Mental Health Nursing and Psychiatric
Disorders Practice Exam questions and
correct answers – Updated 2026 (Graded A+)
instant download pdf
Subject: Mental Health Nursing
Subtopic: Mood Disorders and Bipolar Spectrum
Question 1: A patient with bipolar I disorder is admitted with acute mania. The patient is pacing
the unit, speaking in rapid, pressured sentences, and has not slept in 48 hours. Which nursing
intervention should be prioritized during the initial phase of care?
A) Providing a quiet, low-stimulation environment to decrease sensory overload.
B) Encouraging the patient to participate in group therapy to improve social skills.
C) Assigning the patient to lead a community meeting to channel excess energy.
D) Implementing a strict caloric restriction diet to prevent excessive weight gain.
Correct Answer: A - Providing a quiet, low-stimulation environment to decrease sensory
overload.
Rationale: Patients in an acute manic state are highly susceptible to sensory overstimulation,
which exacerbates agitation and prevents necessary sleep. A low-stimulation environment is
essential to facilitate stabilization. Option B is incorrect because group therapy is often too
stimulating and distracting for a patient in acute mania. Option C is inappropriate as the patient
lacks the impulse control and focus for leadership. Option D is contraindicated because manic
patients often have high caloric needs due to increased physical activity.
Question 2: A patient prescribed lithium carbonate for bipolar disorder reports hand tremors,
mild thirst, and nausea. Which action by the nurse is most appropriate?
A) Instruct the patient to discontinue the medication immediately.
B) Assess the patient’s most recent lithium serum level and current hydration status.
C) Administer an additional dose of lithium to counteract the tremors.
D) Tell the patient these side effects are unrelated to the medication.
,Correct Answer: B - Assess the patient’s most recent lithium serum level and current
hydration status.
Rationale: Lithium has a narrow therapeutic index. Fine hand tremors, thirst, and nausea are
common side effects, but they may also indicate early signs of toxicity if levels are rising.
Assessing serum levels and hydration is the clinical standard to distinguish between expected
side effects and potential toxicity. Option A is incorrect as abrupt discontinuation can trigger a
relapse. Option C is dangerous as it could worsen toxicity. Option D is incorrect as these are
well-documented side effects.
Question 3: A patient with major depressive disorder who has been taking a Selective Serotonin
Reuptake Inhibitor (SSRI) for two weeks states, "I don't feel any better; the medication is not
working." What is the best response by the nurse?
A) "I will call the physician to switch you to a different class of medication."
B) "It is common for these medications to take four to six weeks to show significant therapeutic
effects."
C) "Perhaps you should increase your dose tonight and see if you feel better tomorrow."
D) "Most people feel significant improvement within the first few days of starting this therapy."
Correct Answer: B - "It is common for these medications to take four to six weeks to show
significant therapeutic effects."
Rationale: SSRIs require several weeks of consistent use to achieve clinical improvement in
depressive symptoms. Providing accurate patient education on the expected timeline for
therapeutic response is crucial for medication adherence. Option A is premature. Option C is
unsafe as the nurse cannot independently change dosages. Option D is false and sets unrealistic
expectations.
Subtopic: Anxiety and Trauma-Related Disorders
Question 4: A nurse is caring for a patient experiencing a severe panic attack. Which intervention
is the most effective during the height of the attack?
A) Attempting to teach the patient relaxation techniques.
B) Staying with the patient and providing firm, directive, and simple communication.
C) Asking the patient to describe the history of their trauma in detail.
D) Encouraging the patient to walk alone in the hallway to burn off nervous energy.
,Correct Answer: B - Staying with the patient and providing firm, directive, and simple
communication.
Rationale: During a panic attack, a patient’s cognitive ability to process complex information is
severely impaired. Simple, clear, directive communication provides external structure and safety.
Option A is incorrect because the patient cannot concentrate on learning new techniques during
panic. Option C is incorrect as discussing trauma during a panic attack increases distress.
Option D is unsafe as the patient needs supervision for safety.
Question 5: A veteran diagnosed with Post-Traumatic Stress Disorder (PTSD) expresses feelings
of detachment from family members and persistent negative beliefs about the world. Which term
best describes the symptom of detachment?
A) Hypervigilance.
B) Flashback.
C) Depersonalization/Derealization.
D) Intrusive thoughts.
Correct Answer: C - Depersonalization/Derealization.
Rationale: Detachment and the sense that the world or oneself is unreal are characteristic of
depersonalization and derealization, common symptoms in PTSD. Option A refers to an
exaggerated startle response. Option B refers to re-experiencing the trauma. Option D refers to
unwanted, involuntary memories of the event.
