Psychiatric and Behavioral Health Final Examination
Questions and Verified Answers 2026-2027
Comprehensive Practice Test Bank & Clinical Assessment Guide for Psychiatric Mental
Health Nursing
1. A nurse is conducting an admission assessment for a client diagnosed with major
depressive disorder. The client reports profound fatigue, insomnia, and an inability to
experience pleasure in activities they previously enjoyed. How should the nurse
document the loss of pleasure?
A. Akathisia
B. Anhedonia
C. Anosognosia
D. Alexithymia
Rationale: Anhedonia is the inability to feel pleasure in normally pleasurable activities, a core
symptom of major depressive disorder. Akathisia refers to motor restlessness, anosognosia is
a lack of insight into one's illness, and alexithymia is difficulty identifying emotions.
2. A client diagnosed with schizophrenia states, "The government has implanted a
microchip in my brain to control my thoughts and track my location." How should the
nurse respond to this delusion?
A. "That is impossible; microchips cannot be implanted without major brain surgery."
B. "It sounds frightening to feel like you are being controlled, but I do not see any
evidence of a microchip."
C. "Why do you think the government is interested in tracking your personal life?"
D. "Let's go look in the mirror so you can see there are no incisions or chips."
Rationale: Empathizing with the client's emotional experience while offering reality testing
without directly arguing or direct confrontation is the most therapeutic approach. Confronting
delusions directly often causes defensiveness, while asking "why" can reinforce delusional
beliefs.
3. A client starting lithium therapy for bipolar I disorder requires routine baseline
laboratory monitoring. Which baseline organ function tests are essential prior to
initiating treatment?
A. Serum creatinine, blood urea nitrogen (BUN), and thyroid-stimulating hormone
(TSH)
B. Serum amylase, lipase, and liver enzymes (AST/ALT)
C. Pulmonary function tests and arterial blood gas analysis
D. Echocardiogram and serum troponin levels
Rationale: Lithium is excreted by the kidneys and can alter thyroid function over time,
potentially causing hypothyroidism or renal impairment. Establishing baseline renal and
, thyroid labs is critical prior to drug administration.
4. A client taking haloperidol for acute psychosis develops severe muscle rigidity, a
temperature of 39.8°C (103.6°F), diaphoresis, tachycardia, and labile blood pressure.
What condition should the nurse suspect?
A. Serotonin syndrome
B. Tardive dyskinesia
C. Neuroleptic Malignant Syndrome (NMS)
D. Acute dystonic reaction
Rationale: Neuroleptic Malignant Syndrome (NMS) is a life-threatening reaction to
antipsychotics characterized by severe muscle rigidity, high hyperpyrexia, autonomic
instability, and altered mental status requiring immediate discontinuation of the drug and
emergency supportive care.
5. A client with generalized anxiety disorder presents to the emergency department
experiencing a severe panic attack. Which initial nursing intervention takes priority?
A. Teach the client progressive muscle relaxation techniques.
B. Remain with the client, speak in short simple sentences, and maintain a calm
environment.
C. Encourage the client to discuss the underlying triggers of their anxiety.
D. Administer a high-dose oral selective serotonin reuptake inhibitor (SSRI).
Rationale: During severe panic, cognitive processing is impaired. The nurse must stay with
the client to offer safety, keep directions brief, and reduce ambient stimuli. In-depth teaching
or exploring underlying feelings can only happen after anxiety subsides.
6. A nurse is caring for a client prescribed clozapine for treatment-resistant
schizophrenia. Which blood laboratory monitor is mandatory prior to dispensing this
medication?
A. Platelet count
B. Absolute Neutrophil Count (ANC)
C. Serum potassium level
D. Prothrombin time (PT/INR)
Rationale: Clozapine carries a serious risk of agranulocytosis (severe, life-threatening
neutropenia). Regular monitoring of the Absolute Neutrophil Count (ANC) is required before
and during treatment to catch bone marrow suppression early.
7. A client with a history of severe alcohol use disorder is admitted to the medical unit.
Within 48 to 72 hours post-admission, the client becomes disoriented and exhibits
tremors, gross diaphoresis, visual hallucinations, and a heart rate of 132 bpm. What
condition is developing?
