2026 Mental Health Nursing Study Guide
Exam Prep Psychiatric Disorders
Therapeutic Communication Mental Status
Assessment Psychopharmacology Patient
Safety Review
Section 1: Psychiatric Disorders — Questions 1–40
1. A nurse is assessing a client with major depressive disorder. Which finding
is most concerning?
A. Decreased appetite
B. Suicidal ideation with a specific plan
C. Feelings of hopelessness
D. Insomnia
Rationale: Suicidal ideation with a specific plan indicates imminent risk of self-
harm and requires immediate intervention. The nurse must ensure client safety,
initiate suicide precautions, and notify the provider immediately. Decreased
appetite, hopelessness, and insomnia are common symptoms of depression but do
not indicate immediate danger.
2. A nurse is caring for a client with schizophrenia who is experiencing
auditory hallucinations. Which intervention is most appropriate?
A. Tell the client the voices are not real
B. Ask the client what the voices are saying
C. Ignore the client's statements about voices
D. Restrict the client's access to others
Rationale: Asking the client what the voices are saying helps the nurse assess the
content and command nature of the hallucinations. If the voices are commanding
self-harm or harm to others, immediate safety interventions are needed. Telling the
client the voices are not real dismisses their experience.
,3. A nurse is assessing a client with bipolar disorder who is experiencing a
manic episode. Which finding requires immediate intervention?
A. Increased energy
B. Lack of sleep for 3 days with hyperactivity
C. Pressured speech
D. Grandiose ideas
Rationale: Lack of sleep for 3 days with hyperactivity indicates severe mania that
can lead to exhaustion, cardiac complications, and physical harm. Immediate
intervention, including medication and possibly hospitalization, is required.
4. A nurse is caring for a client with generalized anxiety disorder. Which
finding is characteristic?
A. Excessive worry about multiple events for at least 6 months
B. Fear of specific objects
C. Sudden onset of intense fear
D. Repetitive behaviors
Rationale: Generalized anxiety disorder is characterized by excessive worry about
multiple events for at least 6 months. Fear of specific objects suggests a phobia.
Sudden intense fear suggests panic disorder. Repetitive behaviors suggest
obsessive-compulsive disorder.
5. A nurse is assessing a client with panic disorder. Which finding is
characteristic?
A. Sudden onset of intense fear with physical symptoms
B. Excessive worry about multiple events
C. Fear of specific objects
D. Repetitive behaviors
Rationale: Panic disorder is characterized by sudden, recurrent panic attacks with
intense fear and physical symptoms such as palpitations, sweating, and shortness of
breath. Excessive worry suggests generalized anxiety disorder.
6. A nurse is caring for a client with obsessive-compulsive disorder (OCD).
Which finding is characteristic?
A. Repetitive behaviors performed to reduce anxiety
B. Sudden onset of intense fear
C. Excessive worry about multiple events
D. Fear of specific objects
,Rationale: OCD is characterized by obsessions (intrusive thoughts) and
compulsions (repetitive behaviors) performed to reduce anxiety. Sudden intense
fear suggests panic disorder.
7. A nurse is assessing a client with post-traumatic stress disorder (PTSD).
Which finding is characteristic?
A. Flashbacks and hypervigilance after a traumatic event
B. Excessive worry about multiple events
C. Fear of specific objects
D. Repetitive behaviors
Rationale: PTSD is characterized by flashbacks, nightmares, hypervigilance, and
avoidance behaviors after exposure to a traumatic event. Excessive worry suggests
generalized anxiety disorder.
8. A nurse is caring for a client with borderline personality disorder. Which
finding is characteristic?
A. Unstable relationships and fear of abandonment
B. Grandiose ideas
C. Lack of remorse
D. Social withdrawal
Rationale: Borderline personality disorder is characterized by unstable
relationships, fear of abandonment, impulsivity, and emotional dysregulation.
Grandiose ideas suggest narcissistic personality disorder.
