NSG 130 MENTAL HEALTH NURSING FINAL EXAM] QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Therapeutic Communication Techniques
- Psychiatric Disorders Across the Lifespan
- Psychopharmacology and Side Effect Management
- Legal and Ethical Issues in Mental Health Nursing
- Crisis Intervention and Suicide Prevention
- Defense Mechanisms and Coping Strategies
- Milieu Therapy and Patient Safety
- Co-occurring Disorders (Dual Diagnosis)
- Recovery Model and Patient Advocacy
- Cultural Competence in Psychiatric Nursing
Introduction
This final examination is designed to assess comprehensive knowledge and clinical judgment in mental health
nursing across diverse settings. It evaluates foundational theories, pharmacological interventions, legal and ethical
parameters, and therapeutic communication strategies essential for safe, patient-centered care. Each multiple-
choice question reflects real-world scenarios requiring critical thinking, prioritization, and application of evidence-
based practices. Questions range from basic recall to complex decision-making, preparing students for the NCLEX-
RN and clinical practice. The format emphasizes risk assessment, de-escalation techniques, interdisciplinary
collaboration, and recovery-oriented care. Success requires integration of psychiatric nursing principles with
professional standards and ethical accountability.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse on an inpatient psychiatric unit is caring for a patient with major depressive disorder. The patient states,
“Nothing matters anymore. I just want to go to sleep and never wake up.” Which nursing action is the highest
priority?
A. Document the patient’s statement verbatim in the medical record
B. Ask the patient, “Do you have a plan to end your life?”
C. Encourage the patient to attend the afternoon group therapy session
D. Notify the patient’s family about the statement
🟢B
🔴 RATIONALE: The patient’s statement indicates suicidal ideation. The highest priority is to directly assess for a
suicide plan, means, and intent to ensure immediate safety. Documentation and family notification are
secondary; group therapy is not appropriate when risk is present.
Question 2
A patient with schizophrenia tells the nurse, “The FBI is poisoning my food because I know the truth about the
aliens.” Which term best describes this statement?
A. Illusion
B. Delusion of persecution
,C. Idea of reference
D. Loose association
🟢B
🔴 RATIONALE: This is a persecutory delusion—a fixed false belief that one is being harmed, harassed, or
conspired against. Illusions misperceive real stimuli; ideas of reference misinterpret neutral events; loose
associations reflect disconnected thoughts.
Question 3
A patient prescribed haloperidol develops a fever, muscle rigidity, diaphoresis, and an elevated creatine kinase
level. What is the nurse’s priority action?
A. Administer diphenhydramine as ordered
B. Hold the next dose of haloperidol and notify the provider immediately
C. Increase oral fluid intake to prevent dehydration
D. Place the patient on seizure precautions
🟢B
🔴 RATIONALE: These symptoms suggest neuroleptic malignant syndrome (NMS), a life-threatening reaction to
antipsychotics. The priority is to stop the medication and notify the provider. Antihistamines and fluids are
supportive but not first-line for NMS.
Question 4
, A patient with borderline personality disorder states, “You’re the only nurse who ever understands me. The night
nurse is cruel and doesn’t care.” This is an example of which defense mechanism?
A. Splitting
B. Projection
C. Rationalization
D. Reaction formation
🟢A
🔴 RATIONALE: Splitting involves viewing people as all good or all bad, unable to integrate positive and
negative qualities. This is characteristic of borderline personality disorder and disrupts therapeutic relationships.
Question 5
A nurse is assessing a patient with bipolar I disorder during a manic episode. Which finding would the nurse
expect?
A. Psychomotor retardation, anhedonia, hypersomnia
B. Grandiose delusions, pressured speech, decreased need for sleep
C. Somatic complaints, avoidance behavior, panic attacks
D. Flat affect, avolition, social withdrawal
🟢B
🔴 RATIONALE: Mania includes grandiosity, pressured speech, decreased need for sleep, impulsivity, and
elevated mood. Options A and D describe depression; option C describes anxiety disorders.
