NCLEX RN Mood Disorders Practice
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
Question 1
A client with major depressive disorder reports, “I feel hopeless, and everyone
would be better off without me.” What is the nurse’s priority response?
A. “You should focus on the positive things in your life.”
B. “Why do you think your family would be better off without you?”
C. “Are you thinking about killing yourself?”
D. “Let’s discuss activities that usually make you happy.”
Answer: C. “Are you thinking about killing yourself?”
Rationale: Directly assessing suicidal thoughts is the priority when a client
expresses hopelessness or worthlessness. Asking about suicide does not
increase suicidal behavior and allows the nurse to determine immediate risk
and initiate safety measures.
Question 2
Which finding is most characteristic of a manic episode?
A. Social withdrawal
B. Decreased energy
C. Increased need for sleep
D. Elevated mood and decreased need for sleep
Answer: D. Elevated mood and decreased need for sleep
,Rationale: Mania commonly includes elevated or irritable mood, increased
energy, pressured speech, racing thoughts, impulsivity, grandiosity, and
decreased need for sleep.
Question 3
A client taking lithium reports severe diarrhea, vomiting, coarse hand tremors,
and difficulty walking. What should the nurse do first?
A. Administer the next lithium dose with food.
B. Encourage the client to increase sodium restriction.
C. Hold lithium and notify the provider.
D. Reassure the client that these are expected effects.
Answer: C. Hold lithium and notify the provider.
Rationale: Severe gastrointestinal symptoms, coarse tremors, and ataxia
suggest lithium toxicity. Lithium should be withheld and the provider notified
immediately.
Question 4
Which statement by a client taking lithium indicates correct understanding of
the medication?
A. “I should drastically reduce my sodium intake.”
B. “I should maintain consistent fluid and sodium intake.”
C. “I can stop the medication when I feel better.”
D. “I should double my dose if I miss one.”
Answer: B. “I should maintain consistent fluid and sodium intake.”
Rationale: Sodium and fluid balance affect lithium levels. Consistent dietary
sodium and adequate hydration help prevent fluctuations and toxicity.
Question 5
,A client with bipolar disorder is experiencing acute mania. Which intervention
is most appropriate?
A. Provide a stimulating group environment.
B. Encourage lengthy discussions about feelings.
C. Reduce environmental stimuli.
D. Allow unrestricted activity.
Answer: C. Reduce environmental stimuli.
Rationale: Clients experiencing mania are easily overstimulated. A calm, low-
stimulation environment helps reduce agitation and promotes safety.
Question 6
Which behavior is most concerning in a client with depression?
A. Sleeping 10 hours per night
B. Loss of appetite
C. Giving away personal belongings
D. Expressing feelings of sadness
Answer: C. Giving away personal belongings
Rationale: Giving away possessions can indicate preparation for suicide and
requires immediate suicide-risk assessment and safety interventions.
Question 7
A client taking an SSRI asks when improvement in depressive symptoms should
be expected. Which response is best?
A. “You should feel completely better after one dose.”
B. “Therapeutic effects may take several weeks.”
C. “The medication works only when you feel anxious.”
D. “You should stop taking it if you do not improve in 3 days.”
Answer: B. “Therapeutic effects may take several weeks.”
, Rationale: Antidepressants generally require several weeks to produce
significant improvement in depressive symptoms. Clients should continue
therapy as prescribed unless adverse effects require intervention.
Question 8
Which finding in a client taking an antidepressant requires immediate
attention?
A. Mild nausea
B. Dry mouth
C. Suicidal thoughts
D. Mild headache
Answer: C. Suicidal thoughts
Rationale: Antidepressants can increase energy before mood improves,
particularly early in treatment, potentially increasing suicide risk. New or
worsening suicidal thoughts require immediate evaluation.
Question 9
A client taking sertraline develops agitation, sweating, diarrhea, fever,
hyperreflexia, and muscle rigidity. Which condition should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome can cause agitation, autonomic instability,
diarrhea, hyperreflexia, tremor, fever, and muscle rigidity. It can be life-
threatening and requires urgent intervention.
