ESTUDYR
PSYCHIATRIC COMPREHENSIVE REVIEW FOR
THE NCLEX-PN® EXAMINATION 2025
MULTICHOICE ANSWERED EXAM QUESTIONS
WITH DETAILED RATIONALES
1. A 32-year-old client has been grieving the death of a daughter killed by a drunk driver 6
months ago. Which statement indicates the client is improving?
A. ―I can never stop thinking about her.‖
B. ―I don‘t want to leave the house.‖
C. “I joined a support group for loss of a child.”
D. ―I keep everything her friends gave her.‖
Rationale: Joining a support group shows engagement with outside resources and
developing adaptive coping.
2. A client has been taking an antidepressant for 10 days. Which statement should the PN
expect?
A. ―I feel completely back to normal.‖
B. “I only awaken occasionally during the night.”
C. ―My appetite is fully restored.‖
D. ―I haven‘t noticed any change at all.‖
Rationale: Antidepressants often show early improvement in vegetative symptoms (sleep,
appetite) within 1–2 weeks; full mood improvement takes 2–4 weeks.
3. The PN observes a client sitting alone and mumbling. How should the PN document this?
A. ―Client is psychotic and talking to nonexistent people.‖
B. ―Client is acting bizarre and shouting.‖
C. “Sits alone and mumbles to self.”
D. ―Client refuses to interact with staff.‖
Rationale: Objective, nonjudgmental documentation describes observed behaviors
without interpretation.
4. A client becomes very agitated and begins pulling pictures off the wall. The PN asks to
move the client to a quiet room away from others. What is the most important reason?
A. To give the client privacy.
B. To avoid upsetting other clients.
C. To provide safety for the client and others in the milieu.
D. To administer medication without observation.
Rationale: Safety (preventing harm) is the primary reason for seclusion or removing a
client from the group setting.
5. A client is tearful and experiencing suicidal thoughts related to childhood abuse, with
nightmares and work impairment. What is the PN‘s priority goal?
A. Teach relaxation techniques.
B. Improve sleep hygiene.
C. The patient will report suicidal thoughts to staff.
D. Increase social activities.
,ESTUDYR
Rationale: Client safety is paramount; ensuring the client reports suicidal ideation allows
monitoring and intervention.
6. A client with chronic schizophrenia was discharged 6 weeks ago and returns for follow-
up. Which behavior indicates they will maintain independent living?
A. Regular attendance at social events.
B. Has taken prescribed medications since discharge.
C. Lives alone without any support.
D. Expresses no symptoms during visit.
Rationale: Medication adherence reduces relapse risk and is key for community
functioning.
7. A depressed client with poor judgment insists on leaving the hospital 1 day after
admission. Which chart entry suggests inability to safely care for basic needs?
A. ―Client refuses group activities.‖
B. ―Client cries often.‖
C. “Client forgot to turn off the stove several times in the last month.”
D. ―Client requires prompting to take meds.‖
Rationale: Forgetting to turn off a stove indicates immediate safety risk in independent
living.
8. Police bring a client after a suicide attempt. Which admission question is most important?
A. ―Have you missed work recently?‖
B. ―Do you have family support?‖
C. “Are you experiencing hallucinations that tell you to harm others?”
D. ―Would you like a room near the nurse‘s station?‖
Rationale: Determining presence of psychosis/hallucinations that may command harm is
critical for safety planning.
9. A client with angry outbursts denies voices/suicidal ideas. What is most important for the
PN to obtain?
A. Family history of mental illness.
B. Dietary habits.
C. Use of medications or substances.
D. Sleep schedule.
Rationale: Substance use or medication effects commonly underlie mood lability and
aggression; assessing this is essential.
10. A client with extensive burns cries during dressing change saying, ―I just want to die.‖
Which PN response is best?
A. ―You shouldn‘t talk like that—be strong.‖
B. “These treatments must seem like torture to you, but we want to help you
recover.”
C. ―You‘ll feel better if you cooperate.‖
D. ―I don‘t have time to discuss this.‖
Rationale: Empathic acknowledgment validates feelings without minimizing and supports
therapeutic alliance.
11. An AD client wanders and asks, ―Where should I stand for the parade?‖ Which response
is best?
