Psychiatric Nursing: Contemporary Practice
8th Edition Mega Test Bank Bundle –
Complete Comprehensive Study Guide and
Practice Exam Questions with Detailed
Rationales for Nursing Students
A psychiatric nurse is interviewing a client who says, “Nobody understands what I
am going through.” Which response best demonstrates therapeutic
communication?
A. “You should try to think more positively.”
B. “Other people have experienced similar problems.”
C. “Can you tell me more about what you are experiencing?”
D. “Why do you believe nobody understands you?”
Answer: C. “Can you tell me more about what you are experiencing?”
Rationale: This open-ended response encourages the client to express feelings and
provides the nurse with more information without judging, minimizing, or
interpreting the client's experience.
A client admitted with severe depression states, “I don't think my life is worth
living anymore.” What should the nurse do first?
A. Encourage the client to participate in group activities.
B. Assess the client for suicidal thoughts, intent, and a plan.
C. Explain that depression is treatable.
D. Ask the client's family to provide reassurance.
,Answer: B. Assess the client for suicidal thoughts, intent, and a plan.
Rationale: Statements suggesting hopelessness or worthlessness require immediate
suicide risk assessment. The nurse should determine whether suicidal thoughts,
intent, access to means, or a specific plan are present and implement appropriate
safety precautions.
Which behavior is most consistent with a manic episode?
A. Decreased energy and excessive sleeping
B. Persistent fear of social situations
C. Elevated mood, increased activity, and decreased need for sleep
D. Repeated intrusive thoughts followed by ritualistic behavior
Answer: C. Elevated mood, increased activity, and decreased need for sleep.
Rationale: Mania is characterized by a distinct period of abnormally elevated,
expansive, or irritable mood accompanied by increased energy or activity. Other
features may include pressured speech, racing thoughts, impulsivity, and reduced
need for sleep.
A client experiencing auditory hallucinations tells the nurse, “The voices keep
telling me that I am worthless.” Which response is most appropriate?
A. “The voices are real, and you should listen carefully.”
B. “I do not hear the voices, but I understand that they are distressing to you.”
C. “You need to stop thinking about the voices.”
D. “Those voices are imaginary, so you should ignore them.”
Answer: B. “I do not hear the voices, but I understand that they are distressing to
you.”
Rationale: The nurse acknowledges the client's emotional experience without
reinforcing the hallucination. This response communicates empathy and maintains
a reality-based approach.
,Which finding is most characteristic of obsessive-compulsive disorder (OCD)?
A. Recurrent episodes of elevated mood
B. Intrusive thoughts and repetitive behaviors intended to reduce anxiety
C. Persistent memory loss following a traumatic event
D. Fear of being separated from familiar objects
Answer: B. Intrusive thoughts and repetitive behaviors intended to reduce anxiety.
Rationale: OCD involves obsessions, compulsions, or both. Obsessions are
unwanted, intrusive thoughts or urges, while compulsions are repetitive behaviors
or mental acts performed to reduce distress or prevent a feared outcome.
A nurse is caring for a client experiencing a panic attack. Which intervention is
most appropriate initially?
A. Provide detailed explanations about the causes of anxiety.
B. Leave the client alone to encourage independence.
C. Remain with the client and communicate using short, simple statements.
D. Encourage the client to make important decisions.
Answer: C. Remain with the client and communicate using short, simple
statements.
Rationale: During severe anxiety or panic, the client's ability to process complex
information may be impaired. A calm presence, reduced environmental
stimulation, and simple directions promote safety and help the client regain
control.
Which statement by a client taking lithium indicates a need for further education?
A. “I will attend appointments for blood tests.”
B. “I will maintain a consistent intake of salt and fluids.”
C. “I will contact my healthcare provider if I develop severe diarrhea or vomiting.”
, D. “I will drastically reduce my salt intake to make the medication work better.”
Answer: D. “I will drastically reduce my salt intake to make the medication work
better.”
Rationale: Sodium depletion and dehydration can increase lithium concentrations
and the risk of toxicity. Clients should maintain consistent sodium and fluid intake
and seek medical advice during significant illness, vomiting, or diarrhea. Lithium
levels and kidney and thyroid function require appropriate monitoring.
A client taking an antipsychotic develops a high fever, severe muscle rigidity,
confusion, and unstable blood pressure. Which complication should the nurse
suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Mild anticholinergic effects
D. Tardive dyskinesia
Answer: B. Neuroleptic malignant syndrome.
Rationale: Neuroleptic malignant syndrome is a potentially life-threatening
reaction associated with antipsychotic medications. Findings include hyperthermia,
severe rigidity, altered mental status, and autonomic instability. The nurse should
initiate emergency evaluation and notify the appropriate clinical team immediately.
Which nursing intervention is most appropriate for a client experiencing post-
traumatic stress disorder (PTSD)?
A. Require the client to describe the traumatic event in detail during the first
interview.
B. Avoid discussing safety because it may increase anxiety.
C. Establish trust, promote safety, and allow the client to control the pace of
discussion.
