2026 Psychiatric Nursing Mood Disorders Practice
Questions Answer Rationales Depression Bipolar
Disorder Anxiety Disorders Assessment Treatment
Patient Safety Nursing Care
SECTION 1: DEPRESSION ASSESSMENT AND DIAGNOSIS (Questions 1–
30)
1. A nurse is assessing a client for major depressive disorder. Which finding is
required for diagnosis according to the DSM-5?
A. Elevated mood for at least 1 week
B. Depressed mood or anhedonia for at least 2 weeks
C. Hallucinations for at least 1 month
D. Grandiosity for at least 2 weeks
Answer: B
Rationale: Major depressive disorder requires depressed mood or loss of
interest/pleasure (anhedonia) for at least 2 weeks, along with at least four
additional symptoms such as changes in sleep, appetite, energy, concentration,
psychomotor activity, or suicidal ideation.
2. A nurse is assessing a client with depression. Which symptom is considered
a core feature of major depressive disorder?
A. Grandiosity
B. Anhedonia
C. Flight of ideas
D. Delusions of persecution
Answer: B
,Rationale: Anhedonia (inability to experience pleasure) is a core feature of major
depressive disorder. Grandiosity and flight of ideas are seen in mania. Delusions of
persecution are psychotic symptoms.
3. A nurse is assessing a client with depression who reports waking up several
hours early and being unable to fall back asleep. This is known as:
A. Initial insomnia
B. Middle insomnia
C. Terminal insomnia
D. Hypersomnia
Answer: C
Rationale: Terminal insomnia (early morning awakening) is a classic symptom of
major depressive disorder. Initial insomnia is difficulty falling asleep. Middle
insomnia is difficulty staying asleep.
4. A nurse is assessing a client with depression. Which finding indicates a risk
for suicide?
A. Sleeping 10 hours per night
B. Increased appetite
C. Expressing hopelessness
D. Improved concentration
Answer: C
Rationale: Hopelessness is a significant risk factor for suicide in depression. Other
warning signs include suicidal ideation, giving away possessions, and sudden
calmness after severe agitation.
,5. A nurse is assessing a client with depression who reports feeling worthless
and guilty. These findings are consistent with:
A. Mania
B. Psychotic depression
C. Negative cognitive distortions
D. Anxiety disorder
Answer: C
Rationale: Feelings of worthlessness and excessive guilt are negative cognitive
distortions commonly seen in depression. They reflect the cognitive triad of
negative views about oneself, the world, and the future.
6. A nurse is assessing a client with depression. Which symptom indicates
psychomotor retardation?
A. Rapid speech
B. Pacing
C. Slowed movements and speech
D. Agitation
Answer: C
Rationale: Psychomotor retardation involves slowed movements, speech, and
thinking. It is a common symptom of severe depression. Agitation and pacing are
signs of psychomotor agitation.
7. A nurse is assessing a client with depression. Which symptom indicates
psychomotor agitation?
A. Slowed movements
B. Pacing and restlessness
C. Decreased speech
D. Fatigue
, Answer: B
Rationale: Psychomotor agitation involves increased, purposeless activity such as
pacing, hand-wringing, and restlessness. It is a symptom of depression and anxiety.
8. A nurse is assessing a client with depression. Which finding indicates
melancholic features?
A. Loss of pleasure in all activities
B. Mood reactivity
C. Hypersomnia
D. Weight gain
Answer: A
Rationale: Melancholic features include loss of pleasure in all or almost all
activities, lack of mood reactivity, early morning awakening, psychomotor
retardation or agitation, and significant weight loss.
9. A nurse is assessing a client with depression. Which finding indicates
atypical features?
A. Terminal insomnia
B. Weight loss
C. Mood reactivity and hypersomnia
D. Psychomotor retardation
Answer: C
Rationale: Atypical features include mood reactivity, weight gain, hypersomnia,
leaden paralysis, and rejection sensitivity. Melancholic features include terminal
insomnia and weight loss.