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Therapeutic Communication Techniques
- Psychiatric Disorders Across the Lifespan
- Psychopharmacology and Side Effect Management
- Legal and Ethical Issues in Mental Health Nursing
- Crisis Intervention and Suicide Prevention
- Defense Mechanisms and Coping Strategies
- Milieu Therapy and Patient Safety
- Co-occurring Disorders (Dual Diagnosis)
- Recovery Model and Patient Advocacy
- Cultural Competence in Psychiatric Nursing
Introduction
This final examination is designed to assess comprehensive knowledge and clinical judgment in mental health
nursing across diverse settings. It evaluates foundational theories, pharmacological interventions, legal and ethical
parameters, and therapeutic communication strategies essential for safe, patient-centered care. Each multiple-
choice question reflects real-world scenarios requiring critical thinking, prioritization, and application of evidence-
based practices. Questions range from basic recall to complex decision-making, preparing students for the NCLEX-
RN and clinical practice. The format emphasizes risk assessment, de-escalation techniques, interdisciplinary
collaboration, and recovery-oriented care. Success requires integration of psychiatric nursing principles with
professional standards and ethical accountability.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse on an inpatient psychiatric unit is caring for a patient with major depressive disorder. The patient states,
“Nothing matters anymore. I just want to go to sleep and never wake up.” Which nursing action is the highest
priority?
A. Document the patient’s statement verbatim in the medical record
B. Ask the patient, “Do you have a plan to end your life?”
C. Encourage the patient to attend the afternoon group therapy session
D. Notify the patient’s family about the statement
🟢B
🔴 RATIONALE: The patient’s statement indicates suicidal ideation. The highest priority is to directly assess for a
suicide plan, means, and intent to ensure immediate safety. Documentation and family notification are
secondary; group therapy is not appropriate when risk is present.
Question 2
A patient with schizophrenia tells the nurse, “The FBI is poisoning my food because I know the truth about the
aliens.” Which term best describes this statement?
A. Illusion
B. Delusion of persecution
,C. Idea of reference
D. Loose association
🟢B
🔴 RATIONALE: This is a persecutory delusion—a fixed false belief that one is being harmed, harassed, or
conspired against. Illusions misperceive real stimuli; ideas of reference misinterpret neutral events; loose
associations reflect disconnected thoughts.
Question 3
A patient prescribed haloperidol develops a fever, muscle rigidity, diaphoresis, and an elevated creatine kinase
level. What is the nurse’s priority action?
A. Administer diphenhydramine as ordered
B. Hold the next dose of haloperidol and notify the provider immediately
C. Increase oral fluid intake to prevent dehydration
D. Place the patient on seizure precautions
🟢B
🔴 RATIONALE: These symptoms suggest neuroleptic malignant syndrome (NMS), a life-threatening reaction to
antipsychotics. The priority is to stop the medication and notify the provider. Antihistamines and fluids are
supportive but not first-line for NMS.
Question 4
, A patient with borderline personality disorder states, “You’re the only nurse who ever understands me. The night
nurse is cruel and doesn’t care.” This is an example of which defense mechanism?
A. Splitting
B. Projection
C. Rationalization
D. Reaction formation
🟢A
🔴 RATIONALE: Splitting involves viewing people as all good or all bad, unable to integrate positive and
negative qualities. This is characteristic of borderline personality disorder and disrupts therapeutic relationships.
Question 5
A nurse is assessing a patient with bipolar I disorder during a manic episode. Which finding would the nurse
expect?
A. Psychomotor retardation, anhedonia, hypersomnia
B. Grandiose delusions, pressured speech, decreased need for sleep
C. Somatic complaints, avoidance behavior, panic attacks
D. Flat affect, avolition, social withdrawal
🟢B
🔴 RATIONALE: Mania includes grandiosity, pressured speech, decreased need for sleep, impulsivity, and
elevated mood. Options A and D describe depression; option C describes anxiety disorders.