D. Discourage the client from identifying emotional triggers.
8th Edition Mega Test Bank Bundle –
Complete Comprehensive Study Guide and
Practice Exam Questions with Detailed
Rationales for Nursing Students
A psychiatric nurse is interviewing a client who says, “Nobody understands what I
am going through.” Which response best demonstrates therapeutic
communication?
A. “You should try to think more positively.”
B. “Other people have experienced similar problems.”
C. “Can you tell me more about what you are experiencing?”
D. “Why do you believe nobody understands you?”
Answer: C. “Can you tell me more about what you are experiencing?”
Rationale: This open-ended response encourages the client to express feelings and
provides the nurse with more information without judging, minimizing, or
interpreting the client's experience.
A client admitted with severe depression states, “I don't think my life is worth
living anymore.” What should the nurse do first?
A. Encourage the client to participate in group activities.
B. Assess the client for suicidal thoughts, intent, and a plan.
C. Explain that depression is treatable.
D. Ask the client's family to provide reassurance.
,Answer: B. Assess the client for suicidal thoughts, intent, and a plan.
Rationale: Statements suggesting hopelessness or worthlessness require immediate
suicide risk assessment. The nurse should determine whether suicidal thoughts,
intent, access to means, or a specific plan are present and implement appropriate
safety precautions.
Which behavior is most consistent with a manic episode?
A. Decreased energy and excessive sleeping
B. Persistent fear of social situations
C. Elevated mood, increased activity, and decreased need for sleep
D. Repeated intrusive thoughts followed by ritualistic behavior
Answer: C. Elevated mood, increased activity, and decreased need for sleep.
Rationale: Mania is characterized by a distinct period of abnormally elevated,
expansive, or irritable mood accompanied by increased energy or activity. Other
features may include pressured speech, racing thoughts, impulsivity, and reduced
need for sleep.
A client experiencing auditory hallucinations tells the nurse, “The voices keep
telling me that I am worthless.” Which response is most appropriate?
A. “The voices are real, and you should listen carefully.”
B. “I do not hear the voices, but I understand that they are distressing to you.”
C. “You need to stop thinking about the voices.”
D. “Those voices are imaginary, so you should ignore them.”
Answer: B. “I do not hear the voices, but I understand that they are distressing to
you.”
Rationale: The nurse acknowledges the client's emotional experience without
reinforcing the hallucination. This response communicates empathy and maintains
a reality-based approach.
,Which finding is most characteristic of obsessive-compulsive disorder (OCD)?
A. Recurrent episodes of elevated mood
B. Intrusive thoughts and repetitive behaviors intended to reduce anxiety
C. Persistent memory loss following a traumatic event
D. Fear of being separated from familiar objects
Answer: B. Intrusive thoughts and repetitive behaviors intended to reduce anxiety.
Rationale: OCD involves obsessions, compulsions, or both. Obsessions are
unwanted, intrusive thoughts or urges, while compulsions are repetitive behaviors
or mental acts performed to reduce distress or prevent a feared outcome.
A nurse is caring for a client experiencing a panic attack. Which intervention is
most appropriate initially?
A. Provide detailed explanations about the causes of anxiety.
B. Leave the client alone to encourage independence.
C. Remain with the client and communicate using short, simple statements.
D. Encourage the client to make important decisions.
Answer: C. Remain with the client and communicate using short, simple
statements.
Rationale: During severe anxiety or panic, the client's ability to process complex
information may be impaired. A calm presence, reduced environmental
stimulation, and simple directions promote safety and help the client regain
control.
Which statement by a client taking lithium indicates a need for further education?
A. “I will attend appointments for blood tests.”
B. “I will maintain a consistent intake of salt and fluids.”
C. “I will contact my healthcare provider if I develop severe diarrhea or vomiting.”
, D. “I will drastically reduce my salt intake to make the medication work better.”
Answer: D. “I will drastically reduce my salt intake to make the medication work
better.”
Rationale: Sodium depletion and dehydration can increase lithium concentrations
and the risk of toxicity. Clients should maintain consistent sodium and fluid intake
and seek medical advice during significant illness, vomiting, or diarrhea. Lithium
levels and kidney and thyroid function require appropriate monitoring.
A client taking an antipsychotic develops a high fever, severe muscle rigidity,
confusion, and unstable blood pressure. Which complication should the nurse
suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Mild anticholinergic effects
D. Tardive dyskinesia
Answer: B. Neuroleptic malignant syndrome.
Rationale: Neuroleptic malignant syndrome is a potentially life-threatening
reaction associated with antipsychotic medications. Findings include hyperthermia,
severe rigidity, altered mental status, and autonomic instability. The nurse should
initiate emergency evaluation and notify the appropriate clinical team immediately.
Which nursing intervention is most appropriate for a client experiencing post-
traumatic stress disorder (PTSD)?
A. Require the client to describe the traumatic event in detail during the first
interview.
B. Avoid discussing safety because it may increase anxiety.
C. Establish trust, promote safety, and allow the client to control the pace of
discussion.
D. Discourage the client from identifying emotional triggers.
