1
NCLEX RN Exam Bank: Anxiety, Trauma,
and Crisis Intervention in Mental
Health
Table of Contents
Subtopic 1: Recognition and Assessment of Anxiety and Trauma Disorders (20 Questions) 2
Subtopic 2: Pharmacologic and Non-Pharmacologic Interventions for Anxiety and Trauma
Disorders ................................................................................................................... 10
Subtopic 3: Crisis Intervention Models and Nursing Roles During Psychiatric Emergencies
.................................................................................................................................. 19
Subtopic 4: Trauma-Informed Care Principles and Patient-Centered Approaches ............ 27
Subtopic 5: Substance Use Disorders and Trauma-Related Disorders ............................. 36
Subtopic 6: Pharmacologic Management of Anxiety and Trauma-Related Disorders......... 44
Subtopic 7: PTSD, Acute Stress Reaction, and Trauma-Informed Care............................. 52
Subtopic 8: Acute Stress Reactions and Psychological First Aid (PFA) ............................. 59
Subtopic 9: Emergency Psychiatric Care & Legal/Ethical Considerations in Crisis ............ 68
Subtopic 10: Community-Based Mental Health Resources, Support, and Recovery-
Oriented Care ............................................................................................................. 75
, 2
Subtopic 1: Recognition and Assessment of Anxiety and
Trauma Disorders (20 Questions)
Question 1
A client presents to the ED with shortness of breath, dizziness, chest tightness, and fear of
dying. ECG and cardiac enzymes are normal. What is the nurse’s priority action?
A. Refer the client for a cardiac stress test
B. Remain with the client and use grounding techniques
C. Educate the client about deep vein thrombosis
D. Offer a benzodiazepine without provider order
Correct Answer: B
Rationale: These are signs of a panic attack. Staying with the client and using grounding
techniques provides immediate emotional safety and reassurance, which are priorities
during an acute panic episode.
Question 2
Which symptom is most specific to Generalized Anxiety Disorder (GAD)?
A. Flashbacks
B. Excessive worry about multiple domains
C. Obsessions and compulsions
D. Hallucinations
Correct Answer: B
Rationale: GAD is characterized by persistent, excessive worry about various aspects of life
such as work, health, and finances for at least 6 months.
Question 3
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A combat veteran reports recurrent nightmares, hypervigilance, and social isolation. Which
condition is most likely?
A. Adjustment disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Obsessive-Compulsive Disorder (OCD)
D. Acute stress reaction
Correct Answer: B
Rationale: These hallmark symptoms—nightmares, hypervigilance, and avoidance—are
consistent with PTSD, particularly following trauma.
Question 4
Which tool is most appropriate for screening anxiety severity in the primary care setting?
A. Beck Depression Inventory
B. MMSE
C. GAD-7 Scale
D. PHQ-9
Correct Answer: C
Rationale: The GAD-7 is a validated, easy-to-use screening tool specifically designed to
assess the severity of Generalized Anxiety Disorder.
Question 5
A client in crisis repeatedly states, “I can’t handle this anymore.” What is the nurse’s best
response?
A. “Let’s talk through what’s happening right now.”
B. “Others have gotten through worse.”
, 4
C. “You need to calm down.”
D. “You’re overreacting.”
Correct Answer: A
Rationale: This response promotes therapeutic communication and supports the client in
expressing and managing overwhelming emotions.
Question 6
Which is a physiological sign of moderate anxiety?
A. Inability to function
B. Hallucinations
C. Increased heart rate and respiratory rate
D. Complete lack of awareness
Correct Answer: C
Rationale: Moderate anxiety involves somatic symptoms like increased heart and
respiratory rates, along with a narrowed perceptual field.
Question 7
Which nursing diagnosis is most appropriate for a client with panic disorder?
