RASMUSSEN MENTAL HEALTH ACTUAL EXAM 1 (2026/2027)
150 QUESTIONS AND CORRECT DETAILED ANSWERS | ALREADY GRADED A
Course: Rasmussen University Mental Health Nursing – Examination 1
Core Domains: Foundations of Psychiatric Nursing, Therapeutic Communication & Nurse-Client
Relationships, Mental Health Assessment & Diagnosis, Anxiety & Stress-Related Disorders, Mood
Disorders (Depression, Bipolar), Schizophrenia Spectrum & Psychotic Disorders, Substance Use &
Addictive Disorders, Crisis Intervention & Suicide Prevention, and Psychopharmacology Basics
Nursing Program Focus | Evidence-Based, Lifespan-Centered Care
Exam Structure
The Rasmussen Mental Health Actual Exam 1 for the 2026/2027 academic cycle is a 150-question,
multiple-choice question (MCQ) examination.
Answer Format: All correct answers and nursing interventions are presented in bold and green,
followed by detailed rationales that integrate DSM-6 diagnostic criteria, apply therapeutic
communication principles, explain psychopharmacology mechanisms and side effects, and prioritize
safety and crisis management strategies.
1.
A client says, “I don’t know why I even bother anymore.” What is the most therapeutic response?
A. “You shouldn’t feel that way.”
B. “Let’s talk about something more positive.”
C. “It sounds like you’re feeling hopeless. Can you tell me more?”
D. “Everyone feels down sometimes.”
Rationale: The therapeutic response validates the client’s emotion and invites further
exploration without judgment or false reassurance. This aligns with person-centered care and
builds trust. Options A, B, and D are non-therapeutic (advising, dismissing, minimizing).
2.
Which neurotransmitter is most associated with depression?
A. Dopamine
B. Acetylcholine
C. Serotonin
D. GABA
Rationale: The monoamine hypothesis suggests depression involves deficiencies in serotonin,
norepinephrine, and dopamine. SSRIs target serotonin reuptake, supporting its central role in
mood regulation.
3.
A client with schizophrenia is pacing and muttering. What is the priority nursing action?
A. Administer PRN antipsychotic immediately
B. Assess for command hallucinations or escalating agitation
C. Restrain the client for safety
D. Ignore the behavior to avoid reinforcement
,Rationale">Safety is paramount. The nurse must first assess for risk of harm to self or others,
including presence of command hallucinations. Restraints are last-resort; medication may be
indicated but only after assessment.
4.
Which symptom is required for a DSM-6 diagnosis of major depressive disorder?
A. Weight loss
B. Insomnia
C. Depressed mood or anhedonia nearly every day for at least 2 weeks
D. Fatigue
Rationale">Per DSM-6, a diagnosis of MDD requires at least five symptoms over 2 weeks,
with one being either depressed mood or loss of interest/pleasure (anhedonia). Other
symptoms include changes in sleep, appetite, energy, concentration, worthlessness, or suicidal
ideation.
5.
A client with bipolar I disorder is admitted during a manic episode. Which intervention is most
appropriate?
A. Encourage participation in group therapy
B. Provide a low-stimulation environment and set firm, consistent limits
C. Allow unlimited phone calls to family
D. Offer high-calorie snacks frequently
Rationale">Mania involves hyperactivity, poor judgment, and distractibility. A structured, calm
environment with clear boundaries reduces overstimulation and promotes safety. Group
therapy may be too stimulating initially.
6.
What is the primary purpose of a mental status examination (MSE)?
A. To diagnose psychiatric illness
B. To objectively assess current cognitive, emotional, and behavioral functioning
C. To evaluate intelligence quotient (IQ)
D. To determine legal competency
Rationale">The MSE is a systematic observational tool that evaluates appearance, behavior, speech,
mood, affect, thought process/content, perception, cognition, and insight—providing a snapshot of
current mental functioning to guide care planning.
7.
A client states, “The FBI is watching me through my TV.” This is an example of:
A. Obsession
B. Delusion
C. Hallucination
D. Phobia
Rationale">A delusion is a fixed, false belief not based in reality. This is a persecutory delusion.
