NR 605 Final Exam Psychiatric Mental
Health Lifespan 2026/2027: Q&A with
Detailed Rationales (Verified A+ Grade)
1. A patient with major depressive disorder reports feeling hopeless and states,
“My family would be better off without me.” What is the nurse’s priority action?
A. Encourage the patient to identify positive aspects of life
B. Ask directly whether the patient has thoughts of suicide
C. Encourage participation in a group therapy session
D. Teach the patient about the effects of antidepressants
Answer: _B. Ask directly whether the patient has thoughts of suicide_
Rationale: Directly assessing suicidal thoughts is essential when a patient
expresses hopelessness or perceived burdensomeness. Asking about suicide does
not cause suicidal behavior and helps determine the immediacy of risk and need
for safety interventions.
2. A patient experiencing a manic episode is increasingly restless and has not slept
for 36 hours. Which nursing intervention is most appropriate?
A. Provide a stimulating environment to promote socialization
B. Encourage the patient to complete several activities simultaneously
C. Reduce environmental stimuli and provide opportunities for rest
D. Allow the patient unrestricted participation in group activities
Answer: _C. Reduce environmental stimuli and provide opportunities for rest_
Rationale: Patients experiencing mania can become overstimulated and exhausted.
A quiet, structured environment with reduced stimulation and opportunities for
sleep or rest can help decrease agitation and promote stabilization.
3. Which finding is most characteristic of generalized anxiety disorder?
A. Recurrent intrusive memories of a traumatic event
B. Excessive and difficult-to-control worry about multiple areas of life
,C. Recurrent unexpected panic attacks followed by fear of dying
D. Repetitive behaviors performed to neutralize intrusive thoughts
Answer: _B. Excessive and difficult-to-control worry about multiple areas of life_
Rationale: Generalized anxiety disorder involves excessive anxiety and worry
occurring more days than not over an extended period and involving multiple
domains, such as work, health, finances, or family responsibilities.
4. A patient with schizophrenia reports hearing voices that others cannot hear.
Which response by the nurse is most therapeutic?
A. “The voices are real, so you should listen to them.”
B. “You need to stop thinking about the voices.”
C. “I don't hear the voices, but I understand that you are experiencing them.”
D. “Those voices are imaginary and have no meaning.”
Answer: _C. “I don't hear the voices, but I understand that you are experiencing
them.”_**
Rationale: The nurse should acknowledge the patient's experience without
validating the hallucination as reality. This response communicates acceptance
while maintaining a shared reality.
5. A patient taking lithium for bipolar disorder reports severe diarrhea, vomiting,
coarse tremors, and difficulty walking. What should the nurse do first?
A. Administer the next scheduled dose
B. Encourage increased physical activity
C. Hold the medication and notify the provider
D. Reassure the patient that these effects are expected
Answer: _C. Hold the medication and notify the provider_
Rationale: Severe gastrointestinal symptoms, coarse tremor, and impaired
coordination can indicate lithium toxicity. The medication should be withheld and
the prescriber notified promptly. Lithium levels and renal function may need
evaluation.
6. Which assessment finding is most concerning in a patient with anorexia
nervosa?
,A. Fear of gaining weight
B. Excessive concern with body shape
C. Severe bradycardia and hypotension
D. Preference for eating meals alone
Answer: _C. Severe bradycardia and hypotension**_
Rationale: Severe cardiovascular abnormalities can occur with significant
malnutrition and represent an immediate physiological threat. Medical
stabilization takes priority over longer-term behavioral interventions.
7. A patient with obsessive-compulsive disorder repeatedly washes their hands
because of contamination fears. Which nursing intervention is appropriate?
A. Immediately prohibit all handwashing
B. Reinforce the compulsive behavior whenever anxiety increases
C. Establish structured limits while helping the patient develop alternative coping
strategies
D. Tell the patient that contamination fears are irrational
Answer: _C. Establish structured limits while helping the patient develop
alternative coping strategies**_
Rationale: Nursing care should avoid reinforcing compulsions while supporting
anxiety management. Structured behavioral approaches can gradually reduce
compulsive behaviors and promote healthier coping.
