NCLEX COMPREHENSIVE MENTAL HEALTH AND PSYCHIA
d d d d d
TRIC NURSING EXAM 2026: 75 QUESTIONS WITH 100% COR
d d d d d d d d
RECT ANSWERS AND RATIONALES. TOP PRIORITY QUESTI
d d d d d d
ONS (VERIFIED) d
dA psychotic client reports to the evening nurse that the day nurse put somethings
d d d d d d d d d d d d d d
uspicious in his water with his medication. The nurse replies, “You’re worried abou
d d d d d d d d d d d d
t your medication?” The nurse’s communication is:
d d d d d d
o A. An example of presenting reality
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o B. Reinforcing the client’s delusions
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o C. Focusing on emotional content
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o D. A non-therapeutic technique called mind-reading
d d d d d
Incorrect
Correct Answer: C. Focusing on emotional content
d d d d d d
The nurse should help the client focus on the emotional content rather than delusi
d d d d d d d d d d d d d
onal material. Sometimes during a conversation, patients mention something part
d d d d d d d d d
icularly important. When this happens, nurses can focus on their statement, prom
d d d d d d d d d d d
pting patients to discuss it further. Patients don’t always have anobjective perspect
d d d d d d d d d d d d
ive on what is relevant to their case; as impartial observers, nurses can more easily
d d d d d d d d d d d d d d d
pick out the topics to focus on.
d d d d d d
Option A: Presenting reality isn’t helpful because it can lead to confronta
d d d d d d d d d d d
tion and disengagement. It’s frequently useful for nurses to summarize w
d d d d d d d d d d
hat patients have said after the fact. This demonstrates to patients that th
d d d d d d d d d d d d
e nurse was listening and allows the nurse to document conversations. E
d d d d d d d d d d d
nding a summary with a phrase like “Does that sound correct?” gives pati
d d d d d d d d d d d d
ents explicit permission to make corrections if they’renecessary.
d d d d d d d d
Option B: Agreeing with the client and supporting his beliefs are reinforcin
d d d d d d d d d d d
g delusions. Patients often ask nurses for advice about what theyshould do
d d d d d d d d d d d d d
about particular problems or in specific situations. Nurses can ask patients
d d d d d d d d d d d
what they think they should do, which encourages patients tobe accountab
d d d d d d d d d d d
le for their own actions and helps them come up with solutions themselves.
d d d d d d d d d d d d
Option D: Mind reading isn’t therapeutic. Similar to active listening, askingp
d d d d d d d d d d d
atients for clarification when they say something confusing or ambiguous
d d d d d d d d d
, is important. Saying something like “I’m not sure I understand. Can youexpla
d d d d d d d d d d d d
in it to me?” helps nurses ensure they understand what’s actually being said
d d d d d d d d d d d d d
and can help patients process their ideas more thoroughly
d d d d d d d d
1. 2. Question
d
A client is admitted to the inpatient unit of the mental health center with adi
d d d d d d d d d d d d d d d
agnosis of paranoid schizophrenia. He’s shouting that the government ofFra
d d d d d d d d d d
nce is trying to assassinate him. Which of the following responses
d d d d d d d d d d
is most appropriate?
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A. “I think you’re wrong. France is a friendly country and an ally of the UnitedS
d d d d d d d d d d d d d d d d
tates. Their government wouldn’t try to kill you.”
d d d d d d d
B. “I find it hard to believe that a foreign government or anyone else ist
d d d d d d d d d d d d d d d
rying to hurt you. You must feel frightened by this.”
d d d d d d d d d
C. “You’re wrong. Nobody is trying to kill you.”
d d d d d d d d
D. “A foreign government is trying to kill you? Please tell me more about it.”
d d d d d d d d d d d d d d
Incorrect
Correct Answer: B. “I find it hard to believe that a foreign government oranyo
d d d d d d d d d d d d d d
ne else is trying to hurt you. You must feel frightened by this.” Responses sho
d d d d d d d d d d d d d d
uld focus on reality while acknowledging the client’s feelings.
