2026/2027 South College
Q1. A client diagnosed with schizophrenia continues to experience
occasional auditory hallucinations but has returned to employment,
maintains supportive relationships, and independently manages
daily activities. Which interpretation best reflects recovery-oriented
psychiatric nursing?
A) Recovery is impossible while psychiatric symptoms persist.
B) Recovery requires discontinuation of all psychiatric treatment.
C) Meaningful recovery can include improved functioning and quality of life
despite ongoing symptoms.
D) Employment automatically establishes that a psychiatric diagnosis was
incorrect.
Correct Answer: C) Meaningful recovery can include improved functioning
and quality of life despite ongoing symptoms.
Rationale: Recovery-oriented psychiatric care emphasizes personal goals,
autonomy, functioning, hope, and quality of life. Complete symptom
elimination is not always necessary for a person to achieve meaningful
recovery. Treatment should support the client's chosen roles and continued
symptom management.
Q2. A client reports fatigue, poor concentration, irritability, and
insomnia. The client recently began corticosteroid therapy for an
inflammatory condition. Which assessment approach is most
appropriate?
A) Evaluate medication effects, physical health, psychiatric symptoms, and
psychosocial stressors before attributing symptoms to a primary mental
disorder.
B) Diagnose generalized anxiety disorder without reviewing medications.
C) Assume corticosteroids cannot influence mood or sleep.
D) Recommend stopping the medication without consulting the prescriber.
Correct Answer: A) Evaluate medication effects, physical health, psychiatric
symptoms, and psychosocial stressors before attributing symptoms to a
primary mental disorder.
,Rationale: Corticosteroids can produce mood changes, irritability, insomnia,
and occasionally severe psychiatric symptoms. Comprehensive psychiatric
assessment includes medication review, medical conditions, substance
exposure, and psychosocial factors. Identifying potentially reversible
contributors helps prevent diagnostic errors.
Q3. A client states, "I have been hearing someone calling my name,
but whenever I look around, nobody is there." Which additional
question is most important for evaluating the experience?
A) "What is your favorite type of music?"
B) "Have you experienced similar symptoms during childhood?"
C) "How much time do you spend watching television?"
D) "What does the voice say, how often does it occur, and has it ever
instructed you to do something?"
Correct Answer: D) "What does the voice say, how often does it occur, and
has it ever instructed you to do something?"
Rationale: Auditory experiences require assessment of content, frequency,
distress, insight, behavioral responses, and safety implications. Commands
involving self-harm or harm to others may require urgent intervention.
Additional evaluation should consider medical, neurological, sleep-related,
and substance-related causes.
Q4. A client arrives for an initial psychiatric assessment
accompanied by a family member who answers every question. The
client appears uncomfortable and repeatedly looks toward the
family member before responding. Which nursing action is most
appropriate?
A) Conduct the entire interview through the family member.
B) Arrange an opportunity to interview the client privately while assessing
communication needs and immediate safety.
C) Assume the client lacks decision-making capacity.
D) Exclude the client from treatment planning.
Correct Answer: B) Arrange an opportunity to interview the client privately
while assessing communication needs and immediate safety.
, Rationale: Private assessment supports autonomy, confidentiality, and
accurate information gathering. It can also help identify coercion, abuse, or
concerns the client is reluctant to discuss in front of others. Family
participation should reflect the client's preferences and appropriate clinical
circumstances.
Q5. During a mental status examination, a client correctly identifies
the date and location but cannot remember three objects after a
five-minute delay. Which cognitive domain is most directly affected?
A) Recent memory
B) Orientation
C) Remote memory
D) Abstract reasoning
Correct Answer: A) Recent memory
Rationale: Delayed recall tasks assess the ability to encode and retrieve
recently presented information. A client may remain fully oriented while
experiencing memory impairment. Interpretation should consider attention,
hearing, language, education, and possible neurological or medical
contributors.
Q6. A client speaks continuously about several unrelated subjects
and provides answers that never return to the original question.
Which thought-process abnormality is most consistent with this
presentation?
A) Thought blocking
B) Circumstantiality
C) Tangentiality
D) Echolalia
Correct Answer: C) Tangentiality
Rationale: Tangential thinking involves responses that move away from the
original subject and fail to return to the central point. In circumstantiality, the
client provides excessive detail but eventually answers the question.
Accurate distinction supports documentation of thought processes.