PSYCHIATRIC-MENTAL HEALTH
NURSING – PMH-BC PRACTICE
EXAMINATION QUESTIONS WITH
CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION
WITH INSTANT PDF DOWNLOAD
1.
A patient with major depressive disorder states, “My family would
be better off without me.” Which response by the psychiatric-
mental health nurse is most appropriate?
A. “You should focus on the positive things in your life.”
B. “Do you have a specific plan to harm yourself?”
C. “Your family needs you, so try not to think that way.”
D. “Everyone feels hopeless sometimes.”
Answer: B. “Do you have a specific plan to harm yourself?”
Rationale: Directly asking about suicidal thoughts, intent, and a
specific plan is essential for determining the patient's immediate
level of suicide risk. Asking about suicide does not cause suicidal
behavior. Responses that minimize, reassure prematurely, or
redirect the patient can interfere with accurate risk assessment.
2.
,A patient experiencing acute mania is pacing rapidly, speaking
loudly, and interrupting other patients. Which nursing intervention
is most appropriate?
A. Encourage participation in group therapy.
B. Provide a quiet, low-stimulation environment.
C. Ask the patient to explain the reasons for the behavior.
D. Encourage the patient to participate in strenuous exercise.
Answer: B. Provide a quiet, low-stimulation environment.
Rationale: Patients experiencing acute mania are highly
vulnerable to overstimulation. Reducing environmental stimuli,
using brief and clear communication, and establishing firm but
calm limits can decrease agitation and promote safety.
3.
A patient taking lithium reports diarrhea, vomiting, coarse hand
tremors, and increasing confusion. What should the nurse do
first?
A. Administer the next lithium dose with food.
B. Encourage the patient to drink coffee.
C. Hold the lithium and notify the healthcare provider.
D. Reassure the patient that these effects are expected.
Answer: C. Hold the lithium and notify the healthcare provider.
Rationale: Diarrhea, vomiting, coarse tremors, and confusion can
indicate lithium toxicity. Lithium has a narrow therapeutic index,
and toxicity requires prompt intervention. The medication should
be withheld while the patient is evaluated and appropriate serum
lithium levels and other laboratory tests are obtained.
,4.
A patient with schizophrenia says, “The voices are telling me that
the staff wants to poison me.” Which response is most
therapeutic?
A. “The voices are not real, so ignore them.”
B. “Why do you believe the staff wants to poison you?”
C. “I don't hear the voices, but I understand that they are
frightening to you.”
D. “You should listen to the staff because they are professionals.”
Answer: C. “I don't hear the voices, but I understand that they
are frightening to you.”
Rationale: This response acknowledges the patient's emotional
experience without validating the hallucination. The nurse should
present reality clearly while demonstrating empathy and avoiding
arguments about the patient's perception.
5.
Which finding is most characteristic of delirium rather than
dementia?
A. Gradual cognitive decline
B. Stable level of consciousness
C. Acute onset with fluctuating attention
D. Progressive impairment of memory
Answer: C. Acute onset with fluctuating attention
Rationale: Delirium typically develops rapidly and is characterized
by fluctuating attention, altered awareness, and cognitive
, changes. Dementia usually has a gradual, progressive course and
does not typically produce prominent fluctuations in
consciousness during the early stages.
6.
A patient with obsessive-compulsive disorder repeatedly washes
their hands because of contamination fears. Which nursing
approach is appropriate?
A. Prevent all handwashing immediately.
B. Reinforce the ritual whenever anxiety increases.
C. Establish gradual limits on compulsive behavior while
supporting anxiety management.
D. Tell the patient that contamination fears are irrational.
Answer: C. Establish gradual limits on compulsive behavior
while supporting anxiety management.
Rationale: Nursing care should avoid reinforcing compulsions
while helping the patient tolerate anxiety through therapeutic
interventions. Abruptly preventing rituals may increase distress,
whereas gradual behavioral interventions can support adaptive
coping.
7.
A patient experiencing a panic attack reports chest tightness and
severe fear of dying. What should the nurse do initially?
