BSN3A Mental Health Nursing Exam Practice Questions & [Verified Answers], Plus Explained Rationales |
2026 Latest Update | Instant Download PDF
Questions 1–200
1. A client with major depressive disorder tells the nurse, "I'm a failure. I can't do anything right."
Which response is most therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really down about yourself right now."
C) "Let's list your recent accomplishments."
D) "Why do you feel like a failure?"
Answer B: "It sounds like you're feeling really down about yourself right now."
Rationale: Reflection validates the client's feeling without arguing or false reassurance; avoid "why"
questions.
2. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is the
priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate safety interventions.
3. A client with bipolar disorder in a manic episode is pacing rapidly, talking loudly, and making
grandiose statements. Which intervention is most appropriate?
A) Place the client in seclusion
B) Provide a quiet, low-stimulation environment
C) Confront the client about the grandiose statements
D) Assign a group of staff to restrain the client
Answer B: Provide a quiet, low-stimulation environment
,Rationale: Reducing environmental stimuli helps decrease agitation and manic behavior.
4. A client with borderline personality disorder has a history of self-mutilation (cutting). The client
says, "I want to cut myself." Which intervention should the nurse implement first?
A) Restrict the client to her room
B) Assess the intensity of the urge and review the safety plan
C) Apply soft wrist restraints
D) Administer a PRN sedative
Answer B: Assess the intensity of the urge and review the safety plan
Rationale: First, assess the risk and use de-escalation, including reviewing alternative coping strategies.
5. A client with alcohol use disorder is admitted for detoxification. The last drink was 8 hours ago.
Which assessment finding is most likely first?
A) Seizure activity
B) Anxiety, tremors, and diaphoresis
C) Delirium tremens (DTs)
D) Hallucinations
Answer B: Anxiety, tremors, and diaphoresis
Rationale: Early alcohol withdrawal (6-12 hours) includes tremors, anxiety, and tachycardia.
6. A client on a psychiatric unit tells the nurse, "I'm going to kill myself tonight." What is the nurse's
priority action?
A) Document the statement and tell the next shift
B) Place the client on one-to-one observation and notify the provider
C) Tell the client that this behavior will not be tolerated
D) Remove all sharp objects from the unit
Answer B: Place the client on one-to-one observation and notify the provider
Rationale: Immediate safety interventions include constant observation, removing means, and provider
notification.
7. A client with social anxiety disorder is prescribed paroxetine (SSRI). Which statement indicates
understanding?
,A) "I should feel better within 24 hours."
B) "It may take 4-6 weeks for the full effect."
C) "I can stop the medication once I feel less anxious."
D) "This medication is addictive like Xanax."
Answer B: "It may take 4-6 weeks for the full effect."
Rationale: SSRIs have delayed onset; full therapeutic effect takes several weeks.
8. A client with schizophrenia has been taking haloperidol for 2 weeks and now presents with a stiff
neck, fever, and confusion. Which condition does the nurse suspect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Serotonin syndrome
Answer B: Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, altered mental status, and autonomic instability.
9. A client with major depressive disorder is started on fluoxetine. The client says, "I feel even more
tired and nauseous now." Which response is most appropriate?
A) "The medication is not working; we need to switch it."
B) "These side effects often improve after the first week or two. Try taking it with food."
C) "You should stop taking it immediately."
D) "That means the medication is not right for you."
Answer B: "These side effects often improve after the first week or two. Try taking it with food."
Rationale: Early side effects (nausea, fatigue) are common and often transient; encourage adherence.
10. A client with bipolar disorder is taking lithium. The client reports hand tremors and increased
thirst. What should the nurse do first?
A) Hold the next dose of lithium
B) Check the client's lithium level
C) Administer a beta-blocker for tremors
D) Increase the client's fluid intake
Answer B: Check the client's lithium level
Rationale: Fine tremor and polydipsia can occur at therapeutic levels but may also indicate early toxicity.
