LMR Georgette Question Bank with Answers and Rationale
Which of the following best demonstrates evidence-based Correct Answer: B
practice in psychiatric nursing? Rationale: Evidence-based practice integrates research evidence, clinical expertise,
· A. Using treatments based on tradition only and patient preferences.
· B. Applying interventions supported by research, clinical
expertise, and patient preferences
· C. Relying solely on anecdotal experience
· D. Implementing care without patient consent
Which of the following theorists emphasized the Correct Answer: C
interpersonal relationship as the foundation for psychiatric Rationale: Harry Stack Sullivan’s Interpersonal Theory focuses on the importance
nursing practice? of relationships in mental health.
A. Erik Erikson
B. Jean Piaget
C. Harry Stack Sullivan
D. Abraham Maslow
A patient on clozapine reports flu-like symptoms and sore Correct Answer: B
throat. What should the PMHNP do first? Rationale: Clozapine carries a risk of agranulocytosis; sudden flu-like symptoms
A. Reassure the patient that this is normal require immediate evaluation of WBC.
B. Discontinue clozapine immediately and check WBC
count
C. Decrease the dose by half
D. Advise increased fluid intake only
Which principle is reflected when a PMHNP respects a Correct Answer: D
competent client's right to refuse treatment? Rationale: Autonomy means respecting the client’s right to make their own
A. Nonmaleficence informed healthcare decisions
B. Beneficence
C. Fidelity
D. Autonomy
A PMHNP working with a patient with PTSD chooses Correct Answer: C
cognitive processing therapy. This approach is best Rationale: Cognitive processing therapy is a form of CBT that addresses trauma-
described as: related beliefs and thoughts.
A. A behavioral exposure therapy
B. An insight-oriented psychodynamic therapy
C. A cognitive-behavioral therapy (CBT) approach
D. A pharmacologic-only intervention
Which client would benefit most from a motivational Correct Answer: C
interviewing approach? Rationale: Motivational interviewing helps clients resolve ambivalence and
A. A patient ready to start treatment with no ambivalence supports readiness for change.
B. A patient firmly opposed to any change
C. A patient ambivalent about quitting alcohol use
D. A patient with severe cognitive impairment
What is the primary ethical obligation when using Correct Answer: B
telehealth services? Rationale: Telehealth must follow the same standards for confidentiality, privacy,
A. The PMHNP can relax privacy standards and informed consent.
B. Ensure informed consent and HIPAA compliance
C. Record all sessions without client permission
D. Provide treatment to clients in any state regardless of
licensure
Which statement reflects the best application of Peplau's Correct Answer: C
working phase? Rationale: In Peplau’s model, the working phase focuses on active problem-solving
A. Establishing trust and defining the nurse-client and implementing the plan of care.
relationship
B. Terminating the relationship after goals are met
C. Identifying client problems and implementing
interventions
D. Reviewing discharge planning only
Which medication is most likely to cause metabolic Correct Answer: C
syndrome in a patient with schizophrenia? Rationale: Clozapine (and olanzapine) have higher risks of metabolic side effects
A. Haloperidol like weight gain and dyslipidemia.
B. Aripiprazole
C. Clozapine
D. Buspirone
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
A PMHNP uses the DSM-5 to diagnose a patient. Why is Correct Answer: C
this classification system important? Rationale: The DSM-5 provides clear, standardized diagnostic criteria to promote
A. It provides treatment plans for all conditions accurate, consistent diagnoses.
B. It offers reimbursement coding for insurance only
C. It standardizes diagnostic criteria for mental disorders
D. It replaces the need for clinical judgment
A client with major depressive disorder is started on an Correct Answer: C
SSRI. Which patient education point is most important? Rationale: Clients need to know SSRIs may take several weeks for full effect and
A. Effects will be immediate within 24 hours should not be stopped suddenly.
B. Alcohol use is encouraged to help with sleep
C. Full therapeutic effects may take 4-6 weeks
D. Discontinue the medication abruptly if feeling better
A PMHNP sees a child with repeated angry outbursts and Correct Answer: C
defiance towards authority at home and school. Which Rationale: ODD is characterized by defiance, hostility, and disobedience toward
diagnosis is most likely? authority figures without serious violation of social norms.