Subtopic: Schizophrenia and Psychotic Disorders
Question 6: A patient with schizophrenia is standing in the corner of the room, looking at the
ceiling and mumbling, "They are coming to take the wires out of my brain." What is the most
appropriate nursing response?
A) "There is no one here, and no one is taking wires from your brain."
B) "I understand you are feeling scared, but I do not see or hear what you are experiencing."
C) "Why would someone want to take wires out of your brain?"
D) "You are having a hallucination; you should take your medication."
Correct Answer: B - "I understand you are feeling scared, but I do not see or hear what
you are experiencing."
, Rationale: This response uses the technique of voicing doubt while validating the patient's
feelings. It allows the nurse to establish reality without arguing with the patient’s fixed false
belief. Option A is confrontational. Option C forces the patient to justify a delusion, which is
counterproductive. Option D is a label-based approach that can increase defensiveness.
Question 7: A patient is prescribed clozapine for treatment-resistant schizophrenia. Which
laboratory finding is the most critical to monitor due to the risk of a life-threatening side effect?
A) Blood glucose levels.
B) Absolute Neutrophil Count (ANC).
C) Serum creatinine.
D) Liver function tests.
Correct Answer: B - Absolute Neutrophil Count (ANC).
Rationale: Clozapine carries a black box warning for agranulocytosis (a severe drop in white
blood cell count). Regular monitoring of the ANC is mandatory to prevent fatal infection. While
blood glucose (Option A) should be monitored due to metabolic syndrome risk, ANC is the
priority for immediate life-threatening safety.
Subtopic: Personality Disorders
Question 8: A patient diagnosed with Borderline Personality Disorder (BPD) demonstrates
"splitting" behavior by telling one nurse that they are the only one who understands, while telling
another nurse that the previous nurse is incompetent. What is the most effective nursing strategy?
A) Discuss the patient’s complaints with the nurse who was criticized to determine if it is true.
B) Avoid interacting with the patient to prevent being caught in the middle.
C) Implement a consistent care plan involving all staff and encourage direct communication with
the patient about these observations.
D) Support the patient’s view to build a therapeutic alliance.
Correct Answer: C - Implement a consistent care plan involving all staff and encourage
direct communication with the patient about these observations.
Rationale: Splitting is a defense mechanism common in BPD. Consistency across all staff
members prevents the patient from dividing the team. Open, neutral, and consistent
communication is the standard intervention. Option A and D feed the splitting behavior. Option
B is unprofessional and harmful.
Disorders Practice Exam questions and
correct answers – Updated 2026 (Graded A+)
instant download pdf
Subject: Mental Health Nursing
Subtopic: Mood Disorders and Bipolar Spectrum
Question 1: A patient with bipolar I disorder is admitted with acute mania. The patient is pacing
the unit, speaking in rapid, pressured sentences, and has not slept in 48 hours. Which nursing
intervention should be prioritized during the initial phase of care?
A) Providing a quiet, low-stimulation environment to decrease sensory overload.
B) Encouraging the patient to participate in group therapy to improve social skills.
C) Assigning the patient to lead a community meeting to channel excess energy.
D) Implementing a strict caloric restriction diet to prevent excessive weight gain.
Correct Answer: A - Providing a quiet, low-stimulation environment to decrease sensory
overload.
Rationale: Patients in an acute manic state are highly susceptible to sensory overstimulation,
which exacerbates agitation and prevents necessary sleep. A low-stimulation environment is
essential to facilitate stabilization. Option B is incorrect because group therapy is often too
stimulating and distracting for a patient in acute mania. Option C is inappropriate as the patient
lacks the impulse control and focus for leadership. Option D is contraindicated because manic
patients often have high caloric needs due to increased physical activity.
Question 2: A patient prescribed lithium carbonate for bipolar disorder reports hand tremors,
mild thirst, and nausea. Which action by the nurse is most appropriate?
A) Instruct the patient to discontinue the medication immediately.
B) Assess the patient’s most recent lithium serum level and current hydration status.
C) Administer an additional dose of lithium to counteract the tremors.
D) Tell the patient these side effects are unrelated to the medication.
,Correct Answer: B - Assess the patient’s most recent lithium serum level and current
hydration status.
Rationale: Lithium has a narrow therapeutic index. Fine hand tremors, thirst, and nausea are
common side effects, but they may also indicate early signs of toxicity if levels are rising.
Assessing serum levels and hydration is the clinical standard to distinguish between expected
side effects and potential toxicity. Option A is incorrect as abrupt discontinuation can trigger a
relapse. Option C is dangerous as it could worsen toxicity. Option D is incorrect as these are
well-documented side effects.
Question 3: A patient with major depressive disorder who has been taking a Selective Serotonin
Reuptake Inhibitor (SSRI) for two weeks states, "I don't feel any better; the medication is not
working." What is the best response by the nurse?
