PSYCHIATRIC-MENTAL HEALTH NURSING PRACTICE
EXAMINATION QUESTIONS WITH CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION WITH INSTANT PDF
DOWNLOAD
1. A nurse is assessing a client who reports hearing voices when
no one is present. Which term best describes this experience?
A. Delusion
B. Illusion
C. Hallucination
D. Confabulation
Rationale: A hallucination is a sensory perception that occurs
without an external stimulus. Auditory hallucinations, such as
hearing voices, are common in psychotic disorders. A delusion is
a fixed false belief, while an illusion involves misinterpreting an
actual external stimulus.
2. A client with schizophrenia states, “The television is sending
special messages directly to me.” Which type of delusion is this?
A. Somatic delusion
B. Delusion of reference
C. Nihilistic delusion
D. Grandeur delusion
Rationale: A delusion of reference occurs when a person
incorrectly believes that ordinary events, media, or other people's
actions have a special personal meaning. The belief is not based
on objective evidence.
3. Which nursing intervention is most appropriate when a client is
experiencing auditory hallucinations?
A. Tell the client that the voices are imaginary.
B. Encourage the client to obey the voices.
,C. Acknowledge the client's experience without validating the
hallucination.
D. Ask the client to describe why the voices are real.
Rationale: The nurse should acknowledge that the client is
experiencing voices while presenting reality without arguing. For
example, the nurse may say, “I understand that you hear voices,
but I do not hear them.” This approach supports the client without
reinforcing the hallucination.
4. A client with major depressive disorder says, “My family would
be better off without me.” What should the nurse do first?
A. Encourage the client to identify positive qualities.
B. Ask the client to attend a group activity.
C. Assess directly for suicidal thoughts, plans, and access to
means.
D. Reassure the client that the family cares about them.
Rationale: Statements suggesting hopelessness or perceived
burdensomeness require immediate suicide-risk assessment.
Directly asking about suicide does not cause suicidal behavior
and helps determine the urgency of intervention.
5. Which finding is most characteristic of mania?
A. Social withdrawal
B. Psychomotor retardation
C. Decreased need for sleep with increased energy
D. Persistent feelings of worthlessness
Rationale: Mania commonly involves elevated or irritable mood,
increased energy, decreased need for sleep, pressured speech,
racing thoughts, impulsivity, and increased goal-directed activity.
Depression is more commonly associated with withdrawal, low
energy, and psychomotor slowing.
,6. A client taking lithium reports severe diarrhea, vomiting, coarse
tremors, and unsteady gait. What should the nurse suspect?
A. Therapeutic response
B. Mild anxiety
C. Lithium toxicity
D. Serotonin syndrome
Rationale: Severe gastrointestinal symptoms, coarse tremors,
ataxia, confusion, and other neurologic changes can indicate
lithium toxicity. The medication should be withheld as appropriate
according to the clinical situation, and the healthcare provider
should be notified promptly.
7. Which instruction is most important for a client taking lithium?
A. Eliminate sodium from the diet.
B. Avoid drinking fluids during the day.
C. Maintain consistent fluid and sodium intake.
D. Double the next dose if one dose is missed.
Rationale: Lithium levels are affected by changes in fluid and
sodium balance. Consistent hydration and sodium intake help
reduce fluctuations in lithium concentration and decrease the risk
of toxicity.
8. A client receiving an antipsychotic medication develops severe
muscle rigidity, high fever, altered consciousness, and autonomic
instability. Which condition should the nurse suspect?
A. Tardive dyskinesia
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Panic disorder
Rationale: Neuroleptic malignant syndrome is a potentially life-
threatening reaction associated with antipsychotic medications.
, Classic findings include severe rigidity, hyperthermia, altered
mental status, and autonomic instability and require urgent
intervention.
9. Which symptom is commonly associated with generalized
anxiety disorder?
A. Fixed false beliefs
B. Excessive and difficult-to-control worry
C. Recurrent manic episodes
D. Persistent hallucinations
Rationale: Generalized anxiety disorder is characterized by
excessive anxiety and worry about multiple areas of life that are
difficult to control and are associated with symptoms such as
restlessness, fatigue, irritability, muscle tension, and sleep
disturbance.
10. A client experiencing a panic attack reports intense fear, chest
tightness, and shortness of breath. Which nursing action is most
appropriate?
A. Leave the client alone to reduce stimulation.
B. Ask the client to explain the cause of the anxiety.
C. Remain with the client and use short, calm statements.
D. Encourage detailed problem-solving immediately.
Rationale: During severe panic, the client's ability to process
information and solve problems is impaired. Remaining with the
client, reducing environmental stimulation, and using simple,
calm communication promote safety and decrease anxiety.
11. Which communication technique is most therapeutic when
interacting with a depressed client?