A. Conduct Disorder
B. Autism Spectrum Disorder
C. Oppositional Defiant Disorder (ODD)
D. Attention-Deficit/Hyperactivity Disorder (ADHD)
Which of the following is the primary action of Correct Answer: C
benzodiazepines? Rationale: Benzodiazepines enhance the effect of GABA, an inhibitory
A. Dopamine receptor antagonist neurotransmitter, resulting in anxiolytic effects.
B. Serotonin-norepinephrine reuptake inhibitor
C. GABA receptor agonist
D. Acetylcholine inhibitor
A patient reports they stopped taking their antipsychotic Correct Answer: C
because they "felt fine." Which response best reflects Rationale: Open-ended, nonjudgmental questions encourage discussion and trust.
therapeutic communication?
A. "You should never stop your medication."
B. "I'm disappointed you didn't follow instructions."
C. "Tell me more about your decision to stop the
medication."
D. "I'll have to report this to your family."
The PMHNP is asked about the difference between Correct Answer: B
confidentiality and privilege. Which statement is accurate? Rationale: Privilege refers to a legal right that protects information from disclosure
A. Privilege and confidentiality are the same in legal proceedings.
B. Privilege is a legal concept protecting client disclosures
in court
C. Confidentiality allows sharing of client info with friends
D. Confidentiality is never legally protected
Which ethical principle is violated if the PMHNP fails to Correct Answer: D
explain treatment risks and benefits to a client? Rationale: Autonomy includes the client’s right to make an informed decision; lack
A. Beneficence of informed consent violates this.
B. Fidelity
C. Veracity
D. Autonomy
When using Peplau's Interpersonal Relations Theory, what Correct Answer: C
is the primary tool for the PMHNP? Rationale: Peplau emphasized that the nurse’s self-awareness and use of the
A. Medications relationship are the core tools for helping clients.
B. Family systems therapy
C. The therapeutic use of self
D. Group therapy
A client with panic disorder asks why they experience Correct Answer: A
chest pain during an attack. The best PMHNP response is: Rationale: Panic attacks trigger the sympathetic nervous system, leading to
A. "Your body's fight-or-flight system causes physical physical symptoms like chest pain.
symptoms."
B. "There is always an underlying cardiac issue."
C. "It means your medication is not working."
D. "It's unusual to feel physical symptoms with panic
attacks."
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
Which statement about using seclusion and restraint is Correct Answer: C
true? Rationale: Seclusion and restraints are last-resort safety measures, not for
A. They should be used as punishment for aggressive punishment, and require thorough documentation.
clients
B. They are primary interventions to manage anger
C. They should be used only when less restrictive
measures fail
D. They can be implemented without documentation
A patient taking MAOIs must avoid foods high in tyramine Correct Answer: B
to prevent: Rationale: MAOIs + tyramine-rich foods (e.g., aged cheese, cured meats) can
A. Serotonin syndrome cause dangerous hypertensive crises.
B. Hypertensive crisis
C. Stevens-Johnson syndrome
D. Agranulocytosis
Which lab finding should a PMHNP monitor for a patient on Correct Answer: B
valproic acid? Rationale: Valproic acid can cause hepatotoxicity and thrombocytopenia, so LFTs
A. Potassium and platelets must be monitored.
B. Liver function tests and platelets
C. Thyroid-stimulating hormone (TSH)
D. White blood cell count only
A PMHNP uses motivational interviewing. Which statement Correct Answer: C
reflects this approach? Rationale: Motivational interviewing explores ambivalence and builds motivation for
A. "You should stop using alcohol immediately or I can't change in a collaborative, nonjudgmental way.
help you."
B. "Why can't you just quit?"
C. "What are the pros and cons you see about changing
your drinking?"
D. "You must follow my plan exactly."
A PMHNP uses CBT to help a patient identify cognitive Correct Answer: A
distortions. Which is an example of "catastrophizing"? Rationale: Catastrophizing is a distortion that magnifies worst-case outcomes
A. "I made a mistake; now I'll be fired and homeless." unrealistically.
B. "I'm great at everything I do."
C. "I don't care what happens."
D. "I'll deal with it when it comes."
A PMHNP assesses a patient with ADHD who struggles Correct Answer: C
with insomnia. Which medication is most appropriate to Rationale: Atomoxetine (a non-stimulant) has less risk of insomnia compared to
manage ADHD with the lowest risk of sleep disturbance? stimulants.
