NUR3737C EXAM 1 – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Psychiatric-Mental Health Nursing Foundations
2. Therapeutic Communication and Relationships
3. Legal and Ethical Issues in Psychiatric Nursing
4. Psychopharmacology and Biological Treatments
5. Neurobiology and Psychopathology
6. Crisis Intervention and Suicide Prevention
7. Cultural and Spiritual Considerations in Mental Health
8. Assessment and Diagnosis in Psychiatric Nursing
9. Mood, Anxiety, and Psychotic Disorders
10. Substance Use and Co-occurring Disorders
Introduction:
This comprehensive examination is designed to assess the essential knowledge, critical thinking skills, and
clinical decision-making abilities required for effective psychiatric-mental health nursing practice. The
exam covers foundational theories, psychopharmacological interventions, legal and ethical frameworks,
and therapeutic communication strategies essential for safe, patient-centered care. Through multiple-
choice and scenario-based questions, candidates will demonstrate their ability to apply theoretical
concepts to real-world clinical situations, prioritize interventions, and evaluate outcomes. This assessment
emphasizes the integration of neurobiological principles with nursing care, crisis management, and
culturally competent practice to prepare nurses for the complexities of mental health treatment in diverse
healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A psychiatric nurse is conducting an admission assessment for a client diagnosed with major
depressive disorder. Which statement by the client would the nurse identify as a cognitive symptom of
depression?
A. "I have difficulty falling asleep at night."
B. "I feel like a failure in everything I do."
C. "I have lost my appetite and lost weight."
D. "I experience psychomotor retardation."
🟢 B. "I feel like a failure in everything I do."
,🔴 Explanation: Cognitive symptoms of depression involve negative thought patterns and distorted
thinking, such as feelings of worthlessness or failure. Sleep disturbances (A) are vegetative symptoms,
appetite changes (C) are biological/vegetative symptoms, and psychomotor retardation (D) is a
psychomotor symptom. Option B reflects the cognitive distortion characteristic of depression.
Question 2
A client with schizophrenia is prescribed haloperidol. Which assessment finding would indicate the
client is experiencing an extrapyramidal side effect?
A. Dry mouth and constipation
B. Akathisia and involuntary muscle movements
C. Orthostatic hypotension
D. Weight gain and sedation
🟢 B. Akathisia and involuntary muscle movements
🔴 Explanation: Extrapyramidal side effects (EPS) include akathisia (restlessness), dystonia,
pseudoparkinsonism, and tardive dyskinesia. Dry mouth and constipation (A) are anticholinergic side
effects. Orthostatic hypotension (C) is an alpha-adrenergic blockade effect. Weight gain and sedation
(D) are metabolic and histaminergic side effects. EPS is a significant concern with first-generation
antipsychotics like haloperidol.
Question 3
Which therapeutic communication technique is most effective when a client expresses suicidal
ideation?
A. "You shouldn't think that way; things will get better."
B. "What specific thoughts about suicide are you having?"
C. "Let's talk about something more positive."
D. "I understand how you feel."
🟢 B. "What specific thoughts about suicide are you having?"
🔴 Explanation: Directly asking about suicidal thoughts using specific, open-ended questions is the
safest and most therapeutic approach. This allows for accurate risk assessment and demonstrates the
nurse's willingness to address the client's concerns. Reassuring the client (A) dismisses their feelings,
changing the subject (C) avoids the issue, and "I understand how you feel" (D) is a nontherapeutic
cliché that minimizes the client's unique experience.
Question 4
A client with bipolar disorder is being discharged on lithium therapy. Which teaching point is most
,important for the nurse to include?
A. "Take the medication with a high-sodium diet."
B. "Monitor your blood levels regularly as prescribed."
C. "Stop the medication if you experience weight gain."
D. "Take the medication only when you feel manic."
🟢 B. "Monitor your blood levels regularly as prescribed."
🔴 Explanation: Lithium has a narrow therapeutic index, and regular serum level monitoring is
essential to prevent toxicity. Maintaining consistent sodium intake is important, but a high-sodium diet
(A) could reduce lithium levels. Weight gain (C) is a side effect but not a reason to discontinue without
provider guidance. Taking lithium only when manic (D) is incorrect as it is a maintenance medication.
Question 5
During a mental status examination, the nurse asks the client to interpret the proverb "People who live
in glass houses shouldn't throw stones." This assesses which cognitive function?
A. Memory
B. Abstract reasoning
C. Concentration
D. Insight
🟢 B. Abstract reasoning
🔴 Explanation: Proverb interpretation assesses abstract reasoning and the ability to think
symbolically. Concrete thinking would result in a literal interpretation, while abstract thinking allows
the client to grasp the metaphorical meaning. Memory (A) is assessed through recall tasks,
concentration (C) through serial sevens or spelling backward, and insight (D) through the client's
awareness of their condition.
