Mental Health Assessment A Q&A Test
Bank Comprehensive Psychiatric
Nursing Exam Practice 2026/ 2027
Mental Health Assessment A Q&A Test Bank Comprehensive Psychiatric Nursing Exam Practice 2026-
2027
1) A nurse in a mental health facility observes a client who is experiencing a panic-level anxiety
episode. Which action should the nurse take first?
Answer: Accompany the client to a quiet room.
Rationale: The greatest immediate risk is injury due to severe anxiety. Staying with the client
and moving them to a room with minimal stimuli reduces environmental triggers and ensures
safety, allowing for further therapeutic interventions.
2) A nurse is obtaining a history and physical on a client who presents to the emergency
department of a mental health facility. Which assessment findings are consistent with PTSD?
(Select all that apply)
Answer: Distressing dreams; Difficulty concentrating; Exaggerated startle response.
Rationale: PTSD symptoms often include re-experiencing trauma (distressing dreams),
hyperarousal (exaggerated startle response), and cognitive difficulties (difficulty concentrating).
Recognizing these signs helps guide appropriate interventions.
3) A nurse is providing teaching to a client who has a new prescription for haloperidol. Which
side effect should the nurse instruct the client to report to the provider?
Answer: Shuffling gait.
Rationale: A shuffling gait is a clinical sign of pseudoparkinsonism, an extrapyramidal side
effect that can occur 5 hours to 30 days after starting haloperidol. Reporting this allows the
provider to consider an anti-parkinsonism agent.
4) A home health nurse is assessing an older adult client who lives alone. Which finding
indicates that the client may be experiencing delirium?
, Answer: Sudden onset.
Rationale: Delirium develops rapidly over hours to days, in contrast to dementia, which
develops gradually. Early recognition is crucial for timely intervention.
5) A nurse is caring for a client receiving imipramine for depression. Which adverse effect
should the nurse monitor?
Answer: Urinary retention.
Rationale: Tricyclic antidepressants like imipramine have anticholinergic effects, which can
lead to urinary retention. Monitoring for this prevents complications and ensures patient safety.
6) A nurse is providing care for a client who has bipolar disorder and is experiencing acute
mania. The client’s morning lithium level is 1.5 mEq/L. Which additional laboratory data has the
highest priority?
Answer: Serum sodium 125 mEq/L.
Rationale: Low sodium reduces renal excretion of lithium, increasing the risk of lithium
toxicity. Monitoring sodium levels is critical to prevent life-threatening complications.
7) A nurse is caring for a client with a history of substance use who was involuntarily admitted.
The client refuses oral lorazepam and becomes physically aggressive. What action should the
nurse take?
Answer: Do not administer the lorazepam.
Rationale: Clients retain the right to refuse treatment even if involuntarily admitted. Forcing
medication without consent violates legal and ethical standards.
8) A nurse is developing a discharge plan for a client with a history of gambling dependency and
includes participation in a support group. What is the purpose of attending the group?
Answer: Provide assurance that others have a similar problem.
Rationale: Support groups normalize the client’s experience, provide peer guidance, and offer
alternative coping strategies learned from others.
9) A nurse is caring for a client who is deaf and scheduled for electroconvulsive therapy (ECT).
How should the nurse ensure informed consent is obtained?
Answer: Request a professional interpreter to translate.
Rationale: Using a professional interpreter ensures accurate communication, supports informed
consent, and respects the client’s legal rights.
Bank Comprehensive Psychiatric
Nursing Exam Practice 2026/ 2027
Mental Health Assessment A Q&A Test Bank Comprehensive Psychiatric Nursing Exam Practice 2026-
2027
1) A nurse in a mental health facility observes a client who is experiencing a panic-level anxiety
episode. Which action should the nurse take first?
Answer: Accompany the client to a quiet room.
Rationale: The greatest immediate risk is injury due to severe anxiety. Staying with the client
and moving them to a room with minimal stimuli reduces environmental triggers and ensures
safety, allowing for further therapeutic interventions.
2) A nurse is obtaining a history and physical on a client who presents to the emergency
department of a mental health facility. Which assessment findings are consistent with PTSD?
(Select all that apply)
Answer: Distressing dreams; Difficulty concentrating; Exaggerated startle response.
Rationale: PTSD symptoms often include re-experiencing trauma (distressing dreams),
hyperarousal (exaggerated startle response), and cognitive difficulties (difficulty concentrating).
Recognizing these signs helps guide appropriate interventions.
3) A nurse is providing teaching to a client who has a new prescription for haloperidol. Which
side effect should the nurse instruct the client to report to the provider?
Answer: Shuffling gait.
Rationale: A shuffling gait is a clinical sign of pseudoparkinsonism, an extrapyramidal side
effect that can occur 5 hours to 30 days after starting haloperidol. Reporting this allows the
provider to consider an anti-parkinsonism agent.
4) A home health nurse is assessing an older adult client who lives alone. Which finding
indicates that the client may be experiencing delirium?
, Answer: Sudden onset.
Rationale: Delirium develops rapidly over hours to days, in contrast to dementia, which
develops gradually. Early recognition is crucial for timely intervention.
5) A nurse is caring for a client receiving imipramine for depression. Which adverse effect
should the nurse monitor?
Answer: Urinary retention.
Rationale: Tricyclic antidepressants like imipramine have anticholinergic effects, which can
lead to urinary retention. Monitoring for this prevents complications and ensures patient safety.
6) A nurse is providing care for a client who has bipolar disorder and is experiencing acute
mania. The client’s morning lithium level is 1.5 mEq/L. Which additional laboratory data has the
highest priority?
Answer: Serum sodium 125 mEq/L.
Rationale: Low sodium reduces renal excretion of lithium, increasing the risk of lithium
toxicity. Monitoring sodium levels is critical to prevent life-threatening complications.
7) A nurse is caring for a client with a history of substance use who was involuntarily admitted.
The client refuses oral lorazepam and becomes physically aggressive. What action should the
nurse take?
Answer: Do not administer the lorazepam.
Rationale: Clients retain the right to refuse treatment even if involuntarily admitted. Forcing
medication without consent violates legal and ethical standards.
8) A nurse is developing a discharge plan for a client with a history of gambling dependency and
includes participation in a support group. What is the purpose of attending the group?
Answer: Provide assurance that others have a similar problem.
Rationale: Support groups normalize the client’s experience, provide peer guidance, and offer
alternative coping strategies learned from others.
9) A nurse is caring for a client who is deaf and scheduled for electroconvulsive therapy (ECT).
How should the nurse ensure informed consent is obtained?
Answer: Request a professional interpreter to translate.
Rationale: Using a professional interpreter ensures accurate communication, supports informed
consent, and respects the client’s legal rights.
