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Exam 1 | Psychiatric & Mental Health Nursing
| Western Governors University | Q & A |
2026/2027 Edition
1. A client with agoraphobia tells the nurse, "I can't go to the grocery store because I might get
trapped and not be able to escape." Which nursing diagnosis should the nurse prioritize?
A. Ineffective coping
B. Fear related to being in situations where escape may be difficult
C. Social isolation
D. Risk for injury
Correct Answer: B. Fear related to being in situations where escape may be difficult
Rationale: The client's statement directly reflects the defining characteristic of agoraphobia:
intense fear of situations where escape may be difficult or help unavailable. While social
isolation may be a consequence, the priority is addressing the underlying fear to guide
therapeutic interventions such as gradual exposure therapy.
2. A nurse is assessing a client with generalized anxiety disorder (GAD). Which finding is most
characteristic?
A. Episodic panic attacks
B. Excessive worry about multiple areas of life
,C. Fear of specific objects
D. Avoidance of social situations
Correct Answer: B. Excessive worry about multiple areas of life
Rationale: GAD is characterized by persistent, excessive, and uncontrollable worry about various
aspects of life (work, health, family) for at least 6 months.
3. A client is prescribed lorazepam for anxiety. Which instruction should the nurse include?
A. "Stop the medication abruptly if you feel better."
B. "Avoid alcohol while taking this medication."
C. "Take this medication only when you have a panic attack."
D. "This medication is safe to use long-term."
Correct Answer: B. "Avoid alcohol while taking this medication."
Rationale: Benzodiazepines like lorazepam potentiate the effects of alcohol, increasing the risk
of respiratory depression and sedation. They should not be stopped abruptly due to withdrawal
risk.
4. A nurse is caring for a client with obsessive-compulsive disorder (OCD). Which finding is
expected?
, A. Delusions of grandeur
B. Repetitive handwashing
C. Auditory hallucinations
D. Flat affect
Correct Answer: B. Repetitive handwashing
Rationale: OCD is characterized by obsessions (intrusive thoughts) and compulsions (repetitive
behaviors) such as handwashing, checking, or counting.
5. A client with panic disorder is experiencing hyperventilation. Which action should the nurse
take first?
A. Administer a PRN anxiolytic
B. Coach the client in slow, deep breathing
C. Move the client to a quiet room
D. Obtain a set of vital signs
Correct Answer: B. Coach the client in slow, deep breathing
Rationale: During a panic attack, the priority is to help the client regain control of breathing.
Slow, deep breathing reduces hyperventilation and associated symptoms.
Exam 1 | Psychiatric & Mental Health Nursing
| Western Governors University | Q & A |
2026/2027 Edition
1. A client with agoraphobia tells the nurse, "I can't go to the grocery store because I might get
trapped and not be able to escape." Which nursing diagnosis should the nurse prioritize?
A. Ineffective coping
B. Fear related to being in situations where escape may be difficult
C. Social isolation
D. Risk for injury
Correct Answer: B. Fear related to being in situations where escape may be difficult
Rationale: The client's statement directly reflects the defining characteristic of agoraphobia:
intense fear of situations where escape may be difficult or help unavailable. While social
isolation may be a consequence, the priority is addressing the underlying fear to guide
therapeutic interventions such as gradual exposure therapy.
2. A nurse is assessing a client with generalized anxiety disorder (GAD). Which finding is most
characteristic?
A. Episodic panic attacks
B. Excessive worry about multiple areas of life
,C. Fear of specific objects
D. Avoidance of social situations
Correct Answer: B. Excessive worry about multiple areas of life
Rationale: GAD is characterized by persistent, excessive, and uncontrollable worry about various
aspects of life (work, health, family) for at least 6 months.
3. A client is prescribed lorazepam for anxiety. Which instruction should the nurse include?
A. "Stop the medication abruptly if you feel better."
B. "Avoid alcohol while taking this medication."
C. "Take this medication only when you have a panic attack."
D. "This medication is safe to use long-term."
Correct Answer: B. "Avoid alcohol while taking this medication."
Rationale: Benzodiazepines like lorazepam potentiate the effects of alcohol, increasing the risk
of respiratory depression and sedation. They should not be stopped abruptly due to withdrawal
risk.
4. A nurse is caring for a client with obsessive-compulsive disorder (OCD). Which finding is
expected?
, A. Delusions of grandeur
B. Repetitive handwashing
C. Auditory hallucinations
D. Flat affect
Correct Answer: B. Repetitive handwashing
Rationale: OCD is characterized by obsessions (intrusive thoughts) and compulsions (repetitive
behaviors) such as handwashing, checking, or counting.
5. A client with panic disorder is experiencing hyperventilation. Which action should the nurse
take first?
A. Administer a PRN anxiolytic
B. Coach the client in slow, deep breathing
C. Move the client to a quiet room
D. Obtain a set of vital signs
Correct Answer: B. Coach the client in slow, deep breathing
Rationale: During a panic attack, the priority is to help the client regain control of breathing.
Slow, deep breathing reduces hyperventilation and associated symptoms.
