Rasmussen Mental Health 2026/2027 | Rasmussen University Mental &
Behavioral Health Nursing Final Exam Study Guide, NUR 2488 & NUR 2459
Exam Prep, Psychiatric Nursing, Therapeutic Communication,
Psychopharmacology, Mental Health Disorders, Nursing Interventions &
Practice Questions
Question 1: Which theorist is credited with developing the concept of the
therapeutic nurse-patient relationship, emphasizing trust, empathy, and
unconditional positive regard?
A. Sigmund Freud
B. Hildegard Peplau
C. Erik Erikson
D. B.F. Skinner
CORRECT ANSWER: B. Hildegard Peplau
Rationale: Hildegard Peplau is widely regarded as the mother of psychiatric
nursing. Her theory of interpersonal relations identifies the nurse-patient
relationship as the foundation of nursing practice, progressing through
orientation, working, and termination phases.
Question 2: A client diagnosed with schizophrenia is experiencing auditory
hallucinations. Which nursing intervention is most appropriate initially?
A. Tell the client the voices are not real
B. Ask the client what the voices are saying
C. Ignore the client's reports of voices
D. Restrict the client's privileges until symptoms subside
CORRECT ANSWER: B. Ask the client what the voices are saying
Rationale: Asking what the voices are saying assesses the content and command
nature of the hallucinations, which is critical for safety. Directly challenging the
hallucination can increase anxiety and damage trust.
Question 3: Which class of medications is considered first-line pharmacologic
treatment for generalized anxiety disorder?
A. Benzodiazepines
B. Selective serotonin reuptake inhibitors
,C. Monoamine oxidase inhibitors
D. Antipsychotics
CORRECT ANSWER: B. Selective serotonin reuptake inhibitors
Rationale: SSRIs are first-line for generalized anxiety disorder because of their
favorable safety profile and efficacy. Benzodiazepines are typically reserved for
short-term or adjunctive use due to dependence risk.
Question 4: A client taking lithium carbonate reports nausea, coarse hand
tremors, and confusion. Which action should the nurse take first?
A. Administer the next scheduled dose
B. Encourage increased fluid intake
C. Hold the medication and notify the provider
D. Reassure the client that these are expected effects
CORRECT ANSWER: C. Hold the medication and notify the provider
Rationale: Coarse tremors, confusion, and nausea suggest lithium toxicity. The
nurse must hold the drug, notify the provider, and monitor serum lithium levels
and renal function.
Question 5: Which defense mechanism is a client using when they attribute
their own angry feelings to a nurse?
A. Projection
B. Sublimation
C. Rationalization
D. Regression
CORRECT ANSWER: A. Projection
Rationale: Projection involves attributing one's own unacceptable thoughts or
feelings to another person. The client displaces internal anger onto the nurse
rather than acknowledging it.
Question 6: Which assessment finding is most characteristic of a panic attack?
A. Decreased heart rate
B. Psychomotor retardation
,C. Intense fear with palpitations and shortness of breath
D. Flat affect with social withdrawal
CORRECT ANSWER: C. Intense fear with palpitations and shortness of breath
Rationale: Panic attacks involve abrupt, intense fear or discomfort with
autonomic symptoms such as palpitations, dyspnea, chest pain, and derealization,
peaking within minutes.
Question 7: A nurse is caring for a client with major depressive disorder who
states, "I have no reason to live." Which response is most therapeutic?
A. "You have so much to live for."
B. "Are you thinking about hurting yourself?"
C. "Let's talk about something more positive."
D. "Everyone feels down sometimes."
CORRECT ANSWER: B. "Are you thinking about hurting yourself?"
Rationale: Directly asking about suicidal ideation is essential for risk assessment
and does not implant the idea. It communicates willingness to discuss painful
feelings openly.
Question 8: Which symptom differentiates anorexia nervosa from bulimia
nervosa?
A. Binge eating episodes
B. Self-induced vomiting
C. Significantly low body weight
D. Preoccupation with body shape
CORRECT ANSWER: C. Significantly low body weight
Rationale: Anorexia nervosa is characterized by significantly low body weight,
whereas individuals with bulimia nervosa are often at or near normal weight
despite binge-purge behaviors.
Question 9: A client is prescribed haloperidol and develops muscle rigidity,
fever, and altered mental status. Which condition should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
, C. Tardive dyskinesia
D. Acute dystonia
CORRECT ANSWER: B. Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics marked by hyperthermia, rigidity, autonomic instability, and
altered mental status requiring emergency treatment.
Question 10: Which nursing action best supports a client's autonomy during
inpatient psychiatric treatment?
A. Making all decisions for the client
B. Involving the client in developing the care plan
C. Restricting visitation without explanation
D. Withholding information about medications
CORRECT ANSWER: B. Involving the client in developing the care plan
Rationale: Autonomy is promoted by including clients in treatment decisions.
Collaborative care planning respects the client's right to self-determination and
informed participation.
Question 11: Which finding indicates that a client is experiencing alcohol
withdrawal?
A. Bradycardia and hypotension
B. Constricted pupils and sedation
C. Tremors, diaphoresis, and tachycardia
D. Decreased deep tendon reflexes
CORRECT ANSWER: C. Tremors, diaphoresis, and tachycardia
Rationale: Alcohol withdrawal typically presents with autonomic hyperactivity
including tremors, sweating, tachycardia, hypertension, and anxiety, and can
progress to seizures or delirium tremens.
Question 12: Which therapeutic communication technique involves restating
the client's message in the nurse's own words?
