DEPARTMENT OF PSYCHIATRIC AND
BEHAVIORAL HEALTH NURSING
NUR 374 BEHAVIORAL HEALTH NURSING FINAL EXAMINATION
PRACTICE QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS
LATEST 2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A nurse conducts an initial assessment with a patient admitted with major depressive
disorder. The patient states, "I am a complete failure and my family would be better off
without me." What is the priority nursing intervention?
A) Encourage the patient to participate in group social activities
B) Perform a direct suicide risk assessment asking specifically about intent, plan,
and means
C) Reassure the patient that things will improve once medication begins
D) Document the statement in the medical record as low-risk passive ideation
Rationale: Statements indicating worthlessness or burdening family demand immediate, direct assessment of
suicidal ideation, intent, plan, and lethal access.
2. A patient with schizophrenia tells the nurse, "The voices are telling me to hurt the
doctor." How should the nurse respond initially?
A) "I understand the voices feel real to you, but I do not hear them. What specifically
are they telling you to do?"
B) "You know there are no voices in this room, so you should ignore them."
C) "Why do you think the voices want you to hurt the doctor?"
D) "Let's go to your room and lock the door until the voices go away."
Rationale: Validating the patient's feelings while presenting reality and clarifying command hallucinations
assesses immediate safety risks without reinforcing the hallucination.
3. During a manic episode of bipolar I disorder, a patient paces the hallway incessantly,
talks rapidly with flight of ideas, and has not eaten for 24 hours. What nursing
intervention takes priority?
A) Insist that the patient sit down at the dining table to finish a three-course meal
B) Provide high-calorie, high-protein finger foods and fluids that can be consumed
while moving
, C) Place the patient in quiet seclusion until hyperactive pacing subsides
D) Restrict fluid intake to prevent fluid retention
Rationale: Hyperactive manic patients cannot sit still to eat; portable high-calorie finger foods meet urgent
physiological energy and hydration needs.
4. A patient admitted with Borderline Personality Disorder (BPD) praises one nurse as
"the only caring person on staff" while telling other staff that another nurse is "cruel and
incompetent." What therapeutic response prevents staff splitting?
A) Maintain consistent boundaries and hold open interprofessional team
communication to enforce a unified treatment plan
B) Assign the praised nurse to care for the patient exclusively
C) Confront the patient angrily about trying to manipulate the treatment team
D) Allow the patient to select which staff members deliver daily care
Rationale: Splitting is a primary defense mechanism in BPD; firm boundaries and consistent team communication
prevent staff manipulation and division.
5. A patient with Generalized Anxiety Disorder is experiencing a severe panic attack with
hyperventilation, trembling, and a feeling of impending doom. What is the nurse's
immediate action?
A) Teach the patient detailed cognitive restructuring techniques
B) Stay with the patient in a quiet environment and speak using short, simple, calm
sentences
C) Leave the patient alone to reduce environmental overstimulation
D) Encourage the patient to walk rapidly around the unit
Rationale: Severe panic impairs cognitive processing; staying present and using brief, calm communication
provides safety and de-escalates anxiety.
6. Which therapeutic communication technique is demonstrated when the nurse says,
"You mentioned feeling overwhelmed at work. Can you describe a specific situation
when that happened?"
A) Focusing
B) Paraphrasing
C) Reflecting
D) Restating
Rationale: Focusing guides the patient to expand upon a specific, meaningful topic rather than making broad,
vague generalizations.
7. A patient with Obsessive-Compulsive Disorder (OCD) spends 45 minutes washing
hands before every meal, causing severe skin breakdown. What initial nursing approach
is most appropriate?
, A) Lock the bathroom door to stop the ritual completely on day one
B) Allow initial time for the ritual while gradually negotiating time limits and
introducing coping strategies
C) Tell the patient that handwashing is unnecessary and irrational
D) Ignore the behavior and let the patient take as long as needed
Rationale: Abruptly stopping an OCD ritual creates overwhelming anxiety; structured, gradual time reduction
paired with alternative coping builds self-control safely.
8. What is the primary focus of Cognitive Behavioral Therapy (CBT) in treating patients
with major depressive disorder?
A) Uncovering early childhood unconscious conflicts
B) Identifying and restructuring automatic negative thoughts and cognitive
distortions
C) Modifying physical brain chemistry through direct relaxation alone
D) Enforcing strict behavioral reward systems
Rationale: CBT targets cognitive distortions (automatic negative thoughts) to reframe perceptions, which
subsequently improves mood and behavior.
9. A patient admitted for alcohol detoxification experiences severe coarse tremors,
diaphoresis, hypertension, and auditory hallucinations 48 hours after his last drink. What
acute medical emergency is developing?
A) Delirium Tremens (DTs)
B) Wernicke Encephalopathy
C) Korsakoff Psychosis
D) Neuroleptic Malignant Syndrome
Rationale: Delirium Tremens is a severe, life-threatening manifestation of alcohol withdrawal featuring autonomic
instability, confusion, and vivid hallucinations.
10. What clinical tool is standard for monitoring alcohol withdrawal severity and guiding
symptom-triggered benzodiazepine administration?
A) Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
B) CAGE Questionnaire
C) Abnormal Involuntary Movement Scale (AIMS)
D) PHQ-9 Depression Scale
Rationale: The CIWA-Ar protocol quantifies alcohol withdrawal severity across 10 symptom domains to guide
precise, symptom-triggered drug dosing.
11. A female patient with Anorexia Nervosa is admitted with a body mass index (BMI) of
14 kg/m², bradycardia (HR 36 bpm), and orthostatic hypotension. What physiological risk
requires careful monitoring during initial refeeding?
