Actual Exam Complete Questions and Answers Detailed
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TABLE OF CONTENTS
Section 1 | Foundations of Psychiatric Nursing & Therapeutic Relationships | Q1 – Q10
Section 2 | Mood Disorders, Suicide & Self-Harm | Q11 – Q20
Section 3 | Anxiety, OCD, Trauma & Stressor Disorders | Q21 – Q30
Section 4 | Schizophrenia, Psychosis & Personality Disorders | Q31 – Q40
Section 5 | Substance Use, Eating & Neurocognitive Disorders | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: FOUNDATIONS OF PSYCHIATRIC NURSING & THERAPEUTIC
RELATIONSHIPS Q1 – Q10
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Question 1 of 50
A 34-year-old woman is admitted to the psychiatric unit after a suicide attempt. During
the admission assessment, she states, "I don't want to talk about it. Just leave me
alone." The nurse recognizes that establishing a therapeutic relationship is the priority.
What is the nurse's best initial response?
A. "I understand you don't want to talk, but I need to complete this assessment for your
safety."
B. "You must be feeling overwhelmed right now. I'll sit with you quietly for a few
minutes." ✓ CORRECT
C. "If you don't talk to me, I'll have to call the doctor and report that you're being
uncooperative."
D. "Talking about your feelings will help you feel better. Let's start with what happened
today."
,Correct Answer: B
Rationale: Offering silent presence validates the patient's emotional state without
demanding immediate disclosure, which respects her autonomy and reduces anxiety.
Option A prioritizes the nurse's task over the patient's emotional readiness, which can
increase resistance. Sitting quietly demonstrates unconditional positive regard and
often leads to voluntary engagement within minutes.
Question 2 of 50
A 28-year-old man with schizophrenia is pacing the hallway and muttering to himself.
The nurse approaches and says, "You seem agitated. Let's talk about what's bothering
you." The patient responds, "The voices are telling me the food is poisoned." What is the
nurse's most therapeutic response?
A. "I don't hear any voices. The food is perfectly safe to eat."
B. "The voices are wrong. No one is trying to poison you here."
C. "That must be frightening for you. I'll sit with you while you eat to help you feel safe."
✓ CORRECT
D. "If you don't eat, you'll need to be restrained and given nutrition through a tube."
Correct Answer: C
Rationale: Acknowledging the patient's fear while offering concrete support validates
his experience without arguing about the reality of the hallucination. Option B directly
challenges the delusion, which typically increases defensiveness and agitation in
psychotic patients. Offering to sit with the patient during meals provides emotional
security and encourages intake without coercion.
Question 3 of 50
A 45-year-old woman with bipolar disorder is being discharged after a manic episode.
She tells the nurse, "I feel great now. I don't think I need to take lithium anymore." The
,nurse recognizes this statement as a potential barrier to treatment adherence. What is
the nurse's best response?
A. "If you stop taking lithium, you'll probably end up back in the hospital within a month."
B. "You feel good because the lithium is working. Stopping it puts you at risk for
relapse." ✓ CORRECT
C. "That's your decision, but you need to sign a form saying you refused medical advice."
D. "Your doctor knows what's best for you, so you should just keep taking it as
prescribed."
Correct Answer: B
Rationale: Linking the patient's current stability to medication effectiveness provides a
logical rationale for continued adherence without being punitive. Option A uses
fear-based messaging that can damage the therapeutic relationship and increase
resistance. Framing medication as the reason for wellness empowers the patient to
understand their own treatment.
Question 4 of 50
A 19-year-old college student is brought to the emergency department by campus
security after being found wandering outside in pajamas during a snowstorm. He is
disoriented, has slurred speech, and his breath smells of alcohol. His roommate reports
he has been drinking heavily since his girlfriend broke up with him two weeks ago. What
is the nurse's priority assessment?
A. Assess for signs of alcohol withdrawal, including tremors and autonomic instability.
B. Obtain a comprehensive psychiatric history to determine underlying mental illness.
C. Evaluate for hypothermia and other medical complications related to cold exposure.
✓ CORRECT
D. Contact the student's parents to obtain consent for psychiatric treatment.
Correct Answer: C
, Rationale: The patient's exposure to cold weather while intoxicated and underdressed
creates immediate risk for hypothermia, which can be fatal and must be addressed
before psychiatric concerns. Option A addresses an important issue but withdrawal
typically begins 6-24 hours after last drink, not during acute intoxication. Medical
stabilization always precedes psychiatric assessment in emergency settings.
Question 5 of 50
A 52-year-old man with major depressive disorder tells the nurse, "My wife left me
because I'm worthless. I can't do anything right." The nurse is using cognitive behavioral
therapy techniques. What is the nurse's most appropriate intervention?
A. "Your wife didn't leave you because you're worthless. She had her own issues."
B. "Tell me about the things you do well. Let's look at the evidence against that thought."
✓ CORRECT
C. "Many people feel worthless when they're depressed. This feeling will pass with time."
D. "Have you considered that your depression is making you see things more
negatively?"
Correct Answer: B
Rationale: Examining evidence for and against automatic thoughts is the core cognitive
restructuring technique in CBT, helping the patient challenge distorted thinking patterns.
Option A offers reassurance without teaching the patient skills to evaluate their own
cognitions, which limits long-term benefit. Guiding the patient to identify their strengths
builds self-efficacy and counters depressive thinking.
Question 6 of 50
A 67-year-old woman with dementia is admitted to a long-term care facility. She
repeatedly tries to leave the unit, stating, "I need to get home to feed my dog." The staff
knows she has not had a dog in 15 years. What is the most appropriate nursing
intervention?