FLORIDA BOARD OF NURSING
PSYCHIATRIC MENTAL HEALTH NURSING
EXAM WITH ACTUAL QUESTIONS AND
VERIFIED ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A client with major depressive disorder tells the psychiatric
nurse, “My family would be better off without me. I have been
thinking that everyone would be happier if I were dead.” What is
the nurse’s priority response?
A. “You should focus on the positive things in your life.”
B. “Have you developed a specific plan to kill yourself?”
C. “Your family would be devastated if you died.”
D. “Let’s discuss some activities that usually make you feel better.”
Answer: B. “Have you developed a specific plan to kill yourself?”
Rationale: Directly assessing suicidal ideation, intent, plan, access to
means, and preparatory behavior is essential when a client expresses
hopelessness or thoughts of death. Asking directly about suicide does
not cause suicidal behavior. A specific plan, intent, and access to
lethal means substantially increase risk and require immediate safety
interventions. Reassurance, distraction, or attempting to persuade the
client that the family needs them does not adequately assess immediate
danger.
2. A client experiencing acute mania is pacing rapidly, speaking
loudly, interrupting others, and attempting to enter other clients’
rooms. Which nursing intervention is most appropriate?
1
,A. Encourage the client to participate in group therapy for socialization.
B. Provide a quiet, low-stimulation environment with clear, concise
directions.
C. Ask the client to explain why they believe other clients are ignoring
them.
D. Encourage vigorous exercise until the client becomes tired.
Answer: B. Provide a quiet, low-stimulation environment with clear,
concise directions.
Rationale: Clients experiencing acute mania have increased energy,
impaired judgment, distractibility, and decreased ability to process
complex information. A low-stimulation environment helps reduce
escalation. Communication should be brief, direct, and consistent.
Group activities may increase stimulation, and prolonged questioning
can worsen distractibility. Exercise may be useful in selected
circumstances but is not the priority when the client is becoming
intrusive and behaviorally dysregulated.
3. A client prescribed lithium for bipolar disorder reports severe
diarrhea, persistent vomiting, coarse hand tremors, confusion, and
difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage the client to drink coffee.
C. Hold lithium and notify the healthcare provider immediately.
D. Reassure the client that mild tremors are expected.
Answer: C. Hold lithium and notify the healthcare provider
immediately.
Rationale: The manifestations suggest lithium toxicity. Severe
gastrointestinal symptoms, coarse tremor, confusion, ataxia, and
neurological changes are concerning findings. Lithium has a narrow
2
,therapeutic index, and toxicity can become life-threatening. The
medication should be withheld and the provider notified for urgent
evaluation and serum lithium testing. Dehydration, sodium changes,
and interacting medications can increase lithium concentrations.
4. A client experiencing auditory hallucinations says, “The voices
are telling me that I must stab my roommate tonight.” Which
nursing action has the highest priority?
A. Ask the client to describe the voices in detail and then leave the
room.
B. Tell the client that the voices are not real.
C. Assess the command hallucinations, intent, access to weapons, and
ability to resist the commands.
D. Encourage the client to ignore the voices.
Answer: C. Assess the command hallucinations, intent, access to
weapons, and ability to resist the commands.
Rationale: Command hallucinations involving violence create an
immediate safety concern. The nurse should determine what the voices
are commanding, whether the client intends to comply, whether
weapons or other means are available, and whether the client can
resist the commands. The client may require increased observation,
environmental safety measures, and urgent psychiatric intervention.
Simply arguing that the hallucinations are unreal does not address the
immediate risk.
5. A client taking clozapine reports fever, sore throat, and
generalized weakness. What is the nurse’s priority concern?
A. Acute dystonia
B. Agranulocytosis
3
, C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: B. Agranulocytosis
Rationale: Clozapine can cause severe neutropenia/agranulocytosis,
increasing the risk of life-threatening infection. Fever and sore throat
require prompt evaluation and an appropriate blood count,
particularly the absolute neutrophil count. Neuroleptic malignant
syndrome typically presents with severe rigidity, hyperthermia,
autonomic instability, and altered mental status. Tardive dyskinesia
involves involuntary repetitive movements, whereas acute dystonia
causes sustained muscle contractions.
6. A client taking a selective serotonin reuptake inhibitor develops
agitation, diaphoresis, diarrhea, hyperreflexia, clonus, fever, and
confusion after another serotonergic medication is added. Which
condition should the nurse suspect?
A. Serotonin syndrome
B. Lithium toxicity
C. Anticholinergic toxicity
D. Acute alcohol withdrawal
Answer: A. Serotonin syndrome
Rationale: Serotonin syndrome results from excessive serotonergic
activity and can occur when serotonergic medications are combined.
Characteristic findings include agitation, autonomic instability,
diaphoresis, gastrointestinal symptoms, hyperreflexia, clonus, tremor,
hyperthermia, and altered mental status. It can progress rapidly and
requires immediate intervention. The neuromuscular findings,
particularly clonus and hyperreflexia, are especially important
distinguishing clues.