9. A nurse is assessing a client with antisocial personality disorder. Which
finding is characteristic?
A. Lack of remorse and disregard for others' rights
B. Fear of abandonment
C. Social withdrawal
D. Grandiose ideas
Rationale: Antisocial personality disorder is characterized by lack of remorse,
disregard for others' rights, deceitfulness, and impulsivity. Fear of abandonment
suggests borderline personality disorder.
10. A nurse is caring for a client with narcissistic personality disorder. Which
finding is characteristic?
A. Grandiose ideas and need for admiration
B. Fear of abandonment
, C. Lack of remorse
D. Social withdrawal
Rationale: Narcissistic personality disorder is characterized by grandiose ideas,
need for admiration, and lack of empathy. Fear of abandonment suggests
borderline personality disorder.
11. A nurse is assessing a client with anorexia nervosa. Which finding is
characteristic?
A. Restriction of food intake with significantly low body weight
B. Binge eating followed by purging
C. Excessive exercise without food restriction
D. Normal body weight with purging
Rationale: Anorexia nervosa is characterized by restriction of food intake,
significantly low body weight, intense fear of gaining weight, and distorted body
image. Binge eating followed by purging suggests bulimia nervosa.
12. A nurse is caring for a client with bulimia nervosa. Which finding is
characteristic?
A. Binge eating followed by purging
B. Restriction of food intake with low body weight
C. Normal body weight with no purging
D. Excessive exercise without binge eating
Rationale: Bulimia nervosa is characterized by episodes of binge eating followed
by purging behaviors such as vomiting, laxative use, or excessive exercise. Body
weight is often normal.
13. A nurse is assessing a client with somatic symptom disorder. Which
finding is characteristic?
A. Physical symptoms without an identifiable medical cause
B. Fear of specific objects
C. Repetitive behaviors
D. Grandiose ideas
Rationale: Somatic symptom disorder is characterized by physical symptoms that
cause significant distress and impairment but have no identifiable medical cause.
The client's thoughts, feelings, and behaviors are excessive related to the
symptoms.
Exam Prep Psychiatric Disorders
Therapeutic Communication Mental Status
Assessment Psychopharmacology Patient
Safety Review
Section 1: Psychiatric Disorders — Questions 1–40
1. A nurse is assessing a client with major depressive disorder. Which finding
is most concerning?
A. Decreased appetite
B. Suicidal ideation with a specific plan
C. Feelings of hopelessness
D. Insomnia
Rationale: Suicidal ideation with a specific plan indicates imminent risk of self-
harm and requires immediate intervention. The nurse must ensure client safety,
initiate suicide precautions, and notify the provider immediately. Decreased
appetite, hopelessness, and insomnia are common symptoms of depression but do
not indicate immediate danger.
2. A nurse is caring for a client with schizophrenia who is experiencing
auditory hallucinations. Which intervention is most appropriate?
A. Tell the client the voices are not real
B. Ask the client what the voices are saying
C. Ignore the client's statements about voices
D. Restrict the client's access to others
Rationale: Asking the client what the voices are saying helps the nurse assess the
content and command nature of the hallucinations. If the voices are commanding
self-harm or harm to others, immediate safety interventions are needed. Telling the
client the voices are not real dismisses their experience.
,3. A nurse is assessing a client with bipolar disorder who is experiencing a
manic episode. Which finding requires immediate intervention?
A. Increased energy
B. Lack of sleep for 3 days with hyperactivity
C. Pressured speech
D. Grandiose ideas
Rationale: Lack of sleep for 3 days with hyperactivity indicates severe mania that
can lead to exhaustion, cardiac complications, and physical harm. Immediate
intervention, including medication and possibly hospitalization, is required.
4. A nurse is caring for a client with generalized anxiety disorder. Which
finding is characteristic?
A. Excessive worry about multiple events for at least 6 months
B. Fear of specific objects
C. Sudden onset of intense fear
D. Repetitive behaviors
Rationale: Generalized anxiety disorder is characterized by excessive worry about
multiple events for at least 6 months. Fear of specific objects suggests a phobia.