Questions Answer Rationales Depression Bipolar
Disorder Anxiety Disorders Assessment Treatment
Patient Safety Nursing Care
SECTION 1: DEPRESSION ASSESSMENT AND DIAGNOSIS (Questions 1–
30)
1. A nurse is assessing a client for major depressive disorder. Which finding is
required for diagnosis according to the DSM-5?
A. Elevated mood for at least 1 week
B. Depressed mood or anhedonia for at least 2 weeks
C. Hallucinations for at least 1 month
D. Grandiosity for at least 2 weeks
Answer: B
Rationale: Major depressive disorder requires depressed mood or loss of
interest/pleasure (anhedonia) for at least 2 weeks, along with at least four
additional symptoms such as changes in sleep, appetite, energy, concentration,
psychomotor activity, or suicidal ideation.
2. A nurse is assessing a client with depression. Which symptom is considered
a core feature of major depressive disorder?
A. Grandiosity
B. Anhedonia
C. Flight of ideas
D. Delusions of persecution
Answer: B
,Rationale: Anhedonia (inability to experience pleasure) is a core feature of major
depressive disorder. Grandiosity and flight of ideas are seen in mania. Delusions of
persecution are psychotic symptoms.
3. A nurse is assessing a client with depression who reports waking up several
hours early and being unable to fall back asleep. This is known as:
A. Initial insomnia
B. Middle insomnia
C. Terminal insomnia
D. Hypersomnia
Answer: C
Rationale: Terminal insomnia (early morning awakening) is a classic symptom of
major depressive disorder. Initial insomnia is difficulty falling asleep. Middle
insomnia is difficulty staying asleep.
4. A nurse is assessing a client with depression. Which finding indicates a risk
for suicide?
A. Sleeping 10 hours per night
B. Increased appetite
C. Expressing hopelessness
D. Improved concentration
Answer: C
Rationale: Hopelessness is a significant risk factor for suicide in depression. Other
warning signs include suicidal ideation, giving away possessions, and sudden
calmness after severe agitation.
,5. A nurse is assessing a client with depression who reports feeling worthless
and guilty. These findings are consistent with:
A. Mania
B. Psychotic depression
C. Negative cognitive distortions
D. Anxiety disorder
Answer: C
Rationale: Feelings of worthlessness and excessive guilt are negative cognitive
distortions commonly seen in depression. They reflect the cognitive triad of
negative views about oneself, the world, and the future.
6. A nurse is assessing a client with depression. Which symptom indicates
psychomotor retardation?
A. Rapid speech
B. Pacing
C. Slowed movements and speech
D. Agitation
Answer: C
Rationale: Psychomotor retardation involves slowed movements, speech, and
thinking. It is a common symptom of severe depression. Agitation and pacing are
signs of psychomotor agitation.
7. A nurse is assessing a client with depression. Which symptom indicates
psychomotor agitation?
A. Slowed movements
B. Pacing and restlessness
C. Decreased speech
D. Fatigue
, Answer: B
Rationale: Psychomotor agitation involves increased, purposeless activity such as
pacing, hand-wringing, and restlessness. It is a symptom of depression and anxiety.
8. A nurse is assessing a client with depression. Which finding indicates
melancholic features?
A. Loss of pleasure in all activities
B. Mood reactivity
C. Hypersomnia
D. Weight gain
Answer: A
Rationale: Melancholic features include loss of pleasure in all or almost all
activities, lack of mood reactivity, early morning awakening, psychomotor
retardation or agitation, and significant weight loss.
9. A nurse is assessing a client with depression. Which finding indicates
atypical features?
A. Terminal insomnia
B. Weight loss
C. Mood reactivity and hypersomnia
D. Psychomotor retardation
Answer: C
Rationale: Atypical features include mood reactivity, weight gain, hypersomnia,
leaden paralysis, and rejection sensitivity. Melancholic features include terminal
insomnia and weight loss.
