PNG 2254: Mental Health Nursing –
Exam 1 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A nurse is assessing a client who was brought to the emergency
department after experiencing a severe panic attack. The client states, "I
thought I was having a massive heart attack and was going to die."
Which nursing response is most therapeutic?
A. "You are young and healthy; there is no logical reason for you to
worry about a heart attack."
B. "Let's focus on something relaxing so you can forget about what
happened."
C. "It can be terrifying to feel that way. You are safe here in the
emergency department, and we are running tests to check your
heart."
D. "Why did you think you were having a heart attack when you have
no cardiac history?"
Correct Answer: C
Rationale: Acknowledging the client's intense fear while providing
gentle, realistic reassurance about safety and the ongoing medical
evaluation establishes trust without minimizing their distressing somatic
experience.
Question 2
A nurse is planning care for a client newly diagnosed with obsessive-
compulsive disorder (OCD) who engages in exhaustive hand-washing
,rituals. Which of the following is the primary psychological function of
these compulsive behaviors?
A. To punish themselves for unacceptable subconscious thoughts.
B. To temporarily reduce or neutralize the overwhelming anxiety
caused by intrusive obsessions.
C. To manipulate family members into providing constant care and
attention.
D. To gain physical control over autonomic nervous system
functions.
Correct Answer: B
Rationale: Compulsions are repetitive behaviors or mental acts that the
individual feels driven to perform in response to an obsession. Their
primary psychological purpose is to alleviate or neutralize the acute
distress and anxiety generated by the obsessive thought.
Question 3
A client diagnosed with major depressive disorder is prescribed
fluoxetine. The client's partner asks why the medication takes several
weeks to become fully effective. How should the nurse explain the
pharmacological mechanism?
A. "The medication must completely destroy all serotonin receptors
before new ones can grow."
B. "It takes time for the central nervous system to adapt to sustained
increases in synaptic neurotransmitter availability and down-
regulate hypersensitive receptors."
C. "Fluoxetine is stored in fatty tissues and must reach a toxic
threshold before altering mood."
, D. "Antidepressants work instantly on mood, but patients take weeks
to admit they feel better."
Correct Answer: B
Rationale: While SSRIs quickly block serotonin reuptake, the
therapeutic antidepressant response requires time for neural adaptation,
including changes in receptor sensitivity and intracellular signal
transduction pathways.
Question 4
A nurse is preparing a client with bipolar I disorder for discharge. The
client has been stabilized on lithium carbonate. Which statement by the
client indicates a need for further instruction regarding medication
safety?
A. "I need to drink plenty of fluids every day, especially if I exercise
and sweat heavily."
B. "I will make sure my daily salt intake remains consistent from
week to week."
C. "If I experience a mild stomach virus with vomiting and diarrhea, I
should keep taking my exact lithium dose as scheduled."
D. "I will report coarse hand tremors, confusion, or severe nausea to
my doctor right away."
Correct Answer: C
Rationale: Vomiting, diarrhea, and excessive sweating lead to fluid and
sodium depletion, which can rapidly elevate serum lithium to toxic
levels. Clients must be instructed to hold lithium and contact their
provider if they experience acute gastrointestinal illness or dehydration.
Question 5
, A client diagnosed with schizophrenia tells the psychiatric nurse, "The
shadow creatures are crawling through my bedroom walls at night and
whispering secret conspiracies." How should the nurse document this
perceptual disturbance?
A. Tactile hallucination and auditory hallucination
B. Visual hallucination and auditory hallucination
C. Illusion and neologism
D. Depersonalization and derealization
Correct Answer: B
Rationale: Seeing entities that are not present (shadow creatures
crawling) is a visual hallucination, and hearing voices or whispers
without an external acoustic source is an auditory hallucination.
Question 6
A client is admitted to the psychiatric unit with a diagnosis of acute
mania. The client is pacing the hallway, speaking in a rapid, loud, and
pressured voice, and has not slept in three days. Which nursing diagnosis
is the highest priority?
A. Risk for injury related to hyperactivity, poor judgment, and
exhaustion
B. Impaired social interaction related to intrusive behavior patterns
C. Deficient knowledge related to psychiatric medication regimens
D. Ineffective coping related to situational life stressors
Correct Answer: A
Exam 1 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A nurse is assessing a client who was brought to the emergency
department after experiencing a severe panic attack. The client states, "I
thought I was having a massive heart attack and was going to die."
