PMH-BC Psychiatric Nursing Certification
Exam 2026/2027 | Most Tested Questions &
Verified Answers | Graded A+
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
Rationale: Immediate safety interventions include constant observation, removing
means, and provider notification.
, 7. A client with social anxiety disorder is prescribed paroxetine (SSRI). Which
statement indicates understanding?
A) "I should feel better within 24 hours."
B) "It may take 4-6 weeks for the full effect."
C) "I can stop the medication once I feel less anxious."
D) "This medication is addictive like Xanax."
Answer B: "It may take 4-6 weeks for the full effect."
Rationale: SSRIs have delayed onset; full therapeutic effect takes several weeks.
They are not addictive.
8. A client with schizophrenia has been taking haloperidol for 2 weeks and
now presents with a stiff neck, fever, and confusion. Which condition does
the nurse suspect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Serotonin syndrome
Answer B: Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, altered mental status, and autonomic
instability; a medical emergency.
Exam 2026/2027 | Most Tested Questions &
Verified Answers | Graded A+
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
Rationale: Immediate safety interventions include constant observation, removing
means, and provider notification.
, 7. A client with social anxiety disorder is prescribed paroxetine (SSRI). Which
statement indicates understanding?
A) "I should feel better within 24 hours."
B) "It may take 4-6 weeks for the full effect."
C) "I can stop the medication once I feel less anxious."
D) "This medication is addictive like Xanax."
Answer B: "It may take 4-6 weeks for the full effect."
Rationale: SSRIs have delayed onset; full therapeutic effect takes several weeks.
They are not addictive.
8. A client with schizophrenia has been taking haloperidol for 2 weeks and
now presents with a stiff neck, fever, and confusion. Which condition does
the nurse suspect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Serotonin syndrome
Answer B: Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, altered mental status, and autonomic
instability; a medical emergency.
