WGU D234 – Mental Health Nursing
Exam Questions With Correct Answers
(Verified Answers) Plus Rationales|
2026/2027 Q&A | Instant Download
Pdf.
1. A nurse is assessing a client experiencing major depressive disorder.
Which finding requires the nurse's priority attention?
A. Reports sleeping 10 hours per night
B. Reports decreased appetite
C. States, "My family would be better off without me."
D. Reports difficulty concentrating
Correct answer: C. States, "My family would be better off without
me."
Rationale: Statements suggesting hopelessness, worthlessness, or that
others would be better off without the client may indicate suicidal
ideation and require immediate safety assessment. The nurse should
directly assess for suicidal thoughts, intent, plan, means, and previous
attempts. Although sleep, appetite, and concentration changes are
common depressive symptoms, they are not as immediately life-
threatening as potential suicide risk.
,2. Which assessment finding is most characteristic of a manic episode?
A. Flat affect and social withdrawal
B. Decreased need for sleep with increased energy
C. Slow speech and psychomotor retardation
D. Persistent fear of leaving the home
Correct answer: B. Decreased need for sleep with increased energy
Rationale: Mania is characterized by elevated, expansive, or irritable
mood accompanied by increased energy and activity. Clients may have a
decreased need for sleep without feeling tired, pressured speech, racing
thoughts, distractibility, grandiosity, and impulsive or risky behavior. Flat
affect and psychomotor retardation are more consistent with depressive
symptoms.
3. A client taking lithium for bipolar disorder reports severe diarrhea,
vomiting, coarse hand tremors, and difficulty walking. What should the
nurse do first?
A. Administer the next dose with food
B. Encourage increased physical activity
C. Hold the lithium and notify the healthcare provider
D. Reassure the client that these effects are expected
Correct answer: C. Hold the lithium and notify the healthcare provider
Rationale: Severe gastrointestinal symptoms, coarse tremors, and ataxia
are concerning for lithium toxicity. Lithium has a narrow therapeutic
index, and toxicity can become life-threatening. The medication should
be withheld and the healthcare provider notified promptly. Mild nausea
,or fine tremors can occur early in therapy, but severe neurologic and
gastrointestinal findings require immediate intervention.
4. Which statement by a client demonstrates an understanding of
cognitive behavioral therapy (CBT)?
A. "My therapist will tell me exactly what decisions to make."
B. "I will explore how my thoughts affect my feelings and behaviors."
C. "My therapist will focus primarily on my childhood memories."
D. "I should avoid discussing negative thoughts during therapy."
Correct answer: B. "I will explore how my thoughts affect my feelings
and behaviors."
Rationale: CBT focuses on identifying and modifying maladaptive
thought patterns and behaviors that contribute to emotional distress.
Clients learn to recognize distorted thinking, evaluate the accuracy of
thoughts, and develop healthier cognitive and behavioral responses.
The therapy is generally structured, collaborative, and goal-oriented.
5. A client experiencing schizophrenia tells the nurse, "The voices are
telling me that I need to hurt my roommate." What is the nurse's
priority action?
A. Tell the client that the voices are not real
B. Ask the client about the voices and assess for intent to act
C. Encourage the client to ignore the voices
D. Change the subject to reduce the client's anxiety
, Correct answer: B. Ask the client about the voices and assess for
intent to act
Rationale: Command hallucinations involving harm require immediate
assessment of safety. The nurse should determine what the voices are
saying, whether the client intends to obey them, whether a specific
person has been identified, and whether the client has access to means.
The nurse should remain calm and avoid arguing about whether the
hallucinations are real.
6. Which medication is classified as a second-generation antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Risperidone
D. Fluphenazine
Correct answer: C. Risperidone
Rationale: Risperidone is an atypical, or second-generation,
antipsychotic. Other second-generation antipsychotics include
olanzapine, quetiapine, clozapine, aripiprazole, and ziprasidone.
Haloperidol, chlorpromazine, and fluphenazine are first-generation
antipsychotics.
7. A client taking an antipsychotic develops high fever, severe muscle
rigidity, altered mental status, and unstable blood pressure. Which
condition should the nurse suspect?
