NCLEX PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 2025| 50 ACTUAL NCLEX EXAM QUESTIONS
AND CORRECT ANSWERS GRADED A+
Flumazenil (Romazicon) has been ordered for a male patient who has overdosed on oxazepam (Serax).
Before administering the medication, the nurse should be prepared for which common adverse effect?
A. Seizures
B. Shivering
C. Anxiety
D. Chest pain - RIGHT ANS✔✔ A. Seizures
Rationale: Seizures are the most common adverse effect of using flumazenil to reverse benzodiazepine
overdose. The effect is magnified if the patient has a combined tricyclic antidepressant and
benzodiazepine overdose. Less common adverse effects includer shivering, anxiety, and chest pain.
The nurse is caring for a patient diagnosed with bulimia. The most appropriate initial goal for a patient
diagnosed with bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day - RIGHT ANS✔✔ C. Identify anxiety-causing situations
Rationale: Bulimic behavior is generally a maladaptive coping response to stress and underlying issues.
The patient must identify anxiety-causing situation as that stimulate the bulimic behavior and then
learn new ways of coping with the anxiety. Controlling shopping for large amounts of food isn't a goal
early in treatment. Managing eating impulses and replacing them with adaptive coping mechanisms
can be integrated into the plan of care after initially addressing stress and underlying issues. Eating
three meals per day isn't a realistic goal early in treatment.
A female patient who's at high risk for suicide needs close supervision. To best ensure the patient's
safety, the nurse should:
A. Check on the patient frequently at irregular intervals throughout the night
B. Assure the patient that the nurse will hold in confidence anything the patient says
C. Repeatedly discuss previous suicide attempts with the patient
,D. Disregard decreased communication by the patient because this is common in suicidal patients -
RIGHT ANS✔✔ A. Check on the patient frequently at irregular intervals throughout the night
Rationale: Checking the patient frequently but at irregular intervals prevents the patient from predicting
when observation will take place and altering behavior in a misleading way at these times. Option B may
encourage the patient to try to manipulate the nurse's or seek attention for having a secret suicide plan.
Option C may reinforce a suicidal idea. Decreased communication is a sign of withdrawal that may
indicate the patient has decided to commit suicide; the nurse shouldn't disregard it.
Which of the following drugs should the nurse prepare to administer to a patient with a toxic
acetaminophen (Tylenol) level?
A. deferoxamine mesylate
B. succimer (Chemet)
C. flumazenil (Romazicon)
D. acetylcysteine (Mucomyst) - RIGHT ANS✔✔ D. acetylcysteine (Mucomyth)
Rationale: The antidote for acetaminophen toxicity is acetylcysteine. It enhances conversion of toxic
metabolites to nontoxic metabolites. Deferoxamine meslyate is the antidote for iron intoxication.
Succimer is an antidote for lead poisoning. Flumazenil reverses the sedative effects of benzodiazepines.
A male patient is admitted to the substance abuse unit for alcohol detoxification. Which of the following
medications is the nurse likely to administer to reduce the symptoms of alcohol withdrawal?
A. naloxone (Narcan)
B. haloperidol (Haldol)
C. magnesium sulfate
D. chlordiazepoxide (Librium) - RIGHT ANS✔✔ D. clordiazepoxide (Librium)
Rationale: Chlordiazepoxide (Librium) and other tranquilizers help reduce the symptoms of alcohol
withdrawal. Haloperidol (Haldol) may be given to treat patients with psychosis, severe agitation, or
delirium. Naloxone (Narcan) is administered for narcotic overdose. Magnesium sulfate and other
anticonvulsant medications are only administer to treat seizures if they occur during the withdrawal.
During postprandial monitor, a female patient with bulimia nervosa tells the nurse, "You can sit with me,
but you're just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my
goal is to do it twice." What is the nurse's BEST responses?
A. "I trust you not to purge."
B. "How are you purging and when do you do it?"
, C. "Don't worry. I won't allow you to purge today."
D. "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."
- RIGHT ANS✔✔ D. "I know it's important for you to feel in control, but I'll monitor you for 90
minutes after you eat."