Hallucinations involve sensory perceptions without external stimuli (e.g., hearing voices).
Obsessions are intrusive thoughts; phobias are irrational fears.
8.
Which medication is a first-line treatment for generalized anxiety disorder (GAD)?
,A. Alprazolam
B. Hydroxyzine
C. Escitalopram
D. Propranolol
Rationale">SSRIs like escitalopram are first-line for GAD due to efficacy, safety, and low abuse
potential. Benzodiazepines (e.g., alprazolam) are for short-term use only due to dependence risk.
9.
A client with depression says, “I’m a burden to everyone.” This statement reflects which cognitive
distortion?
A. Overgeneralization
B. Personalization
C. Catastrophizing
D. All-or-nothing thinking
Rationale">Personalization occurs when a person attributes external events to themselves in
an exaggerated or inappropriate way. Cognitive-behavioral therapy helps clients identify and
reframe such distortions.
10.
What is the most important assessment when evaluating suicide risk?
A. Family history of depression
B. Presence of a specific plan, means, and intent
C. Level of social support
D. History of previous attempts
Rationale">While all factors matter, the most predictive indicators of imminent risk are a
concrete plan, access to lethal means, and stated intent. These require immediate safety
planning and possible hospitalization.
11.
A client with alcohol use disorder is experiencing tremors, anxiety, and tachycardia 12 hours after last
drink. What is the priority concern?
A. Wernicke’s encephalopathy
B. Alcohol withdrawal syndrome
C. Hepatic encephalopathy
D. Delirium tremens (DTs)
Rationale">Symptoms beginning 6–24 hours post-last drink indicate alcohol withdrawal
syndrome. DTs (fever, hallucinations, seizures) typically occur 48–72 hours later. Withdrawal can
progress rapidly—requires CIWA protocol and benzodiazepines.
12.
Which defense mechanism is demonstrated when a client yells at the nurse after being denied a pass?
A. Repression
B. Displacement
C. Projection
D. Denial
Rationale">Displacement involves redirecting emotions from a threatening target to a safer one.
The client displaces anger toward staff instead of accepting the limit. Understanding defense
mechanisms guides empathetic responses.
13.
, A client taking clozapine reports sore throat and fever. What is the priority action?
A. Administer acetaminophen
B. Obtain absolute neutrophil count (ANC) immediately
C. Increase fluid intake
D. Monitor temperature every 4 hours
Rationale">Clozapine carries a black box warning for agranulocytosis. Sore throat and fever may
indicate infection due to severely low ANC. Weekly CBC monitoring is mandatory; any signs of
infection require urgent ANC check.
14.
Which statement best demonstrates therapeutic use of silence?
A. “Go on…”
B. Maintaining eye contact and waiting quietly after the client pauses
C. “I understand.”
D. Changing the subject
Rationale">Therapeutic silence gives the client space to reflect and continue sharing. Nonverbal
attentiveness during silence conveys respect and patience, encouraging deeper expression.
15.
A client with PTSD startles easily and avoids crowds. These are examples of which symptom clusters?
A. Intrusion and negative alterations
B. Hyperarousal and avoidance
C. Dissociation and mood dysregulation
D. Re-experiencing and amnesia
Rationale">DSM-6 PTSD includes four clusters: intrusion, avoidance, negative cognitions/mood,
and arousal/reactivity. Hypervigilance/startle = hyperarousal; avoiding reminders
= avoidance.
16.
What is the primary goal of crisis intervention?
A. Long-term personality change
B. Restore the individual to pre-crisis level of functioning
C. Diagnose underlying mental illness
D. Initiate psychotherapy
Rationale">Crisis intervention is time-limited (4–6 weeks) and focuses on immediate
stabilization and return to baseline, not deep psychological work. It emphasizes problem-
solving and support systems.
17.
A client with schizophrenia says, “My thoughts are being broadcast on the radio.” This is a:
A. Somatic delusion
B. Thought broadcasting
C. Idea of reference
D. Grandiose delusion
Rationale">Thought broadcasting is a first-rank symptom of schizophrenia where the
individual believes their thoughts are audible to others. It reflects impaired ego boundaries and is
part of positive symptoms.
