PSYCHIATRIC-COMMUNITY MENTAL HEALTH NURSING (NUR
222/NUR222) FINAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains:
Foundations of Psychiatric-Mental Health Nursing
Therapeutic Communication and the Nurse-Client Relationship
Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders
Mood Disorders: Depressive and Bipolar
Schizophrenia Spectrum and Other Psychotic Disorders
Psychopharmacology and Somatic Therapies
Crisis Intervention, Suicide, and Anger Management
Legal and Ethical Issues in Psychiatric Nursing
Introduction
This examination assesses the nursing student's competency in
psychiatric-community mental health nursing practice. The test
evaluates therapeutic communication techniques, psychiatric
assessment skills, psychopharmacology knowledge, crisis
intervention, and legal-ethical principles. Questions are structured
as multiple-choice and scenario-based items requiring clinical
judgment, patient safety prioritization, and application of recovery-
oriented care. Emphasis is placed on real-world decision-making,
evidence-based interventions, and the nurse's role in promoting
mental health across diverse populations.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has generalized anxiety
disorder. Which statement by the client indicates the use of a
maladaptive defense mechanism?
,A. “I make a list of things to do when I feel overwhelmed.”
B. “I drink a glass of wine every night to calm down.”
C. “I talk to my friend when I am stressed.”
D. “I go for a walk when I feel anxious.”
🟢 B. “I drink a glass of wine every night to calm down.”
🔴 RATIONALE: Using alcohol to manage anxiety is a maladaptive
coping mechanism that can lead to substance use disorder. The
other options are healthy adaptive coping strategies .
2. A client with major depressive disorder says, “I am worthless.
Everyone would be better off without me.” Which response by
the nurse is most appropriate initially?
A. “You shouldn't say things like that.”
B. “Are you thinking about harming yourself?”
C. “Let's talk about why you feel that way.”
D. “I am sure your family loves you.”
🟢 B. “Are you thinking about harming yourself?”
🔴 RATIONALE: The priority is to assess for suicidal ideation.
Directly asking about self-harm is essential to ensure safety. The
other responses minimize the client's feelings or do not assess risk
.
3. A nurse is teaching a client about phenelzine. Which statement
indicates a need for further teaching?
A. “I will avoid aged cheese and red wine.”
B. “I can take over-the-counter cold medicine if needed.”
C. “I will report any severe headache to my provider.”
D. “I will not stop the medication abruptly.”
🟢 B. “I can take over-the-counter cold medicine if needed.”
,🔴 RATIONALE: MAOIs have dangerous interactions with
sympathomimetic amines found in many OTC cold medications,
which can cause hypertensive crisis. Clients must avoid these .
4. A client with schizophrenia is experiencing auditory
hallucinations. Which nursing intervention is most appropriate?
A. Tell the client the voices are not real.
B. Ask the client what the voices are saying.
C. Ignore the client when they are talking to themselves.
D. Restrict the client's privileges until the voices stop.
🟢 B. Ask the client what the voices are saying.
🔴 RATIONALE: Asking about the content of hallucinations helps
assess for command hallucinations (which may be dangerous) and
builds trust. Directly challenging the hallucination is not
therapeutic .
5. A nurse is assessing a client with anorexia nervosa. Which
finding requires immediate intervention?
A. Body mass index (BMI) of 17.5
B. Heart rate of 48 beats per minute
C. Reporting feeling “fat” despite being underweight
D. Eating only small amounts at meals
🟢 B. Heart rate of 48 beats per minute
🔴 RATIONALE: Bradycardia is a life-threatening complication of
anorexia nervosa due to severe malnutrition and electrolyte
imbalances. Immediate medical intervention is required .
6. A client with bipolar disorder is in the manic phase. Which
intervention should the nurse implement first?
, A. Encourage group participation
B. Provide a stimulating environment
C. Ensure adequate nutrition and hydration
D. Encourage competitive activities
🟢 C. Ensure adequate nutrition and hydration
🔴 RATIONALE: During mania, clients often neglect basic needs
due to increased activity and decreased attention to self-care.
Ensuring nutrition and hydration is a priority. Stimulating
environments and competitive activities can worsen mania.
7. A client taking lithium reports severe diarrhea, vomiting, coarse
hand tremors, and difficulty walking. What should the nurse
do?
A. Administer the next dose with food.
B. Encourage increased caffeine intake.
C. Hold the medication and notify the provider.
D. Tell the client these are expected effects.
🟢 C. Hold the medication and notify the provider.
🔴 RATIONALE: Severe gastrointestinal symptoms, coarse tremor,
and ataxia can indicate lithium toxicity. The medication should be
withheld and the client promptly evaluated .
8. A client with schizophrenia says, “The television is sending me
secret messages.” Which type of symptom is this?
