Psychiatric Nursing 2026 Study Guide Practice
Questions Answer Explanations Mental Health
Assessment Therapeutic Relationships Psychiatric
Disorders Clinical Interventions
SECTION 1: MENTAL HEALTH ASSESSMENT (Questions 1–32)
1. A nurse is conducting a mental status examination. Which component
assesses the client's ability to think logically and coherently?
A. Affect
B. Thought process
C. Insight
D. Judgment
Rationale: Thought process refers to the flow and coherence of thoughts,
including whether thinking is logical, organized, and goal-directed. Affect refers to
the observable expression of emotion. Insight is the client's understanding of their
illness. Judgment is the ability to make sound decisions.
2. A nurse is assessing a client's orientation. Which finding indicates the client
is oriented times three?
A. Knows their name only
B. Knows person, place, and time
C. Knows person and place only
D. Knows time only
Rationale: Orientation times three (x3) means the client is oriented to person,
place, and time. Disorientation to time is often the first sign of confusion or
cognitive impairment.
,3. A nurse is assessing a client's mood. Which question is most appropriate?
A. "Do you hear voices?"
B. "How would you describe your mood today?"
C. "Do you know where you are?"
D. "Can you tell me the date?"
Rationale: Mood is the client's subjective emotional state. Asking "How would
you describe your mood today?" allows the client to express their feelings. The
other questions assess different aspects of mental status.
4. A nurse is assessing a client's affect. Which finding indicates a blunted
affect?
A. Reduced intensity of emotional expression
B. Absence of emotional expression
C. Exaggerated emotional expression
D. Appropriate emotional expression
Rationale: A blunted affect refers to reduced intensity of emotional expression. A
flat affect is the absence of emotional expression. An exaggerated affect is
inappropriate or overly intense.
5. A nurse is assessing a client for suicidal ideation. Which question is most
appropriate?
A. "You're not thinking of hurting yourself, are you?"
B. "Are you having thoughts of harming yourself?"
C. "Why would you want to hurt yourself?"
D. "You wouldn't do anything stupid, would you?"
Rationale: Direct, non-judgmental questioning about suicidal ideation is essential.
Asking "Are you having thoughts of harming yourself?" is direct and allows the
client to answer honestly. Avoid judgmental or leading questions.
,6. A nurse is assessing a client's judgment. Which scenario best assesses
judgment?
A. "What day is it today?"
B. "What would you do if you found a wallet on the street?"
C. "How are you feeling today?"
D. "Do you hear voices?"
Rationale: Judgment is assessed by presenting hypothetical scenarios that require
decision-making. Asking what the client would do if they found a wallet assesses
their ability to make sound decisions.
7. A nurse is assessing a client's insight. Which statement indicates good
insight?
A. "I don't have any problems."
B. "I know I have depression and need treatment."
C. "The voices are real."
D. "I don't need medication."
Rationale: Insight refers to the client's understanding of their illness and need for
treatment. A statement acknowledging the illness and need for treatment indicates
good insight.
8. A nurse is assessing a client for hallucinations. Which question is most
appropriate?
A. "Do you feel sad?"
B. "Do you hear voices when no one is around?"
C. "Do you know where you are?"
D. "What day is it?"
Rationale: Hallucinations are sensory perceptions without external stimuli. Asking
about hearing voices when no one is around assesses for auditory hallucinations,
the most common type.
, 9. A nurse is assessing a client for delusions. Which finding indicates a
delusion of grandeur?
A. "I am being poisoned."
B. "I am the president of the United States."
C. "Everyone is out to get me."
D. "I am responsible for everything bad that happens."
Rationale: A delusion of grandeur is a false belief that one has special powers,
wealth, or identity. Believing one is the president is a classic example. Delusions
of persecution involve beliefs of being targeted.
10. A nurse is assessing a client's speech. Which finding indicates pressured
speech?
A. Rapid, continuous speech that is difficult to interrupt
B. Slow, deliberate speech
C. Soft, barely audible speech
D. Absence of speech
Rationale: Pressured speech is rapid, continuous speech that is difficult to
interrupt. It is commonly seen in mania. Slow speech may indicate depression. Soft
speech may indicate anxiety or depression.
11. A nurse is assessing a client's attention and concentration. Which test is
most appropriate?
A. Serial sevens
B. Mini-Mental State Examination
C. Glasgow Coma Scale
D. AVPU scale
Rationale: Serial sevens (counting backward from 100 by 7s) assesses attention
and concentration. The Mini-Mental State Examination assesses cognitive
function. The Glasgow Coma Scale assesses level of consciousness.