A. Clarification
B. Paraphrasing
Behavioral Health Nursing Final Exam Study Guide, NUR 2488 & NUR 2459
Exam Prep, Psychiatric Nursing, Therapeutic Communication,
Psychopharmacology, Mental Health Disorders, Nursing Interventions &
Practice Questions
Question 1: Which theorist is credited with developing the concept of the
therapeutic nurse-patient relationship, emphasizing trust, empathy, and
unconditional positive regard?
A. Sigmund Freud
B. Hildegard Peplau
C. Erik Erikson
D. B.F. Skinner
CORRECT ANSWER: B. Hildegard Peplau
Rationale: Hildegard Peplau is widely regarded as the mother of psychiatric
nursing. Her theory of interpersonal relations identifies the nurse-patient
relationship as the foundation of nursing practice, progressing through
orientation, working, and termination phases.
Question 2: A client diagnosed with schizophrenia is experiencing auditory
hallucinations. Which nursing intervention is most appropriate initially?
A. Tell the client the voices are not real
B. Ask the client what the voices are saying
C. Ignore the client's reports of voices
D. Restrict the client's privileges until symptoms subside
CORRECT ANSWER: B. Ask the client what the voices are saying
Rationale: Asking what the voices are saying assesses the content and command
nature of the hallucinations, which is critical for safety. Directly challenging the
hallucination can increase anxiety and damage trust.
Question 3: Which class of medications is considered first-line pharmacologic
treatment for generalized anxiety disorder?
A. Benzodiazepines
B. Selective serotonin reuptake inhibitors
,C. Monoamine oxidase inhibitors
D. Antipsychotics
CORRECT ANSWER: B. Selective serotonin reuptake inhibitors
Rationale: SSRIs are first-line for generalized anxiety disorder because of their
favorable safety profile and efficacy. Benzodiazepines are typically reserved for
short-term or adjunctive use due to dependence risk.
Question 4: A client taking lithium carbonate reports nausea, coarse hand
tremors, and confusion. Which action should the nurse take first?
A. Administer the next scheduled dose
B. Encourage increased fluid intake
C. Hold the medication and notify the provider
D. Reassure the client that these are expected effects
CORRECT ANSWER: C. Hold the medication and notify the provider
Rationale: Coarse tremors, confusion, and nausea suggest lithium toxicity. The
nurse must hold the drug, notify the provider, and monitor serum lithium levels
and renal function.
Question 5: Which defense mechanism is a client using when they attribute
their own angry feelings to a nurse?
A. Projection
B. Sublimation
C. Rationalization
D. Regression
CORRECT ANSWER: A. Projection
Rationale: Projection involves attributing one's own unacceptable thoughts or
feelings to another person. The client displaces internal anger onto the nurse
rather than acknowledging it.
Question 6: Which assessment finding is most characteristic of a panic attack?
A. Decreased heart rate
B. Psychomotor retardation
,C. Intense fear with palpitations and shortness of breath
D. Flat affect with social withdrawal
CORRECT ANSWER: C. Intense fear with palpitations and shortness of breath
Rationale: Panic attacks involve abrupt, intense fear or discomfort with
autonomic symptoms such as palpitations, dyspnea, chest pain, and derealization,
peaking within minutes.
Question 7: A nurse is caring for a client with major depressive disorder who
states, "I have no reason to live." Which response is most therapeutic?
A. "You have so much to live for."
B. "Are you thinking about hurting yourself?"
C. "Let's talk about something more positive."
D. "Everyone feels down sometimes."
CORRECT ANSWER: B. "Are you thinking about hurting yourself?"
Rationale: Directly asking about suicidal ideation is essential for risk assessment
and does not implant the idea. It communicates willingness to discuss painful
feelings openly.
Question 8: Which symptom differentiates anorexia nervosa from bulimia
nervosa?
A. Binge eating episodes
B. Self-induced vomiting
C. Significantly low body weight
D. Preoccupation with body shape
CORRECT ANSWER: C. Significantly low body weight
Rationale: Anorexia nervosa is characterized by significantly low body weight,
whereas individuals with bulimia nervosa are often at or near normal weight
despite binge-purge behaviors.
Question 9: A client is prescribed haloperidol and develops muscle rigidity,
fever, and altered mental status. Which condition should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
, C. Tardive dyskinesia
D. Acute dystonia
CORRECT ANSWER: B. Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics marked by hyperthermia, rigidity, autonomic instability, and
altered mental status requiring emergency treatment.
Question 10: Which nursing action best supports a client's autonomy during
inpatient psychiatric treatment?
A. Making all decisions for the client
B. Involving the client in developing the care plan
C. Restricting visitation without explanation
D. Withholding information about medications
CORRECT ANSWER: B. Involving the client in developing the care plan
Rationale: Autonomy is promoted by including clients in treatment decisions.
Collaborative care planning respects the client's right to self-determination and
informed participation.
Question 11: Which finding indicates that a client is experiencing alcohol
withdrawal?
A. Bradycardia and hypotension
B. Constricted pupils and sedation
C. Tremors, diaphoresis, and tachycardia
D. Decreased deep tendon reflexes
CORRECT ANSWER: C. Tremors, diaphoresis, and tachycardia
Rationale: Alcohol withdrawal typically presents with autonomic hyperactivity
including tremors, sweating, tachycardia, hypertension, and anxiety, and can
progress to seizures or delirium tremens.
Question 12: Which therapeutic communication technique involves restating
the client's message in the nurse's own words?
A. Clarification
B. Paraphrasing
