NUR 222 PSYCH FINAL EXAM (HFCN)
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD
PDF
Core Domains
Therapeutic Communication and the Nurse-Client Relationship
Psychiatric Assessment and Mental Status Examination
Mood Disorders and Suicide Risk
Anxiety, Trauma, and Stressor-Related Disorders
Psychotic Disorders and Schizophrenia
Personality Disorders and Defense Mechanisms
Substance Use and Addictive Disorders
Psychopharmacology and Medication Management
Crisis Intervention and Milieu Therapy
Legal, Ethical, and Cultural Considerations in Psychiatric Nursing
Introduction
The NUR 222 Psychiatric Mental Health Nursing Final Exam assesses essential knowledge and clinical
judgment required for safe, compassionate care of clients with psychiatric and mental health conditions.
This examination evaluates therapeutic communication, psychiatric assessment, psychopharmacology,
crisis intervention, and legal-ethical decision-making. Questions are structured in multiple-choice and
scenario-based formats emphasizing prioritization, safety, de-escalation, and real-world clinical
application. Candidates must demonstrate competency in recognizing psychiatric emergencies,
implementing evidence-based interventions, and integrating recovery-oriented, client-centered principles
into practice across diverse care settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with schizophrenia is experiencing auditory hallucinations telling him to harm himself. Which
response by the nurse is most therapeutic?
A. "You should ignore those voices."
B. "The voices are not real and cannot hurt you."
,C. "What are the voices saying to you right now?"
D. "I will turn up the television so you cannot hear them."
C. "What are the voices saying to you right now?"
RATIONALE: Asking directly about the content of hallucinations assesses suicide risk and
demonstrates willingness to discuss the client's experience without judgment. Ignoring, minimizing, or
masking the voices with distraction is dismissive and may increase risk. Assessment must precede
intervention.
Question 2
A client with major depressive disorder says, "I just want to go to sleep and never wake up." What is the
nurse's priority action?
A. Document the statement and continue the assessment
B. Ask directly whether the client has thoughts of suicide
C. Reassure the client that things will get better
D. Encourage the client to attend group therapy
B. Ask directly whether the client has thoughts of suicide
RATIONALE: Any statement suggesting death wishes requires immediate, direct suicide assessment.
Asking directly about suicide does not plant the idea and is essential for determining safety and level of
observation. Reassurance and activity are not priority when safety is in question.
Question 3
A client is admitted with acute mania. Which intervention is the priority?
A. Encourage competitive group activities
B. Provide a structured, low-stimulation environment
C. Allow the client to set their own schedule
D. Restrict all oral fluids
B. Provide a structured, low-stimulation environment
RATIONALE: Clients in acute mania are highly distractible and overwhelmed by stimulation. A
structured, low-stimulation milieu reduces agitation and supports safety. Competitive activities increase
arousal. Fluid restriction is not appropriate and may worsen dehydration.
Question 4
A client taking lithium reports nausea, vomiting, coarse hand tremors, and confusion. Which action
should the nurse take first?
A. Withhold the next dose and notify the provider
B. Encourage increased fluid intake and continue monitoring
C. Administer the next dose as prescribed
D. Document the findings as expected side effects
, A. Withhold the next dose and notify the provider
RATIONALE: Coarse tremors, vomiting, and confusion indicate lithium toxicity. The nurse must
withhold the medication and notify the provider immediately. These are not expected side effects, and
continuing the drug can worsen toxicity.
Question 5
A client with an anxiety disorder is hyperventilating during a panic attack. Which instruction is most
appropriate?
A. "Breathe into this paper bag."
B. "Take rapid, deep breaths."
C. "Breathe slowly with me, in through your nose and out through your mouth."
D. "Hold your breath as long as you can."
C. "Breathe slowly with me, in through your nose and out through your mouth."
RATIONALE: Guided slow breathing reduces hyperventilation and promotes parasympathetic
activation. Paper bag rebreathing is no longer recommended. Rapid deep breathing worsens
hypocapnia. Breath-holding may increase anxiety.
Question 6
A client with anorexia nervosa has a BMI of 15.2 and refuses to eat. Which nursing intervention is
priority?
A. Allow the client to choose all foods
B. Monitor vital signs and weight daily
C. Discuss body image distortions in group therapy
D. Restrict family visits until intake improves
B. Monitor vital signs and weight daily
RATIONALE: Physiological stabilization is the priority in severe malnutrition. Daily weights, vital signs,
and electrolyte monitoring detect life-threatening complications such as refeeding syndrome and
cardiac dysrhythmias. Psychotherapy occurs after stabilization.
