DEPARTMENT OF PSYCHIATRIC AND MENTAL
HEALTH NURSING
NUR 371 PSYCHIATRIC NURSING FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A client diagnosed with schizophrenia states, "The television host is sending secret
encrypted messages specifically to me." What symptom is the client demonstrating?
A) Grandiose delusion
B) Delusion of reference
C) Persecutory delusion
D) Somatic delusion
Rationale: Delusions of reference involve believing neutral public events or media remarks carry personal
meaning intended specifically for the individual.
2. What therapeutic communication technique is demonstrated when a nurse states, "It
sounds like you feel overwhelmed by your current family situation"?
A) Reflection / Paraphrasing
B) Offering false reassurance
C) Requesting an explanation
D) Giving advice
Rationale: Reflection conveys empathy and helps clients clarify their emotional experiences without imposing
judgment or unsolicited advice.
3. A client admitted with major depressive disorder presents with severe psychomotor
retardation, flat affect, and anhedonia. What is the priority nursing intervention during
the initial 24 hours of admission?
A) Assessing for suicidal ideation, intent, and maintaining continuous safety
precautions
B) Encouraging participation in aggressive group therapy sessions
C) Teaching complex cognitive reframing strategies
D) Leaving the client alone in a dark room to rest undisturbed
, Rationale: Safety is the primary priority in severe depression; assessing suicide risk and instituting appropriate
precautions takes precedence over secondary therapies.
4. A client receiving haloperidol develops high fever, muscle rigidity, autonomic
instability, and altered mental status. What life-threatening complication does the nurse
suspect?
A) Tardive dyskinesia
B) Neuroleptic Malignant Syndrome (NMS)
C) Serotonin syndrome
D) Acute dystonic reaction
Rationale: NMS is a medical emergency triggered by antipsychotic dopamine blockade, characterized by
hyperpyrexia, severe muscle rigidity, fluctuating vitals, and altered consciousness.
5. What immediate intervention is indicated when a client exhibits signs of Neuroleptic
Malignant Syndrome (NMS)?
A) Discontinue the antipsychotic medication immediately and initiate supportive
cooling
B) Administer an additional dose of haloperidol
C) Increase oral fluid restriction
D) Administer intramuscular flumazenil
Rationale: Stopping the causative antipsychotic agent immediately and providing supportive medical care
(cooling, hydration, dantrolene/bromocriptine) is vital to reduce mortality.
6. A client with bipolar I disorder in a severe manic state is pacing the hallway, shouting
loudly, and intrusive with peers. What nursing strategy manages this behavior
effectively?
A) Engaging the client in a competitive group board game
B) Redirecting the client to a low-stimulation environment with a physical outlet
C) Placing the client in immediate physical restraints
D) Challenging the client's grandiose statements publicly
Rationale: Reducing environmental stimulation helps de-escalate manic agitation, while channeling high energy
into structured physical tasks prevents conflict.
7. A client taking lithium carbonate for bipolar disorder presents with coarse hand
tremors, confusion, diarrhea, vomiting, and an uncoordinated gait. What action should
the nurse take?
A) Hold the lithium dose, notify the provider, and request a stat serum lithium level
B) Administer the scheduled lithium dose with a full glass of water
C) Encourage a low-sodium diet to balance lithium levels
D) Reassure the client that these are normal initial side effects
HEALTH NURSING
NUR 371 PSYCHIATRIC NURSING FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A client diagnosed with schizophrenia states, "The television host is sending secret
encrypted messages specifically to me." What symptom is the client demonstrating?
A) Grandiose delusion
B) Delusion of reference
C) Persecutory delusion
D) Somatic delusion
Rationale: Delusions of reference involve believing neutral public events or media remarks carry personal
meaning intended specifically for the individual.
2. What therapeutic communication technique is demonstrated when a nurse states, "It
sounds like you feel overwhelmed by your current family situation"?
A) Reflection / Paraphrasing
B) Offering false reassurance
C) Requesting an explanation
D) Giving advice
Rationale: Reflection conveys empathy and helps clients clarify their emotional experiences without imposing
judgment or unsolicited advice.
3. A client admitted with major depressive disorder presents with severe psychomotor
retardation, flat affect, and anhedonia. What is the priority nursing intervention during
the initial 24 hours of admission?
A) Assessing for suicidal ideation, intent, and maintaining continuous safety
precautions
B) Encouraging participation in aggressive group therapy sessions
C) Teaching complex cognitive reframing strategies
D) Leaving the client alone in a dark room to rest undisturbed
, Rationale: Safety is the primary priority in severe depression; assessing suicide risk and instituting appropriate
precautions takes precedence over secondary therapies.
4. A client receiving haloperidol develops high fever, muscle rigidity, autonomic
instability, and altered mental status. What life-threatening complication does the nurse
suspect?
A) Tardive dyskinesia
B) Neuroleptic Malignant Syndrome (NMS)
C) Serotonin syndrome
D) Acute dystonic reaction
Rationale: NMS is a medical emergency triggered by antipsychotic dopamine blockade, characterized by
hyperpyrexia, severe muscle rigidity, fluctuating vitals, and altered consciousness.
5. What immediate intervention is indicated when a client exhibits signs of Neuroleptic
Malignant Syndrome (NMS)?
A) Discontinue the antipsychotic medication immediately and initiate supportive
cooling
B) Administer an additional dose of haloperidol
C) Increase oral fluid restriction
D) Administer intramuscular flumazenil
Rationale: Stopping the causative antipsychotic agent immediately and providing supportive medical care
(cooling, hydration, dantrolene/bromocriptine) is vital to reduce mortality.
6. A client with bipolar I disorder in a severe manic state is pacing the hallway, shouting
loudly, and intrusive with peers. What nursing strategy manages this behavior
effectively?
A) Engaging the client in a competitive group board game
B) Redirecting the client to a low-stimulation environment with a physical outlet
C) Placing the client in immediate physical restraints
D) Challenging the client's grandiose statements publicly
Rationale: Reducing environmental stimulation helps de-escalate manic agitation, while channeling high energy
into structured physical tasks prevents conflict.
7. A client taking lithium carbonate for bipolar disorder presents with coarse hand
tremors, confusion, diarrhea, vomiting, and an uncoordinated gait. What action should
the nurse take?
A) Hold the lithium dose, notify the provider, and request a stat serum lithium level
B) Administer the scheduled lithium dose with a full glass of water
C) Encourage a low-sodium diet to balance lithium levels
D) Reassure the client that these are normal initial side effects