A. Methylphenidate
B. Amphetamine salts
C. Atomoxetine
D. Modafinil
A patient on sertraline reports new-onset sexual Correct Answer: B
dysfunction. Which is the best first action? Rationale: SSRIs can cause sexual side effects; patient education and possible
A. Stop the medication abruptly dosage or med adjustments are appropriate.
B. Educate the patient that this can be a side effect
C. Ignore the concern
D. Double the dose
A client says, "My neighbor is spying on me through my Correct Answer: C
TV." Which is the PMHNP's best response? Rationale: The PMHNP uses therapeutic communication to explore the delusion
A. "That's not true. You are wrong." without reinforcing or denying it.
B. "I believe you."
C. "Tell me more about what you're experiencing."
D. "You should watch less TV."
A PMHNP uses the recovery model in planning care. Correct Answer: B
Which statement aligns with this model? Rationale: The recovery model emphasizes hope, self-direction, and living a
A. "Your illness defines who you are." meaningful life with or without complete symptom resolution.
B. "Recovery means living a meaningful life despite
symptoms."
C. "You will be fully cured if you follow directions."
D. "You must rely on professionals for all decisions."
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
A patient with a new diagnosis of bipolar I disorder asks Correct Answer: B
about treatment. Which education point is correct? Rationale: Mood stabilizers like lithium are typically long-term to prevent relapse;
A. "You will only need medication when you feel manic." psychotherapy also helps with adherence and coping.
B. "Mood stabilizers are often needed long-term to prevent
episodes."
C. "Psychotherapy is never helpful for bipolar disorder."
D. "Once symptoms improve, medications can be stopped
immediately."
Which statement best demonstrates veracity in the nurse- Correct Answer: B
client relationship? Rationale: Veracity means truthfulness, a key ethical principle in building trust.
A. "I will keep secrets from your treatment team."
B. "I will tell you the truth about your diagnosis and
treatment."
C. "I will decide what you need to know."
D. "It is best not to share your test results."
A PMHNP working with older adults is aware that which Correct Answer: A
factor most increases risk for medication toxicity? Rationale: Older adults often have reduced liver and kidney function, increasing
A. Decreased renal and hepatic function risk for toxicity.
B. Increased protein binding
C. Faster metabolism with age
D. Higher body water content
Which statement by the PMHNP most accurately reflects Correct Answer: b) "We can go over the risks and benefits of each option together,
the principle of shared decision-making in psychiatric and then decide on the approach that fits your values and preferences."
care? Rationale: Shared decision-making requires collaboration and respects both the
a) "I'll make the final decision about your treatment plan clinician's expertise and the patient's autonomy.
since I know the evidence best."
b) "We can go over the risks and benefits of each option
together, and then decide on the approach that fits your
values and preferences."
c) "You should decide entirely on your own which
medication to take; I can provide some written material to
help."
d) "I'll prescribe what I think is most effective, but you may
decline it if you strongly disagree."
A PMHNP uses the psychodynamic approach to therapy. Correct Answer: B
What is a key technique? Rationale: Psychodynamic therapy explores unconscious processes and early
A. Challenging distorted thoughts directly experiences affecting current behavior.
B. Exploring unconscious conflicts and past experiences
C. Teaching relaxation techniques only
D. Focusing exclusively on present behavior
A client says, "I'm worthless and nothing will ever get Correct Answer: B
better." Which CBT technique would a PMHNP use first? Rationale: CBT focuses on identifying and restructuring distorted thoughts
A. Psychodynamic interpretation contributing to depression.
B. Identify and challenge negative automatic thoughts
C. Medication only, no therapy needed
D. Use aversion therapy
Which factor is most important when planning care for a Correct Answer: A
patient with a substance use disorder? Rationale: Motivation is key to readiness for change and engagement in treatment.