A. ―That‘s not happening—stop asking.‖
B. ―You‘re confused.‖
, ESTUDYR
C. “Let’s go back to the activity room and see what is going on in there.”
D. ―Who told you about a parade?‖
Rationale: Redirecting to a safe, familiar activity reduces anxiety and meets the client
where they are cognitively.
12. A client crying about a friend‘s death says, ―I cannot believe this happened.‖ Which PN
response is most therapeutic?
A. ―You‘ll get over it.‖
B. ―At least you had time together.‖
C. “Tell me more about how you’re feeling.”
D. ―You shouldn‘t feel that way.‖
Rationale: Open-ended prompts encourage exploration of feelings and support grieving.
13. A client admitted with schizophrenia. Which mental status finding is most characteristic?
A. Depressed mood.
B. Rapid speech.
C. Incongruent affect.
D. Grandiosity only.
Rationale: Affect that does not match thought content (incongruent affect) is typical in
schizophrenia.
14. A client with major depression after retirement has a care plan goal: identify psychosocial
stressors and begin to modify them. What is the PN‘s expectation?
A. Depression is permanent and unchangeable.
B. The depression is retirement-related and may dissipate as the client adjusts.
C. Medication alone will resolve the issue immediately.
D. The client will reenter workforce within a week.
Rationale: Retirement is a life change causing stress; awareness and adjustment can
reduce depressive symptoms over time.
15. During the first 48 hours after admission of a very depressed client, what is the most
important intervention?
A. Start antidepressants immediately.
B. Assign group therapy.
C. Maintain safety in the client’s milieu.
D. Encourage family visitation.
Rationale: Suicide risk is highest; ensuring safety and observation is the top priority.
16. A client repeatedly washes the top of the same table. Which initial intervention should
the PN implement?
A. Prevent the ritual immediately.
B. Allow time for the ritual, then redirect to other activities.
C. Punish the behavior.
D. Restrain the client.
Rationale: Rituals reduce anxiety; allowing brief completion then redirecting is least
intrusive and therapeutic.
17. A client with schizophrenia hears voices telling them to walk in the middle of the street.
Which statement indicates need for continued hospitalization?
A. ―I can ignore the voices most of the time.‖
B. “No matter what I do, I cannot make the voices go away.”
C. ―The voices are just background noise.‖
PSYCHIATRIC COMPREHENSIVE REVIEW FOR
THE NCLEX-PN® EXAMINATION 2025
MULTICHOICE ANSWERED EXAM QUESTIONS
WITH DETAILED RATIONALES
1. A 32-year-old client has been grieving the death of a daughter killed by a drunk driver 6
months ago. Which statement indicates the client is improving?
A. ―I can never stop thinking about her.‖
B. ―I don‘t want to leave the house.‖
C. “I joined a support group for loss of a child.”
D. ―I keep everything her friends gave her.‖
Rationale: Joining a support group shows engagement with outside resources and
developing adaptive coping.
2. A client has been taking an antidepressant for 10 days. Which statement should the PN
expect?
A. ―I feel completely back to normal.‖
B. “I only awaken occasionally during the night.”
C. ―My appetite is fully restored.‖
D. ―I haven‘t noticed any change at all.‖
Rationale: Antidepressants often show early improvement in vegetative symptoms (sleep,
appetite) within 1–2 weeks; full mood improvement takes 2–4 weeks.
3. The PN observes a client sitting alone and mumbling. How should the PN document this?
A. ―Client is psychotic and talking to nonexistent people.‖
B. ―Client is acting bizarre and shouting.‖
C. “Sits alone and mumbles to self.”
D. ―Client refuses to interact with staff.‖
Rationale: Objective, nonjudgmental documentation describes observed behaviors
without interpretation.
4. A client becomes very agitated and begins pulling pictures off the wall. The PN asks to
move the client to a quiet room away from others. What is the most important reason?
A. To give the client privacy.
B. To avoid upsetting other clients.
C. To provide safety for the client and others in the milieu.
D. To administer medication without observation.
Rationale: Safety (preventing harm) is the primary reason for seclusion or removing a
client from the group setting.
5. A client is tearful and experiencing suicidal thoughts related to childhood abuse, with
nightmares and work impairment. What is the PN‘s priority goal?
A. Teach relaxation techniques.
B. Improve sleep hygiene.
C. The patient will report suicidal thoughts to staff.
D. Increase social activities.
,ESTUDYR
Rationale: Client safety is paramount; ensuring the client reports suicidal ideation allows
monitoring and intervention.