Question 6
A client has been diagnosed with borderline personality disorder. Which nursing intervention is most
appropriate for managing self-harm behaviors?
A. Establish a no-harm contract with the client
B. Use seclusion whenever self-harm is threatened
C. Provide consistent boundaries and behavioral expectations
D. Ignore self-harm behaviors to avoid reinforcing them
🟢 C. Provide consistent boundaries and behavioral expectations
🔴 Explanation: Clients with borderline personality disorder benefit from clear, consistent boundaries
and expectations to manage maladaptive behaviors. No-harm contracts (A) are not evidence-based for
, preventing self-harm. Seclusion (B) should be a last resort. Ignoring self-harm behaviors (D) is unsafe
and neglects the client's needs.
Question 7
Which medication is considered a first-line treatment for generalized anxiety disorder (GAD)?
A. Alprazolam
B. Bupropion
C. Sertraline
D. Haloperidol
🟢 C. Sertraline
🔴 Explanation: SSRIs, such as sertraline, are first-line pharmacological treatments for GAD due to
their efficacy and favorable side effect profile. Alprazolam (A) is a benzodiazepine used for short-term
relief but not first-line due to dependence risk. Bupropion (B) is used primarily for depression and
smoking cessation. Haloperidol (D) is an antipsychotic not indicated for GAD.
Question 8
A client with post-traumatic stress disorder (PTSD) reports recurrent nightmares and hypervigilance.
Based on the biopsychosocial model, which intervention should the nurse prioritize?
A. Administering a sedative for sleep
B. Teaching relaxation techniques for anxiety management
C. Encouraging the client to avoid trauma triggers
D. Using a cognitive-behavioral approach with exposure therapy
🟢 D. Using a cognitive-behavioral approach with exposure therapy
🔴 Explanation: CBT with exposure therapy is a first-line evidence-based treatment for PTSD that
addresses the neurobiological and psychological aspects of the disorder. Sedation (A) only addresses
sleep temporarily. Relaxation techniques (B) are adjunctive but not primary. Avoidance (C) reinforces
the disorder and prevents recovery.
Question 9
Which of the following is a legal requirement when considering involuntary hospitalization for a client?
A. The client must be willing to receive treatment
B. The client must pose a danger to self or others
C. A family member must consent to admission
D. The client must have a diagnosis of schizophrenia
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Psychiatric-Mental Health Nursing Foundations
2. Therapeutic Communication and Relationships
3. Legal and Ethical Issues in Psychiatric Nursing
4. Psychopharmacology and Biological Treatments
5. Neurobiology and Psychopathology
6. Crisis Intervention and Suicide Prevention
7. Cultural and Spiritual Considerations in Mental Health
8. Assessment and Diagnosis in Psychiatric Nursing
9. Mood, Anxiety, and Psychotic Disorders
10. Substance Use and Co-occurring Disorders
Introduction:
This comprehensive examination is designed to assess the essential knowledge, critical thinking skills, and
clinical decision-making abilities required for effective psychiatric-mental health nursing practice. The
exam covers foundational theories, psychopharmacological interventions, legal and ethical frameworks,
and therapeutic communication strategies essential for safe, patient-centered care. Through multiple-
choice and scenario-based questions, candidates will demonstrate their ability to apply theoretical
concepts to real-world clinical situations, prioritize interventions, and evaluate outcomes. This assessment
emphasizes the integration of neurobiological principles with nursing care, crisis management, and
culturally competent practice to prepare nurses for the complexities of mental health treatment in diverse
healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A psychiatric nurse is conducting an admission assessment for a client diagnosed with major
depressive disorder. Which statement by the client would the nurse identify as a cognitive symptom of
depression?
A. "I have difficulty falling asleep at night."
B. "I feel like a failure in everything I do."
C. "I have lost my appetite and lost weight."
D. "I experience psychomotor retardation."
🟢 B. "I feel like a failure in everything I do."
,🔴 Explanation: Cognitive symptoms of depression involve negative thought patterns and distorted
thinking, such as feelings of worthlessness or failure. Sleep disturbances (A) are vegetative symptoms,
appetite changes (C) are biological/vegetative symptoms, and psychomotor retardation (D) is a
psychomotor symptom. Option B reflects the cognitive distortion characteristic of depression.
Question 2
A client with schizophrenia is prescribed haloperidol. Which assessment finding would indicate the
client is experiencing an extrapyramidal side effect?
