ORIGINAL PRACTICE QUESTION SET — Varcarolis (5th Ed.) —
Chapters 1–28
Format: For each chapter there are 3 original MCQs. Each question lists choices (A–D), then the
correct answer and a brief rationale.
Chapter 1 — Foundations of Psychiatric-Mental Health Nursing
1. Which statement best reflects the biopsychosocial model of mental health?
A. Mental illness is caused only by chemical imbalances.
B. Mental health is the product of biological, psychological, and social factors.
C. Social environment is the only determinant of mental health.
D. Genetics solely determines psychiatric disorders.
Answer: B. Rationale: Biopsychosocial includes biological, psychological, and social influences.
2. A nurse practicing trauma-informed care should first:
A. Diagnose psychiatric disorders.
B. Assume the patient will disclose traumatic history immediately.
C. Create safety, trust, and choice in interactions.
D. Focus solely on medication adherence.
Answer: C. Rationale: Trauma-informed care prioritizes safety, trustworthiness, and
empowerment.
3. An example of primary prevention in mental health is:
A. Crisis intervention after attempted suicide.
B. School programs teaching coping and resilience before disorders develop.
C. Hospitalization for acute psychosis.
D. Long-term case management for chronic severe mental illness.
Answer: B. Rationale: Primary prevention aims to prevent disorder onset through education
and resilience building.
Chapter 2 — Therapeutic Nurse-Client Relationship
4. The most important factor in establishing a therapeutic nurse–client relationship is:
A. Sharing personal experiences to build rapport.
B. Maintaining therapeutic boundaries and consistent empathy.
C. Rapid problem solving.
D. Using friendship language.
Answer: B. Rationale: Empathy and clear boundaries form the therapeutic foundation.
5. A nurse should set limits when a patient:
A. Discusses symptoms calmly.
B. Requests to borrow the nurse’s phone daily.
C. Expresses fear about medication side effects.
D. Asks for clarification about discharge plans.
Answer: B. Rationale: Boundary setting is needed for requests that could lead to dependency
or ethical issues.
, 6. During the working phase, the nurse’s role primarily is to:
A. Terminate the relationship quickly.
B. Identify client strengths, set goals, and implement interventions.
C. Share personal beliefs to influence client choices.
D. Avoid confrontation at all costs.
Answer: B. Rationale: The working phase focuses on goal-directed therapeutic work.
Chapter 3 — Cultural Considerations
7. A culturally competent nurse should first:
A. Assume cultural beliefs are identical across all people of the same group.
B. Ask open, respectful questions about the client’s beliefs and preferences.
C. Ignore culture and treat everyone identically.
D. Rely on stereotypes to anticipate needs.
Answer: B. Rationale: Individualized inquiry avoids stereotyping and supports culturally
responsive care.
8. Spiritual beliefs that influence mental health treatment plans are best handled by:
A. Disregarding them if they conflict with evidence.
B. Collaborating with the client to incorporate beliefs into the care plan when safe.
C. Replacing them with medical explanations only.
D. Forcing the client to follow hospital norms.
Answer: B. Rationale: Collaboration respects beliefs while ensuring safety and therapeutic aims.
9. A nurse notes that a client refuses blood products for religious reasons. The nurse should:
A. Immediately notify the ethics committee without discussion.
B. Explore alternatives, document informed refusal, and respect client autonomy.
C. Force treatment in the client’s best interest.
D. Dismiss the client from care.
Answer: B. Rationale: Respect for autonomy and documentation are required; explore safe
alternatives.
Chapter 4 — Legal & Ethical Issues
10. The principle of autonomy in psychiatric nursing means:
A. Forcing treatment when it is believed to be best.
B. Respecting a competent client’s right to refuse treatment.
C. Always deferring to family decisions.
D. Sharing client information with anyone concerned.
Answer: B. Rationale: Autonomy supports informed decision-making by competent clients.
11. Involuntary commitment may be justified when a client:
A. Has mild anxiety and wants outpatient care.
B. Is noncompliant with medication but poses no danger.
C. Is an imminent danger to self or others or cannot care for basic needs.
D. Expresses anger at staff.
Answer: C. Rationale: Criteria usually require danger to self/others or severe inability to care for
self.