d d d d d d d d
Sometimes during a conversation, patients mention something particularly import
d d d d d d d d
ant. When this happens, nurses can focus on their statement, prompting patients t
d d d d d d d d d d d d
o discuss it further. Patients don’t always have an objective perspectiveon what is re
d d d d d d d d d d d d d d
levant to their case; as impartial observers, nurses can more easily pick out the topi
d d d d d d d d d d d d d d
cs to focus on.
d d d
Option A: Arguing with the client or denying his belief isn’t therapeutic. Byu
d d d d d d d d d d d d d
sing nonverbal and verbal cues such as nodding and saying “I see,” nursesca
d d d d d d d d d d d d d
n encourage patients to continue talking. Active listening involves showing i
d d d d d d d d d d
nterest in what patients have to say, acknowledging that you’re listening an
d d d d d d d d d d d
d understanding, and engaging with them throughout the conversation. Nu
d d d d d d d d d
rses can offer general leads such as “What happened next?” to guide the co
d d d d d d d d d d d d d
nversation or propel it forward. d d d d
, Option C: Arguing can also inhibit development of a trusting relationship. C
d d d d d d d d d d d
ontinuing to talk about delusions may aggravate the psychosis. It’s frequent
d d d d d d d d d d
ly useful for nurses to summarize what patients have said after thefact. This
d d d d d d d d d d d d d d
demonstrates to patients that the nurse was listening and allows the nurse td d d d d d d d d d d d
o document conversations. Ending a summary with a phrase like“Does that s
d d d d d d d d d d d d
ound correct?” gives patients explicit permission to make corrections if they
d d d d d d d d d d
’re necessary.
d
Option D: Asking the client if a foreign government is trying to kill him m
d d d d d d d d d d d d d d
ay increase his anxiety level and can reinforce his delusions. Voicing doubt
d d d d d d d d d d d
dcan be a gentler way to call attention to the incorrect or delusional
d d d d d d d d d d d d
2. 3. Question
d
A client receiving haloperidol (Haldol) complains of a stiff jaw and difficultyswallow
d d d d d d d d d d d d
ing. The nurse’s first action is to:
d d d d d d
A. Reassure the client and administer as needed lorazepam (Ativan) I.M.
d d d d d d d d d d
B. Administer as needed dose of benztropine (Cogentin) I.M. as ordered.
d d d d d d d d d d
C. Administer as needed dose of benztropine (Cogentin) by mouth aso
d d d d d d d d d d d
rdered.
D. Administer as needed dose of haloperidol (Haldol) by mouth.
d d d d d d d d d
Incorrect
Correct Answer: B. Administer as needed dose of benztropine (Cogentin)
d d d d d d d d d
I.M. as ordered.
d d
The client is most likely suffering from muscle rigidity due to haloperidol. I.M. benz
d d d d d d d d d d d d d
tropine should be administered to prevent asphyxia or aspiration. The extrapyrami
d d d d d d d d d d
dal symptoms are muscular weakness or rigidity, a generalized or localized tremor
d d d d d d d d d d d d
that may be characterized by the akinetic or agitation types ofmovements, respecti
d d d d d d d d d d d d
vely. Haloperidol overdose is also associated with ECG changes known as torsade
d d d d d d d d d d d d
de pointes, which may cause arrhythmia or cardiac arrest.
d d d d d d d d
Option A: Lorazepam treats anxiety, not extrapyramidal effects. Lorazepami
d d d d d d d d d
s a benzodiazepine medication developed by DJ Richards. It went on the ma
d d d d d d d d d d d d
rket in the United States in 1977. Lorazepam has common use as the
d d d d d d d d d d d d
, sedative and anxiolytic of choice in the inpatient setting owing to its fast (1t
d d d d d d d d d d d d d d
o 3 minute) onset of action when administered intravenously. Lorazepam is
d d d d d d d d d d d
also one of the few sedative-
d d d d d
hypnotics with a relatively clean side effect profile. Lorazepam is FDA appro
d d d d d d d d d d d
ved for short- d d
term (4 months) relief of anxiety symptoms related to anxiety disorders, anx
d d d d d d d d d d d
iety-
associated insomnia, anesthesia premedication in adults to relieve anxiety,
d d d d d d d d d
or to produce sedation/amnesia, and treatment of status epilepticus.
