# D449 Objective Assessment – WGU Psychiatric & Mental
Health OA – (2026) Actual Questions & Study Guide |
Guarantee Pass
Questions 1–200
1. A client with major depressive disorder tells the nurse, "I'm a
failure. I can't do anything right." Which response is most
therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really down about yourself right
now."
C) "Let's list your recent accomplishments."
D) "Why do you feel like a failure?"
,Answer B: "It sounds like you're feeling really down about yourself
right now."
Rationale: Reflection validates the client's feeling without arguing or
false reassurance. Avoid "why" questions.
2. A client with schizophrenia tells the nurse, "The voices are telling
me to hurt myself." What is the priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate
safety interventions (constant observation, environment safety).
3. A client with bipolar disorder in a manic episode is pacing rapidly,
talking loudly, and making grandiose statements. Which
intervention is most appropriate?
A) Place the client in seclusion
,B) Provide a quiet, low-stimulation environment
C) Confront the client about the grandiose statements
D) Assign a group of staff to restrain the client
Answer B: Provide a quiet, low-stimulation environment
Rationale: Reducing environmental stimuli helps decrease agitation
and manic behavior. Restraints are a last resort.
4. A client with borderline personality disorder has a history of self-
mutilation (cutting). The client says, "I want to cut myself." Which
intervention should the nurse implement first?
A) Restrict the client to her room
B) Assess the intensity of the urge and review the safety plan
C) Apply soft wrist restraints
D) Administer a PRN sedative
Answer B: Assess the intensity of the urge and review the safety
plan
Rationale: First, assess the risk and use de-escalation, including
reviewing alternative coping strategies.
, 5. A client with alcohol use disorder is admitted for detoxification.
The last drink was 8 hours ago. Which assessment finding is most
likely first?
A) Seizure activity
B) Anxiety, tremors, and diaphoresis
C) Delirium tremens (DTs)
D) Hallucinations
Answer B: Anxiety, tremors, and diaphoresis
Rationale: Early alcohol withdrawal (6-12 hours) includes tremors,
anxiety, and tachycardia. DTs occur at 48-72 hours.
6. A client on a psychiatric unit tells the nurse, "I'm going to kill
myself tonight." What is the nurse's priority action?
A) Document the statement and tell the next shift
B) Place the client on one-to-one observation and notify the provider
C) Tell the client that this behavior will not be tolerated
D) Remove all sharp objects from the unit
Answer B: Place the client on one-to-one observation and notify the
provider
Health OA – (2026) Actual Questions & Study Guide |
Guarantee Pass
Questions 1–200
1. A client with major depressive disorder tells the nurse, "I'm a
failure. I can't do anything right." Which response is most
therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really down about yourself right
now."
C) "Let's list your recent accomplishments."
D) "Why do you feel like a failure?"
,Answer B: "It sounds like you're feeling really down about yourself
right now."
Rationale: Reflection validates the client's feeling without arguing or
false reassurance. Avoid "why" questions.
2. A client with schizophrenia tells the nurse, "The voices are telling
me to hurt myself." What is the priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate
safety interventions (constant observation, environment safety).
3. A client with bipolar disorder in a manic episode is pacing rapidly,
talking loudly, and making grandiose statements. Which
intervention is most appropriate?
A) Place the client in seclusion
,B) Provide a quiet, low-stimulation environment
C) Confront the client about the grandiose statements
D) Assign a group of staff to restrain the client
Answer B: Provide a quiet, low-stimulation environment
Rationale: Reducing environmental stimuli helps decrease agitation
and manic behavior. Restraints are a last resort.
4. A client with borderline personality disorder has a history of self-
mutilation (cutting). The client says, "I want to cut myself." Which
intervention should the nurse implement first?
A) Restrict the client to her room
B) Assess the intensity of the urge and review the safety plan
C) Apply soft wrist restraints
D) Administer a PRN sedative
Answer B: Assess the intensity of the urge and review the safety
plan
Rationale: First, assess the risk and use de-escalation, including
reviewing alternative coping strategies.
, 5. A client with alcohol use disorder is admitted for detoxification.
The last drink was 8 hours ago. Which assessment finding is most
likely first?
A) Seizure activity
B) Anxiety, tremors, and diaphoresis
C) Delirium tremens (DTs)
D) Hallucinations
Answer B: Anxiety, tremors, and diaphoresis
Rationale: Early alcohol withdrawal (6-12 hours) includes tremors,
anxiety, and tachycardia. DTs occur at 48-72 hours.
6. A client on a psychiatric unit tells the nurse, "I'm going to kill
myself tonight." What is the nurse's priority action?
A) Document the statement and tell the next shift
B) Place the client on one-to-one observation and notify the provider
C) Tell the client that this behavior will not be tolerated
D) Remove all sharp objects from the unit
Answer B: Place the client on one-to-one observation and notify the
provider
