NCLEX-RN Psychosocial Integrity 5 Exam
(2025/2026) | 115 Verified Q&A |
Specialist-Level Mental Health & Advanced
Clinical Psychiatry
NCLEX-RN Psychosocial Integrity Exam (2025/2026) — Questions 1
1. A patient with schizophrenia reports hearing voices that command them to harm
others. Which nursing action is the priority?
A. Ask the patient to describe the voices.
B. Ensure the patient is in a safe environment.
C. Explain that the voices are not real.
D. Encourage group therapy participation.
Answer: B. Ensure the patient is in a safe environment.
Rationale: Safety is always the priority when a patient experiences command hallucinations
that could lead to harm. Interventions to de-escalate or explore hallucinations come after
ensuring safety.
2. A patient with major depressive disorder has been noncompliant with antidepressant
therapy. Which nursing intervention is most appropriate?
A. Educate about side effects of medication.
B. Explore reasons for noncompliance in a supportive manner.
C. Encourage the patient to join a support group.
D. Suggest cognitive behavioral therapy (CBT) as an alternative.
Answer: B. Explore reasons for noncompliance in a supportive manner.
Rationale: Understanding barriers to adherence allows individualized interventions and fosters
therapeutic trust.
,3. Which symptom indicates a manic episode in a patient with bipolar I disorder?
A. Fatigue and hypersomnia.
B. Flight of ideas and pressured speech.
C. Social withdrawal and anhedonia.
D. Memory loss and disorientation.
Answer: B. Flight of ideas and pressured speech.
Rationale: Mania is characterized by elevated mood, increased energy, rapid speech, and
distractibility.
4. A patient experiencing panic disorder presents to the ED hyperventilating. Which initial
intervention is appropriate?
A. Teach deep breathing exercises.
B. Encourage reflection on past trauma.
C. Administer antipsychotic medication.
D. Have the patient walk briskly to expend energy.
Answer: A. Teach deep breathing exercises.
Rationale: Panic attacks require immediate calming interventions; slow, deep breathing helps
reduce hyperventilation and physiological arousal.
5. A patient with PTSD avoids talking about a traumatic event. Which nursing approach is
best?
A. Confront the patient to discuss the trauma.
B. Allow the patient to set the pace for sharing.
C. Encourage immediate journaling of the event.
D. Suggest exposure therapy in the first session.
Answer: B. Allow the patient to set the pace for sharing.
Rationale: Respecting the patient’s readiness builds trust and prevents retraumatization.
6. Which is a priority nursing diagnosis for a patient with borderline personality disorder
who is engaging in self-harm?
A. Risk for loneliness.
B. Ineffective coping.
C. Risk for self-directed violence.
D. Social isolation.
, Answer: C. Risk for self-directed violence.
Rationale: Immediate safety concerns take precedence over psychosocial or relational issues.
7. A patient with schizophrenia states, “People are controlling my thoughts.” This is an
example of:
A. Hallucination.
B. Delusion of persecution.
C. Thought broadcasting.
D. Echolalia.
Answer: B. Delusion of persecution.
Rationale: Delusions are fixed false beliefs; persecutory delusions involve feeling targeted or
controlled by others.
8. Which intervention is most appropriate for a patient experiencing severe anxiety in an
inpatient psychiatric unit?
A. Encourage complex problem-solving.
B. Provide a quiet, low-stimulation environment.
C. Assign multiple group therapy sessions.
D. Increase physical activity to expend energy.
Answer: B. Provide a quiet, low-stimulation environment.
Rationale: Reducing stimuli helps the patient regain control over anxiety.
9. A patient with obsessive-compulsive disorder (OCD) spends hours washing hands.
Which intervention should the nurse prioritize?
A. Restrict hand washing immediately.
B. Teach time management strategies for rituals.
C. Encourage gradual reduction in compulsive behavior.
D. Administer PRN anxiolytics only.
Answer: C. Encourage gradual reduction in compulsive behavior.
Rationale: Exposure and response prevention (ERP) therapy is the evidence-based approach
for OCD; abrupt restriction can increase anxiety.
10. A patient with anorexia nervosa has a BMI of 16 kg/m². Which is the highest priority
intervention?