Rationale: This response acknowledges that the patients is testing limits and that the nurse is setting
them by performing postprandial monitoring to prevent self-induced eyes is. Patients with bulimia
nervosa need to feel in control of the diet because they feel they lack control over all other aspects of
their lives.
Because their therapeutic relationships with caregivers are less important than their need to purge, they
don't fear betraying the nurse's trust by engaging in the activity. They commonly plot purging and rarely
share their secrets about it. An authoritarian or challenging response may trigger a power struggle
between the nurse and patient.
A male patient admitted to the psychiatric unit for treatment of substance abuse says to the nurse, "It
felt so wonderful to get high." Which of the following is the most appropriate response?
A. "If you continue to talk like that, I'm going to stop speaking to you."
B. "You told me you got fired from your past job for missing too may days after taking drugs all night."
C. "Tell me more about how it felt to get high."
D. "Don't you know it's illegal to use drugs?" - RIGHT ANS✔✔ B. "You told me you got fired from your
past job for missing too many days after taking drugs all night."
Rationale: Confronting the patient with the consequences of substance abuse helps to break through
denial. Making threats (option A) isn't an effective way to promote self-disclosure or establish a rapport
with the patient. Although the nurse should encourage the patient to discuss feelings, the discussing
should focus on how the patient felt before, not during, an episode of substance abuse (option C).
Encouraging elaboration about his experience while getting high may reinforce the abusive behavior.
The patient undoubtedly is aware that drug use is illegal; a reminder to this effect (option D) is unlikely
to alter behavior.
For a female patient with anorexia nervosa, the nurse is aware that which goal takes the highest
priority?
A. The patient will establish adequate daily nutritional intake
B. The patient will make a contract with the nurse that sets a target weight
C. The patient will identify self-perceptions about body size as unrealistic
D. The patient will verbalize the possible psychological consequences of self-starvation - RIGHT ANS✔✔
A. The patient will establish adequate daily nutritional intake
Rationale: According to Maslow's Hierarchy of Needs, all humans need to meet basic physiological needs
first. Because a patient with anorexia nervosa eats little or nothing, the nurse must first plan to help the
EXAM 2025| 50 ACTUAL NCLEX EXAM QUESTIONS
AND CORRECT ANSWERS GRADED A+
Flumazenil (Romazicon) has been ordered for a male patient who has overdosed on oxazepam (Serax).
Before administering the medication, the nurse should be prepared for which common adverse effect?
A. Seizures
B. Shivering
C. Anxiety
D. Chest pain - RIGHT ANS✔✔ A. Seizures
Rationale: Seizures are the most common adverse effect of using flumazenil to reverse benzodiazepine
overdose. The effect is magnified if the patient has a combined tricyclic antidepressant and
benzodiazepine overdose. Less common adverse effects includer shivering, anxiety, and chest pain.
The nurse is caring for a patient diagnosed with bulimia. The most appropriate initial goal for a patient
diagnosed with bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day - RIGHT ANS✔✔ C. Identify anxiety-causing situations
Rationale: Bulimic behavior is generally a maladaptive coping response to stress and underlying issues.
The patient must identify anxiety-causing situation as that stimulate the bulimic behavior and then
learn new ways of coping with the anxiety. Controlling shopping for large amounts of food isn't a goal
early in treatment. Managing eating impulses and replacing them with adaptive coping mechanisms
can be integrated into the plan of care after initially addressing stress and underlying issues. Eating
three meals per day isn't a realistic goal early in treatment.
A female patient who's at high risk for suicide needs close supervision. To best ensure the patient's
safety, the nurse should:
A. Check on the patient frequently at irregular intervals throughout the night
B. Assure the patient that the nurse will hold in confidence anything the patient says
C. Repeatedly discuss previous suicide attempts with the patient
,D. Disregard decreased communication by the patient because this is common in suicidal patients -
RIGHT ANS✔✔ A. Check on the patient frequently at irregular intervals throughout the night
Rationale: Checking the patient frequently but at irregular intervals prevents the patient from predicting
when observation will take place and altering behavior in a misleading way at these times. Option B may
encourage the patient to try to manipulate the nurse's or seek attention for having a secret suicide plan.
