WGU D449 PSYCHOLOGY AND
MENTAL HEALTH LATEST 2026
FINAL ASSESSMENT EXAM(OA)
COMPLETE
Q1: Which therapeutic communication technique involves the nurse repeating
the patient's words to encourage deeper exploration?
• A) Clarification
• B) Reflection ✓
• C) Validation
• D) Active listening
Rationale: Reflection involves paraphrasing or echoing the patient's words,
encouraging them to elaborate on their feelings. Active listening is attending fully;
clarification seeks more information; validation acknowledges emotions.
Q2: The nurse is caring for a patient with major depressive disorder who has
not gotten out of bed for two days. What is the most appropriate initial nursing
action?
• A) Allow the patient to rest until they feel ready
• B) Gently assist the patient with morning care and encourage activity ✓
• C) Tell the patient that staying in bed will worsen their depression
• D) Ask the patient why they do not want to get up
Rationale: Patients with severe depression lack motivation and energy; supportive
assistance with ADLs is therapeutic and prevents further withdrawal. Allowing
continued isolation or asking "why" can be perceived as judgmental.
Q3: A patient is prescribed clonazepam for anxiety. What common side effect
should the nurse teach about?
, • A) Insomnia
• B) Tachycardia
• C) Weight loss
• D) Drowsiness ✓
Rationale: Benzodiazepines enhance GABA activity, causing CNS depression and
sedation. Drowsiness is expected and often diminishes with continued use.
Q4: A patient with depression is started on phenelzine, an MAOI. Which dietary
instruction is essential?
• A) "Increase intake of protein-rich foods"
• B) "Avoid foods high in tyramine, such as aged cheese and cured meats" ✓
• C) "Take this medication with a high-fiber diet"
• D) "You may drink red wine in moderation"
Rationale: MAOIs inhibit tyramine breakdown; consuming tyramine-rich foods can
cause hypertensive crisis. Strict dietary restrictions are necessary.
Q5: A patient tells the nurse, "I have a plan to kill myself, and I have the means
to do it." What is the priority nursing intervention?
• A) Ask the patient to sign a no-suicide contract
• B) Place the patient on one-to-one observation and ensure a safe
environment ✓
• C) Encourage the patient to attend group therapy
• D) Notify the family of the patient's intent
Rationale: When a patient has a plan and means, immediate safety measures are
required, including constant observation and removal of potentially harmful objects.
A no-suicide contract is not reliable.
Q6: A patient with schizophrenia tells the nurse, "The voices are telling me to
hurt myself." What is the priority nursing action?
• A) Ask what the voices are saying and ensure a safe environment ✓
, • B) Tell the patient the voices are not real and to ignore them
• C) Administer antipsychotic medication without further assessment
• D) Change the subject to distract the patient
Rationale: Command hallucinations require immediate assessment of content to
determine risk of harm. Safety is the priority; ignoring or distracting does not address
the potential danger.
Q7: A patient is experiencing acute alcohol withdrawal. The nurse should
anticipate administering which medication?
• A) Naloxone
• B) Lorazepam ✓
• C) Disulfiram
• D) Methadone
Rationale: Benzodiazepines are the first-line treatment for alcohol withdrawal to
prevent seizures and reduce autonomic hyperactivity. Naloxone is for opioid
overdose, disulfiram for abstinence maintenance.
Q8: Which finding is most characteristic of serotonin syndrome?
• A) Muscle rigidity, hyperthermia, and altered mental status ✓
• B) Hypothermia, bradycardia, and constipation
• C) Polyuria, polydipsia, and weight loss
• D) Orthostatic hypotension and dry mouth
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by
excessive serotonergic activity, presenting with autonomic instability, neuromuscular
hyperactivity, and altered cognition.
Q9: The nurse is caring for a patient with anorexia nervosa. Which finding is
most concerning?
• A) Body weight 85% of ideal
• B) Amenorrhea
, • C) Serum potassium 2.8 mEq/L ✓
• D) Bradycardia of 54 bpm
Rationale: Severe hypokalemia can cause life-threatening cardiac arrhythmias. While
the other findings are expected in anorexia, electrolyte disturbances require
immediate intervention.
Q10: A patient with borderline personality disorder tells the nurse, "You're the
only one who cares. The other nurses are incompetent." The nurse recognizes
this as:
• A) Projection
• B) Splitting ✓
• C) Rationalization
• D) Denial
Rationale: Splitting is the inability to integrate positive and negative aspects of self or
others, leading to all-good or all-bad thinking, a hallmark of borderline personality
disorder.
Q11: A patient taking an SSRI reports that they have stopped the medication
suddenly because they felt better. What withdrawal symptoms should the nurse
monitor for?
• A) Hypertensive crisis
• B) Flu-like symptoms, dizziness, and sensory disturbances ✓
• C) Weight gain and sedation
• D) Seizures
Rationale: Abrupt SSRI discontinuation can cause discontinuation syndrome, which
includes flu-like symptoms, dizziness, sensory disturbances ("brain zaps"), and
nausea. Gradual tapering is essential to prevent this syndrome .
Q12: A patient with depression is prescribed mirtazapine (Remeron). Which side
effect should the nurse prioritize monitoring in an older adult client?
