PSYCHIATRIC NURSING PRACTICE QUESTIONS 2026 / COMPLETE
MENTAL HEALTH EXAM REVIEW WITH ANSWER KEY AND DETAILED
RATIONALES
1. A client admitted to an inpatient psychiatric unit reports hearing a voice
that repeatedly commands the client to jump from a third-floor window
and states that the voice has become increasingly difficult to resist. Which
nursing action should be implemented first?
A. Tell the client that the voice is not real and encourage the client to ignore
it
B. Ask the client to describe the command, intent to follow it, and access to
the means of self-harm
C. Encourage the client to remain alone until the hallucination decreases
D. Tell the client that auditory hallucinations are common during psychiatric
hospitalization
Answer: B
2. A client with major depressive disorder states, “My family would be better
off without me, and I have already decided how I will kill myself.” Which
nursing response is most appropriate?
A. “Your family needs you, so you should not think about suicide.”
B. “Try to focus on the positive things happening in your life.”
C. “Tell me about your plan, whether you have access to the method, and
when you intend to act.”
D. “You should discuss these feelings with your therapist at your next
appointment.”
Answer: C
3. A client experiencing an acute manic episode is pacing continuously,
speaking rapidly, interrupting others, and eating very little because the
client is unable to remain seated. Which nursing intervention is most
appropriate?
A. Provide frequent high-calorie finger foods and nutritious fluids that can
be consumed while moving
pg. 1
, B. Require the client to remain seated in the dining room until the meal is
completed
C. Encourage participation in competitive group activities to use excess
energy
D. Offer several stimulating recreational activities throughout the day
Answer: A
4. A client with schizophrenia states, “The television announcer is sending
secret messages directly to me through the evening news.” Which response
by the nurse is most therapeutic?
A. “That cannot happen because television announcers do not know you.”
B. “Why do you believe the announcer has chosen you?”
C. “You should stop watching television until these thoughts disappear.”
D. “I understand that you believe the messages are directed toward you,
but I do not perceive them that way.”
Answer: D
5. A client receiving an antipsychotic medication develops severe muscle
rigidity, high fever, altered consciousness, diaphoresis, and unstable blood
pressure. Which complication should the nurse suspect?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Serotonin syndrome
Answer: B
6. A client receiving haloperidol suddenly develops neck spasms, involuntary
upward deviation of the eyes, and difficulty controlling the jaw. Which
medication should the nurse anticipate administering?
A. Lithium
B. Fluoxetine
C. Benztropine
D. Buspirone
Answer: C
pg. 2
, 7. A client who has received an antipsychotic medication for several years
develops repetitive chewing movements, tongue protrusion, and
involuntary facial movements. Which adverse effect is most likely?
A. Tardive dyskinesia
B. Acute dystonia
C. Akathisia
D. Neuroleptic malignant syndrome
Answer: A
8. A client taking clozapine reports fever, sore throat, chills, and unusual
weakness. Which nursing action is most appropriate?
A. Administer the next dose with food
B. Encourage strenuous exercise
C. Reassure the client that these symptoms are expected
D. Notify the healthcare provider and anticipate evaluation of the white
blood cell count
Answer: D
9. A client with generalized anxiety disorder reports persistent uncontrollable
worry about finances, family, health, and employment and states that the
worry interferes with sleep. Which nursing intervention is most
appropriate?
A. Encourage the client to avoid all situations that cause anxiety
B. Help the client identify triggers and develop adaptive coping strategies
C. Tell the client that excessive worry is simply a matter of attitude
D. Encourage the client to make important decisions while highly anxious
Answer: B
10. A client experiencing a panic attack is trembling, hyperventilating, and
repeatedly stating, “Something terrible is going to happen.” Which nursing
action should be taken initially?
A. Ask the client to describe childhood experiences contributing to the
anxiety
B. Provide detailed education about long-term anxiety management
pg. 3
, C. Remain with the client, use short calm statements, and reduce
environmental stimulation
D. Encourage the client to participate in a group activity
Answer: C
11. A client with obsessive-compulsive disorder repeatedly washes the hands
because of intrusive fears of contamination and reports that anxiety
becomes unbearable when the ritual is prevented. Which statement best
describes the handwashing behavior?
A. It is a compulsion performed to reduce anxiety associated with an
obsession
B. It is a hallucination caused by sensory misinterpretation
C. It is a delusion based on a fixed false belief
D. It is disorganized behavior caused by schizophrenia
Answer: A
12. A client with obsessive-compulsive disorder repeatedly asks the nurse
whether the door is locked after checking it several times. Which nursing
approach is most appropriate?
A. Provide reassurance every time the client asks
B. Lock the door personally whenever the client becomes anxious
C. Tell the client to stop asking questions immediately
D. Establish consistent limits while helping the client tolerate anxiety
without performing the ritual
Answer: D
13. A client with post-traumatic stress disorder becomes extremely distressed
after hearing a loud noise similar to one associated with a previous
traumatic event. Which nursing intervention is appropriate?