Question 7
A client is prescribed haloperidol and develops muscle rigidity, fever, and altered mental status. Which
complication should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Acute dystonia
B. Neuroleptic malignant syndrome
, RATIONALE: Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics
characterized by rigidity, hyperthermia, autonomic instability, and altered mental status. It requires
immediate discontinuation of the antipsychotic and emergency treatment. Serotonin syndrome occurs
with serotonergic drugs.
Question 8
A nurse is using active listening with a client. Which behavior best demonstrates this technique?
A. Interrupting to offer solutions
B. Maintaining eye contact and nodding
C. Changing the subject when uncomfortable
D. Giving advice based on personal experience
B. Maintaining eye contact and nodding
RATIONALE: Active listening involves focused attention, eye contact, and nonverbal encouragement
without interrupting or advising. Offering solutions, changing subjects, and giving personal advice block
communication and shift focus away from the client.
Question 9
A client with borderline personality disorder is demanding extra attention from the nurse. Which
response is most therapeutic?
A. Set consistent, firm limits on attention-seeking behavior
B. Allow special privileges to reduce anxiety
C. Ignore the client completely
D. Rotate staff frequently to prevent attachment
A. Set consistent, firm limits on attention-seeking behavior
RATIONALE: Consistent, non-punitive limit setting provides structure and safety for clients with
borderline personality disorder. Special privileges reinforce maladaptive behavior. Ignoring and rotating
staff undermine trust and therapeutic consistency.
Question 10
A client is experiencing alcohol withdrawal. Which finding indicates impending delirium tremens?
A. Mild tremors and anxiety
B. Diaphoresis, tachycardia, and hallucinations
C. Bradycardia and hypotension
D. Constricted pupils and sedation
B. Diaphoresis, tachycardia, and hallucinations
RATIONALE: Delirium tremens is a medical emergency characterized by severe autonomic
hyperactivity, hallucinations, disorientation, and seizures. It typically occurs 48 to 96 hours after
cessation. Bradycardia, hypotension, and sedation are not consistent with withdrawal.
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026/2027 Q&A | INSTANT DOWNLOAD
Core Domains
Therapeutic Communication and the Nurse-Client Relationship
Psychiatric Assessment and Mental Status Examination
Mood Disorders and Suicide Risk
Anxiety, Trauma, and Stressor-Related Disorders
Psychotic Disorders and Schizophrenia
Personality Disorders and Defense Mechanisms
Substance Use and Addictive Disorders
Psychopharmacology and Medication Management
Crisis Intervention and Milieu Therapy
Legal, Ethical, and Cultural Considerations in Psychiatric Nursing
Introduction
The NUR 222 Psychiatric Mental Health Nursing Final Exam assesses essential knowledge and clinical
judgment required for safe, compassionate care of clients with psychiatric and mental health conditions.
This examination evaluates therapeutic communication, psychiatric assessment, psychopharmacology,
crisis intervention, and legal-ethical decision-making. Questions are structured in multiple-choice and
scenario-based formats emphasizing prioritization, safety, de-escalation, and real-world clinical
application. Candidates must demonstrate competency in recognizing psychiatric emergencies,
implementing evidence-based interventions, and integrating recovery-oriented, client-centered principles
into practice across diverse care settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A client with schizophrenia is experiencing auditory hallucinations telling him to harm himself. Which
response by the nurse is most therapeutic?
A. "You should ignore those voices."
B. "The voices are not real and cannot hurt you."
,C. "What are the voices saying to you right now?"
D. "I will turn up the television so you cannot hear them."
C. "What are the voices saying to you right now?"
RATIONALE: Asking directly about the content of hallucinations assesses suicide risk and
demonstrates willingness to discuss the client's experience without judgment. Ignoring, minimizing, or
masking the voices with distraction is dismissive and may increase risk. Assessment must precede
intervention.
Question 2
A client with major depressive disorder says, "I just want to go to sleep and never wake up." What is the
nurse's priority action?
A. Document the statement and continue the assessment
B. Ask directly whether the client has thoughts of suicide
C. Reassure the client that things will get better
D. Encourage the client to attend group therapy
B. Ask directly whether the client has thoughts of suicide
RATIONALE: Any statement suggesting death wishes requires immediate, direct suicide assessment.
