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Mental Health Nursing Test Bank 2025–2026 | NCLEX
Psychiatric Questions + Answers with Rationales | A+
Psych Nursing Prep
QUESTION 1
A 62-year-old client is admitted with community-acquired pneumonia and started on IV ceftriaxone.
Ten minutes after initiating the infusion, the nurse notes the client is developing shortness of breath,
facial flushing, and generalized hives. Oxygen saturation has dropped from 97% to 89%. What is the
nurse’s priority action?
A. Stop the antibiotic infusion immediately
B. Administer IV diphenhydramine as prescribed
C. Notify the provider
D. Assess for a rash progression
✅ Correct Answer: A. Stop the antibiotic infusion immediately
Rationale: The client is exhibiting signs of anaphylaxis. The first and most urgent action is to
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discontinue the suspected allergen (antibiotic). Subsequent actions include airway support,
administration of epinephrine and antihistamines, and provider notification.
✅ QUESTION 2
A nurse is caring for a 78-year-old post-operative client who underwent hip replacement surgery 6
hours ago. The client is confused, pulling at IV lines, and attempting to get out of bed. The nurse notes
oxygen saturation is 90%, respiratory rate is 28/min, and temperature is 101°F (38.3°C). What should
the nurse do first?
A. Apply soft wrist restraints
B. Notify the provider of possible infection
C. Raise the head of the bed and apply oxygen
D. Administer PRN antipyretic for fever
✅ Correct Answer: C. Raise the head of the bed and apply oxygen
Rationale: The client is at risk for hypoxia, a common cause of acute confusion in older adults.
Airway and breathing must be addressed before further assessments or provider notification. Oxygen
improves saturation and may reduce delirium.
✅ QUESTION 3
The nurse is reviewing discharge instructions with a client who was newly prescribed warfarin for
atrial fibrillation. Which of the following statements by the client indicates a need for further
teaching?
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A. “I’ll avoid aspirin and NSAIDs unless my provider approves.”
B. “I’ll keep my intake of leafy greens consistent.”
C. “I’ll use a soft toothbrush and electric razor.”
D. “I’ll take extra doses if I miss one to keep my blood thin.”
✅ Correct Answer: D. “I’ll take extra doses if I miss one to keep my blood thin.”
Rationale: Warfarin dosing should never be doubled or adjusted independently by the client. Missed
doses should be managed according to provider guidance. This statement reflects a dangerous
misunderstanding.
✅ QUESTION 4
A client with heart failure is receiving digoxin. Morning labs reveal: potassium 3.0 mEq/L, digoxin
level 2.3 ng/mL. The client reports nausea and seeing halos around lights. What is the most
appropriate action by the nurse?
A. Hold the next dose of digoxin and notify the provider
B. Recheck potassium level in 4 hours
C. Encourage potassium-rich foods
D. Document the findings and continue the medication
✅ Correct Answer: A.
Rationale: The client is showing signs of digoxin toxicity (nausea, visual changes), and both digoxin
level and hypokalemia increase the risk. The nurse should withhold the medication and contact the
provider immediately.
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✅ QUESTION 5
A 36-year-old client presents to the ER with severe lower abdominal pain, vaginal spotting, and a
positive pregnancy test. Vital signs: BP 88/60 mmHg, HR 122, RR 28, SpO₂ 94%. What is the
priority nursing intervention?
A. Insert a large-bore IV catheter and begin fluid resuscitation
B. Prepare for transvaginal ultrasound
C. Administer oxygen via nasal cannula
D. Collect a urine sample for additional testing
✅ Correct Answer: A. Insert a large-bore IV catheter and begin fluid resuscitation
Rationale: These signs suggest a ruptured ectopic pregnancy and hypovolemic shock. The priority is
to stabilize circulation with fluids before diagnostic imaging or labs.
✅ QUESTION 6
A nurse is caring for a client on contact precautions for C. difficile infection. Which of the following
actions by the nurse requires correction?