4
PSYCHIATRIC MENTAL HEALTH NURSING
EXAM WITH ACTUAL QUESTIONS AND
VERIFIED ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1. A client with major depressive disorder tells the psychiatric
nurse, “My family would be better off without me. I have been
thinking that everyone would be happier if I were dead.” What is
the nurse’s priority response?
A. “You should focus on the positive things in your life.”
B. “Have you developed a specific plan to kill yourself?”
C. “Your family would be devastated if you died.”
D. “Let’s discuss some activities that usually make you feel better.”
Answer: B. “Have you developed a specific plan to kill yourself?”
Rationale: Directly assessing suicidal ideation, intent, plan, access to
means, and preparatory behavior is essential when a client expresses
hopelessness or thoughts of death. Asking directly about suicide does
not cause suicidal behavior. A specific plan, intent, and access to
lethal means substantially increase risk and require immediate safety
interventions. Reassurance, distraction, or attempting to persuade the
client that the family needs them does not adequately assess immediate
danger.
2. A client experiencing acute mania is pacing rapidly, speaking
loudly, interrupting others, and attempting to enter other clients’
rooms. Which nursing intervention is most appropriate?
1
,A. Encourage the client to participate in group therapy for socialization.
B. Provide a quiet, low-stimulation environment with clear, concise
directions.
C. Ask the client to explain why they believe other clients are ignoring
them.
D. Encourage vigorous exercise until the client becomes tired.
Answer: B. Provide a quiet, low-stimulation environment with clear,
concise directions.
Rationale: Clients experiencing acute mania have increased energy,
impaired judgment, distractibility, and decreased ability to process
complex information. A low-stimulation environment helps reduce
escalation. Communication should be brief, direct, and consistent.
Group activities may increase stimulation, and prolonged questioning
can worsen distractibility. Exercise may be useful in selected
circumstances but is not the priority when the client is becoming
intrusive and behaviorally dysregulated.
3. A client prescribed lithium for bipolar disorder reports severe
diarrhea, persistent vomiting, coarse hand tremors, confusion, and
difficulty walking. What should the nurse do first?
A. Administer the next dose with food.
B. Encourage the client to drink coffee.
C. Hold lithium and notify the healthcare provider immediately.
D. Reassure the client that mild tremors are expected.
Answer: C. Hold lithium and notify the healthcare provider
immediately.
Rationale: The manifestations suggest lithium toxicity. Severe
gastrointestinal symptoms, coarse tremor, confusion, ataxia, and
neurological changes are concerning findings. Lithium has a narrow
2
,therapeutic index, and toxicity can become life-threatening. The
medication should be withheld and the provider notified for urgent
evaluation and serum lithium testing. Dehydration, sodium changes,
and interacting medications can increase lithium concentrations.
4. A client experiencing auditory hallucinations says, “The voices
are telling me that I must stab my roommate tonight.” Which
nursing action has the highest priority?
A. Ask the client to describe the voices in detail and then leave the
room.
B. Tell the client that the voices are not real.
C. Assess the command hallucinations, intent, access to weapons, and
ability to resist the commands.
D. Encourage the client to ignore the voices.
Answer: C. Assess the command hallucinations, intent, access to
weapons, and ability to resist the commands.
Rationale: Command hallucinations involving violence create an
immediate safety concern. The nurse should determine what the voices
are commanding, whether the client intends to comply, whether
weapons or other means are available, and whether the client can
resist the commands. The client may require increased observation,
environmental safety measures, and urgent psychiatric intervention.
Simply arguing that the hallucinations are unreal does not address the
immediate risk.
5. A client taking clozapine reports fever, sore throat, and
generalized weakness. What is the nurse’s priority concern?
A. Acute dystonia
B. Agranulocytosis
3
, C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: B. Agranulocytosis
Rationale: Clozapine can cause severe neutropenia/agranulocytosis,
increasing the risk of life-threatening infection. Fever and sore throat
require prompt evaluation and an appropriate blood count,
particularly the absolute neutrophil count. Neuroleptic malignant
syndrome typically presents with severe rigidity, hyperthermia,
autonomic instability, and altered mental status. Tardive dyskinesia
involves involuntary repetitive movements, whereas acute dystonia
causes sustained muscle contractions.
6. A client taking a selective serotonin reuptake inhibitor develops
agitation, diaphoresis, diarrhea, hyperreflexia, clonus, fever, and
confusion after another serotonergic medication is added. Which
condition should the nurse suspect?
A. Serotonin syndrome
B. Lithium toxicity
C. Anticholinergic toxicity
D. Acute alcohol withdrawal
Answer: A. Serotonin syndrome
Rationale: Serotonin syndrome results from excessive serotonergic
activity and can occur when serotonergic medications are combined.
Characteristic findings include agitation, autonomic instability,
diaphoresis, gastrointestinal symptoms, hyperreflexia, clonus, tremor,
hyperthermia, and altered mental status. It can progress rapidly and
requires immediate intervention. The neuromuscular findings,
particularly clonus and hyperreflexia, are especially important
distinguishing clues.
4
