720 Must-Know NCLEX Questions in Psychiatric-Mental Health Nursing – Based on Varcarolis (2025)

,720 Must-Know NCLEX Questions in
Psychiatric-Mental Health Nursing – Based
on Varcarolis (2025)

A Guaranteed-Pass Resource for Nursing Students, Instructors, and
Exam Prep Aligned with the Latest Clinical Standards and NCLEX-RN
Test Plan.




UNIT I: Foundations in Theory

1. Mental Health and Mental Illness

 Definitions of mental health and mental illness

 Continuum of mental health

 Risk and protective factors

 Stigma and public perceptions

 Diagnostic classification systems (DSM-5-TR, ICD-11)

 Recovery-oriented care

2. Theories and Therapies

 Psychoanalytic theory (Freud)

 Developmental theories (Erikson, Piaget)

 Behavioral and cognitive theories (Pavlov, Skinner, Beck)

 Humanistic theories (Maslow, Rogers)

 Biological theories

 Milieu therapy

,  Therapeutic modalities (CBT, DBT, group therapy)

3. Psychobiology and Psychopharmacology

 Structure and function of the nervous system

 Neurotransmitters and psychiatric disorders

 Brain imaging techniques

 Psychotropic medications:

o Antidepressants

o Antipsychotics

o Mood stabilizers

o Anxiolytics

 Side effects and nursing implications

 Pharmacogenetics



UNIT II: Foundations for Practice

4. Treatment Settings

 Inpatient vs. outpatient care

 Roles in interdisciplinary teams

 Levels of prevention (primary, secondary, tertiary)

 Mental health parity and access to care

 Continuum of care

5. Cultural Implications

 Cultural competence and humility

 Transcultural nursing theories (e.g., Leininger)

 Impact of culture on mental health

 Culture-bound syndromes

 Communication barriers and strategies

6. Legal and Ethical Considerations

 Patients’ rights (informed consent, right to treatment/refusal)

 Confidentiality and HIPAA

,  Commitment procedures (voluntary, involuntary)

 Ethical principles (autonomy, beneficence, justice)

 Legal issues in mental health nursing

 Tarasoff ruling and duty to warn



UNIT III: Psychosocial Nursing Tools

7. The Nursing Process and Standards of Care

 ANA Psychiatric Nursing Standards

 Assessment, Diagnosis, Planning, Implementation, Evaluation

 Nursing diagnoses (NANDA)

 Documentation and evaluation tools

 Evidence-based practice

8. Therapeutic Relationships

 Phases of nurse–patient relationship (Peplau’s theory)

 Boundaries and transference/countertransference

 Empathy vs. sympathy

 Building trust and rapport

9. Therapeutic Communication

 Verbal and non-verbal communication

 Therapeutic vs. non-therapeutic techniques

 Active listening

 Motivational interviewing

 Communication with special populations

10. Stress Responses and Stress Management

 Physiological and psychological responses to stress

 General adaptation syndrome

 Coping strategies (adaptive and maladaptive)

 Stress reduction techniques (relaxation, mindfulness)

,UNIT IV: Psychobiological Disorders

11. Childhood and Neurodevelopmental Disorders

 Autism spectrum disorder

 ADHD

 Tic disorders (Tourette’s)

 Intellectual disabilities

 Assessment and treatment strategies

 Family involvement

12. Schizophrenia Spectrum Disorders

 Symptoms (positive, negative, cognitive)

 Phases of schizophrenia

 Risk factors and neurobiology

 Treatment (medications, therapy, psychoeducation)

 Nursing care plans

13. Bipolar and Related Disorders

 Bipolar I and II

 Cyclothymic disorder

 Mania and depression symptoms

 Pharmacologic and non-pharmacologic treatments

 Managing risk behaviors

14. Depressive Disorders

 Major depressive disorder

 Persistent depressive disorder (dysthymia)

 Grief vs. clinical depression

 Antidepressants and therapies (CBT, ECT)

 Suicide risk assessment

15. Anxiety and Obsessive-Compulsive Disorders

 Generalized anxiety disorder

 Panic disorder

,  Phobias

 OCD and related disorders

 Behavioral therapies (exposure, desensitization)