A. Anxiety related to perceived threat to self, as evidenced by palpitations and fear
B. Risk for injury related to violent behavior
C. Social isolation related to language barrier
D. Disturbed sensory perception related to hallucinations
Correct Answer: A
NCLEX RN Exam Bank: Anxiety, Trauma,
and Crisis Intervention in Mental
Health
Table of Contents
Subtopic 1: Recognition and Assessment of Anxiety and Trauma Disorders (20 Questions) 2
Subtopic 2: Pharmacologic and Non-Pharmacologic Interventions for Anxiety and Trauma
Disorders ................................................................................................................... 10
Subtopic 3: Crisis Intervention Models and Nursing Roles During Psychiatric Emergencies
.................................................................................................................................. 19
Subtopic 4: Trauma-Informed Care Principles and Patient-Centered Approaches ............ 27
Subtopic 5: Substance Use Disorders and Trauma-Related Disorders ............................. 36
Subtopic 6: Pharmacologic Management of Anxiety and Trauma-Related Disorders......... 44
Subtopic 7: PTSD, Acute Stress Reaction, and Trauma-Informed Care............................. 52
Subtopic 8: Acute Stress Reactions and Psychological First Aid (PFA) ............................. 59
Subtopic 9: Emergency Psychiatric Care & Legal/Ethical Considerations in Crisis ............ 68
Subtopic 10: Community-Based Mental Health Resources, Support, and Recovery-
Oriented Care ............................................................................................................. 75
, 2
Subtopic 1: Recognition and Assessment of Anxiety and
Trauma Disorders (20 Questions)
Question 1
A client presents to the ED with shortness of breath, dizziness, chest tightness, and fear of
dying. ECG and cardiac enzymes are normal. What is the nurse’s priority action?
A. Refer the client for a cardiac stress test
B. Remain with the client and use grounding techniques
C. Educate the client about deep vein thrombosis
D. Offer a benzodiazepine without provider order
Correct Answer: B
Rationale: These are signs of a panic attack. Staying with the client and using grounding
techniques provides immediate emotional safety and reassurance, which are priorities
during an acute panic episode.
Question 2
Which symptom is most specific to Generalized Anxiety Disorder (GAD)?
A. Flashbacks
B. Excessive worry about multiple domains
C. Obsessions and compulsions
D. Hallucinations
Correct Answer: B
Rationale: GAD is characterized by persistent, excessive worry about various aspects of life
such as work, health, and finances for at least 6 months.
Question 3
, 3
A combat veteran reports recurrent nightmares, hypervigilance, and social isolation. Which
condition is most likely?
A. Adjustment disorder
B. Post-Traumatic Stress Disorder (PTSD)
C. Obsessive-Compulsive Disorder (OCD)
D. Acute stress reaction
Correct Answer: B
Rationale: These hallmark symptoms—nightmares, hypervigilance, and avoidance—are
consistent with PTSD, particularly following trauma.
Question 4
Which tool is most appropriate for screening anxiety severity in the primary care setting?
A. Beck Depression Inventory
B. MMSE
C. GAD-7 Scale
D. PHQ-9
Correct Answer: C
Rationale: The GAD-7 is a validated, easy-to-use screening tool specifically designed to
assess the severity of Generalized Anxiety Disorder.
Question 5
A client in crisis repeatedly states, “I can’t handle this anymore.” What is the nurse’s best
response?
A. “Let’s talk through what’s happening right now.”
B. “Others have gotten through worse.”
, 4
C. “You need to calm down.”
D. “You’re overreacting.”
Correct Answer: A
Rationale: This response promotes therapeutic communication and supports the client in
expressing and managing overwhelming emotions.
Question 6
Which is a physiological sign of moderate anxiety?
A. Inability to function
B. Hallucinations
C. Increased heart rate and respiratory rate
D. Complete lack of awareness
Correct Answer: C
Rationale: Moderate anxiety involves somatic symptoms like increased heart and
respiratory rates, along with a narrowed perceptual field.
Question 7
Which nursing diagnosis is most appropriate for a client with panic disorder?
A. Anxiety related to perceived threat to self, as evidenced by palpitations and fear
B. Risk for injury related to violent behavior
C. Social isolation related to language barrier
D. Disturbed sensory perception related to hallucinations
Correct Answer: A