• A) Insomnia
• B) Weight gain
• C) Sedation ✓
MENTAL HEALTH LATEST 2026
FINAL ASSESSMENT EXAM(OA)
COMPLETE
Q1: Which therapeutic communication technique involves the nurse repeating
the patient's words to encourage deeper exploration?
• A) Clarification
• B) Reflection ✓
• C) Validation
• D) Active listening
Rationale: Reflection involves paraphrasing or echoing the patient's words,
encouraging them to elaborate on their feelings. Active listening is attending fully;
clarification seeks more information; validation acknowledges emotions.
Q2: The nurse is caring for a patient with major depressive disorder who has
not gotten out of bed for two days. What is the most appropriate initial nursing
action?
• A) Allow the patient to rest until they feel ready
• B) Gently assist the patient with morning care and encourage activity ✓
• C) Tell the patient that staying in bed will worsen their depression
• D) Ask the patient why they do not want to get up
Rationale: Patients with severe depression lack motivation and energy; supportive
assistance with ADLs is therapeutic and prevents further withdrawal. Allowing
continued isolation or asking "why" can be perceived as judgmental.
Q3: A patient is prescribed clonazepam for anxiety. What common side effect
should the nurse teach about?
, • A) Insomnia
• B) Tachycardia
• C) Weight loss
• D) Drowsiness ✓
Rationale: Benzodiazepines enhance GABA activity, causing CNS depression and
sedation. Drowsiness is expected and often diminishes with continued use.
Q4: A patient with depression is started on phenelzine, an MAOI. Which dietary
instruction is essential?
• A) "Increase intake of protein-rich foods"
• B) "Avoid foods high in tyramine, such as aged cheese and cured meats" ✓
• C) "Take this medication with a high-fiber diet"
• D) "You may drink red wine in moderation"
Rationale: MAOIs inhibit tyramine breakdown; consuming tyramine-rich foods can
cause hypertensive crisis. Strict dietary restrictions are necessary.
Q5: A patient tells the nurse, "I have a plan to kill myself, and I have the means
to do it." What is the priority nursing intervention?
• A) Ask the patient to sign a no-suicide contract
• B) Place the patient on one-to-one observation and ensure a safe
environment ✓
• C) Encourage the patient to attend group therapy
• D) Notify the family of the patient's intent
Rationale: When a patient has a plan and means, immediate safety measures are
required, including constant observation and removal of potentially harmful objects.
A no-suicide contract is not reliable.
Q6: A patient with schizophrenia tells the nurse, "The voices are telling me to
hurt myself." What is the priority nursing action?
• A) Ask what the voices are saying and ensure a safe environment ✓
, • B) Tell the patient the voices are not real and to ignore them
• C) Administer antipsychotic medication without further assessment
• D) Change the subject to distract the patient
Rationale: Command hallucinations require immediate assessment of content to
determine risk of harm. Safety is the priority; ignoring or distracting does not address
the potential danger.
Q7: A patient is experiencing acute alcohol withdrawal. The nurse should
anticipate administering which medication?
• A) Naloxone
• B) Lorazepam ✓
• C) Disulfiram
• D) Methadone
Rationale: Benzodiazepines are the first-line treatment for alcohol withdrawal to
prevent seizures and reduce autonomic hyperactivity. Naloxone is for opioid
overdose, disulfiram for abstinence maintenance.
Q8: Which finding is most characteristic of serotonin syndrome?
• A) Muscle rigidity, hyperthermia, and altered mental status ✓
• B) Hypothermia, bradycardia, and constipation
• C) Polyuria, polydipsia, and weight loss
• D) Orthostatic hypotension and dry mouth
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by
excessive serotonergic activity, presenting with autonomic instability, neuromuscular
hyperactivity, and altered cognition.
Q9: The nurse is caring for a patient with anorexia nervosa. Which finding is
most concerning?
• A) Body weight 85% of ideal
• B) Amenorrhea
, • C) Serum potassium 2.8 mEq/L ✓
• D) Bradycardia of 54 bpm
Rationale: Severe hypokalemia can cause life-threatening cardiac arrhythmias. While
the other findings are expected in anorexia, electrolyte disturbances require
immediate intervention.
Q10: A patient with borderline personality disorder tells the nurse, "You're the
only one who cares. The other nurses are incompetent." The nurse recognizes
this as:
• A) Projection
• B) Splitting ✓
• C) Rationalization
• D) Denial
Rationale: Splitting is the inability to integrate positive and negative aspects of self or
others, leading to all-good or all-bad thinking, a hallmark of borderline personality
disorder.
Q11: A patient taking an SSRI reports that they have stopped the medication
suddenly because they felt better. What withdrawal symptoms should the nurse
monitor for?
• A) Hypertensive crisis
• B) Flu-like symptoms, dizziness, and sensory disturbances ✓
• C) Weight gain and sedation
• D) Seizures
Rationale: Abrupt SSRI discontinuation can cause discontinuation syndrome, which
includes flu-like symptoms, dizziness, sensory disturbances ("brain zaps"), and
nausea. Gradual tapering is essential to prevent this syndrome .
Q12: A patient with depression is prescribed mirtazapine (Remeron). Which side
effect should the nurse prioritize monitoring in an older adult client?
• A) Insomnia
• B) Weight gain
• C) Sedation ✓
