MENTAL HEALTH NURSING EXAM PREP
2026/2027: VERIFIED QUESTIONS, ANSWERS &
RATIONALES
Question 1
A 28-year-old male is brought to the emergency department by his family. Over the
past 7 months, he has become increasingly isolated, expresses beliefs that his thoughts
are being broadcasted on television, and frequently reacts to auditory hallucinations.
He exhibits a flat affect and disorganized speech. What is the most likely diagnosis?
A) Schizophreniform disorder
B) Schizophrenia
,C) Schizoid personality disorder
D) Brief psychotic disorder
VERIFIED ANSWER: B) Schizophrenia
EXPLANATION: Schizophrenia requires the presence of characteristic symptoms
(such as delusions, hallucinations, or disorganized speech) along with significant
social or occupational dysfunction for a continuous period of at least 6 months.
Schizophreniform disorder shares similar symptomatic criteria but lasts between 1
and 6 months. Brief psychotic disorder lasts less than 1 month, while schizoid
personality disorder involves social detachment without active psychotic features.
Question 2
A 42-year-old female presents with a 3-week history of severe depressed mood,
anhedonia, insomnia, significant weight loss, and feelings of worthlessness. Her
family history is significant for major depressive disorder. When selecting a selective
serotonin reuptake inhibitor (SSRI), the clinician should monitor for which black box
warning associated with this class of medication?
A) Increased risk of hypertensive crisis
B) Increased risk of suicidal ideation and behavior in children, adolescents, and young
adults
C) Risk of severe agranulocytosis
D) Development of tardive dyskinesia
VERIFIED ANSWER: B) Increased risk of suicidal ideation and behavior in
children, adolescents, and young adults
EXPLANATION: The US Food and Drug Administration (FDA) mandates a black
box warning on all antidepressants, including SSRIs, regarding an increased risk of
suicidal thoughts and behavior in patients aged 24 and younger during the initial
stages of treatment. Hypertensive crisis is primarily associated with MAOIs,
,agranulocytosis with clozapine, and tardive dyskinesia with long-term antipsychotic
use.
Question 3
During a psychiatric evaluation, a patient exhibits a defense mechanism where they
attribute their own unacceptable or distressing feelings, impulses, or thoughts to
another person. For instance, the patient states, "My boss hates me and wants to fire
me," when in reality, the patient harbors intense anger toward the boss. Which defense
mechanism is being demonstrated?
A) Displacement
B) Projection
C) Reaction formation
D) Sublimation
VERIFIED ANSWER: B) Projection
EXPLANATION: Projection is an immature defense mechanism where an
individual attributes their own unacknowledged, unacceptable thoughts or feelings
onto someone else. Displacement involves transferring an emotion from its original
target to a less threatening substitute. Reaction formation converts an unacceptable
impulse into its exact opposite, and sublimation is a mature mechanism that
channels unacceptable impulses into socially constructive activities.
Question 4
A 65-year-old male with a history of chronic alcohol use disorder is admitted to the
hospital for a fractured femur. Within 48 hours of admission, he becomes agitated,
diaphoretic, tachycardic, and begins experiencing visual hallucinations of insects
crawling on the wall. What is the first-line pharmacological intervention to manage
, this patient's condition?
A) Haloperidol
B) Chlordiazepoxide
C) Disulfiram
D) Acamprosate
VERIFIED ANSWER: B) Chlordiazepoxide
EXPLANATION: The patient is exhibiting signs of alcohol withdrawal delirium
(delirium tremens), which is a medical emergency. Long-acting benzodiazepines,
such as chlordiazepoxide or diazepam, are the first-line treatment choice to stabilize
vital signs, prevent seizures, and reduce agitation. Antipsychotics like haloperidol
can lower the seizure threshold and are not first-line. Disulfiram and acamprosate
are used for maintaining abstinence after withdrawal is resolved.
Question 5
A 19-year-old female college student presents to the university clinic complaining of
extreme anxiety regarding her academic performance. She describes recurrent,
intrusive episodes of intense fear accompanied by palpitations, shortness of breath,
dizziness, and a fear of dying, which peak within 10 minutes. These episodes occur
unexpectedly. What is the most appropriate long-term first-line pharmacological
treatment for this condition?
A) Alprazolam
B) Sertraline
C) Propropanol
D) Buspirone
VERIFIED ANSWER: B) Sertraline
EXPLANATION: The patient’s symptoms are classic for panic disorder,
characterized by recurrent, unexpected panic attacks. Selective serotonin reuptake
inhibitors (SSRIs) like sertraline, or serotonin-norepinephrine reuptake inhibitors
2026/2027: VERIFIED QUESTIONS, ANSWERS &
RATIONALES
Question 1
A 28-year-old male is brought to the emergency department by his family. Over the
past 7 months, he has become increasingly isolated, expresses beliefs that his thoughts
are being broadcasted on television, and frequently reacts to auditory hallucinations.