d d d d d d d d
Option C: Benztropine belongs to the synthetic class of muscarinic receptor
d d d d d d d d d d
dantagonists (anticholinergic drugs). Thus, it has a structure similar to that of
d d d d d d d d d d d d
diphenhydramine and atropine. However, it is long- d d d d d d
acting so thatits administration can be with less frequency than diphenhydr
d d d d d d d d d d d
amine. It alsoinduces less CNS stimulation effect compared to that of trihexy
d d d d d d d d d d d d
phenidyl, making it a preferable drug of choice for geriatric patients.
d d d d d d d d d d
Option D: Another dose of haloperidol would increase the severity of ther
d d d d d d d d d d d d
eaction. Since there is no specific antidote, supportive treatment is the mai
d d d d d d d d d d d
nstay of haloperidol toxicity. If a patient develops signs and symptomsof to
d d d d d d d d d d d d
xicities, the clinician should consider gastric lavage or induction of emesis
d d d d d d d d d d d
as soon as possible, followed by the administration of activated charcoal.
d d d d d d d d d d d
Maintenance of Airway, Breathing, and circulation are the most important f d d d d d d d d d d
actors for survival. d d
3. 4. Question
d
The nurse is caring for a client with schizophrenia who experiences auditory hallucinatio
d d d d d d d d d d d d
ns. The client appears to be listening to someone who isn’t visible. Hegestures, shouts an
d d d d d d d d d d d d d d d
grily, and stops shouting in mid-
d d d d d
sentence. Which nursing intervention is the most appropriate?
d d d d d d d
A. Approach the client and touch him to get his attention.
d d d d d d d d d d
B. Encourage the client to go to his room where he’ll experience fewerd
d d d d d d d d d d d d d
istractions.
C. Acknowledge that the client is hearing voices but make it clear thatt
d d d d d d d d d d d d d
he nurse doesn’t hear these voices.
d d d d d
D. Ask the client to describe what the voices are saying.
d d d d d d d d d d
d d d d d
TRIC NURSING EXAM 2026: 75 QUESTIONS WITH 100% COR
d d d d d d d d
RECT ANSWERS AND RATIONALES. TOP PRIORITY QUESTI
d d d d d d
ONS (VERIFIED) d
dA psychotic client reports to the evening nurse that the day nurse put somethings
d d d d d d d d d d d d d d
uspicious in his water with his medication. The nurse replies, “You’re worried abou
d d d d d d d d d d d d
t your medication?” The nurse’s communication is:
d d d d d d
o A. An example of presenting reality
d d d d d
o B. Reinforcing the client’s delusions
d d d d
o C. Focusing on emotional content
d d d d
o D. A non-therapeutic technique called mind-reading
d d d d d
Incorrect
Correct Answer: C. Focusing on emotional content
d d d d d d
The nurse should help the client focus on the emotional content rather than delusi
d d d d d d d d d d d d d
onal material. Sometimes during a conversation, patients mention something part
d d d d d d d d d
icularly important. When this happens, nurses can focus on their statement, prom
d d d d d d d d d d d
pting patients to discuss it further. Patients don’t always have anobjective perspect
d d d d d d d d d d d d
ive on what is relevant to their case; as impartial observers, nurses can more easily
d d d d d d d d d d d d d d d
pick out the topics to focus on.
d d d d d d
Option A: Presenting reality isn’t helpful because it can lead to confronta
d d d d d d d d d d d
tion and disengagement. It’s frequently useful for nurses to summarize w
d d d d d d d d d d
hat patients have said after the fact. This demonstrates to patients that th
d d d d d d d d d d d d
e nurse was listening and allows the nurse to document conversations. E
d d d d d d d d d d d
nding a summary with a phrase like “Does that sound correct?” gives pati
d d d d d d d d d d d d
ents explicit permission to make corrections if they’renecessary.