BEHAVIORAL HEALTH NURSING
NUR 374 BEHAVIORAL HEALTH NURSING FINAL EXAMINATION
PRACTICE QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS
LATEST 2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A nurse conducts an initial assessment with a patient admitted with major depressive
disorder. The patient states, "I am a complete failure and my family would be better off
without me." What is the priority nursing intervention?
A) Encourage the patient to participate in group social activities
B) Perform a direct suicide risk assessment asking specifically about intent, plan,
and means
C) Reassure the patient that things will improve once medication begins
D) Document the statement in the medical record as low-risk passive ideation
Rationale: Statements indicating worthlessness or burdening family demand immediate, direct assessment of
suicidal ideation, intent, plan, and lethal access.
2. A patient with schizophrenia tells the nurse, "The voices are telling me to hurt the
doctor." How should the nurse respond initially?
A) "I understand the voices feel real to you, but I do not hear them. What specifically
are they telling you to do?"
B) "You know there are no voices in this room, so you should ignore them."
C) "Why do you think the voices want you to hurt the doctor?"
D) "Let's go to your room and lock the door until the voices go away."
Rationale: Validating the patient's feelings while presenting reality and clarifying command hallucinations
assesses immediate safety risks without reinforcing the hallucination.
3. During a manic episode of bipolar I disorder, a patient paces the hallway incessantly,
talks rapidly with flight of ideas, and has not eaten for 24 hours. What nursing
intervention takes priority?
A) Insist that the patient sit down at the dining table to finish a three-course meal
B) Provide high-calorie, high-protein finger foods and fluids that can be consumed
while moving
, C) Place the patient in quiet seclusion until hyperactive pacing subsides
D) Restrict fluid intake to prevent fluid retention
Rationale: Hyperactive manic patients cannot sit still to eat; portable high-calorie finger foods meet urgent
physiological energy and hydration needs.
4. A patient admitted with Borderline Personality Disorder (BPD) praises one nurse as
"the only caring person on staff" while telling other staff that another nurse is "cruel and
incompetent." What therapeutic response prevents staff splitting?
A) Maintain consistent boundaries and hold open interprofessional team
communication to enforce a unified treatment plan
B) Assign the praised nurse to care for the patient exclusively
C) Confront the patient angrily about trying to manipulate the treatment team
D) Allow the patient to select which staff members deliver daily care
Rationale: Splitting is a primary defense mechanism in BPD; firm boundaries and consistent team communication
prevent staff manipulation and division.
5. A patient with Generalized Anxiety Disorder is experiencing a severe panic attack with
hyperventilation, trembling, and a feeling of impending doom. What is the nurse's
immediate action?
A) Teach the patient detailed cognitive restructuring techniques
B) Stay with the patient in a quiet environment and speak using short, simple, calm
sentences
C) Leave the patient alone to reduce environmental overstimulation
D) Encourage the patient to walk rapidly around the unit
Rationale: Severe panic impairs cognitive processing; staying present and using brief, calm communication
provides safety and de-escalates anxiety.
6. Which therapeutic communication technique is demonstrated when the nurse says,
"You mentioned feeling overwhelmed at work. Can you describe a specific situation
when that happened?"
A) Focusing
B) Paraphrasing
C) Reflecting
D) Restating
Rationale: Focusing guides the patient to expand upon a specific, meaningful topic rather than making broad,
vague generalizations.
7. A patient with Obsessive-Compulsive Disorder (OCD) spends 45 minutes washing
hands before every meal, causing severe skin breakdown. What initial nursing approach
is most appropriate?
, A) Lock the bathroom door to stop the ritual completely on day one
B) Allow initial time for the ritual while gradually negotiating time limits and
introducing coping strategies
C) Tell the patient that handwashing is unnecessary and irrational
D) Ignore the behavior and let the patient take as long as needed
Rationale: Abruptly stopping an OCD ritual creates overwhelming anxiety; structured, gradual time reduction
paired with alternative coping builds self-control safely.
8. What is the primary focus of Cognitive Behavioral Therapy (CBT) in treating patients
with major depressive disorder?
A) Uncovering early childhood unconscious conflicts
B) Identifying and restructuring automatic negative thoughts and cognitive
distortions
C) Modifying physical brain chemistry through direct relaxation alone
D) Enforcing strict behavioral reward systems
Rationale: CBT targets cognitive distortions (automatic negative thoughts) to reframe perceptions, which
subsequently improves mood and behavior.
9. A patient admitted for alcohol detoxification experiences severe coarse tremors,
diaphoresis, hypertension, and auditory hallucinations 48 hours after his last drink. What
acute medical emergency is developing?
A) Delirium Tremens (DTs)
B) Wernicke Encephalopathy
C) Korsakoff Psychosis
D) Neuroleptic Malignant Syndrome
Rationale: Delirium Tremens is a severe, life-threatening manifestation of alcohol withdrawal featuring autonomic
instability, confusion, and vivid hallucinations.
10. What clinical tool is standard for monitoring alcohol withdrawal severity and guiding
symptom-triggered benzodiazepine administration?
A) Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
B) CAGE Questionnaire
C) Abnormal Involuntary Movement Scale (AIMS)
D) PHQ-9 Depression Scale
Rationale: The CIWA-Ar protocol quantifies alcohol withdrawal severity across 10 symptom domains to guide
precise, symptom-triggered drug dosing.
11. A female patient with Anorexia Nervosa is admitted with a body mass index (BMI) of
14 kg/m², bradycardia (HR 36 bpm), and orthostatic hypotension. What physiological risk
requires careful monitoring during initial refeeding?