A) "I will call the physician to switch you to a different class of medication."
B) "It is common for these medications to take four to six weeks to show significant therapeutic
effects."
C) "Perhaps you should increase your dose tonight and see if you feel better tomorrow."
D) "Most people feel significant improvement within the first few days of starting this therapy."
Correct Answer: B - "It is common for these medications to take four to six weeks to show
significant therapeutic effects."
Rationale: SSRIs require several weeks of consistent use to achieve clinical improvement in
depressive symptoms. Providing accurate patient education on the expected timeline for
therapeutic response is crucial for medication adherence. Option A is premature. Option C is
unsafe as the nurse cannot independently change dosages. Option D is false and sets unrealistic
expectations.
Subtopic: Anxiety and Trauma-Related Disorders
Question 4: A nurse is caring for a patient experiencing a severe panic attack. Which intervention
is the most effective during the height of the attack?
A) Attempting to teach the patient relaxation techniques.
B) Staying with the patient and providing firm, directive, and simple communication.
C) Asking the patient to describe the history of their trauma in detail.
D) Encouraging the patient to walk alone in the hallway to burn off nervous energy.
,Correct Answer: B - Staying with the patient and providing firm, directive, and simple
communication.
Rationale: During a panic attack, a patient’s cognitive ability to process complex information is
severely impaired. Simple, clear, directive communication provides external structure and safety.
Option A is incorrect because the patient cannot concentrate on learning new techniques during
panic. Option C is incorrect as discussing trauma during a panic attack increases distress.
Option D is unsafe as the patient needs supervision for safety.
Question 5: A veteran diagnosed with Post-Traumatic Stress Disorder (PTSD) expresses feelings
of detachment from family members and persistent negative beliefs about the world. Which term
best describes the symptom of detachment?
A) Hypervigilance.
B) Flashback.
C) Depersonalization/Derealization.
D) Intrusive thoughts.
Correct Answer: C - Depersonalization/Derealization.
Rationale: Detachment and the sense that the world or oneself is unreal are characteristic of
depersonalization and derealization, common symptoms in PTSD. Option A refers to an
exaggerated startle response. Option B refers to re-experiencing the trauma. Option D refers to
unwanted, involuntary memories of the event.
Subtopic: Schizophrenia and Psychotic Disorders
Question 6: A patient with schizophrenia is standing in the corner of the room, looking at the
ceiling and mumbling, "They are coming to take the wires out of my brain." What is the most
appropriate nursing response?
A) "There is no one here, and no one is taking wires from your brain."
B) "I understand you are feeling scared, but I do not see or hear what you are experiencing."
C) "Why would someone want to take wires out of your brain?"
D) "You are having a hallucination; you should take your medication."
Correct Answer: B - "I understand you are feeling scared, but I do not see or hear what
you are experiencing."
, Rationale: This response uses the technique of voicing doubt while validating the patient's
feelings. It allows the nurse to establish reality without arguing with the patient’s fixed false
belief. Option A is confrontational. Option C forces the patient to justify a delusion, which is
counterproductive. Option D is a label-based approach that can increase defensiveness.
Question 7: A patient is prescribed clozapine for treatment-resistant schizophrenia. Which
laboratory finding is the most critical to monitor due to the risk of a life-threatening side effect?
A) Blood glucose levels.
B) Absolute Neutrophil Count (ANC).
C) Serum creatinine.
D) Liver function tests.
Correct Answer: B - Absolute Neutrophil Count (ANC).
Rationale: Clozapine carries a black box warning for agranulocytosis (a severe drop in white
blood cell count). Regular monitoring of the ANC is mandatory to prevent fatal infection. While
blood glucose (Option A) should be monitored due to metabolic syndrome risk, ANC is the
priority for immediate life-threatening safety.
Subtopic: Personality Disorders
Question 8: A patient diagnosed with Borderline Personality Disorder (BPD) demonstrates
"splitting" behavior by telling one nurse that they are the only one who understands, while telling
another nurse that the previous nurse is incompetent. What is the most effective nursing strategy?
A) Discuss the patient’s complaints with the nurse who was criticized to determine if it is true.
B) Avoid interacting with the patient to prevent being caught in the middle.
C) Implement a consistent care plan involving all staff and encourage direct communication with
the patient about these observations.
D) Support the patient’s view to build a therapeutic alliance.
Correct Answer: C - Implement a consistent care plan involving all staff and encourage
direct communication with the patient about these observations.
Rationale: Splitting is a defense mechanism common in BPD. Consistency across all staff
members prevents the patient from dividing the team. Open, neutral, and consistent
communication is the standard intervention. Option A and D feed the splitting behavior. Option
B is unprofessional and harmful.