d d d d d d d d
Option B: Agreeing with the client and supporting his beliefs are reinforcin
d d d d d d d d d d d
g delusions. Patients often ask nurses for advice about what theyshould do
d d d d d d d d d d d d d
about particular problems or in specific situations. Nurses can ask patients
d d d d d d d d d d d
what they think they should do, which encourages patients tobe accountab
d d d d d d d d d d d
le for their own actions and helps them come up with solutions themselves.
d d d d d d d d d d d d
Option D: Mind reading isn’t therapeutic. Similar to active listening, askingp
d d d d d d d d d d d
atients for clarification when they say something confusing or ambiguous
d d d d d d d d d
, is important. Saying something like “I’m not sure I understand. Can youexpla
d d d d d d d d d d d d
in it to me?” helps nurses ensure they understand what’s actually being said
d d d d d d d d d d d d d
and can help patients process their ideas more thoroughly
d d d d d d d d
1. 2. Question
d
A client is admitted to the inpatient unit of the mental health center with adi
d d d d d d d d d d d d d d d
agnosis of paranoid schizophrenia. He’s shouting that the government ofFra
d d d d d d d d d d
nce is trying to assassinate him. Which of the following responses
d d d d d d d d d d
is most appropriate?
d d
A. “I think you’re wrong. France is a friendly country and an ally of the UnitedS
d d d d d d d d d d d d d d d d
tates. Their government wouldn’t try to kill you.”
d d d d d d d
B. “I find it hard to believe that a foreign government or anyone else ist
d d d d d d d d d d d d d d d
rying to hurt you. You must feel frightened by this.”
d d d d d d d d d
C. “You’re wrong. Nobody is trying to kill you.”
d d d d d d d d
D. “A foreign government is trying to kill you? Please tell me more about it.”
d d d d d d d d d d d d d d
Incorrect
Correct Answer: B. “I find it hard to believe that a foreign government oranyo
d d d d d d d d d d d d d d
ne else is trying to hurt you. You must feel frightened by this.” Responses sho
d d d d d d d d d d d d d d
uld focus on reality while acknowledging the client’s feelings.
d d d d d d d d
Sometimes during a conversation, patients mention something particularly import
d d d d d d d d
ant. When this happens, nurses can focus on their statement, prompting patients t
d d d d d d d d d d d d
o discuss it further. Patients don’t always have an objective perspectiveon what is re
d d d d d d d d d d d d d d
levant to their case; as impartial observers, nurses can more easily pick out the topi
d d d d d d d d d d d d d d
cs to focus on.
d d d
Option A: Arguing with the client or denying his belief isn’t therapeutic. Byu
d d d d d d d d d d d d d
sing nonverbal and verbal cues such as nodding and saying “I see,” nursesca
d d d d d d d d d d d d d
n encourage patients to continue talking. Active listening involves showing i
d d d d d d d d d d
nterest in what patients have to say, acknowledging that you’re listening an
d d d d d d d d d d d
d understanding, and engaging with them throughout the conversation. Nu
d d d d d d d d d
rses can offer general leads such as “What happened next?” to guide the co
d d d d d d d d d d d d d
nversation or propel it forward. d d d d
, Option C: Arguing can also inhibit development of a trusting relationship. C
d d d d d d d d d d d
ontinuing to talk about delusions may aggravate the psychosis. It’s frequent
d d d d d d d d d d
ly useful for nurses to summarize what patients have said after thefact. This
d d d d d d d d d d d d d d
demonstrates to patients that the nurse was listening and allows the nurse td d d d d d d d d d d d
o document conversations. Ending a summary with a phrase like“Does that s
d d d d d d d d d d d d
ound correct?” gives patients explicit permission to make corrections if they
d d d d d d d d d d
’re necessary.
d
Option D: Asking the client if a foreign government is trying to kill him m
d d d d d d d d d d d d d d
ay increase his anxiety level and can reinforce his delusions. Voicing doubt
d d d d d d d d d d d
dcan be a gentler way to call attention to the incorrect or delusional
d d d d d d d d d d d d
2. 3. Question
d
A client receiving haloperidol (Haldol) complains of a stiff jaw and difficultyswallow
d d d d d d d d d d d d
ing. The nurse’s first action is to:
d d d d d d
A. Reassure the client and administer as needed lorazepam (Ativan) I.M.
d d d d d d d d d d
B. Administer as needed dose of benztropine (Cogentin) I.M. as ordered.
d d d d d d d d d d
C. Administer as needed dose of benztropine (Cogentin) by mouth aso
d d d d d d d d d d d
rdered.