Exam Questions With Correct Answers
(Verified Answers) Plus Rationales|
2026/2027 Q&A | Instant Download
Pdf.
1. A nurse is assessing a client experiencing major depressive disorder.
Which finding requires the nurse's priority attention?
A. Reports sleeping 10 hours per night
B. Reports decreased appetite
C. States, "My family would be better off without me."
D. Reports difficulty concentrating
Correct answer: C. States, "My family would be better off without
me."
Rationale: Statements suggesting hopelessness, worthlessness, or that
others would be better off without the client may indicate suicidal
ideation and require immediate safety assessment. The nurse should
directly assess for suicidal thoughts, intent, plan, means, and previous
attempts. Although sleep, appetite, and concentration changes are
common depressive symptoms, they are not as immediately life-
threatening as potential suicide risk.
,2. Which assessment finding is most characteristic of a manic episode?
A. Flat affect and social withdrawal
B. Decreased need for sleep with increased energy
C. Slow speech and psychomotor retardation
D. Persistent fear of leaving the home
Correct answer: B. Decreased need for sleep with increased energy
Rationale: Mania is characterized by elevated, expansive, or irritable
mood accompanied by increased energy and activity. Clients may have a
decreased need for sleep without feeling tired, pressured speech, racing
thoughts, distractibility, grandiosity, and impulsive or risky behavior. Flat
affect and psychomotor retardation are more consistent with depressive
symptoms.
3. A client taking lithium for bipolar disorder reports severe diarrhea,
vomiting, coarse hand tremors, and difficulty walking. What should the
nurse do first?
A. Administer the next dose with food
B. Encourage increased physical activity
C. Hold the lithium and notify the healthcare provider
D. Reassure the client that these effects are expected
Correct answer: C. Hold the lithium and notify the healthcare provider
Rationale: Severe gastrointestinal symptoms, coarse tremors, and ataxia
are concerning for lithium toxicity. Lithium has a narrow therapeutic
index, and toxicity can become life-threatening. The medication should
be withheld and the healthcare provider notified promptly. Mild nausea
,or fine tremors can occur early in therapy, but severe neurologic and
gastrointestinal findings require immediate intervention.
4. Which statement by a client demonstrates an understanding of
cognitive behavioral therapy (CBT)?
A. "My therapist will tell me exactly what decisions to make."
B. "I will explore how my thoughts affect my feelings and behaviors."
C. "My therapist will focus primarily on my childhood memories."
D. "I should avoid discussing negative thoughts during therapy."
Correct answer: B. "I will explore how my thoughts affect my feelings
and behaviors."
Rationale: CBT focuses on identifying and modifying maladaptive
thought patterns and behaviors that contribute to emotional distress.
Clients learn to recognize distorted thinking, evaluate the accuracy of
thoughts, and develop healthier cognitive and behavioral responses.
The therapy is generally structured, collaborative, and goal-oriented.
5. A client experiencing schizophrenia tells the nurse, "The voices are
telling me that I need to hurt my roommate." What is the nurse's
priority action?
A. Tell the client that the voices are not real
B. Ask the client about the voices and assess for intent to act
C. Encourage the client to ignore the voices
D. Change the subject to reduce the client's anxiety
, Correct answer: B. Ask the client about the voices and assess for
intent to act
Rationale: Command hallucinations involving harm require immediate
assessment of safety. The nurse should determine what the voices are
saying, whether the client intends to obey them, whether a specific
person has been identified, and whether the client has access to means.
The nurse should remain calm and avoid arguing about whether the
hallucinations are real.
6. Which medication is classified as a second-generation antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Risperidone
D. Fluphenazine
Correct answer: C. Risperidone
Rationale: Risperidone is an atypical, or second-generation,
antipsychotic. Other second-generation antipsychotics include
olanzapine, quetiapine, clozapine, aripiprazole, and ziprasidone.
Haloperidol, chlorpromazine, and fluphenazine are first-generation
antipsychotics.
7. A client taking an antipsychotic develops high fever, severe muscle
rigidity, altered mental status, and unstable blood pressure. Which
condition should the nurse suspect?