Asking directly about suicide does not plant the idea and is essential for determining safety and level of
observation. Reassurance and activity are not priority when safety is in question.
Question 3
A client is admitted with acute mania. Which intervention is the priority?
A. Encourage competitive group activities
B. Provide a structured, low-stimulation environment
C. Allow the client to set their own schedule
D. Restrict all oral fluids
B. Provide a structured, low-stimulation environment
RATIONALE: Clients in acute mania are highly distractible and overwhelmed by stimulation. A
structured, low-stimulation milieu reduces agitation and supports safety. Competitive activities increase
arousal. Fluid restriction is not appropriate and may worsen dehydration.
Question 4
A client taking lithium reports nausea, vomiting, coarse hand tremors, and confusion. Which action
should the nurse take first?
A. Withhold the next dose and notify the provider
B. Encourage increased fluid intake and continue monitoring
C. Administer the next dose as prescribed
D. Document the findings as expected side effects
, A. Withhold the next dose and notify the provider
RATIONALE: Coarse tremors, vomiting, and confusion indicate lithium toxicity. The nurse must
withhold the medication and notify the provider immediately. These are not expected side effects, and
continuing the drug can worsen toxicity.
Question 5
A client with an anxiety disorder is hyperventilating during a panic attack. Which instruction is most
appropriate?
A. "Breathe into this paper bag."
B. "Take rapid, deep breaths."
C. "Breathe slowly with me, in through your nose and out through your mouth."
D. "Hold your breath as long as you can."
C. "Breathe slowly with me, in through your nose and out through your mouth."
RATIONALE: Guided slow breathing reduces hyperventilation and promotes parasympathetic
activation. Paper bag rebreathing is no longer recommended. Rapid deep breathing worsens
hypocapnia. Breath-holding may increase anxiety.
Question 6
A client with anorexia nervosa has a BMI of 15.2 and refuses to eat. Which nursing intervention is
priority?
A. Allow the client to choose all foods
B. Monitor vital signs and weight daily
C. Discuss body image distortions in group therapy
D. Restrict family visits until intake improves
B. Monitor vital signs and weight daily
RATIONALE: Physiological stabilization is the priority in severe malnutrition. Daily weights, vital signs,
and electrolyte monitoring detect life-threatening complications such as refeeding syndrome and
cardiac dysrhythmias. Psychotherapy occurs after stabilization.
Question 7
A client is prescribed haloperidol and develops muscle rigidity, fever, and altered mental status. Which
complication should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Tardive dyskinesia
D. Acute dystonia
B. Neuroleptic malignant syndrome
, RATIONALE: Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics
characterized by rigidity, hyperthermia, autonomic instability, and altered mental status. It requires
immediate discontinuation of the antipsychotic and emergency treatment. Serotonin syndrome occurs
with serotonergic drugs.
Question 8
A nurse is using active listening with a client. Which behavior best demonstrates this technique?
A. Interrupting to offer solutions
B. Maintaining eye contact and nodding
C. Changing the subject when uncomfortable
D. Giving advice based on personal experience
B. Maintaining eye contact and nodding
RATIONALE: Active listening involves focused attention, eye contact, and nonverbal encouragement
without interrupting or advising. Offering solutions, changing subjects, and giving personal advice block
communication and shift focus away from the client.
Question 9
A client with borderline personality disorder is demanding extra attention from the nurse. Which
response is most therapeutic?
A. Set consistent, firm limits on attention-seeking behavior
B. Allow special privileges to reduce anxiety
C. Ignore the client completely
D. Rotate staff frequently to prevent attachment
A. Set consistent, firm limits on attention-seeking behavior
RATIONALE: Consistent, non-punitive limit setting provides structure and safety for clients with
borderline personality disorder. Special privileges reinforce maladaptive behavior. Ignoring and rotating
staff undermine trust and therapeutic consistency.
Question 10
A client is experiencing alcohol withdrawal. Which finding indicates impending delirium tremens?
A. Mild tremors and anxiety
B. Diaphoresis, tachycardia, and hallucinations
C. Bradycardia and hypotension
D. Constricted pupils and sedation
B. Diaphoresis, tachycardia, and hallucinations
RATIONALE: Delirium tremens is a medical emergency characterized by severe autonomic
hyperactivity, hallucinations, disorientation, and seizures. It typically occurs 48 to 96 hours after
cessation. Bradycardia, hypotension, and sedation are not consistent with withdrawal.