A. Wernicke's encephalopathy
B. Korsakoff's psychosis
Questions and Verified Answers 2026-2027
Comprehensive Practice Test Bank & Clinical Assessment Guide for Psychiatric Mental
Health Nursing
1. A nurse is conducting an admission assessment for a client diagnosed with major
depressive disorder. The client reports profound fatigue, insomnia, and an inability to
experience pleasure in activities they previously enjoyed. How should the nurse
document the loss of pleasure?
A. Akathisia
B. Anhedonia
C. Anosognosia
D. Alexithymia
Rationale: Anhedonia is the inability to feel pleasure in normally pleasurable activities, a core
symptom of major depressive disorder. Akathisia refers to motor restlessness, anosognosia is
a lack of insight into one's illness, and alexithymia is difficulty identifying emotions.
2. A client diagnosed with schizophrenia states, "The government has implanted a
microchip in my brain to control my thoughts and track my location." How should the
nurse respond to this delusion?
A. "That is impossible; microchips cannot be implanted without major brain surgery."
B. "It sounds frightening to feel like you are being controlled, but I do not see any
evidence of a microchip."
C. "Why do you think the government is interested in tracking your personal life?"
D. "Let's go look in the mirror so you can see there are no incisions or chips."
Rationale: Empathizing with the client's emotional experience while offering reality testing
without directly arguing or direct confrontation is the most therapeutic approach. Confronting
delusions directly often causes defensiveness, while asking "why" can reinforce delusional
beliefs.
3. A client starting lithium therapy for bipolar I disorder requires routine baseline
laboratory monitoring. Which baseline organ function tests are essential prior to
initiating treatment?
A. Serum creatinine, blood urea nitrogen (BUN), and thyroid-stimulating hormone
(TSH)
B. Serum amylase, lipase, and liver enzymes (AST/ALT)
C. Pulmonary function tests and arterial blood gas analysis
D. Echocardiogram and serum troponin levels
Rationale: Lithium is excreted by the kidneys and can alter thyroid function over time,
potentially causing hypothyroidism or renal impairment. Establishing baseline renal and
, thyroid labs is critical prior to drug administration.
4. A client taking haloperidol for acute psychosis develops severe muscle rigidity, a
temperature of 39.8°C (103.6°F), diaphoresis, tachycardia, and labile blood pressure.
What condition should the nurse suspect?
A. Serotonin syndrome
B. Tardive dyskinesia
C. Neuroleptic Malignant Syndrome (NMS)
D. Acute dystonic reaction
Rationale: Neuroleptic Malignant Syndrome (NMS) is a life-threatening reaction to
antipsychotics characterized by severe muscle rigidity, high hyperpyrexia, autonomic
instability, and altered mental status requiring immediate discontinuation of the drug and
emergency supportive care.
5. A client with generalized anxiety disorder presents to the emergency department
experiencing a severe panic attack. Which initial nursing intervention takes priority?
A. Teach the client progressive muscle relaxation techniques.
B. Remain with the client, speak in short simple sentences, and maintain a calm
environment.
C. Encourage the client to discuss the underlying triggers of their anxiety.
D. Administer a high-dose oral selective serotonin reuptake inhibitor (SSRI).
Rationale: During severe panic, cognitive processing is impaired. The nurse must stay with
the client to offer safety, keep directions brief, and reduce ambient stimuli. In-depth teaching
or exploring underlying feelings can only happen after anxiety subsides.
6. A nurse is caring for a client prescribed clozapine for treatment-resistant
schizophrenia. Which blood laboratory monitor is mandatory prior to dispensing this
medication?
A. Platelet count
B. Absolute Neutrophil Count (ANC)
C. Serum potassium level
D. Prothrombin time (PT/INR)
Rationale: Clozapine carries a serious risk of agranulocytosis (severe, life-threatening
neutropenia). Regular monitoring of the Absolute Neutrophil Count (ANC) is required before
and during treatment to catch bone marrow suppression early.
7. A client with a history of severe alcohol use disorder is admitted to the medical unit.
Within 48 to 72 hours post-admission, the client becomes disoriented and exhibits
tremors, gross diaphoresis, visual hallucinations, and a heart rate of 132 bpm. What
condition is developing?
A. Wernicke's encephalopathy
B. Korsakoff's psychosis
