NUR 2459 Mental and Behavioral Health
Nursing Exam 2 Comprehensive
Examination 2026/2027: Verified Practice
Questions & Detailed Rationales |
Rasmussen College | Psychiatric Nursing,
Anxiety, Mood Disorders, Schizophrenia,
Psychopharmacology, an
1. A client with panic disorder is hyperventilating and states, "I'm going to die."
Which nursing action is priority?
A. Teach diaphragmatic breathing
B. Stay with the client and speak in short, simple sentences
C. Ask the client to identify the trigger
D. Administer PRN lorazepam immediately
Answer: B
Rationale: During panic, the client cannot process teaching or insight-oriented
questions. A calm, present nurse using brief simple statements provides safety
and reduces stimulation. Breathing techniques (A) and trigger identification (C)
are appropriate after anxiety decreases. Medication (D) may be given but is not
the first action — presence and safety come first.
2. Which finding indicates a client's anxiety has moved from moderate to
severe?
A. Increased focus and alertness
B. Narrowed perceptual field but able to problem-solve with help
C. Severely narrowed perception with difficulty noticing environment
D. Complete disorganization with loss of reality contact
Answer: C
Rationale: Severe anxiety severely narrows the perceptual field; the client misses
,much of what happens around them and cannot problem-solve even with
direction. A is mild, B is moderate, D describes panic.
3. A client on buspirone asks when they will feel better. Best response?
A. "It works immediately, so you should feel calm today."
B. "It usually takes 2 to 4 weeks for full effect."
C. "You can stop it once you feel better."
D. "It works best taken only when you feel anxious."
Answer: B
Rationale: Buspirone requires 2–4 weeks for therapeutic effect and must be taken
consistently. It is not PRN (D), not immediate (A), and should not be stopped
abruptly without provider guidance (C). It also has no dependence potential,
unlike benzodiazepines.
4. Which client statement shows correct understanding of benzodiazepine
therapy?
A. "I can drink alcohol as long as I don't drive."
B. "I should stop the drug abruptly when I feel better."
C. "I'll avoid alcohol and never stop suddenly without my provider."
D. "This is safe to take long-term for my anxiety."
Answer: C
Rationale: Benzodiazepines potentiate CNS depression with alcohol and cause
withdrawal (seizures) if stopped abruptly. They are intended for short-term use
due to dependence risk, so D is incorrect.
5. A client with performance anxiety is prescribed propranolol. The nurse
explains it works by:
A. Increasing GABA activity
B. Blocking physical symptoms like tachycardia and tremor
C. Raising serotonin levels
D. Reducing intrusive thoughts
Answer: B
Rationale: Propranolol is a beta-blocker that blunts peripheral sympathetic
symptoms (racing heart, tremors, sweating). It does not act on GABA (A),
serotonin (C), or cognition (D).
, 6. Which is the first-line pharmacologic treatment for generalized anxiety
disorder?
A. Alprazolam
B. Lorazepam
C. Escitalopram
D. Diphenhydramine
Answer: C
Rationale: SSRIs such as escitalopram are first-line for GAD due to efficacy and
lower dependence risk. Benzodiazepines (A, B) are adjunctive/short-term.
Diphenhydramine (D) is not indicated.
7. A client in a panic attack is placed in a quiet room. The nurse's priority
assessment is:
A. Suicide risk
B. Blood glucose
C. Pain level
D. Family history
Answer: A
Rationale: Panic can accompany suicidal ideation and the nurse must always
assess safety first. The other options are not the priority in acute panic.
8. Which statement by a client with anxiety indicates a need for further teaching
about caffeine?
A. "I'll switch to decaf coffee."
B. "I'll limit energy drinks."
C. "Caffeine helps calm my nerves."
D. "I'll read labels for stimulants."
Answer: C
Rationale: Caffeine is a stimulant that worsens anxiety, insomnia, and
palpitations. The client needs correction.
9. A nurse is teaching a client about relaxation techniques. Which is most
accurate?