A. Dry mouth and constipation
B. Akathisia and involuntary muscle movements
C. Orthostatic hypotension
D. Weight gain and sedation
🟢 B. Akathisia and involuntary muscle movements
🔴 Explanation: Extrapyramidal side effects (EPS) include akathisia (restlessness), dystonia,
pseudoparkinsonism, and tardive dyskinesia. Dry mouth and constipation (A) are anticholinergic side
effects. Orthostatic hypotension (C) is an alpha-adrenergic blockade effect. Weight gain and sedation
(D) are metabolic and histaminergic side effects. EPS is a significant concern with first-generation
antipsychotics like haloperidol.
Question 3
Which therapeutic communication technique is most effective when a client expresses suicidal
ideation?
A. "You shouldn't think that way; things will get better."
B. "What specific thoughts about suicide are you having?"
C. "Let's talk about something more positive."
D. "I understand how you feel."
🟢 B. "What specific thoughts about suicide are you having?"
🔴 Explanation: Directly asking about suicidal thoughts using specific, open-ended questions is the
safest and most therapeutic approach. This allows for accurate risk assessment and demonstrates the
nurse's willingness to address the client's concerns. Reassuring the client (A) dismisses their feelings,
changing the subject (C) avoids the issue, and "I understand how you feel" (D) is a nontherapeutic
cliché that minimizes the client's unique experience.
Question 4
A client with bipolar disorder is being discharged on lithium therapy. Which teaching point is most
,important for the nurse to include?
A. "Take the medication with a high-sodium diet."
B. "Monitor your blood levels regularly as prescribed."
C. "Stop the medication if you experience weight gain."
D. "Take the medication only when you feel manic."
🟢 B. "Monitor your blood levels regularly as prescribed."
🔴 Explanation: Lithium has a narrow therapeutic index, and regular serum level monitoring is
essential to prevent toxicity. Maintaining consistent sodium intake is important, but a high-sodium diet
(A) could reduce lithium levels. Weight gain (C) is a side effect but not a reason to discontinue without
provider guidance. Taking lithium only when manic (D) is incorrect as it is a maintenance medication.
Question 5
During a mental status examination, the nurse asks the client to interpret the proverb "People who live
in glass houses shouldn't throw stones." This assesses which cognitive function?
A. Memory
B. Abstract reasoning
C. Concentration
D. Insight
🟢 B. Abstract reasoning
🔴 Explanation: Proverb interpretation assesses abstract reasoning and the ability to think
symbolically. Concrete thinking would result in a literal interpretation, while abstract thinking allows
the client to grasp the metaphorical meaning. Memory (A) is assessed through recall tasks,
concentration (C) through serial sevens or spelling backward, and insight (D) through the client's
awareness of their condition.
Question 6
A client has been diagnosed with borderline personality disorder. Which nursing intervention is most
appropriate for managing self-harm behaviors?
A. Establish a no-harm contract with the client
B. Use seclusion whenever self-harm is threatened
C. Provide consistent boundaries and behavioral expectations
D. Ignore self-harm behaviors to avoid reinforcing them
🟢 C. Provide consistent boundaries and behavioral expectations
🔴 Explanation: Clients with borderline personality disorder benefit from clear, consistent boundaries
and expectations to manage maladaptive behaviors. No-harm contracts (A) are not evidence-based for
, preventing self-harm. Seclusion (B) should be a last resort. Ignoring self-harm behaviors (D) is unsafe
and neglects the client's needs.
Question 7
Which medication is considered a first-line treatment for generalized anxiety disorder (GAD)?
A. Alprazolam
B. Bupropion
C. Sertraline
D. Haloperidol
🟢 C. Sertraline
🔴 Explanation: SSRIs, such as sertraline, are first-line pharmacological treatments for GAD due to
their efficacy and favorable side effect profile. Alprazolam (A) is a benzodiazepine used for short-term
relief but not first-line due to dependence risk. Bupropion (B) is used primarily for depression and
smoking cessation. Haloperidol (D) is an antipsychotic not indicated for GAD.
Question 8
A client with post-traumatic stress disorder (PTSD) reports recurrent nightmares and hypervigilance.
Based on the biopsychosocial model, which intervention should the nurse prioritize?
A. Administering a sedative for sleep
B. Teaching relaxation techniques for anxiety management
C. Encouraging the client to avoid trauma triggers
D. Using a cognitive-behavioral approach with exposure therapy
🟢 D. Using a cognitive-behavioral approach with exposure therapy
🔴 Explanation: CBT with exposure therapy is a first-line evidence-based treatment for PTSD that
addresses the neurobiological and psychological aspects of the disorder. Sedation (A) only addresses
sleep temporarily. Relaxation techniques (B) are adjunctive but not primary. Avoidance (C) reinforces
the disorder and prevents recovery.
Question 9
Which of the following is a legal requirement when considering involuntary hospitalization for a client?
A. The client must be willing to receive treatment
B. The client must pose a danger to self or others
C. A family member must consent to admission
D. The client must have a diagnosis of schizophrenia