Which nursing response is most therapeutic?
A. "You are young and healthy; there is no logical reason for you to
worry about a heart attack."
B. "Let's focus on something relaxing so you can forget about what
happened."
C. "It can be terrifying to feel that way. You are safe here in the
emergency department, and we are running tests to check your
heart."
D. "Why did you think you were having a heart attack when you have
no cardiac history?"
Correct Answer: C
Rationale: Acknowledging the client's intense fear while providing
gentle, realistic reassurance about safety and the ongoing medical
evaluation establishes trust without minimizing their distressing somatic
experience.
Question 2
A nurse is planning care for a client newly diagnosed with obsessive-
compulsive disorder (OCD) who engages in exhaustive hand-washing
,rituals. Which of the following is the primary psychological function of
these compulsive behaviors?
A. To punish themselves for unacceptable subconscious thoughts.
B. To temporarily reduce or neutralize the overwhelming anxiety
caused by intrusive obsessions.
C. To manipulate family members into providing constant care and
attention.
D. To gain physical control over autonomic nervous system
functions.
Correct Answer: B
Rationale: Compulsions are repetitive behaviors or mental acts that the
individual feels driven to perform in response to an obsession. Their
primary psychological purpose is to alleviate or neutralize the acute
distress and anxiety generated by the obsessive thought.
Question 3
A client diagnosed with major depressive disorder is prescribed
fluoxetine. The client's partner asks why the medication takes several
weeks to become fully effective. How should the nurse explain the
pharmacological mechanism?
A. "The medication must completely destroy all serotonin receptors
before new ones can grow."
B. "It takes time for the central nervous system to adapt to sustained
increases in synaptic neurotransmitter availability and down-
regulate hypersensitive receptors."
C. "Fluoxetine is stored in fatty tissues and must reach a toxic
threshold before altering mood."
, D. "Antidepressants work instantly on mood, but patients take weeks
to admit they feel better."
Correct Answer: B
Rationale: While SSRIs quickly block serotonin reuptake, the
therapeutic antidepressant response requires time for neural adaptation,
including changes in receptor sensitivity and intracellular signal
transduction pathways.
Question 4
A nurse is preparing a client with bipolar I disorder for discharge. The
client has been stabilized on lithium carbonate. Which statement by the
client indicates a need for further instruction regarding medication
safety?
A. "I need to drink plenty of fluids every day, especially if I exercise
and sweat heavily."
B. "I will make sure my daily salt intake remains consistent from
week to week."
C. "If I experience a mild stomach virus with vomiting and diarrhea, I
should keep taking my exact lithium dose as scheduled."
D. "I will report coarse hand tremors, confusion, or severe nausea to
my doctor right away."
Correct Answer: C
Rationale: Vomiting, diarrhea, and excessive sweating lead to fluid and
sodium depletion, which can rapidly elevate serum lithium to toxic
levels. Clients must be instructed to hold lithium and contact their
provider if they experience acute gastrointestinal illness or dehydration.
Question 5
, A client diagnosed with schizophrenia tells the psychiatric nurse, "The
shadow creatures are crawling through my bedroom walls at night and
whispering secret conspiracies." How should the nurse document this
perceptual disturbance?
A. Tactile hallucination and auditory hallucination
B. Visual hallucination and auditory hallucination
C. Illusion and neologism
D. Depersonalization and derealization
Correct Answer: B
Rationale: Seeing entities that are not present (shadow creatures
crawling) is a visual hallucination, and hearing voices or whispers
without an external acoustic source is an auditory hallucination.
Question 6
A client is admitted to the psychiatric unit with a diagnosis of acute
mania. The client is pacing the hallway, speaking in a rapid, loud, and
pressured voice, and has not slept in three days. Which nursing diagnosis
is the highest priority?
A. Risk for injury related to hyperactivity, poor judgment, and
exhaustion
B. Impaired social interaction related to intrusive behavior patterns
C. Deficient knowledge related to psychiatric medication regimens
D. Ineffective coping related to situational life stressors
Correct Answer: A