A. Encourage immediate detailed discussion of every traumatic event
B. Help the client identify the present environment and use grounding
techniques
C. Tell the client to suppress all thoughts about the trauma
pg. 4
MENTAL HEALTH EXAM REVIEW WITH ANSWER KEY AND DETAILED
RATIONALES
1. A client admitted to an inpatient psychiatric unit reports hearing a voice
that repeatedly commands the client to jump from a third-floor window
and states that the voice has become increasingly difficult to resist. Which
nursing action should be implemented first?
A. Tell the client that the voice is not real and encourage the client to ignore
it
B. Ask the client to describe the command, intent to follow it, and access to
the means of self-harm
C. Encourage the client to remain alone until the hallucination decreases
D. Tell the client that auditory hallucinations are common during psychiatric
hospitalization
Answer: B
2. A client with major depressive disorder states, “My family would be better
off without me, and I have already decided how I will kill myself.” Which
nursing response is most appropriate?
A. “Your family needs you, so you should not think about suicide.”
B. “Try to focus on the positive things happening in your life.”
C. “Tell me about your plan, whether you have access to the method, and
when you intend to act.”
D. “You should discuss these feelings with your therapist at your next
appointment.”
Answer: C
3. A client experiencing an acute manic episode is pacing continuously,
speaking rapidly, interrupting others, and eating very little because the
client is unable to remain seated. Which nursing intervention is most
appropriate?
A. Provide frequent high-calorie finger foods and nutritious fluids that can
be consumed while moving
pg. 1
, B. Require the client to remain seated in the dining room until the meal is
completed
C. Encourage participation in competitive group activities to use excess
energy
D. Offer several stimulating recreational activities throughout the day
Answer: A
4. A client with schizophrenia states, “The television announcer is sending
secret messages directly to me through the evening news.” Which response
by the nurse is most therapeutic?
A. “That cannot happen because television announcers do not know you.”
B. “Why do you believe the announcer has chosen you?”
C. “You should stop watching television until these thoughts disappear.”
D. “I understand that you believe the messages are directed toward you,
but I do not perceive them that way.”
Answer: D
5. A client receiving an antipsychotic medication develops severe muscle
rigidity, high fever, altered consciousness, diaphoresis, and unstable blood
pressure. Which complication should the nurse suspect?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Serotonin syndrome
Answer: B
6. A client receiving haloperidol suddenly develops neck spasms, involuntary
upward deviation of the eyes, and difficulty controlling the jaw. Which
medication should the nurse anticipate administering?
A. Lithium
B. Fluoxetine
C. Benztropine
D. Buspirone
Answer: C
pg. 2
, 7. A client who has received an antipsychotic medication for several years
develops repetitive chewing movements, tongue protrusion, and
involuntary facial movements. Which adverse effect is most likely?
A. Tardive dyskinesia
B. Acute dystonia
C. Akathisia
D. Neuroleptic malignant syndrome
Answer: A
8. A client taking clozapine reports fever, sore throat, chills, and unusual
weakness. Which nursing action is most appropriate?
A. Administer the next dose with food
B. Encourage strenuous exercise
C. Reassure the client that these symptoms are expected
D. Notify the healthcare provider and anticipate evaluation of the white
blood cell count
Answer: D
9. A client with generalized anxiety disorder reports persistent uncontrollable
worry about finances, family, health, and employment and states that the
worry interferes with sleep. Which nursing intervention is most
appropriate?
A. Encourage the client to avoid all situations that cause anxiety
B. Help the client identify triggers and develop adaptive coping strategies
C. Tell the client that excessive worry is simply a matter of attitude
D. Encourage the client to make important decisions while highly anxious
Answer: B
10. A client experiencing a panic attack is trembling, hyperventilating, and
repeatedly stating, “Something terrible is going to happen.” Which nursing
action should be taken initially?
A. Ask the client to describe childhood experiences contributing to the
anxiety
B. Provide detailed education about long-term anxiety management
pg. 3
, C. Remain with the client, use short calm statements, and reduce
environmental stimulation
D. Encourage the client to participate in a group activity
Answer: C
11. A client with obsessive-compulsive disorder repeatedly washes the hands
because of intrusive fears of contamination and reports that anxiety
becomes unbearable when the ritual is prevented. Which statement best
describes the handwashing behavior?
A. It is a compulsion performed to reduce anxiety associated with an
obsession
B. It is a hallucination caused by sensory misinterpretation
C. It is a delusion based on a fixed false belief
D. It is disorganized behavior caused by schizophrenia
Answer: A
12. A client with obsessive-compulsive disorder repeatedly asks the nurse
whether the door is locked after checking it several times. Which nursing
approach is most appropriate?
A. Provide reassurance every time the client asks
B. Lock the door personally whenever the client becomes anxious
C. Tell the client to stop asking questions immediately
D. Establish consistent limits while helping the client tolerate anxiety
without performing the ritual
Answer: D
13. A client with post-traumatic stress disorder becomes extremely distressed
after hearing a loud noise similar to one associated with a previous
traumatic event. Which nursing intervention is appropriate?
A. Encourage immediate detailed discussion of every traumatic event
B. Help the client identify the present environment and use grounding
techniques
C. Tell the client to suppress all thoughts about the trauma
pg. 4