16. Trauma, Stressor-Related, and Dissociative Disorders

 PTSD and acute stress disorder

 Reactive attachment disorder

 Dissociative identity disorder

 Trauma-informed care

 Treatment options and nursing roles

17. Somatic Symptom Disorders

 Illness anxiety disorder

 Conversion disorder

 Factitious disorder

 Managing symptoms without reinforcing them

18. Eating and Feeding Disorders

 Anorexia nervosa

 Bulimia nervosa

 Binge-eating disorder

 Nutritional and psychological interventions

 Family therapy

19. Sleep-Wake Disorders

 Insomnia and hypersomnia

 Narcolepsy

 Sleep apnea

 Circadian rhythm disturbances

 Sleep hygiene

20. Sexual Dysfunction, Gender Dysphoria, and Paraphilic Disorders

 Types of sexual dysfunction

 DSM-5 gender dysphoria criteria

,  Paraphilic disorders (exhibitionism, pedophilia)

 Therapeutic approaches and ethical issues

21. Impulse Control Disorders

 Intermittent explosive disorder

 Kleptomania

 Pyromania

 Nursing interventions and behavioral management

22. Substance-Related and Addictive Disorders

 Alcohol, opioids, stimulants

 CAGE and SBIRT screening tools

 Detoxification and withdrawal management

 Relapse prevention

 12-step and other treatment programs

23. Neurocognitive Disorders

 Delirium vs. dementia

 Alzheimer’s disease and related dementias

 Pharmacologic management

 Safety and communication strategies

24. Personality Disorders

 Cluster A, B, and C disorders

 Borderline, antisocial, narcissistic traits

 Dialectical behavior therapy (DBT)

 Setting limits and managing manipulative behavior



UNIT V: Trauma Interventions

25. Suicide and Non-suicidal Self-Injury

 Risk factors and warning signs

 Suicide assessment tools (SAD PERSONS scale)

 Levels of risk and interventions

,  Safety planning and crisis intervention

 Managing self-harming behaviors

26. Crisis and Disaster

 Types of crisis (maturational, situational, adventitious)

 Phases of crisis intervention

 Psychological first aid

 Community disaster mental health

27. Anger, Aggression, and Violence

 Triggers and risk assessment

 De-escalation strategies

 Use of restraints and seclusion

 Staff safety and legal documentation

28. Child, Older Adult, and Intimate Partner Violence

 Forms and signs of abuse

 Mandatory reporting laws

 Trauma-informed assessment

 Safety planning

29. Sexual Assault

 Acute stress and rape trauma syndrome

 Sexual Assault Nurse Examiner (SANE) role

 Legal and ethical care considerations

 Emotional and psychological support



UNIT VI: Interventions for Special Populations

30. Dying, Death, and Grieving

 Theories of grief (Kubler-Ross, Worden)

 Anticipatory grief and complicated grief

 Culturally sensitive care

 Supporting families and caregivers

,31. Older Adults

 Normal vs. abnormal aging

 Polypharmacy concerns

 Cognitive and sensory changes

 Abuse and neglect in older adults

32. Serious Mental Illness

 Characteristics of SMI

 Stigma and social issues

 Recovery models and ACT teams

 Housing and employment supports

33. Forensic Nursing

 Roles in criminal justice system

 Competency and criminal responsibility

 Court testimony and documentation

 Ethical and legal issues



UNIT VII: Other Intervention Modalities

34. Therapeutic Groups

 Types of groups (psychoeducational, support, therapy)

 Group development and roles

 Facilitator responsibilities

 Managing group dynamics

35. Family Interventions

 Family systems theory

 Psychoeducation

 Family assessment tools

 Involving families in treatment planning

36. Integrative Care

 Complementary and alternative therapies

,  Mind-body practices (yoga, meditation)

 Herbal remedies and their risks

 Whole-person and holistic models



Unit I: Foundations in Theory from Varcarolis’ Foundations of
Psychiatric-Mental Health Nursing, 9th Ed.
Q1. Which definition best describes "mental health" in a holistic
nursing framework? a. Complete absence of psychiatric
symptoms b. A state of emotional and psychological well-being
enabling coping with life’s stresses c. A permanent condition of
happiness and contentment d. The inability to experience
distressing emotions Correct answer: b Rationale: Mental
health is defined as emotional and psychological well-being,
allowing individuals to adapt and function despite life’s
stresses.
Q2. A nurse explains the continuum of mental health to a
student. Which statement accurately reflects this concept? a.
Individuals are either mentally healthy or mentally ill with no
in-between b. Mental health is static and does not change over
time c. People move along a spectrum from wellness to illness
based on stressors and supports d. Once diagnosed with a
disorder, a person cannot return to wellness Correct answer: c
Rationale: The continuum illustrates that mental health
fluctuates along a spectrum influenced by stressors and
supports.