18.
150 QUESTIONS AND CORRECT DETAILED ANSWERS | ALREADY GRADED A
Course: Rasmussen University Mental Health Nursing – Examination 1
Core Domains: Foundations of Psychiatric Nursing, Therapeutic Communication & Nurse-Client
Relationships, Mental Health Assessment & Diagnosis, Anxiety & Stress-Related Disorders, Mood
Disorders (Depression, Bipolar), Schizophrenia Spectrum & Psychotic Disorders, Substance Use &
Addictive Disorders, Crisis Intervention & Suicide Prevention, and Psychopharmacology Basics
Nursing Program Focus | Evidence-Based, Lifespan-Centered Care
Exam Structure
The Rasmussen Mental Health Actual Exam 1 for the 2026/2027 academic cycle is a 150-question,
multiple-choice question (MCQ) examination.
Answer Format: All correct answers and nursing interventions are presented in bold and green,
followed by detailed rationales that integrate DSM-6 diagnostic criteria, apply therapeutic
communication principles, explain psychopharmacology mechanisms and side effects, and prioritize
safety and crisis management strategies.
1.
A client says, “I don’t know why I even bother anymore.” What is the most therapeutic response?
A. “You shouldn’t feel that way.”
B. “Let’s talk about something more positive.”
C. “It sounds like you’re feeling hopeless. Can you tell me more?”
D. “Everyone feels down sometimes.”
Rationale: The therapeutic response validates the client’s emotion and invites further
exploration without judgment or false reassurance. This aligns with person-centered care and
builds trust. Options A, B, and D are non-therapeutic (advising, dismissing, minimizing).
2.
Which neurotransmitter is most associated with depression?
A. Dopamine
B. Acetylcholine
C. Serotonin
D. GABA
Rationale: The monoamine hypothesis suggests depression involves deficiencies in serotonin,
norepinephrine, and dopamine. SSRIs target serotonin reuptake, supporting its central role in
mood regulation.
3.
A client with schizophrenia is pacing and muttering. What is the priority nursing action?
A. Administer PRN antipsychotic immediately
B. Assess for command hallucinations or escalating agitation
C. Restrain the client for safety
D. Ignore the behavior to avoid reinforcement
,Rationale">Safety is paramount. The nurse must first assess for risk of harm to self or others,
including presence of command hallucinations. Restraints are last-resort; medication may be
indicated but only after assessment.
4.
Which symptom is required for a DSM-6 diagnosis of major depressive disorder?
A. Weight loss
B. Insomnia
C. Depressed mood or anhedonia nearly every day for at least 2 weeks
D. Fatigue
Rationale">Per DSM-6, a diagnosis of MDD requires at least five symptoms over 2 weeks,
with one being either depressed mood or loss of interest/pleasure (anhedonia). Other
symptoms include changes in sleep, appetite, energy, concentration, worthlessness, or suicidal
ideation.
5.
A client with bipolar I disorder is admitted during a manic episode. Which intervention is most
appropriate?
A. Encourage participation in group therapy
B. Provide a low-stimulation environment and set firm, consistent limits
C. Allow unlimited phone calls to family
D. Offer high-calorie snacks frequently
Rationale">Mania involves hyperactivity, poor judgment, and distractibility. A structured, calm
environment with clear boundaries reduces overstimulation and promotes safety. Group
therapy may be too stimulating initially.
6.
What is the primary purpose of a mental status examination (MSE)?
A. To diagnose psychiatric illness
B. To objectively assess current cognitive, emotional, and behavioral functioning
C. To evaluate intelligence quotient (IQ)
D. To determine legal competency
Rationale">The MSE is a systematic observational tool that evaluates appearance, behavior, speech,
mood, affect, thought process/content, perception, cognition, and insight—providing a snapshot of
current mental functioning to guide care planning.
7.
A client states, “The FBI is watching me through my TV.” This is an example of:
A. Obsession
B. Delusion
C. Hallucination
D. Phobia
Rationale">A delusion is a fixed, false belief not based in reality. This is a persecutory delusion.
Hallucinations involve sensory perceptions without external stimuli (e.g., hearing voices).
