Psychiatric/Mental Health Nursing Exam Review 2026:
100 Questions, Answers & Rationales
1. A client tells the nurse, “I don’t want to live anymore.” What is the nurse’s priority
response?
A. “You have so much to live for.”
B. “Why do you feel that way?”
C. “Are you thinking about killing yourself?”
D. “Let’s talk about something more positive.”
Answer: C
Rationale: Directly assessing suicidal thoughts is appropriate and does not increase
suicide risk. The nurse must determine the level of immediate danger.
2. Which statement demonstrates therapeutic communication?
A. “Everything will be okay.”
B. “Why did you do that?”
C. “Tell me more about what you’re feeling.”
D. “I know exactly how you feel.”
Answer: C
Rationale: Open-ended questions encourage the client to express feelings and provide
additional information.
3. A client experiencing severe anxiety is pacing and unable to concentrate. What
should the nurse do first?
A. Teach relaxation techniques in detail.
B. Ask the client to identify the cause of anxiety.
C. Move the client to a quiet environment.
D. Encourage participation in group therapy.
Answer: C
Rationale: Severe anxiety significantly reduces the client’s ability to process information.
Reducing environmental stimuli helps decrease anxiety.
,4. A client with schizophrenia says, “The voices are telling me that the nurses are
poisoning my food.” What is the best response?
A. “The voices aren’t real.”
B. “You shouldn’t listen to those voices.”
C. “I don’t hear the voices, but I understand that they are frightening you.”
D. “The nurses would never poison your food.”
Answer: C
Rationale: The nurse acknowledges the client’s feelings without validating the
hallucination.
5. Which finding is a positive symptom of schizophrenia?
A. Avolition
B. Flat affect
C. Social withdrawal
D. Auditory hallucinations
Answer: D
Rationale: Positive symptoms include hallucinations, delusions, and disorganized
speech or behavior. Negative symptoms include reduced motivation, affect, speech, and
social interaction.
6. A client experiencing mania has been continuously walking around the unit and
refuses to sit for meals. Which intervention is most appropriate?
A. Encourage a large three-course meal.
B. Provide high-calorie finger foods.
C. Restrict all physical activity.
D. Encourage the client to participate in group therapy.
Answer: B
Rationale: Clients experiencing mania may be too active to sit for meals. Nutritious,
high-calorie finger foods help maintain adequate nutrition.
7. Which finding is most characteristic of mania?
A. Decreased energy
, B. Increased need for sleep
C. Flight of ideas
D. Social withdrawal
Answer: C
Rationale: Mania commonly causes elevated or irritable mood, increased energy,
decreased need for sleep, pressured speech, and flight of ideas.
8. A client taking lithium reports severe diarrhea, vomiting, coarse tremors, and
confusion. What should the nurse suspect?
A. Therapeutic response
B. Lithium toxicity
C. Depression
D. Serotonin deficiency
Answer: B
Rationale: Severe gastrointestinal symptoms, coarse tremors, confusion, and ataxia can
indicate lithium toxicity and require urgent evaluation.
9. Which statement by a client taking lithium indicates a need for further teaching?
A. “I will maintain adequate fluid intake.”
B. “I will keep my sodium intake relatively consistent.”
C. “I can stop taking lithium when I feel better.”
D. “I will attend recommended laboratory monitoring.”
Answer: C
Rationale: Lithium should not be stopped abruptly without prescriber guidance. Ongoing
treatment and monitoring are important.
10. A client with depression suddenly becomes more energetic after several weeks of
severe depression. What should the nurse do?
A. Assume the depression has resolved.
B. Encourage increased social activity.
C. Reassess suicide risk.
D. Discontinue suicide precautions immediately.
100 Questions, Answers & Rationales
1. A client tells the nurse, “I don’t want to live anymore.” What is the nurse’s priority
response?
A. “You have so much to live for.”
B. “Why do you feel that way?”
C. “Are you thinking about killing yourself?”
D. “Let’s talk about something more positive.”
Answer: C
Rationale: Directly assessing suicidal thoughts is appropriate and does not increase
suicide risk. The nurse must determine the level of immediate danger.
2. Which statement demonstrates therapeutic communication?
A. “Everything will be okay.”
B. “Why did you do that?”
C. “Tell me more about what you’re feeling.”
D. “I know exactly how you feel.”
Answer: C
Rationale: Open-ended questions encourage the client to express feelings and provide
additional information.
3. A client experiencing severe anxiety is pacing and unable to concentrate. What
should the nurse do first?
A. Teach relaxation techniques in detail.
B. Ask the client to identify the cause of anxiety.
C. Move the client to a quiet environment.
D. Encourage participation in group therapy.
Answer: C
Rationale: Severe anxiety significantly reduces the client’s ability to process information.
Reducing environmental stimuli helps decrease anxiety.
,4. A client with schizophrenia says, “The voices are telling me that the nurses are
poisoning my food.” What is the best response?
A. “The voices aren’t real.”
B. “You shouldn’t listen to those voices.”
C. “I don’t hear the voices, but I understand that they are frightening you.”
D. “The nurses would never poison your food.”
Answer: C
Rationale: The nurse acknowledges the client’s feelings without validating the
hallucination.
5. Which finding is a positive symptom of schizophrenia?
A. Avolition
B. Flat affect
C. Social withdrawal
D. Auditory hallucinations
Answer: D
Rationale: Positive symptoms include hallucinations, delusions, and disorganized
speech or behavior. Negative symptoms include reduced motivation, affect, speech, and
social interaction.
6. A client experiencing mania has been continuously walking around the unit and
refuses to sit for meals. Which intervention is most appropriate?
A. Encourage a large three-course meal.
B. Provide high-calorie finger foods.
C. Restrict all physical activity.
D. Encourage the client to participate in group therapy.
Answer: B
Rationale: Clients experiencing mania may be too active to sit for meals. Nutritious,
high-calorie finger foods help maintain adequate nutrition.
7. Which finding is most characteristic of mania?
A. Decreased energy
, B. Increased need for sleep
C. Flight of ideas
D. Social withdrawal
Answer: C
Rationale: Mania commonly causes elevated or irritable mood, increased energy,
decreased need for sleep, pressured speech, and flight of ideas.
8. A client taking lithium reports severe diarrhea, vomiting, coarse tremors, and
confusion. What should the nurse suspect?
A. Therapeutic response
B. Lithium toxicity
C. Depression
D. Serotonin deficiency
Answer: B
Rationale: Severe gastrointestinal symptoms, coarse tremors, confusion, and ataxia can
indicate lithium toxicity and require urgent evaluation.
9. Which statement by a client taking lithium indicates a need for further teaching?
A. “I will maintain adequate fluid intake.”
B. “I will keep my sodium intake relatively consistent.”
C. “I can stop taking lithium when I feel better.”
D. “I will attend recommended laboratory monitoring.”
Answer: C
Rationale: Lithium should not be stopped abruptly without prescriber guidance. Ongoing
treatment and monitoring are important.
10. A client with depression suddenly becomes more energetic after several weeks of
severe depression. What should the nurse do?
A. Assume the depression has resolved.
B. Encourage increased social activity.
C. Reassess suicide risk.
D. Discontinue suicide precautions immediately.
