,NUR 227 Clinical Judgment Exam Psychiatric Nursing Questions And
Answers 2026/2027 Jersey College
Q1. A patient admitted after a relationship breakup says, “I gave my
dog away and wrote letters to everyone. Tonight will be the last
night.” Which action has priority?
A) Initiate immediate suicide precautions and assess plan, intent, and access
to means
B) Encourage participation in group therapy
C) Ask the patient to write about positive memories
D) Allow privacy to process the breakup
Correct Answer: A) Initiate immediate suicide precautions and assess plan,
intent, and access to means
Rationale: Preparatory behaviors and a statement indicating imminent
death suggest acute suicide risk requiring immediate protection.
Q2. A patient with schizophrenia says, “The voice says my brother is
possessed and I have to stop him.” Which assessment is most
important?
A) Whether the patient likes the brother
B) Whether the patient intends to act on the command and has access to the
brother or a weapon
C) How frequently the patient watches television
D) Whether the patient slept well last night
Correct Answer: B) Whether the patient intends to act on the command and
has access to the brother or a weapon
Rationale: Harm-related command hallucinations require assessment of
intent, means, opportunity, and the safety of the potential target.
Q3. A patient is pacing rapidly, glaring at staff, clenching fists, and
speaking progressively louder. Which interpretation is most
appropriate?
A) The patient is becoming less anxious
B) The behavior represents normal frustration
C) The patient is showing escalating risk for aggression
D) The patient should be left completely alone
Correct Answer: C) The patient is showing escalating risk for aggression
,Rationale: Increasing motor activity, threatening posture, and escalating
verbal intensity are warning cues for possible violence.
Q4. Verbal de-escalation has failed, and a patient begins swinging a
chair toward another patient. What is the priority?
A) Continue discussing feelings
B) Ask peers to calm the patient
C) Wait for the patient to tire
D) Protect everyone from immediate harm using the least restrictive
effective intervention
Correct Answer: D) Protect everyone from immediate harm using the least
restrictive effective intervention
Rationale: Active violence requires immediate safety intervention while still
using the least restrictive method capable of controlling the danger.
Q5. A suicidal patient who had been withdrawn all week suddenly
appears cheerful and asks how soon discharge can occur. What
should the nurse do?
A) Reassess suicide risk before interpreting the mood change as
improvement
B) Reduce observation immediately
C) Begin discharge teaching
D) Assume the antidepressant has fully worked
Correct Answer: A) Reassess suicide risk before interpreting the mood
change as improvement
Rationale: Sudden calmness can occur after a suicidal person decides to act
and may indicate increased rather than decreased risk.
Q6. Which patient requires assessment first?
A) A patient with obsessive handwashing
B) A patient saying, “I have a gun in my car and I'm going to shoot myself
when I leave.”
C) A patient with moderate anxiety awaiting medication
D) A patient with chronic auditory hallucinations that are noncommanding
Correct Answer: B) A patient saying, “I have a gun in my car and I'm going to
shoot myself when I leave.”
, Rationale: Specific suicidal intent combined with immediate access to a
highly lethal method represents an acute emergency.
Q7. A patient placed in restraints for violent behavior reports numb
fingers. Which action is most appropriate?
A) Reassure the patient that numbness is expected
B) Wait until the next scheduled assessment
C) Assess circulation and restraint placement immediately
D) Tighten the restraints to prevent movement
Correct Answer: C) Assess circulation and restraint placement immediately
Rationale: Numbness can indicate neurovascular compromise and requires
immediate assessment.
Q8. A previously aggressive patient in seclusion is now calm, follows
directions, and no longer threatens anyone. Which action is
appropriate?
A) Continue seclusion until the next shift
B) Require an apology before release
C) Continue seclusion as a consequence
D) Discontinue the restrictive intervention as soon as safety criteria are met
Correct Answer: D) Discontinue the restrictive intervention as soon as safety
criteria are met
Rationale: Seclusion and restraints should end when the immediate danger
requiring them has resolved.
Q9. A patient says, “Everyone would be better off without me.”
Which response is most appropriate?
A) “Are you thinking about killing yourself?”
B) “You shouldn't think that way.”
C) “Your family needs you.”
D) “Try to focus on something positive.”
Correct Answer: A) “Are you thinking about killing yourself?”
Rationale: Direct questioning is appropriate when statements suggest
possible suicide risk.