, 11. A client with obsessive-compulsive disorder (OCD) spends 2 hours washing hands daily. Which
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 nursing intervention is most appropriate?
j0 j0 j0 j0
A) Punish the behavior by taking away privileges
j0 j0 j0 j0 j0 j0 j0
B) Allow time for the ritual initially, then gradually set limits
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
C) Force the client to stop the behavior immediately
j0 j0 j0 j0 j0 j0 j0 j0
D) Distract the client every time they start washing
j0 j0 j0 j0 j0 j0 j0 j0
Answer B: Allow time for the ritual initially, then gradually set limits
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
Rationale: Rituals should be gradually decreased (behavioral modification) to avoid anxiety escalation.
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
12. A client with post-traumatic stress disorder (PTSD) has frequent nightmares about a combat
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 event. Which class of medication is often first-line?
j0 j0 j0 j0 j0 j0 j0
A) Benzodiazepines
j0
B) SSRIs (sertraline, paroxetine)
j0 j0 j0
C) Antipsychotics
j0
D) Beta-blockers
j0
Answer B: SSRIs (sertraline, paroxetine)
j0 j0 j0 j0
Rationale: SSRIs are first-line pharmacotherapy for PTSD to reduce core symptoms.
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
13. A client with alcohol use disorder is prescribed disulfiram. Which instruction is most
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 important?
A) "Take the medication only when you feel like drinking."
j0 j0 j0 j0 j0 j0 j0 j0 j0
B) "Avoid all alcohol, including mouthwash and cooking wine."
j0 j0 j0 j0 j0 j0 j0 j0
C) "You may drink in small amounts without a reaction."
j0 j0 j0 j0 j0 j0 j0 j0 j0
D) "Take the medication on an empty stomach."
j0 j0 j0 j0 j0 j0 j0
Answer B: "Avoid all alcohol, including mouthwash and cooking wine."
j0 j0 j0 j0 j0 j0 j0 j0 j0
Rationale: Disulfiram causes a severe reaction with any alcohol ingestion; hidden sources must be
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 avoided.
14. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 the priority nursing action?
j0 j0 j0
A) Ask the client what the voices are saying in detail
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
2026 Latest Update | Instant Download PDF
Questions 1–200
1. A client with major depressive disorder tells the nurse, "I'm a failure. I can't do anything right."
Which response is most therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really down about yourself right now."
C) "Let's list your recent accomplishments."
D) "Why do you feel like a failure?"
Answer B: "It sounds like you're feeling really down about yourself right now."
Rationale: Reflection validates the client's feeling without arguing or false reassurance; avoid "why"
questions.
2. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is the
priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate safety interventions.
3. A client with bipolar disorder in a manic episode is pacing rapidly, talking loudly, and making
grandiose statements. Which intervention is most appropriate?
A) Place the client in seclusion
B) Provide a quiet, low-stimulation environment
C) Confront the client about the grandiose statements
D) Assign a group of staff to restrain the client
Answer B: Provide a quiet, low-stimulation environment
,Rationale: Reducing environmental stimuli helps decrease agitation and manic behavior.
4. A client with borderline personality disorder has a history of self-mutilation (cutting). The client
says, "I want to cut myself." Which intervention should the nurse implement first?
A) Restrict the client to her room
B) Assess the intensity of the urge and review the safety plan
C) Apply soft wrist restraints
D) Administer a PRN sedative
Answer B: Assess the intensity of the urge and review the safety plan
Rationale: First, assess the risk and use de-escalation, including reviewing alternative coping strategies.
5. A client with alcohol use disorder is admitted for detoxification. The last drink was 8 hours ago.
Which assessment finding is most likely first?
A) Seizure activity
B) Anxiety, tremors, and diaphoresis
C) Delirium tremens (DTs)
D) Hallucinations
Answer B: Anxiety, tremors, and diaphoresis
Rationale: Early alcohol withdrawal (6-12 hours) includes tremors, anxiety, and tachycardia.
6. A client on a psychiatric unit tells the nurse, "I'm going to kill myself tonight." What is the nurse's
priority action?