Questions Answer Explanations Mental Health
Assessment Therapeutic Relationships Psychiatric
Disorders Clinical Interventions
SECTION 1: MENTAL HEALTH ASSESSMENT (Questions 1–32)
1. A nurse is conducting a mental status examination. Which component
assesses the client's ability to think logically and coherently?
A. Affect
B. Thought process
C. Insight
D. Judgment
Rationale: Thought process refers to the flow and coherence of thoughts,
including whether thinking is logical, organized, and goal-directed. Affect refers to
the observable expression of emotion. Insight is the client's understanding of their
illness. Judgment is the ability to make sound decisions.
2. A nurse is assessing a client's orientation. Which finding indicates the client
is oriented times three?
A. Knows their name only
B. Knows person, place, and time
C. Knows person and place only
D. Knows time only
Rationale: Orientation times three (x3) means the client is oriented to person,
place, and time. Disorientation to time is often the first sign of confusion or
cognitive impairment.
,3. A nurse is assessing a client's mood. Which question is most appropriate?
A. "Do you hear voices?"
B. "How would you describe your mood today?"
C. "Do you know where you are?"
D. "Can you tell me the date?"
Rationale: Mood is the client's subjective emotional state. Asking "How would
you describe your mood today?" allows the client to express their feelings. The
other questions assess different aspects of mental status.
4. A nurse is assessing a client's affect. Which finding indicates a blunted
affect?
A. Reduced intensity of emotional expression
B. Absence of emotional expression
C. Exaggerated emotional expression
D. Appropriate emotional expression
Rationale: A blunted affect refers to reduced intensity of emotional expression. A
flat affect is the absence of emotional expression. An exaggerated affect is
inappropriate or overly intense.
5. A nurse is assessing a client for suicidal ideation. Which question is most
appropriate?
A. "You're not thinking of hurting yourself, are you?"
B. "Are you having thoughts of harming yourself?"
C. "Why would you want to hurt yourself?"
D. "You wouldn't do anything stupid, would you?"
Rationale: Direct, non-judgmental questioning about suicidal ideation is essential.
Asking "Are you having thoughts of harming yourself?" is direct and allows the
client to answer honestly. Avoid judgmental or leading questions.
,6. A nurse is assessing a client's judgment. Which scenario best assesses
judgment?
A. "What day is it today?"
B. "What would you do if you found a wallet on the street?"
C. "How are you feeling today?"
D. "Do you hear voices?"
Rationale: Judgment is assessed by presenting hypothetical scenarios that require
decision-making. Asking what the client would do if they found a wallet assesses
their ability to make sound decisions.
7. A nurse is assessing a client's insight. Which statement indicates good
insight?
A. "I don't have any problems."
B. "I know I have depression and need treatment."
C. "The voices are real."
D. "I don't need medication."
Rationale: Insight refers to the client's understanding of their illness and need for
treatment. A statement acknowledging the illness and need for treatment indicates
good insight.
8. A nurse is assessing a client for hallucinations. Which question is most
appropriate?
A. "Do you feel sad?"
B. "Do you hear voices when no one is around?"
C. "Do you know where you are?"
D. "What day is it?"
Rationale: Hallucinations are sensory perceptions without external stimuli. Asking
about hearing voices when no one is around assesses for auditory hallucinations,
the most common type.
, 9. A nurse is assessing a client for delusions. Which finding indicates a
delusion of grandeur?
A. "I am being poisoned."
B. "I am the president of the United States."
C. "Everyone is out to get me."
D. "I am responsible for everything bad that happens."
Rationale: A delusion of grandeur is a false belief that one has special powers,
wealth, or identity. Believing one is the president is a classic example. Delusions
of persecution involve beliefs of being targeted.
10. A nurse is assessing a client's speech. Which finding indicates pressured
speech?
A. Rapid, continuous speech that is difficult to interrupt
B. Slow, deliberate speech
C. Soft, barely audible speech
D. Absence of speech
Rationale: Pressured speech is rapid, continuous speech that is difficult to
interrupt. It is commonly seen in mania. Slow speech may indicate depression. Soft
speech may indicate anxiety or depression.
11. A nurse is assessing a client's attention and concentration. Which test is
most appropriate?
A. Serial sevens
B. Mini-Mental State Examination
C. Glasgow Coma Scale
D. AVPU scale
Rationale: Serial sevens (counting backward from 100 by 7s) assesses attention
and concentration. The Mini-Mental State Examination assesses cognitive
function. The Glasgow Coma Scale assesses level of consciousness.