A. Encourage participation in group therapy.
(2025/2026) | 115 Verified Q&A |
Specialist-Level Mental Health & Advanced
Clinical Psychiatry
NCLEX-RN Psychosocial Integrity Exam (2025/2026) — Questions 1
1. A patient with schizophrenia reports hearing voices that command them to harm
others. Which nursing action is the priority?
A. Ask the patient to describe the voices.
B. Ensure the patient is in a safe environment.
C. Explain that the voices are not real.
D. Encourage group therapy participation.
Answer: B. Ensure the patient is in a safe environment.
Rationale: Safety is always the priority when a patient experiences command hallucinations
that could lead to harm. Interventions to de-escalate or explore hallucinations come after
ensuring safety.
2. A patient with major depressive disorder has been noncompliant with antidepressant
therapy. Which nursing intervention is most appropriate?
A. Educate about side effects of medication.
B. Explore reasons for noncompliance in a supportive manner.
C. Encourage the patient to join a support group.
D. Suggest cognitive behavioral therapy (CBT) as an alternative.
Answer: B. Explore reasons for noncompliance in a supportive manner.
Rationale: Understanding barriers to adherence allows individualized interventions and fosters
therapeutic trust.
,3. Which symptom indicates a manic episode in a patient with bipolar I disorder?
A. Fatigue and hypersomnia.
B. Flight of ideas and pressured speech.
C. Social withdrawal and anhedonia.
D. Memory loss and disorientation.
Answer: B. Flight of ideas and pressured speech.
Rationale: Mania is characterized by elevated mood, increased energy, rapid speech, and
distractibility.
4. A patient experiencing panic disorder presents to the ED hyperventilating. Which initial
intervention is appropriate?
A. Teach deep breathing exercises.
B. Encourage reflection on past trauma.
C. Administer antipsychotic medication.
D. Have the patient walk briskly to expend energy.
Answer: A. Teach deep breathing exercises.
Rationale: Panic attacks require immediate calming interventions; slow, deep breathing helps
reduce hyperventilation and physiological arousal.
5. A patient with PTSD avoids talking about a traumatic event. Which nursing approach is
best?
A. Confront the patient to discuss the trauma.
B. Allow the patient to set the pace for sharing.
C. Encourage immediate journaling of the event.
D. Suggest exposure therapy in the first session.
Answer: B. Allow the patient to set the pace for sharing.
Rationale: Respecting the patient’s readiness builds trust and prevents retraumatization.
6. Which is a priority nursing diagnosis for a patient with borderline personality disorder
who is engaging in self-harm?
A. Risk for loneliness.
B. Ineffective coping.
C. Risk for self-directed violence.
D. Social isolation.
, Answer: C. Risk for self-directed violence.
Rationale: Immediate safety concerns take precedence over psychosocial or relational issues.
7. A patient with schizophrenia states, “People are controlling my thoughts.” This is an
example of:
A. Hallucination.
B. Delusion of persecution.
C. Thought broadcasting.
D. Echolalia.
Answer: B. Delusion of persecution.
Rationale: Delusions are fixed false beliefs; persecutory delusions involve feeling targeted or
controlled by others.
8. Which intervention is most appropriate for a patient experiencing severe anxiety in an
inpatient psychiatric unit?
A. Encourage complex problem-solving.
B. Provide a quiet, low-stimulation environment.
C. Assign multiple group therapy sessions.
D. Increase physical activity to expend energy.
Answer: B. Provide a quiet, low-stimulation environment.
Rationale: Reducing stimuli helps the patient regain control over anxiety.
9. A patient with obsessive-compulsive disorder (OCD) spends hours washing hands.
Which intervention should the nurse prioritize?
A. Restrict hand washing immediately.
B. Teach time management strategies for rituals.
C. Encourage gradual reduction in compulsive behavior.
D. Administer PRN anxiolytics only.
Answer: C. Encourage gradual reduction in compulsive behavior.
Rationale: Exposure and response prevention (ERP) therapy is the evidence-based approach
for OCD; abrupt restriction can increase anxiety.
10. A patient with anorexia nervosa has a BMI of 16 kg/m². Which is the highest priority
intervention?
A. Encourage participation in group therapy.