A. "Use them only during a panic attack."
B. "Practice them daily when calm so they're easier to use when anxious."
Nursing Exam 2 Comprehensive
Examination 2026/2027: Verified Practice
Questions & Detailed Rationales |
Rasmussen College | Psychiatric Nursing,
Anxiety, Mood Disorders, Schizophrenia,
Psychopharmacology, an
1. A client with panic disorder is hyperventilating and states, "I'm going to die."
Which nursing action is priority?
A. Teach diaphragmatic breathing
B. Stay with the client and speak in short, simple sentences
C. Ask the client to identify the trigger
D. Administer PRN lorazepam immediately
Answer: B
Rationale: During panic, the client cannot process teaching or insight-oriented
questions. A calm, present nurse using brief simple statements provides safety
and reduces stimulation. Breathing techniques (A) and trigger identification (C)
are appropriate after anxiety decreases. Medication (D) may be given but is not
the first action — presence and safety come first.
2. Which finding indicates a client's anxiety has moved from moderate to
severe?
A. Increased focus and alertness
B. Narrowed perceptual field but able to problem-solve with help
C. Severely narrowed perception with difficulty noticing environment
D. Complete disorganization with loss of reality contact
Answer: C
Rationale: Severe anxiety severely narrows the perceptual field; the client misses
,much of what happens around them and cannot problem-solve even with
direction. A is mild, B is moderate, D describes panic.
3. A client on buspirone asks when they will feel better. Best response?
A. "It works immediately, so you should feel calm today."
B. "It usually takes 2 to 4 weeks for full effect."
C. "You can stop it once you feel better."
D. "It works best taken only when you feel anxious."
Answer: B
Rationale: Buspirone requires 2–4 weeks for therapeutic effect and must be taken
consistently. It is not PRN (D), not immediate (A), and should not be stopped
abruptly without provider guidance (C). It also has no dependence potential,
unlike benzodiazepines.
4. Which client statement shows correct understanding of benzodiazepine
therapy?
A. "I can drink alcohol as long as I don't drive."
B. "I should stop the drug abruptly when I feel better."
C. "I'll avoid alcohol and never stop suddenly without my provider."
D. "This is safe to take long-term for my anxiety."
Answer: C
Rationale: Benzodiazepines potentiate CNS depression with alcohol and cause
withdrawal (seizures) if stopped abruptly. They are intended for short-term use
due to dependence risk, so D is incorrect.
5. A client with performance anxiety is prescribed propranolol. The nurse
explains it works by:
A. Increasing GABA activity
B. Blocking physical symptoms like tachycardia and tremor
C. Raising serotonin levels
D. Reducing intrusive thoughts
Answer: B
Rationale: Propranolol is a beta-blocker that blunts peripheral sympathetic
symptoms (racing heart, tremors, sweating). It does not act on GABA (A),
serotonin (C), or cognition (D).
, 6. Which is the first-line pharmacologic treatment for generalized anxiety
disorder?
A. Alprazolam
B. Lorazepam
C. Escitalopram
D. Diphenhydramine
Answer: C
Rationale: SSRIs such as escitalopram are first-line for GAD due to efficacy and
lower dependence risk. Benzodiazepines (A, B) are adjunctive/short-term.
Diphenhydramine (D) is not indicated.
7. A client in a panic attack is placed in a quiet room. The nurse's priority
assessment is:
A. Suicide risk
B. Blood glucose
C. Pain level
D. Family history
Answer: A
Rationale: Panic can accompany suicidal ideation and the nurse must always
assess safety first. The other options are not the priority in acute panic.
8. Which statement by a client with anxiety indicates a need for further teaching
about caffeine?
A. "I'll switch to decaf coffee."
B. "I'll limit energy drinks."
C. "Caffeine helps calm my nerves."
D. "I'll read labels for stimulants."
Answer: C
Rationale: Caffeine is a stimulant that worsens anxiety, insomnia, and
palpitations. The client needs correction.
9. A nurse is teaching a client about relaxation techniques. Which is most
accurate?
A. "Use them only during a panic attack."
B. "Practice them daily when calm so they're easier to use when anxious."