6. A client with chronic schizophrenia was discharged 6 weeks ago and returns for follow-
up. Which behavior indicates they will maintain independent living?
A. Regular attendance at social events.
B. Has taken prescribed medications since discharge.
C. Lives alone without any support.
D. Expresses no symptoms during visit.
Rationale: Medication adherence reduces relapse risk and is key for community
functioning.
7. A depressed client with poor judgment insists on leaving the hospital 1 day after
admission. Which chart entry suggests inability to safely care for basic needs?
A. ―Client refuses group activities.‖
B. ―Client cries often.‖
C. “Client forgot to turn off the stove several times in the last month.”
D. ―Client requires prompting to take meds.‖
Rationale: Forgetting to turn off a stove indicates immediate safety risk in independent
living.
8. Police bring a client after a suicide attempt. Which admission question is most important?
A. ―Have you missed work recently?‖
B. ―Do you have family support?‖
C. “Are you experiencing hallucinations that tell you to harm others?”
D. ―Would you like a room near the nurse‘s station?‖
Rationale: Determining presence of psychosis/hallucinations that may command harm is
critical for safety planning.
9. A client with angry outbursts denies voices/suicidal ideas. What is most important for the
PN to obtain?
A. Family history of mental illness.
B. Dietary habits.
C. Use of medications or substances.
D. Sleep schedule.
Rationale: Substance use or medication effects commonly underlie mood lability and
aggression; assessing this is essential.
10. A client with extensive burns cries during dressing change saying, ―I just want to die.‖
Which PN response is best?
A. ―You shouldn‘t talk like that—be strong.‖
B. “These treatments must seem like torture to you, but we want to help you
recover.”
C. ―You‘ll feel better if you cooperate.‖
D. ―I don‘t have time to discuss this.‖
Rationale: Empathic acknowledgment validates feelings without minimizing and supports
therapeutic alliance.
11. An AD client wanders and asks, ―Where should I stand for the parade?‖ Which response
is best?
A. ―That‘s not happening—stop asking.‖
B. ―You‘re confused.‖
, ESTUDYR
C. “Let’s go back to the activity room and see what is going on in there.”
D. ―Who told you about a parade?‖
Rationale: Redirecting to a safe, familiar activity reduces anxiety and meets the client
where they are cognitively.
12. A client crying about a friend‘s death says, ―I cannot believe this happened.‖ Which PN
response is most therapeutic?
A. ―You‘ll get over it.‖
B. ―At least you had time together.‖
C. “Tell me more about how you’re feeling.”
D. ―You shouldn‘t feel that way.‖
Rationale: Open-ended prompts encourage exploration of feelings and support grieving.
13. A client admitted with schizophrenia. Which mental status finding is most characteristic?
A. Depressed mood.
B. Rapid speech.
C. Incongruent affect.
D. Grandiosity only.
Rationale: Affect that does not match thought content (incongruent affect) is typical in
schizophrenia.
14. A client with major depression after retirement has a care plan goal: identify psychosocial
stressors and begin to modify them. What is the PN‘s expectation?
A. Depression is permanent and unchangeable.
B. The depression is retirement-related and may dissipate as the client adjusts.
C. Medication alone will resolve the issue immediately.
D. The client will reenter workforce within a week.
Rationale: Retirement is a life change causing stress; awareness and adjustment can
reduce depressive symptoms over time.
15. During the first 48 hours after admission of a very depressed client, what is the most
important intervention?
A. Start antidepressants immediately.
B. Assign group therapy.
C. Maintain safety in the client’s milieu.
D. Encourage family visitation.
Rationale: Suicide risk is highest; ensuring safety and observation is the top priority.
16. A client repeatedly washes the top of the same table. Which initial intervention should
the PN implement?
A. Prevent the ritual immediately.
B. Allow time for the ritual, then redirect to other activities.
C. Punish the behavior.
D. Restrain the client.
Rationale: Rituals reduce anxiety; allowing brief completion then redirecting is least
intrusive and therapeutic.
17. A client with schizophrenia hears voices telling them to walk in the middle of the street.
Which statement indicates need for continued hospitalization?
A. ―I can ignore the voices most of the time.‖
B. “No matter what I do, I cannot make the voices go away.”
C. ―The voices are just background noise.‖