Chapters 1–28
Format: For each chapter there are 3 original MCQs. Each question lists choices (A–D), then the
correct answer and a brief rationale.
Chapter 1 — Foundations of Psychiatric-Mental Health Nursing
1. Which statement best reflects the biopsychosocial model of mental health?
A. Mental illness is caused only by chemical imbalances.
B. Mental health is the product of biological, psychological, and social factors.
C. Social environment is the only determinant of mental health.
D. Genetics solely determines psychiatric disorders.
Answer: B. Rationale: Biopsychosocial includes biological, psychological, and social influences.
2. A nurse practicing trauma-informed care should first:
A. Diagnose psychiatric disorders.
B. Assume the patient will disclose traumatic history immediately.
C. Create safety, trust, and choice in interactions.
D. Focus solely on medication adherence.
Answer: C. Rationale: Trauma-informed care prioritizes safety, trustworthiness, and
empowerment.
3. An example of primary prevention in mental health is:
A. Crisis intervention after attempted suicide.
B. School programs teaching coping and resilience before disorders develop.
C. Hospitalization for acute psychosis.
D. Long-term case management for chronic severe mental illness.
Answer: B. Rationale: Primary prevention aims to prevent disorder onset through education
and resilience building.
Chapter 2 — Therapeutic Nurse-Client Relationship
4. The most important factor in establishing a therapeutic nurse–client relationship is:
A. Sharing personal experiences to build rapport.
B. Maintaining therapeutic boundaries and consistent empathy.
C. Rapid problem solving.
D. Using friendship language.
Answer: B. Rationale: Empathy and clear boundaries form the therapeutic foundation.
5. A nurse should set limits when a patient:
A. Discusses symptoms calmly.
B. Requests to borrow the nurse’s phone daily.
C. Expresses fear about medication side effects.
D. Asks for clarification about discharge plans.
Answer: B. Rationale: Boundary setting is needed for requests that could lead to dependency
or ethical issues.
, 6. During the working phase, the nurse’s role primarily is to:
A. Terminate the relationship quickly.
B. Identify client strengths, set goals, and implement interventions.
C. Share personal beliefs to influence client choices.
D. Avoid confrontation at all costs.
Answer: B. Rationale: The working phase focuses on goal-directed therapeutic work.
Chapter 3 — Cultural Considerations
7. A culturally competent nurse should first:
A. Assume cultural beliefs are identical across all people of the same group.
B. Ask open, respectful questions about the client’s beliefs and preferences.
C. Ignore culture and treat everyone identically.
D. Rely on stereotypes to anticipate needs.
Answer: B. Rationale: Individualized inquiry avoids stereotyping and supports culturally
responsive care.
8. Spiritual beliefs that influence mental health treatment plans are best handled by:
A. Disregarding them if they conflict with evidence.
B. Collaborating with the client to incorporate beliefs into the care plan when safe.
C. Replacing them with medical explanations only.
D. Forcing the client to follow hospital norms.
Answer: B. Rationale: Collaboration respects beliefs while ensuring safety and therapeutic aims.
9. A nurse notes that a client refuses blood products for religious reasons. The nurse should:
A. Immediately notify the ethics committee without discussion.
B. Explore alternatives, document informed refusal, and respect client autonomy.
C. Force treatment in the client’s best interest.
D. Dismiss the client from care.
Answer: B. Rationale: Respect for autonomy and documentation are required; explore safe
alternatives.
Chapter 4 — Legal & Ethical Issues
10. The principle of autonomy in psychiatric nursing means:
A. Forcing treatment when it is believed to be best.
B. Respecting a competent client’s right to refuse treatment.
C. Always deferring to family decisions.
D. Sharing client information with anyone concerned.
Answer: B. Rationale: Autonomy supports informed decision-making by competent clients.
11. Involuntary commitment may be justified when a client:
A. Has mild anxiety and wants outpatient care.
B. Is noncompliant with medication but poses no danger.
C. Is an imminent danger to self or others or cannot care for basic needs.
D. Expresses anger at staff.
Answer: C. Rationale: Criteria usually require danger to self/others or severe inability to care for
self.