A. The patient's motivation for change
B. The length of time they have used substances
C. The patient's educational level
D. The patient's IQ score
Stuvia 2026-2027
Which of the following best demonstrates evidence-based Correct Answer: B
practice in psychiatric nursing? Rationale: Evidence-based practice integrates research evidence, clinical expertise,
· A. Using treatments based on tradition only and patient preferences.
· B. Applying interventions supported by research, clinical
expertise, and patient preferences
· C. Relying solely on anecdotal experience
· D. Implementing care without patient consent
Which of the following theorists emphasized the Correct Answer: C
interpersonal relationship as the foundation for psychiatric Rationale: Harry Stack Sullivan’s Interpersonal Theory focuses on the importance
nursing practice? of relationships in mental health.
A. Erik Erikson
B. Jean Piaget
C. Harry Stack Sullivan
D. Abraham Maslow
A patient on clozapine reports flu-like symptoms and sore Correct Answer: B
throat. What should the PMHNP do first? Rationale: Clozapine carries a risk of agranulocytosis; sudden flu-like symptoms
A. Reassure the patient that this is normal require immediate evaluation of WBC.
B. Discontinue clozapine immediately and check WBC
count
C. Decrease the dose by half
D. Advise increased fluid intake only
Which principle is reflected when a PMHNP respects a Correct Answer: D
competent client's right to refuse treatment? Rationale: Autonomy means respecting the client’s right to make their own
A. Nonmaleficence informed healthcare decisions
B. Beneficence
C. Fidelity
D. Autonomy
A PMHNP working with a patient with PTSD chooses Correct Answer: C
cognitive processing therapy. This approach is best Rationale: Cognitive processing therapy is a form of CBT that addresses trauma-
described as: related beliefs and thoughts.
A. A behavioral exposure therapy
B. An insight-oriented psychodynamic therapy
C. A cognitive-behavioral therapy (CBT) approach
D. A pharmacologic-only intervention
Which client would benefit most from a motivational Correct Answer: C
interviewing approach? Rationale: Motivational interviewing helps clients resolve ambivalence and
A. A patient ready to start treatment with no ambivalence supports readiness for change.
B. A patient firmly opposed to any change
C. A patient ambivalent about quitting alcohol use
D. A patient with severe cognitive impairment
What is the primary ethical obligation when using Correct Answer: B
telehealth services? Rationale: Telehealth must follow the same standards for confidentiality, privacy,
A. The PMHNP can relax privacy standards and informed consent.
B. Ensure informed consent and HIPAA compliance
C. Record all sessions without client permission
D. Provide treatment to clients in any state regardless of
licensure
Which statement reflects the best application of Peplau's Correct Answer: C
working phase? Rationale: In Peplau’s model, the working phase focuses on active problem-solving
A. Establishing trust and defining the nurse-client and implementing the plan of care.
relationship
B. Terminating the relationship after goals are met
C. Identifying client problems and implementing
interventions
D. Reviewing discharge planning only
Which medication is most likely to cause metabolic Correct Answer: C
syndrome in a patient with schizophrenia? Rationale: Clozapine (and olanzapine) have higher risks of metabolic side effects
A. Haloperidol like weight gain and dyslipidemia.
B. Aripiprazole
C. Clozapine
D. Buspirone
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
A PMHNP uses the DSM-5 to diagnose a patient. Why is Correct Answer: C
this classification system important? Rationale: The DSM-5 provides clear, standardized diagnostic criteria to promote
A. It provides treatment plans for all conditions accurate, consistent diagnoses.
B. It offers reimbursement coding for insurance only
C. It standardizes diagnostic criteria for mental disorders
D. It replaces the need for clinical judgment
A client with major depressive disorder is started on an Correct Answer: C
SSRI. Which patient education point is most important? Rationale: Clients need to know SSRIs may take several weeks for full effect and
A. Effects will be immediate within 24 hours should not be stopped suddenly.
B. Alcohol use is encouraged to help with sleep
C. Full therapeutic effects may take 4-6 weeks
D. Discontinue the medication abruptly if feeling better
A PMHNP sees a child with repeated angry outbursts and Correct Answer: C
defiance towards authority at home and school. Which Rationale: ODD is characterized by defiance, hostility, and disobedience toward
diagnosis is most likely? authority figures without serious violation of social norms.