D. Administer as needed dose of haloperidol (Haldol) by mouth.
d d d d d d d d d
Incorrect
Correct Answer: B. Administer as needed dose of benztropine (Cogentin)
d d d d d d d d d
I.M. as ordered.
d d
The client is most likely suffering from muscle rigidity due to haloperidol. I.M. benz
d d d d d d d d d d d d d
tropine should be administered to prevent asphyxia or aspiration. The extrapyrami
d d d d d d d d d d
dal symptoms are muscular weakness or rigidity, a generalized or localized tremor
d d d d d d d d d d d d
that may be characterized by the akinetic or agitation types ofmovements, respecti
d d d d d d d d d d d d
vely. Haloperidol overdose is also associated with ECG changes known as torsade
d d d d d d d d d d d d
de pointes, which may cause arrhythmia or cardiac arrest.
d d d d d d d d
Option A: Lorazepam treats anxiety, not extrapyramidal effects. Lorazepami
d d d d d d d d d
s a benzodiazepine medication developed by DJ Richards. It went on the ma
d d d d d d d d d d d d
rket in the United States in 1977. Lorazepam has common use as the
d d d d d d d d d d d d
, sedative and anxiolytic of choice in the inpatient setting owing to its fast (1t
d d d d d d d d d d d d d d
o 3 minute) onset of action when administered intravenously. Lorazepam is
d d d d d d d d d d d
also one of the few sedative-
d d d d d
hypnotics with a relatively clean side effect profile. Lorazepam is FDA appro
d d d d d d d d d d d
ved for short- d d
term (4 months) relief of anxiety symptoms related to anxiety disorders, anx
d d d d d d d d d d d
iety-
associated insomnia, anesthesia premedication in adults to relieve anxiety,
d d d d d d d d d
or to produce sedation/amnesia, and treatment of status epilepticus.
d d d d d d d d
Option C: Benztropine belongs to the synthetic class of muscarinic receptor
d d d d d d d d d d
dantagonists (anticholinergic drugs). Thus, it has a structure similar to that of
d d d d d d d d d d d d
diphenhydramine and atropine. However, it is long- d d d d d d
acting so thatits administration can be with less frequency than diphenhydr
d d d d d d d d d d d
amine. It alsoinduces less CNS stimulation effect compared to that of trihexy
d d d d d d d d d d d d
phenidyl, making it a preferable drug of choice for geriatric patients.
d d d d d d d d d d
Option D: Another dose of haloperidol would increase the severity of ther
d d d d d d d d d d d d
eaction. Since there is no specific antidote, supportive treatment is the mai
d d d d d d d d d d d
nstay of haloperidol toxicity. If a patient develops signs and symptomsof to
d d d d d d d d d d d d
xicities, the clinician should consider gastric lavage or induction of emesis
d d d d d d d d d d d
as soon as possible, followed by the administration of activated charcoal.
d d d d d d d d d d d
Maintenance of Airway, Breathing, and circulation are the most important f d d d d d d d d d d
actors for survival. d d
3. 4. Question
d
The nurse is caring for a client with schizophrenia who experiences auditory hallucinatio
d d d d d d d d d d d d
ns. The client appears to be listening to someone who isn’t visible. Hegestures, shouts an
d d d d d d d d d d d d d d d
grily, and stops shouting in mid-
d d d d d
sentence. Which nursing intervention is the most appropriate?
d d d d d d d
A. Approach the client and touch him to get his attention.
d d d d d d d d d d
B. Encourage the client to go to his room where he’ll experience fewerd
d d d d d d d d d d d d d
istractions.
C. Acknowledge that the client is hearing voices but make it clear thatt
d d d d d d d d d d d d d
he nurse doesn’t hear these voices.
d d d d d
D. Ask the client to describe what the voices are saying.
d d d d d d d d d d