A. Leave the patient alone to reduce stimulation.
B. Stay with the patient and use short, calm statements.
NURSING – PMH-BC PRACTICE
EXAMINATION QUESTIONS WITH
CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION
WITH INSTANT PDF DOWNLOAD
1.
A patient with major depressive disorder states, “My family would
be better off without me.” Which response by the psychiatric-
mental health nurse is most appropriate?
A. “You should focus on the positive things in your life.”
B. “Do you have a specific plan to harm yourself?”
C. “Your family needs you, so try not to think that way.”
D. “Everyone feels hopeless sometimes.”
Answer: B. “Do you have a specific plan to harm yourself?”
Rationale: Directly asking about suicidal thoughts, intent, and a
specific plan is essential for determining the patient's immediate
level of suicide risk. Asking about suicide does not cause suicidal
behavior. Responses that minimize, reassure prematurely, or
redirect the patient can interfere with accurate risk assessment.
2.
,A patient experiencing acute mania is pacing rapidly, speaking
loudly, and interrupting other patients. Which nursing intervention
is most appropriate?
A. Encourage participation in group therapy.
B. Provide a quiet, low-stimulation environment.
C. Ask the patient to explain the reasons for the behavior.
D. Encourage the patient to participate in strenuous exercise.
Answer: B. Provide a quiet, low-stimulation environment.
Rationale: Patients experiencing acute mania are highly
vulnerable to overstimulation. Reducing environmental stimuli,
using brief and clear communication, and establishing firm but
calm limits can decrease agitation and promote safety.
3.
A patient taking lithium reports diarrhea, vomiting, coarse hand
tremors, and increasing confusion. What should the nurse do
first?
A. Administer the next lithium dose with food.
B. Encourage the patient to drink coffee.
C. Hold the lithium and notify the healthcare provider.
D. Reassure the patient that these effects are expected.
Answer: C. Hold the lithium and notify the healthcare provider.
Rationale: Diarrhea, vomiting, coarse tremors, and confusion can
indicate lithium toxicity. Lithium has a narrow therapeutic index,
and toxicity requires prompt intervention. The medication should
be withheld while the patient is evaluated and appropriate serum
lithium levels and other laboratory tests are obtained.
,4.
A patient with schizophrenia says, “The voices are telling me that
the staff wants to poison me.” Which response is most
therapeutic?
A. “The voices are not real, so ignore them.”
B. “Why do you believe the staff wants to poison you?”
C. “I don't hear the voices, but I understand that they are
frightening to you.”
D. “You should listen to the staff because they are professionals.”
Answer: C. “I don't hear the voices, but I understand that they
are frightening to you.”
Rationale: This response acknowledges the patient's emotional
experience without validating the hallucination. The nurse should
present reality clearly while demonstrating empathy and avoiding
arguments about the patient's perception.
5.
Which finding is most characteristic of delirium rather than
dementia?
A. Gradual cognitive decline
B. Stable level of consciousness
C. Acute onset with fluctuating attention
D. Progressive impairment of memory
Answer: C. Acute onset with fluctuating attention
Rationale: Delirium typically develops rapidly and is characterized
by fluctuating attention, altered awareness, and cognitive
, changes. Dementia usually has a gradual, progressive course and
does not typically produce prominent fluctuations in
consciousness during the early stages.
6.
A patient with obsessive-compulsive disorder repeatedly washes
their hands because of contamination fears. Which nursing
approach is appropriate?
A. Prevent all handwashing immediately.
B. Reinforce the ritual whenever anxiety increases.
C. Establish gradual limits on compulsive behavior while
supporting anxiety management.
D. Tell the patient that contamination fears are irrational.
Answer: C. Establish gradual limits on compulsive behavior
while supporting anxiety management.
Rationale: Nursing care should avoid reinforcing compulsions
while helping the patient tolerate anxiety through therapeutic
interventions. Abruptly preventing rituals may increase distress,
whereas gradual behavioral interventions can support adaptive
coping.
7.
A patient experiencing a panic attack reports chest tightness and
severe fear of dying. What should the nurse do initially?
A. Leave the patient alone to reduce stimulation.
B. Stay with the patient and use short, calm statements.