He exhibits a flat affect and disorganized speech. What is the most likely diagnosis?
A) Schizophreniform disorder
B) Schizophrenia
,C) Schizoid personality disorder
D) Brief psychotic disorder
VERIFIED ANSWER: B) Schizophrenia
EXPLANATION: Schizophrenia requires the presence of characteristic symptoms
(such as delusions, hallucinations, or disorganized speech) along with significant
social or occupational dysfunction for a continuous period of at least 6 months.
Schizophreniform disorder shares similar symptomatic criteria but lasts between 1
and 6 months. Brief psychotic disorder lasts less than 1 month, while schizoid
personality disorder involves social detachment without active psychotic features.
Question 2
A 42-year-old female presents with a 3-week history of severe depressed mood,
anhedonia, insomnia, significant weight loss, and feelings of worthlessness. Her
family history is significant for major depressive disorder. When selecting a selective
serotonin reuptake inhibitor (SSRI), the clinician should monitor for which black box
warning associated with this class of medication?
A) Increased risk of hypertensive crisis
B) Increased risk of suicidal ideation and behavior in children, adolescents, and young
adults
C) Risk of severe agranulocytosis
D) Development of tardive dyskinesia
VERIFIED ANSWER: B) Increased risk of suicidal ideation and behavior in
children, adolescents, and young adults
EXPLANATION: The US Food and Drug Administration (FDA) mandates a black
box warning on all antidepressants, including SSRIs, regarding an increased risk of
suicidal thoughts and behavior in patients aged 24 and younger during the initial
stages of treatment. Hypertensive crisis is primarily associated with MAOIs,
,agranulocytosis with clozapine, and tardive dyskinesia with long-term antipsychotic
use.
Question 3
During a psychiatric evaluation, a patient exhibits a defense mechanism where they
attribute their own unacceptable or distressing feelings, impulses, or thoughts to
another person. For instance, the patient states, "My boss hates me and wants to fire
me," when in reality, the patient harbors intense anger toward the boss. Which defense
mechanism is being demonstrated?
A) Displacement
B) Projection
C) Reaction formation
D) Sublimation
VERIFIED ANSWER: B) Projection
EXPLANATION: Projection is an immature defense mechanism where an
individual attributes their own unacknowledged, unacceptable thoughts or feelings
onto someone else. Displacement involves transferring an emotion from its original
target to a less threatening substitute. Reaction formation converts an unacceptable
impulse into its exact opposite, and sublimation is a mature mechanism that
channels unacceptable impulses into socially constructive activities.
Question 4
A 65-year-old male with a history of chronic alcohol use disorder is admitted to the
hospital for a fractured femur. Within 48 hours of admission, he becomes agitated,
diaphoretic, tachycardic, and begins experiencing visual hallucinations of insects
crawling on the wall. What is the first-line pharmacological intervention to manage
, this patient's condition?
A) Haloperidol
B) Chlordiazepoxide
C) Disulfiram
D) Acamprosate
VERIFIED ANSWER: B) Chlordiazepoxide
EXPLANATION: The patient is exhibiting signs of alcohol withdrawal delirium
(delirium tremens), which is a medical emergency. Long-acting benzodiazepines,
such as chlordiazepoxide or diazepam, are the first-line treatment choice to stabilize
vital signs, prevent seizures, and reduce agitation. Antipsychotics like haloperidol
can lower the seizure threshold and are not first-line. Disulfiram and acamprosate
are used for maintaining abstinence after withdrawal is resolved.
Question 5
A 19-year-old female college student presents to the university clinic complaining of
extreme anxiety regarding her academic performance. She describes recurrent,
intrusive episodes of intense fear accompanied by palpitations, shortness of breath,
dizziness, and a fear of dying, which peak within 10 minutes. These episodes occur
unexpectedly. What is the most appropriate long-term first-line pharmacological
treatment for this condition?
A) Alprazolam
B) Sertraline
C) Propropanol
D) Buspirone
VERIFIED ANSWER: B) Sertraline
EXPLANATION: The patient’s symptoms are classic for panic disorder,
characterized by recurrent, unexpected panic attacks. Selective serotonin reuptake
inhibitors (SSRIs) like sertraline, or serotonin-norepinephrine reuptake inhibitors