A) Document the statement and tell the next shift
B) Place the client on one-to-one observation and notify the provider
C) Tell the client that this behavior will not be tolerated
D) Remove all sharp objects from the unit
Answer B: Place the client on one-to-one observation and notify the provider
Rationale: Immediate safety interventions include constant observation, removing means, and provider
notification.
7. A client with social anxiety disorder is prescribed paroxetine (SSRI). Which statement indicates
understanding?
,A) "I should feel better within 24 hours."
B) "It may take 4-6 weeks for the full effect."
C) "I can stop the medication once I feel less anxious."
D) "This medication is addictive like Xanax."
Answer B: "It may take 4-6 weeks for the full effect."
Rationale: SSRIs have delayed onset; full therapeutic effect takes several weeks.
8. A client with schizophrenia has been taking haloperidol for 2 weeks and now presents with a stiff
neck, fever, and confusion. Which condition does the nurse suspect?
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Serotonin syndrome
Answer B: Neuroleptic malignant syndrome (NMS)
Rationale: NMS presents with fever, rigidity, altered mental status, and autonomic instability.
9. A client with major depressive disorder is started on fluoxetine. The client says, "I feel even more
tired and nauseous now." Which response is most appropriate?
A) "The medication is not working; we need to switch it."
B) "These side effects often improve after the first week or two. Try taking it with food."
C) "You should stop taking it immediately."
D) "That means the medication is not right for you."
Answer B: "These side effects often improve after the first week or two. Try taking it with food."
Rationale: Early side effects (nausea, fatigue) are common and often transient; encourage adherence.
10. A client with bipolar disorder is taking lithium. The client reports hand tremors and increased
thirst. What should the nurse do first?
A) Hold the next dose of lithium
B) Check the client's lithium level
C) Administer a beta-blocker for tremors
D) Increase the client's fluid intake
Answer B: Check the client's lithium level
Rationale: Fine tremor and polydipsia can occur at therapeutic levels but may also indicate early toxicity.
, 11. A client with obsessive-compulsive disorder (OCD) spends 2 hours washing hands daily. Which
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 nursing intervention is most appropriate?
j0 j0 j0 j0
A) Punish the behavior by taking away privileges
j0 j0 j0 j0 j0 j0 j0
B) Allow time for the ritual initially, then gradually set limits
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
C) Force the client to stop the behavior immediately
j0 j0 j0 j0 j0 j0 j0 j0
D) Distract the client every time they start washing
j0 j0 j0 j0 j0 j0 j0 j0
Answer B: Allow time for the ritual initially, then gradually set limits
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
Rationale: Rituals should be gradually decreased (behavioral modification) to avoid anxiety escalation.
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
12. A client with post-traumatic stress disorder (PTSD) has frequent nightmares about a combat
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 event. Which class of medication is often first-line?
j0 j0 j0 j0 j0 j0 j0
A) Benzodiazepines
j0
B) SSRIs (sertraline, paroxetine)
j0 j0 j0
C) Antipsychotics
j0
D) Beta-blockers
j0
Answer B: SSRIs (sertraline, paroxetine)
j0 j0 j0 j0
Rationale: SSRIs are first-line pharmacotherapy for PTSD to reduce core symptoms.
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
13. A client with alcohol use disorder is prescribed disulfiram. Which instruction is most
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 important?
A) "Take the medication only when you feel like drinking."
j0 j0 j0 j0 j0 j0 j0 j0 j0
B) "Avoid all alcohol, including mouthwash and cooking wine."
j0 j0 j0 j0 j0 j0 j0 j0
C) "You may drink in small amounts without a reaction."
j0 j0 j0 j0 j0 j0 j0 j0 j0
D) "Take the medication on an empty stomach."
j0 j0 j0 j0 j0 j0 j0
Answer B: "Avoid all alcohol, including mouthwash and cooking wine."
j0 j0 j0 j0 j0 j0 j0 j0 j0
Rationale: Disulfiram causes a severe reaction with any alcohol ingestion; hidden sources must be
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 avoided.
14. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
j0 the priority nursing action?
j0 j0 j0
A) Ask the client what the voices are saying in detail
j0 j0 j0 j0 j0 j0 j0 j0 j0 j0
