive worry about
multiple domains.
7. A nurse is assessing a client with post-traumatic stress disorder (PTSD). Which symptom is
characteristic of the "hyperarousal" cluster?
A. Recurrent, intrusive memories of the trauma
B. Avoidance of trauma-related stimuli
C. Hypervigilance and an exaggerated startle response
D. Negative alterations in cognition and mood
Answer: C
Rationale: The hyperarousal cluster of PTSD includes hypervigilance, exaggerated startle
response, sleep disturbances, irritability, and difficulty concentrating. Intrusive memories (A) are
part of the intrusion cluster. Avoidance (B) is the avoidance cluster. Negative alterations in
cognition and mood (D) are the negative alterations cluster.
3
, 8. A client is brought to the emergency department by police after being found wandering in
the street, disoriented, and unable to provide identifying information. The client's speech is
incoherent, and they appear to be responding to internal stimuli. Which is the priority nursing
action?
A. Obtain a complete psychiatric history
B. Perform a physical assessment and obtain vital signs
C. Administer an antipsychotic medication
D. Place the client in seclusion
Answer: B
Rationale: The priority is to rule out medical causes of the acute mental status change. A
physical assessment, vital signs, and laboratory work (e.g., glucose, electrolytes, toxicology
screen) are essential to identify potential medical emergencies (e.g., hypoglycemia, infection,
substance intoxication). Obtaining a psychiatric history (A) is important but not the priority.
Medication (C) and seclusion (D) should not be the first interventions without a medical
evaluation.
9. A nurse is using the CAGE questionnaire to screen a client for alcohol use disorder. Which
question is part of the CAGE screening tool?
A. "Have you ever felt you should cut down on your drinking?"
B. "How many drinks do you have on a typical day?"
C. "Have you ever experienced withdrawal symptoms?"
D. "Do you drink alcohol to cope with stress?"
Answer: A
Rationale: The CAGE questionnaire consists of four questions: Cut down, Annoyed, Guilty,
and Eye-opener. "Have you ever felt you should cut down on your drinking?" is the "Cut down"
question. Quantity of drinks (B), withdrawal symptoms (C), and coping (D) are not part of the
CAGE tool.
10. A client with borderline personality disorder is admitted following a self-harm incident.
The nurse should prioritize which assessment?
A. History of childhood trauma
B. Current risk for suicide and self-harm
4