Q10. Which finding most strongly indicates that a violence-
prevention intervention has been effective?
Answers 2026/2027 Jersey College
Q1. A patient admitted after a relationship breakup says, “I gave my
dog away and wrote letters to everyone. Tonight will be the last
night.” Which action has priority?
A) Initiate immediate suicide precautions and assess plan, intent, and access
to means
B) Encourage participation in group therapy
C) Ask the patient to write about positive memories
D) Allow privacy to process the breakup
Correct Answer: A) Initiate immediate suicide precautions and assess plan,
intent, and access to means
Rationale: Preparatory behaviors and a statement indicating imminent
death suggest acute suicide risk requiring immediate protection.
Q2. A patient with schizophrenia says, “The voice says my brother is
possessed and I have to stop him.” Which assessment is most
important?
A) Whether the patient likes the brother
B) Whether the patient intends to act on the command and has access to the
brother or a weapon
C) How frequently the patient watches television
D) Whether the patient slept well last night
Correct Answer: B) Whether the patient intends to act on the command and
has access to the brother or a weapon
Rationale: Harm-related command hallucinations require assessment of
intent, means, opportunity, and the safety of the potential target.
Q3. A patient is pacing rapidly, glaring at staff, clenching fists, and
speaking progressively louder. Which interpretation is most
appropriate?
A) The patient is becoming less anxious
B) The behavior represents normal frustration
C) The patient is showing escalating risk for aggression
D) The patient should be left completely alone
Correct Answer: C) The patient is showing escalating risk for aggression
,Rationale: Increasing motor activity, threatening posture, and escalating
verbal intensity are warning cues for possible violence.
Q4. Verbal de-escalation has failed, and a patient begins swinging a
chair toward another patient. What is the priority?
A) Continue discussing feelings
B) Ask peers to calm the patient
C) Wait for the patient to tire
D) Protect everyone from immediate harm using the least restrictive
effective intervention
Correct Answer: D) Protect everyone from immediate harm using the least
restrictive effective intervention
Rationale: Active violence requires immediate safety intervention while still
using the least restrictive method capable of controlling the danger.
Q5. A suicidal patient who had been withdrawn all week suddenly
appears cheerful and asks how soon discharge can occur. What
should the nurse do?
A) Reassess suicide risk before interpreting the mood change as
improvement
B) Reduce observation immediately
C) Begin discharge teaching
D) Assume the antidepressant has fully worked
Correct Answer: A) Reassess suicide risk before interpreting the mood
change as improvement
Rationale: Sudden calmness can occur after a suicidal person decides to act
and may indicate increased rather than decreased risk.
Q6. Which patient requires assessment first?
A) A patient with obsessive handwashing
B) A patient saying, “I have a gun in my car and I'm going to shoot myself
when I leave.”
C) A patient with moderate anxiety awaiting medication
D) A patient with chronic auditory hallucinations that are noncommanding
Correct Answer: B) A patient saying, “I have a gun in my car and I'm going to
shoot myself when I leave.”
, Rationale: Specific suicidal intent combined with immediate access to a
highly lethal method represents an acute emergency.
Q7. A patient placed in restraints for violent behavior reports numb
fingers. Which action is most appropriate?
A) Reassure the patient that numbness is expected
B) Wait until the next scheduled assessment
C) Assess circulation and restraint placement immediately
D) Tighten the restraints to prevent movement
Correct Answer: C) Assess circulation and restraint placement immediately
Rationale: Numbness can indicate neurovascular compromise and requires
immediate assessment.
Q8. A previously aggressive patient in seclusion is now calm, follows
directions, and no longer threatens anyone. Which action is
appropriate?
A) Continue seclusion until the next shift
B) Require an apology before release
C) Continue seclusion as a consequence
D) Discontinue the restrictive intervention as soon as safety criteria are met
Correct Answer: D) Discontinue the restrictive intervention as soon as safety
criteria are met
Rationale: Seclusion and restraints should end when the immediate danger
requiring them has resolved.
Q9. A patient says, “Everyone would be better off without me.”
Which response is most appropriate?
A) “Are you thinking about killing yourself?”
B) “You shouldn't think that way.”
C) “Your family needs you.”
D) “Try to focus on something positive.”
Correct Answer: A) “Are you thinking about killing yourself?”
Rationale: Direct questioning is appropriate when statements suggest
possible suicide risk.
Q10. Which finding most strongly indicates that a violence-
prevention intervention has been effective?