8. Which symptom is commonly associated with post-traumatic stress disorder?
A. Persistent elevated mood without impairment
B. Re-experiencing a traumatic event through intrusive memories or nightmares
C. Progressive memory loss caused by normal aging
D. Repetitive movements without associated anxiety
Answer: _B. Re-experiencing a traumatic event through intrusive memories or
nightmares**_
Rationale: PTSD may involve intrusive memories, nightmares, flashbacks,
avoidance, negative changes in cognition or mood, and increased arousal
following exposure to trauma.
, 9. A patient with borderline personality disorder becomes angry when the nurse
establishes a limit. Which nursing approach is most appropriate?
A. Remove all limits to prevent conflict
B. Respond emotionally to demonstrate empathy
C. Maintain consistent, clear boundaries and communicate calmly
D. Allow different staff members to establish different rules
Answer: _C. Maintain consistent, clear boundaries and communicate calmly**_
Rationale: Consistency and clear boundaries help promote safety and reduce
splitting and interpersonal instability. Staff should communicate consistently and
avoid responding reactively to provocative behavior.
10. An older adult develops sudden confusion, fluctuating attention, and visual
hallucinations after being hospitalized for an infection. Which condition should the
nurse suspect?
A. Delirium
B. Major depressive disorder
C. Generalized anxiety disorder
D. Chronic schizophrenia
Answer: _A. Delirium**_
Rationale: Delirium is characterized by an acute change in attention and
awareness with fluctuating cognition. Infection, medications, metabolic
disturbances, and hospitalization are common contributing factors in older adults.
11. Which behavior is most consistent with a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions of persecution
C. Flat or reduced emotional expression
D. Disorganized speech
Answer: _C. Flat or reduced emotional expression**_
Rationale: Negative symptoms involve diminished normal functioning and may
include flat affect, avolition, alogia, anhedonia, and social withdrawal.
Hallucinations and delusions are positive symptoms.
Health Lifespan 2026/2027: Q&A with
Detailed Rationales (Verified A+ Grade)
1. A patient with major depressive disorder reports feeling hopeless and states,
“My family would be better off without me.” What is the nurse’s priority action?
A. Encourage the patient to identify positive aspects of life
B. Ask directly whether the patient has thoughts of suicide
C. Encourage participation in a group therapy session
D. Teach the patient about the effects of antidepressants
Answer: _B. Ask directly whether the patient has thoughts of suicide_
Rationale: Directly assessing suicidal thoughts is essential when a patient
expresses hopelessness or perceived burdensomeness. Asking about suicide does
not cause suicidal behavior and helps determine the immediacy of risk and need
for safety interventions.
2. A patient experiencing a manic episode is increasingly restless and has not slept
for 36 hours. Which nursing intervention is most appropriate?
A. Provide a stimulating environment to promote socialization
B. Encourage the patient to complete several activities simultaneously
C. Reduce environmental stimuli and provide opportunities for rest
D. Allow the patient unrestricted participation in group activities
Answer: _C. Reduce environmental stimuli and provide opportunities for rest_
Rationale: Patients experiencing mania can become overstimulated and exhausted.
A quiet, structured environment with reduced stimulation and opportunities for
sleep or rest can help decrease agitation and promote stabilization.
3. Which finding is most characteristic of generalized anxiety disorder?
A. Recurrent intrusive memories of a traumatic event
B. Excessive and difficult-to-control worry about multiple areas of life
,C. Recurrent unexpected panic attacks followed by fear of dying
D. Repetitive behaviors performed to neutralize intrusive thoughts
Answer: _B. Excessive and difficult-to-control worry about multiple areas of life_
Rationale: Generalized anxiety disorder involves excessive anxiety and worry
occurring more days than not over an extended period and involving multiple
domains, such as work, health, finances, or family responsibilities.
4. A patient with schizophrenia reports hearing voices that others cannot hear.
Which response by the nurse is most therapeutic?