Question 10
Exam 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026
Question 1
A client with major depressive disorder reports, “I feel hopeless, and everyone
would be better off without me.” What is the nurse’s priority response?
A. “You should focus on the positive things in your life.”
B. “Why do you think your family would be better off without you?”
C. “Are you thinking about killing yourself?”
D. “Let’s discuss activities that usually make you happy.”
Answer: C. “Are you thinking about killing yourself?”
Rationale: Directly assessing suicidal thoughts is the priority when a client
expresses hopelessness or worthlessness. Asking about suicide does not
increase suicidal behavior and allows the nurse to determine immediate risk
and initiate safety measures.
Question 2
Which finding is most characteristic of a manic episode?
A. Social withdrawal
B. Decreased energy
C. Increased need for sleep
D. Elevated mood and decreased need for sleep
Answer: D. Elevated mood and decreased need for sleep
,Rationale: Mania commonly includes elevated or irritable mood, increased
energy, pressured speech, racing thoughts, impulsivity, grandiosity, and
decreased need for sleep.
Question 3
A client taking lithium reports severe diarrhea, vomiting, coarse hand tremors,
and difficulty walking. What should the nurse do first?
A. Administer the next lithium dose with food.
B. Encourage the client to increase sodium restriction.
C. Hold lithium and notify the provider.
D. Reassure the client that these are expected effects.
Answer: C. Hold lithium and notify the provider.
Rationale: Severe gastrointestinal symptoms, coarse tremors, and ataxia
suggest lithium toxicity. Lithium should be withheld and the provider notified
immediately.
Question 4
Which statement by a client taking lithium indicates correct understanding of
the medication?
A. “I should drastically reduce my sodium intake.”
B. “I should maintain consistent fluid and sodium intake.”
C. “I can stop the medication when I feel better.”
D. “I should double my dose if I miss one.”
Answer: B. “I should maintain consistent fluid and sodium intake.”
Rationale: Sodium and fluid balance affect lithium levels. Consistent dietary
sodium and adequate hydration help prevent fluctuations and toxicity.
Question 5
,A client with bipolar disorder is experiencing acute mania. Which intervention
is most appropriate?
A. Provide a stimulating group environment.
B. Encourage lengthy discussions about feelings.
C. Reduce environmental stimuli.
D. Allow unrestricted activity.
Answer: C. Reduce environmental stimuli.
Rationale: Clients experiencing mania are easily overstimulated. A calm, low-
stimulation environment helps reduce agitation and promotes safety.
Question 6
Which behavior is most concerning in a client with depression?
A. Sleeping 10 hours per night
B. Loss of appetite
C. Giving away personal belongings
D. Expressing feelings of sadness
Answer: C. Giving away personal belongings
Rationale: Giving away possessions can indicate preparation for suicide and
requires immediate suicide-risk assessment and safety interventions.
Question 7
A client taking an SSRI asks when improvement in depressive symptoms should
be expected. Which response is best?
A. “You should feel completely better after one dose.”
B. “Therapeutic effects may take several weeks.”
C. “The medication works only when you feel anxious.”
D. “You should stop taking it if you do not improve in 3 days.”
Answer: B. “Therapeutic effects may take several weeks.”
, Rationale: Antidepressants generally require several weeks to produce
significant improvement in depressive symptoms. Clients should continue
therapy as prescribed unless adverse effects require intervention.
Question 8
Which finding in a client taking an antidepressant requires immediate
attention?
A. Mild nausea
B. Dry mouth
C. Suicidal thoughts
D. Mild headache
Answer: C. Suicidal thoughts
Rationale: Antidepressants can increase energy before mood improves,
particularly early in treatment, potentially increasing suicide risk. New or
worsening suicidal thoughts require immediate evaluation.
Question 9
A client taking sertraline develops agitation, sweating, diarrhea, fever,
hyperreflexia, and muscle rigidity. Which condition should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome can cause agitation, autonomic instability,
diarrhea, hyperreflexia, tremor, fever, and muscle rigidity. It can be life-
threatening and requires urgent intervention.
Question 10