A. Conduct Disorder
B. Autism Spectrum Disorder
C. Oppositional Defiant Disorder (ODD)
D. Attention-Deficit/Hyperactivity Disorder (ADHD)
Which of the following is the primary action of Correct Answer: C
benzodiazepines? Rationale: Benzodiazepines enhance the effect of GABA, an inhibitory
A. Dopamine receptor antagonist neurotransmitter, resulting in anxiolytic effects.
B. Serotonin-norepinephrine reuptake inhibitor
C. GABA receptor agonist
D. Acetylcholine inhibitor
A patient reports they stopped taking their antipsychotic Correct Answer: C
because they "felt fine." Which response best reflects Rationale: Open-ended, nonjudgmental questions encourage discussion and trust.
therapeutic communication?
A. "You should never stop your medication."
B. "I'm disappointed you didn't follow instructions."
C. "Tell me more about your decision to stop the
medication."
D. "I'll have to report this to your family."
The PMHNP is asked about the difference between Correct Answer: B
confidentiality and privilege. Which statement is accurate? Rationale: Privilege refers to a legal right that protects information from disclosure
A. Privilege and confidentiality are the same in legal proceedings.
B. Privilege is a legal concept protecting client disclosures
in court
C. Confidentiality allows sharing of client info with friends
D. Confidentiality is never legally protected
Which ethical principle is violated if the PMHNP fails to Correct Answer: D
explain treatment risks and benefits to a client? Rationale: Autonomy includes the client’s right to make an informed decision; lack
A. Beneficence of informed consent violates this.
B. Fidelity
C. Veracity
D. Autonomy
When using Peplau's Interpersonal Relations Theory, what Correct Answer: C
is the primary tool for the PMHNP? Rationale: Peplau emphasized that the nurse’s self-awareness and use of the
A. Medications relationship are the core tools for helping clients.
B. Family systems therapy
C. The therapeutic use of self
D. Group therapy
A client with panic disorder asks why they experience Correct Answer: A
chest pain during an attack. The best PMHNP response is: Rationale: Panic attacks trigger the sympathetic nervous system, leading to
A. "Your body's fight-or-flight system causes physical physical symptoms like chest pain.
symptoms."
B. "There is always an underlying cardiac issue."
C. "It means your medication is not working."
D. "It's unusual to feel physical symptoms with panic
attacks."
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
Which statement about using seclusion and restraint is Correct Answer: C
true? Rationale: Seclusion and restraints are last-resort safety measures, not for
A. They should be used as punishment for aggressive punishment, and require thorough documentation.
clients
B. They are primary interventions to manage anger
C. They should be used only when less restrictive
measures fail
D. They can be implemented without documentation
A patient taking MAOIs must avoid foods high in tyramine Correct Answer: B
to prevent: Rationale: MAOIs + tyramine-rich foods (e.g., aged cheese, cured meats) can
A. Serotonin syndrome cause dangerous hypertensive crises.
B. Hypertensive crisis
C. Stevens-Johnson syndrome
D. Agranulocytosis
Which lab finding should a PMHNP monitor for a patient on Correct Answer: B
valproic acid? Rationale: Valproic acid can cause hepatotoxicity and thrombocytopenia, so LFTs
A. Potassium and platelets must be monitored.
B. Liver function tests and platelets
C. Thyroid-stimulating hormone (TSH)
D. White blood cell count only
A PMHNP uses motivational interviewing. Which statement Correct Answer: C
reflects this approach? Rationale: Motivational interviewing explores ambivalence and builds motivation for
A. "You should stop using alcohol immediately or I can't change in a collaborative, nonjudgmental way.
help you."
B. "Why can't you just quit?"
C. "What are the pros and cons you see about changing
your drinking?"
D. "You must follow my plan exactly."
A PMHNP uses CBT to help a patient identify cognitive Correct Answer: A
distortions. Which is an example of "catastrophizing"? Rationale: Catastrophizing is a distortion that magnifies worst-case outcomes
A. "I made a mistake; now I'll be fired and homeless." unrealistically.
B. "I'm great at everything I do."
C. "I don't care what happens."
D. "I'll deal with it when it comes."
A PMHNP assesses a patient with ADHD who struggles Correct Answer: C
with insomnia. Which medication is most appropriate to Rationale: Atomoxetine (a non-stimulant) has less risk of insomnia compared to
manage ADHD with the lowest risk of sleep disturbance? stimulants.