A. Hallucination
B. Delusion of reference
C. Illusion
D. Thought broadcasting
🟢 B. Delusion of reference
222/NUR222) FINAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains:
Foundations of Psychiatric-Mental Health Nursing
Therapeutic Communication and the Nurse-Client Relationship
Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders
Mood Disorders: Depressive and Bipolar
Schizophrenia Spectrum and Other Psychotic Disorders
Psychopharmacology and Somatic Therapies
Crisis Intervention, Suicide, and Anger Management
Legal and Ethical Issues in Psychiatric Nursing
Introduction
This examination assesses the nursing student's competency in
psychiatric-community mental health nursing practice. The test
evaluates therapeutic communication techniques, psychiatric
assessment skills, psychopharmacology knowledge, crisis
intervention, and legal-ethical principles. Questions are structured
as multiple-choice and scenario-based items requiring clinical
judgment, patient safety prioritization, and application of recovery-
oriented care. Emphasis is placed on real-world decision-making,
evidence-based interventions, and the nurse's role in promoting
mental health across diverse populations.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has generalized anxiety
disorder. Which statement by the client indicates the use of a
maladaptive defense mechanism?
,A. “I make a list of things to do when I feel overwhelmed.”
B. “I drink a glass of wine every night to calm down.”
C. “I talk to my friend when I am stressed.”
D. “I go for a walk when I feel anxious.”
🟢 B. “I drink a glass of wine every night to calm down.”
🔴 RATIONALE: Using alcohol to manage anxiety is a maladaptive
coping mechanism that can lead to substance use disorder. The
other options are healthy adaptive coping strategies .
2. A client with major depressive disorder says, “I am worthless.
Everyone would be better off without me.” Which response by
the nurse is most appropriate initially?
A. “You shouldn't say things like that.”
B. “Are you thinking about harming yourself?”
C. “Let's talk about why you feel that way.”
D. “I am sure your family loves you.”
🟢 B. “Are you thinking about harming yourself?”
🔴 RATIONALE: The priority is to assess for suicidal ideation.
Directly asking about self-harm is essential to ensure safety. The
other responses minimize the client's feelings or do not assess risk
.
3. A nurse is teaching a client about phenelzine. Which statement
indicates a need for further teaching?
A. “I will avoid aged cheese and red wine.”
B. “I can take over-the-counter cold medicine if needed.”
C. “I will report any severe headache to my provider.”
D. “I will not stop the medication abruptly.”
🟢 B. “I can take over-the-counter cold medicine if needed.”
,🔴 RATIONALE: MAOIs have dangerous interactions with
sympathomimetic amines found in many OTC cold medications,
which can cause hypertensive crisis. Clients must avoid these .
4. A client with schizophrenia is experiencing auditory
hallucinations. Which nursing intervention is most appropriate?
A. Tell the client the voices are not real.
B. Ask the client what the voices are saying.
C. Ignore the client when they are talking to themselves.
D. Restrict the client's privileges until the voices stop.
🟢 B. Ask the client what the voices are saying.
🔴 RATIONALE: Asking about the content of hallucinations helps
assess for command hallucinations (which may be dangerous) and
builds trust. Directly challenging the hallucination is not
therapeutic .
5. A nurse is assessing a client with anorexia nervosa. Which
finding requires immediate intervention?
A. Body mass index (BMI) of 17.5
B. Heart rate of 48 beats per minute
C. Reporting feeling “fat” despite being underweight
D. Eating only small amounts at meals
🟢 B. Heart rate of 48 beats per minute
🔴 RATIONALE: Bradycardia is a life-threatening complication of
anorexia nervosa due to severe malnutrition and electrolyte
imbalances. Immediate medical intervention is required .
6. A client with bipolar disorder is in the manic phase. Which
intervention should the nurse implement first?
, A. Encourage group participation
B. Provide a stimulating environment
C. Ensure adequate nutrition and hydration
D. Encourage competitive activities
🟢 C. Ensure adequate nutrition and hydration
🔴 RATIONALE: During mania, clients often neglect basic needs
due to increased activity and decreased attention to self-care.
Ensuring nutrition and hydration is a priority. Stimulating
environments and competitive activities can worsen mania.
7. A client taking lithium reports severe diarrhea, vomiting, coarse
hand tremors, and difficulty walking. What should the nurse
do?
A. Administer the next dose with food.
B. Encourage increased caffeine intake.
C. Hold the medication and notify the provider.
D. Tell the client these are expected effects.
🟢 C. Hold the medication and notify the provider.
🔴 RATIONALE: Severe gastrointestinal symptoms, coarse tremor,
and ataxia can indicate lithium toxicity. The medication should be
withheld and the client promptly evaluated .
8. A client with schizophrenia says, “The television is sending me
secret messages.” Which type of symptom is this?
A. Hallucination
B. Delusion of reference
C. Illusion
D. Thought broadcasting
🟢 B. Delusion of reference