A. “You should try to look at the positive side.”
B. “Other people have problems too.”
EXAMINATION QUESTIONS WITH CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION WITH INSTANT PDF
DOWNLOAD
1. A nurse is assessing a client who reports hearing voices when
no one is present. Which term best describes this experience?
A. Delusion
B. Illusion
C. Hallucination
D. Confabulation
Rationale: A hallucination is a sensory perception that occurs
without an external stimulus. Auditory hallucinations, such as
hearing voices, are common in psychotic disorders. A delusion is
a fixed false belief, while an illusion involves misinterpreting an
actual external stimulus.
2. A client with schizophrenia states, “The television is sending
special messages directly to me.” Which type of delusion is this?
A. Somatic delusion
B. Delusion of reference
C. Nihilistic delusion
D. Grandeur delusion
Rationale: A delusion of reference occurs when a person
incorrectly believes that ordinary events, media, or other people's
actions have a special personal meaning. The belief is not based
on objective evidence.
3. Which nursing intervention is most appropriate when a client is
experiencing auditory hallucinations?
A. Tell the client that the voices are imaginary.
B. Encourage the client to obey the voices.
,C. Acknowledge the client's experience without validating the
hallucination.
D. Ask the client to describe why the voices are real.
Rationale: The nurse should acknowledge that the client is
experiencing voices while presenting reality without arguing. For
example, the nurse may say, “I understand that you hear voices,
but I do not hear them.” This approach supports the client without
reinforcing the hallucination.
4. A client with major depressive disorder says, “My family would
be better off without me.” What should the nurse do first?
A. Encourage the client to identify positive qualities.
B. Ask the client to attend a group activity.
C. Assess directly for suicidal thoughts, plans, and access to
means.
D. Reassure the client that the family cares about them.
Rationale: Statements suggesting hopelessness or perceived
burdensomeness require immediate suicide-risk assessment.
Directly asking about suicide does not cause suicidal behavior
and helps determine the urgency of intervention.
5. Which finding is most characteristic of mania?
A. Social withdrawal
B. Psychomotor retardation
C. Decreased need for sleep with increased energy
D. Persistent feelings of worthlessness
Rationale: Mania commonly involves elevated or irritable mood,
increased energy, decreased need for sleep, pressured speech,
racing thoughts, impulsivity, and increased goal-directed activity.
Depression is more commonly associated with withdrawal, low
energy, and psychomotor slowing.
,6. A client taking lithium reports severe diarrhea, vomiting, coarse
tremors, and unsteady gait. What should the nurse suspect?
A. Therapeutic response
B. Mild anxiety
C. Lithium toxicity
D. Serotonin syndrome
Rationale: Severe gastrointestinal symptoms, coarse tremors,
ataxia, confusion, and other neurologic changes can indicate
lithium toxicity. The medication should be withheld as appropriate
according to the clinical situation, and the healthcare provider
should be notified promptly.
7. Which instruction is most important for a client taking lithium?
A. Eliminate sodium from the diet.
B. Avoid drinking fluids during the day.
C. Maintain consistent fluid and sodium intake.
D. Double the next dose if one dose is missed.
Rationale: Lithium levels are affected by changes in fluid and
sodium balance. Consistent hydration and sodium intake help
reduce fluctuations in lithium concentration and decrease the risk
of toxicity.
8. A client receiving an antipsychotic medication develops severe
muscle rigidity, high fever, altered consciousness, and autonomic
instability. Which condition should the nurse suspect?
A. Tardive dyskinesia
B. Acute dystonia
C. Neuroleptic malignant syndrome
D. Panic disorder
Rationale: Neuroleptic malignant syndrome is a potentially life-
threatening reaction associated with antipsychotic medications.
, Classic findings include severe rigidity, hyperthermia, altered
mental status, and autonomic instability and require urgent
intervention.
9. Which symptom is commonly associated with generalized
anxiety disorder?
A. Fixed false beliefs
B. Excessive and difficult-to-control worry
C. Recurrent manic episodes
D. Persistent hallucinations
Rationale: Generalized anxiety disorder is characterized by
excessive anxiety and worry about multiple areas of life that are
difficult to control and are associated with symptoms such as
restlessness, fatigue, irritability, muscle tension, and sleep
disturbance.
10. A client experiencing a panic attack reports intense fear, chest
tightness, and shortness of breath. Which nursing action is most
appropriate?
A. Leave the client alone to reduce stimulation.
B. Ask the client to explain the cause of the anxiety.
C. Remain with the client and use short, calm statements.
D. Encourage detailed problem-solving immediately.
Rationale: During severe panic, the client's ability to process
information and solve problems is impaired. Remaining with the
client, reducing environmental stimulation, and using simple,
calm communication promote safety and decrease anxiety.
11. Which communication technique is most therapeutic when
interacting with a depressed client?
A. “You should try to look at the positive side.”
B. “Other people have problems too.”