A. Wears a gown and gloves upon room entry
B. Uses alcohol-based hand sanitizer after client care
C. Disposes of PPE before exiting the room
D. Cleans reusable equipment with bleach-based solution
Mental Health Nursing Test Bank 2025–2026 | NCLEX
Psychiatric Questions + Answers with Rationales | A+
Psych Nursing Prep
QUESTION 1
A 62-year-old client is admitted with community-acquired pneumonia and started on IV ceftriaxone.
Ten minutes after initiating the infusion, the nurse notes the client is developing shortness of breath,
facial flushing, and generalized hives. Oxygen saturation has dropped from 97% to 89%. What is the
nurse’s priority action?
A. Stop the antibiotic infusion immediately
B. Administer IV diphenhydramine as prescribed
C. Notify the provider
D. Assess for a rash progression
✅ Correct Answer: A. Stop the antibiotic infusion immediately
Rationale: The client is exhibiting signs of anaphylaxis. The first and most urgent action is to
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discontinue the suspected allergen (antibiotic). Subsequent actions include airway support,
administration of epinephrine and antihistamines, and provider notification.
✅ QUESTION 2
A nurse is caring for a 78-year-old post-operative client who underwent hip replacement surgery 6
hours ago. The client is confused, pulling at IV lines, and attempting to get out of bed. The nurse notes
oxygen saturation is 90%, respiratory rate is 28/min, and temperature is 101°F (38.3°C). What should
the nurse do first?
A. Apply soft wrist restraints
B. Notify the provider of possible infection
C. Raise the head of the bed and apply oxygen
D. Administer PRN antipyretic for fever
✅ Correct Answer: C. Raise the head of the bed and apply oxygen
Rationale: The client is at risk for hypoxia, a common cause of acute confusion in older adults.
Airway and breathing must be addressed before further assessments or provider notification. Oxygen
improves saturation and may reduce delirium.
✅ QUESTION 3
The nurse is reviewing discharge instructions with a client who was newly prescribed warfarin for
atrial fibrillation. Which of the following statements by the client indicates a need for further
teaching?
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A. “I’ll avoid aspirin and NSAIDs unless my provider approves.”
B. “I’ll keep my intake of leafy greens consistent.”
C. “I’ll use a soft toothbrush and electric razor.”
D. “I’ll take extra doses if I miss one to keep my blood thin.”
✅ Correct Answer: D. “I’ll take extra doses if I miss one to keep my blood thin.”
Rationale: Warfarin dosing should never be doubled or adjusted independently by the client. Missed
doses should be managed according to provider guidance. This statement reflects a dangerous
misunderstanding.
✅ QUESTION 4
A client with heart failure is receiving digoxin. Morning labs reveal: potassium 3.0 mEq/L, digoxin
level 2.3 ng/mL. The client reports nausea and seeing halos around lights. What is the most
appropriate action by the nurse?
A. Hold the next dose of digoxin and notify the provider
B. Recheck potassium level in 4 hours
C. Encourage potassium-rich foods
D. Document the findings and continue the medication
✅ Correct Answer: A.
Rationale: The client is showing signs of digoxin toxicity (nausea, visual changes), and both digoxin
level and hypokalemia increase the risk. The nurse should withhold the medication and contact the
provider immediately.
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✅ QUESTION 5
A 36-year-old client presents to the ER with severe lower abdominal pain, vaginal spotting, and a
positive pregnancy test. Vital signs: BP 88/60 mmHg, HR 122, RR 28, SpO₂ 94%. What is the
priority nursing intervention?
A. Insert a large-bore IV catheter and begin fluid resuscitation
B. Prepare for transvaginal ultrasound
C. Administer oxygen via nasal cannula
D. Collect a urine sample for additional testing
✅ Correct Answer: A. Insert a large-bore IV catheter and begin fluid resuscitation
Rationale: These signs suggest a ruptured ectopic pregnancy and hypovolemic shock. The priority is
to stabilize circulation with fluids before diagnostic imaging or labs.
✅ QUESTION 6
A nurse is caring for a client on contact precautions for C. difficile infection. Which of the following
actions by the nurse requires correction?
A. Wears a gown and gloves upon room entry
B. Uses alcohol-based hand sanitizer after client care
C. Disposes of PPE before exiting the room
D. Cleans reusable equipment with bleach-based solution