Sudden intense fear suggests panic disorder. Repetitive behaviors suggest
obsessive-compulsive disorder.
5. A nurse is assessing a client with panic disorder. Which finding is
characteristic?
A. Sudden onset of intense fear with physical symptoms
B. Excessive worry about multiple events
C. Fear of specific objects
D. Repetitive behaviors
Rationale: Panic disorder is characterized by sudden, recurrent panic attacks with
intense fear and physical symptoms such as palpitations, sweating, and shortness of
breath. Excessive worry suggests generalized anxiety disorder.
6. A nurse is caring for a client with obsessive-compulsive disorder (OCD).
Which finding is characteristic?
A. Repetitive behaviors performed to reduce anxiety
B. Sudden onset of intense fear
C. Excessive worry about multiple events
D. Fear of specific objects
,Rationale: OCD is characterized by obsessions (intrusive thoughts) and
compulsions (repetitive behaviors) performed to reduce anxiety. Sudden intense
fear suggests panic disorder.
7. A nurse is assessing a client with post-traumatic stress disorder (PTSD).
Which finding is characteristic?
A. Flashbacks and hypervigilance after a traumatic event
B. Excessive worry about multiple events
C. Fear of specific objects
D. Repetitive behaviors
Rationale: PTSD is characterized by flashbacks, nightmares, hypervigilance, and
avoidance behaviors after exposure to a traumatic event. Excessive worry suggests
generalized anxiety disorder.
8. A nurse is caring for a client with borderline personality disorder. Which
finding is characteristic?
A. Unstable relationships and fear of abandonment
B. Grandiose ideas
C. Lack of remorse
D. Social withdrawal
Rationale: Borderline personality disorder is characterized by unstable
relationships, fear of abandonment, impulsivity, and emotional dysregulation.
Grandiose ideas suggest narcissistic personality disorder.
9. A nurse is assessing a client with antisocial personality disorder. Which
finding is characteristic?
A. Lack of remorse and disregard for others' rights
B. Fear of abandonment
C. Social withdrawal
D. Grandiose ideas
Rationale: Antisocial personality disorder is characterized by lack of remorse,
disregard for others' rights, deceitfulness, and impulsivity. Fear of abandonment
suggests borderline personality disorder.
10. A nurse is caring for a client with narcissistic personality disorder. Which
finding is characteristic?
A. Grandiose ideas and need for admiration
B. Fear of abandonment
, C. Lack of remorse
D. Social withdrawal
Rationale: Narcissistic personality disorder is characterized by grandiose ideas,
need for admiration, and lack of empathy. Fear of abandonment suggests
borderline personality disorder.
11. A nurse is assessing a client with anorexia nervosa. Which finding is
characteristic?
A. Restriction of food intake with significantly low body weight
B. Binge eating followed by purging
C. Excessive exercise without food restriction
D. Normal body weight with purging
Rationale: Anorexia nervosa is characterized by restriction of food intake,
significantly low body weight, intense fear of gaining weight, and distorted body
image. Binge eating followed by purging suggests bulimia nervosa.
12. A nurse is caring for a client with bulimia nervosa. Which finding is
characteristic?
A. Binge eating followed by purging
B. Restriction of food intake with low body weight
C. Normal body weight with no purging
D. Excessive exercise without binge eating
Rationale: Bulimia nervosa is characterized by episodes of binge eating followed
by purging behaviors such as vomiting, laxative use, or excessive exercise. Body
weight is often normal.
13. A nurse is assessing a client with somatic symptom disorder. Which
finding is characteristic?
A. Physical symptoms without an identifiable medical cause
B. Fear of specific objects
C. Repetitive behaviors
D. Grandiose ideas
Rationale: Somatic symptom disorder is characterized by physical symptoms that
cause significant distress and impairment but have no identifiable medical cause.
The client's thoughts, feelings, and behaviors are excessive related to the
symptoms.