A. “The voices are real, so you should listen to them.”
B. “You need to stop thinking about the voices.”
C. “I don't hear the voices, but I understand that you are experiencing them.”
D. “Those voices are imaginary and have no meaning.”
Answer: _C. “I don't hear the voices, but I understand that you are experiencing
them.”_**
Rationale: The nurse should acknowledge the patient's experience without
validating the hallucination as reality. This response communicates acceptance
while maintaining a shared reality.
5. A patient taking lithium for bipolar disorder reports severe diarrhea, vomiting,
coarse tremors, and difficulty walking. What should the nurse do first?
A. Administer the next scheduled dose
B. Encourage increased physical activity
C. Hold the medication and notify the provider
D. Reassure the patient that these effects are expected
Answer: _C. Hold the medication and notify the provider_
Rationale: Severe gastrointestinal symptoms, coarse tremor, and impaired
coordination can indicate lithium toxicity. The medication should be withheld and
the prescriber notified promptly. Lithium levels and renal function may need
evaluation.
6. Which assessment finding is most concerning in a patient with anorexia
nervosa?
,A. Fear of gaining weight
B. Excessive concern with body shape
C. Severe bradycardia and hypotension
D. Preference for eating meals alone
Answer: _C. Severe bradycardia and hypotension**_
Rationale: Severe cardiovascular abnormalities can occur with significant
malnutrition and represent an immediate physiological threat. Medical
stabilization takes priority over longer-term behavioral interventions.
7. A patient with obsessive-compulsive disorder repeatedly washes their hands
because of contamination fears. Which nursing intervention is appropriate?
A. Immediately prohibit all handwashing
B. Reinforce the compulsive behavior whenever anxiety increases
C. Establish structured limits while helping the patient develop alternative coping
strategies
D. Tell the patient that contamination fears are irrational
Answer: _C. Establish structured limits while helping the patient develop
alternative coping strategies**_
Rationale: Nursing care should avoid reinforcing compulsions while supporting
anxiety management. Structured behavioral approaches can gradually reduce
compulsive behaviors and promote healthier coping.
8. Which symptom is commonly associated with post-traumatic stress disorder?
A. Persistent elevated mood without impairment
B. Re-experiencing a traumatic event through intrusive memories or nightmares
C. Progressive memory loss caused by normal aging
D. Repetitive movements without associated anxiety
Answer: _B. Re-experiencing a traumatic event through intrusive memories or
nightmares**_
Rationale: PTSD may involve intrusive memories, nightmares, flashbacks,
avoidance, negative changes in cognition or mood, and increased arousal
following exposure to trauma.
, 9. A patient with borderline personality disorder becomes angry when the nurse
establishes a limit. Which nursing approach is most appropriate?
A. Remove all limits to prevent conflict
B. Respond emotionally to demonstrate empathy
C. Maintain consistent, clear boundaries and communicate calmly
D. Allow different staff members to establish different rules
Answer: _C. Maintain consistent, clear boundaries and communicate calmly**_
Rationale: Consistency and clear boundaries help promote safety and reduce
splitting and interpersonal instability. Staff should communicate consistently and
avoid responding reactively to provocative behavior.
10. An older adult develops sudden confusion, fluctuating attention, and visual
hallucinations after being hospitalized for an infection. Which condition should the
nurse suspect?
A. Delirium
B. Major depressive disorder
C. Generalized anxiety disorder
D. Chronic schizophrenia
Answer: _A. Delirium**_
Rationale: Delirium is characterized by an acute change in attention and
awareness with fluctuating cognition. Infection, medications, metabolic
disturbances, and hospitalization are common contributing factors in older adults.
11. Which behavior is most consistent with a negative symptom of schizophrenia?
A. Auditory hallucinations
B. Delusions of persecution
C. Flat or reduced emotional expression
D. Disorganized speech
Answer: _C. Flat or reduced emotional expression**_
Rationale: Negative symptoms involve diminished normal functioning and may
include flat affect, avolition, alogia, anhedonia, and social withdrawal.
Hallucinations and delusions are positive symptoms.