A. Methylphenidate
B. Amphetamine salts
C. Atomoxetine
D. Modafinil
A patient on sertraline reports new-onset sexual Correct Answer: B
dysfunction. Which is the best first action? Rationale: SSRIs can cause sexual side effects; patient education and possible
A. Stop the medication abruptly dosage or med adjustments are appropriate.
B. Educate the patient that this can be a side effect
C. Ignore the concern
D. Double the dose
A client says, "My neighbor is spying on me through my Correct Answer: C
TV." Which is the PMHNP's best response? Rationale: The PMHNP uses therapeutic communication to explore the delusion
A. "That's not true. You are wrong." without reinforcing or denying it.
B. "I believe you."
C. "Tell me more about what you're experiencing."
D. "You should watch less TV."
A PMHNP uses the recovery model in planning care. Correct Answer: B
Which statement aligns with this model? Rationale: The recovery model emphasizes hope, self-direction, and living a
A. "Your illness defines who you are." meaningful life with or without complete symptom resolution.
B. "Recovery means living a meaningful life despite
symptoms."
C. "You will be fully cured if you follow directions."
D. "You must rely on professionals for all decisions."
Stuvia 2026-2027
, LMR Georgette Question Bank with Answers and Rationale
A patient with a new diagnosis of bipolar I disorder asks Correct Answer: B
about treatment. Which education point is correct? Rationale: Mood stabilizers like lithium are typically long-term to prevent relapse;
A. "You will only need medication when you feel manic." psychotherapy also helps with adherence and coping.
B. "Mood stabilizers are often needed long-term to prevent
episodes."
C. "Psychotherapy is never helpful for bipolar disorder."
D. "Once symptoms improve, medications can be stopped
immediately."
Which statement best demonstrates veracity in the nurse- Correct Answer: B
client relationship? Rationale: Veracity means truthfulness, a key ethical principle in building trust.
A. "I will keep secrets from your treatment team."
B. "I will tell you the truth about your diagnosis and
treatment."
C. "I will decide what you need to know."
D. "It is best not to share your test results."
A PMHNP working with older adults is aware that which Correct Answer: A
factor most increases risk for medication toxicity? Rationale: Older adults often have reduced liver and kidney function, increasing
A. Decreased renal and hepatic function risk for toxicity.
B. Increased protein binding
C. Faster metabolism with age
D. Higher body water content
Which statement by the PMHNP most accurately reflects Correct Answer: b) "We can go over the risks and benefits of each option together,
the principle of shared decision-making in psychiatric and then decide on the approach that fits your values and preferences."
care? Rationale: Shared decision-making requires collaboration and respects both the
a) "I'll make the final decision about your treatment plan clinician's expertise and the patient's autonomy.
since I know the evidence best."
b) "We can go over the risks and benefits of each option
together, and then decide on the approach that fits your
values and preferences."
c) "You should decide entirely on your own which
medication to take; I can provide some written material to
help."
d) "I'll prescribe what I think is most effective, but you may
decline it if you strongly disagree."
A PMHNP uses the psychodynamic approach to therapy. Correct Answer: B
What is a key technique? Rationale: Psychodynamic therapy explores unconscious processes and early
A. Challenging distorted thoughts directly experiences affecting current behavior.
B. Exploring unconscious conflicts and past experiences
C. Teaching relaxation techniques only
D. Focusing exclusively on present behavior
A client says, "I'm worthless and nothing will ever get Correct Answer: B
better." Which CBT technique would a PMHNP use first? Rationale: CBT focuses on identifying and restructuring distorted thoughts
A. Psychodynamic interpretation contributing to depression.
B. Identify and challenge negative automatic thoughts
C. Medication only, no therapy needed
D. Use aversion therapy
Which factor is most important when planning care for a Correct Answer: A
patient with a substance use disorder? Rationale: Motivation is key to readiness for change and engagement in treatment.
A. The patient's motivation for change
B. The length of time they have used substances
C. The patient's educational level
D. The patient's IQ score
Stuvia 2026-2027