Option C may reinforce a suicidal idea. Decreased communication is a sign of withdrawal that may
indicate the patient has decided to commit suicide; the nurse shouldn't disregard it.
Which of the following drugs should the nurse prepare to administer to a patient with a toxic
acetaminophen (Tylenol) level?
A. deferoxamine mesylate
B. succimer (Chemet)
C. flumazenil (Romazicon)
D. acetylcysteine (Mucomyst) - RIGHT ANS✔✔ D. acetylcysteine (Mucomyth)
Rationale: The antidote for acetaminophen toxicity is acetylcysteine. It enhances conversion of toxic
metabolites to nontoxic metabolites. Deferoxamine meslyate is the antidote for iron intoxication.
Succimer is an antidote for lead poisoning. Flumazenil reverses the sedative effects of benzodiazepines.
A male patient is admitted to the substance abuse unit for alcohol detoxification. Which of the following
medications is the nurse likely to administer to reduce the symptoms of alcohol withdrawal?
A. naloxone (Narcan)
B. haloperidol (Haldol)
C. magnesium sulfate
D. chlordiazepoxide (Librium) - RIGHT ANS✔✔ D. clordiazepoxide (Librium)
Rationale: Chlordiazepoxide (Librium) and other tranquilizers help reduce the symptoms of alcohol
withdrawal. Haloperidol (Haldol) may be given to treat patients with psychosis, severe agitation, or
delirium. Naloxone (Narcan) is administered for narcotic overdose. Magnesium sulfate and other
anticonvulsant medications are only administer to treat seizures if they occur during the withdrawal.
During postprandial monitor, a female patient with bulimia nervosa tells the nurse, "You can sit with me,
but you're just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my
goal is to do it twice." What is the nurse's BEST responses?
A. "I trust you not to purge."
B. "How are you purging and when do you do it?"
, C. "Don't worry. I won't allow you to purge today."
D. "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."
- RIGHT ANS✔✔ D. "I know it's important for you to feel in control, but I'll monitor you for 90
minutes after you eat."
Rationale: This response acknowledges that the patients is testing limits and that the nurse is setting
them by performing postprandial monitoring to prevent self-induced eyes is. Patients with bulimia
nervosa need to feel in control of the diet because they feel they lack control over all other aspects of
their lives.
Because their therapeutic relationships with caregivers are less important than their need to purge, they
don't fear betraying the nurse's trust by engaging in the activity. They commonly plot purging and rarely
share their secrets about it. An authoritarian or challenging response may trigger a power struggle
between the nurse and patient.
A male patient admitted to the psychiatric unit for treatment of substance abuse says to the nurse, "It
felt so wonderful to get high." Which of the following is the most appropriate response?
A. "If you continue to talk like that, I'm going to stop speaking to you."
B. "You told me you got fired from your past job for missing too may days after taking drugs all night."
C. "Tell me more about how it felt to get high."
D. "Don't you know it's illegal to use drugs?" - RIGHT ANS✔✔ B. "You told me you got fired from your
past job for missing too many days after taking drugs all night."
Rationale: Confronting the patient with the consequences of substance abuse helps to break through
denial. Making threats (option A) isn't an effective way to promote self-disclosure or establish a rapport
with the patient. Although the nurse should encourage the patient to discuss feelings, the discussing
should focus on how the patient felt before, not during, an episode of substance abuse (option C).
Encouraging elaboration about his experience while getting high may reinforce the abusive behavior.
The patient undoubtedly is aware that drug use is illegal; a reminder to this effect (option D) is unlikely
to alter behavior.
For a female patient with anorexia nervosa, the nurse is aware that which goal takes the highest
priority?
A. The patient will establish adequate daily nutritional intake
B. The patient will make a contract with the nurse that sets a target weight
C. The patient will identify self-perceptions about body size as unrealistic
D. The patient will verbalize the possible psychological consequences of self-starvation - RIGHT ANS✔✔
A. The patient will establish adequate daily nutritional intake
Rationale: According to Maslow's Hierarchy of Needs, all humans need to meet basic physiological needs
first. Because a patient with anorexia nervosa eats little or nothing, the nurse must first plan to help the