Obsessions are intrusive thoughts; phobias are irrational fears.
8.
Which medication is a first-line treatment for generalized anxiety disorder (GAD)?
,A. Alprazolam
B. Hydroxyzine
C. Escitalopram
D. Propranolol
Rationale">SSRIs like escitalopram are first-line for GAD due to efficacy, safety, and low abuse
potential. Benzodiazepines (e.g., alprazolam) are for short-term use only due to dependence risk.
9.
A client with depression says, “I’m a burden to everyone.” This statement reflects which cognitive
distortion?
A. Overgeneralization
B. Personalization
C. Catastrophizing
D. All-or-nothing thinking
Rationale">Personalization occurs when a person attributes external events to themselves in
an exaggerated or inappropriate way. Cognitive-behavioral therapy helps clients identify and
reframe such distortions.
10.
What is the most important assessment when evaluating suicide risk?
A. Family history of depression
B. Presence of a specific plan, means, and intent
C. Level of social support
D. History of previous attempts
Rationale">While all factors matter, the most predictive indicators of imminent risk are a
concrete plan, access to lethal means, and stated intent. These require immediate safety
planning and possible hospitalization.
11.
A client with alcohol use disorder is experiencing tremors, anxiety, and tachycardia 12 hours after last
drink. What is the priority concern?
A. Wernicke’s encephalopathy
B. Alcohol withdrawal syndrome
C. Hepatic encephalopathy
D. Delirium tremens (DTs)
Rationale">Symptoms beginning 6–24 hours post-last drink indicate alcohol withdrawal
syndrome. DTs (fever, hallucinations, seizures) typically occur 48–72 hours later. Withdrawal can
progress rapidly—requires CIWA protocol and benzodiazepines.
12.
Which defense mechanism is demonstrated when a client yells at the nurse after being denied a pass?
A. Repression
B. Displacement
C. Projection
D. Denial
Rationale">Displacement involves redirecting emotions from a threatening target to a safer one.
The client displaces anger toward staff instead of accepting the limit. Understanding defense
mechanisms guides empathetic responses.
13.
, A client taking clozapine reports sore throat and fever. What is the priority action?
A. Administer acetaminophen
B. Obtain absolute neutrophil count (ANC) immediately
C. Increase fluid intake
D. Monitor temperature every 4 hours
Rationale">Clozapine carries a black box warning for agranulocytosis. Sore throat and fever may
indicate infection due to severely low ANC. Weekly CBC monitoring is mandatory; any signs of
infection require urgent ANC check.
14.
Which statement best demonstrates therapeutic use of silence?
A. “Go on…”
B. Maintaining eye contact and waiting quietly after the client pauses
C. “I understand.”
D. Changing the subject
Rationale">Therapeutic silence gives the client space to reflect and continue sharing. Nonverbal
attentiveness during silence conveys respect and patience, encouraging deeper expression.
15.
A client with PTSD startles easily and avoids crowds. These are examples of which symptom clusters?
A. Intrusion and negative alterations
B. Hyperarousal and avoidance
C. Dissociation and mood dysregulation
D. Re-experiencing and amnesia
Rationale">DSM-6 PTSD includes four clusters: intrusion, avoidance, negative cognitions/mood,
and arousal/reactivity. Hypervigilance/startle = hyperarousal; avoiding reminders
= avoidance.
16.
What is the primary goal of crisis intervention?
A. Long-term personality change
B. Restore the individual to pre-crisis level of functioning
C. Diagnose underlying mental illness
D. Initiate psychotherapy
Rationale">Crisis intervention is time-limited (4–6 weeks) and focuses on immediate
stabilization and return to baseline, not deep psychological work. It emphasizes problem-
solving and support systems.
17.
A client with schizophrenia says, “My thoughts are being broadcast on the radio.” This is a:
A. Somatic delusion
B. Thought broadcasting
C. Idea of reference
D. Grandiose delusion
Rationale">Thought broadcasting is a first-rank symptom of schizophrenia where the
individual believes their thoughts are audible to others. It reflects impaired ego boundaries and is
part of positive symptoms.
18.
