• Psychiatric NursiNg Exam 2026 — comPlEtE
mENtal hEalth & Psychiatric NursiNg rEviEw,
thEraPEutic commuNicatioN, PatiENt assEssmENt,
crisis iNtErvENtioN, PsychoPharmacology, lEgal
& Ethical coNsidEratioNs, NclEx-stylE PracticE
QuEstioNs, casE scENarios & high-yiEld Exam
PrEParatioN
Question 1:
A nurse is caring for a patient diagnosed with schizophrenia who exhibits command
hallucinations. Which of the following interventions is most appropriate for the nurse to
implement?
• A) Encourage the patient to dismiss the voices
• B) Ask the patient to describe the hallucinations in detail
• C) Establish a supportive relationship and engage the patient in reality-based
conversations
• D) Administer additional medication immediately
CORRECT ANSWER: C) Establish a supportive relationship and engage the patient
in reality-based conversations
Rationale:
Establishing a supportive relationship helps the patient feel safe and understood, which
is essential in managing psychotic symptoms. Engaging the patient in reality-based
conversations can help redirect their focus and reduce the intensity of hallucinations.
Options A and B may invalidate the patient's experience or encourage further fixation on
the hallucinations. Option D would only be appropriate if there were immediate safety
concerns or worsening symptoms.
Question 2:
A nurse is performing an assessment on a patient diagnosed with major depressive
disorder (MDD). Which symptom would the nurse consider as a core feature of this
disorder?
• A) Increased energy levels
• B) Apathy and lack of interest in previously enjoyed activities
• C) Elevated mood and euphoria
• D) Rapid speech and excessive talkativeness
CORRECT ANSWER: B) Apathy and lack of interest in previously enjoyed activities
Rationale:
Apathy and anhedonia (lack of pleasure in activities) are core symptoms of major
,depressive disorder and critical for diagnosis. Increased energy levels and elevated
moods typically align with hypomanic or manic episodes, not depression. Rapid speech
and excessive talkativeness are characteristic of manic or hypomanic states, not MDD.
Question 3:
A patient with bipolar disorder is experiencing a manic episode. Which of the following
nursing interventions is most effective in ensuring patient safety?
• A) Provide the patient with a quiet, low-stimulation environment
• B) Offer choices in their daily schedule to promote autonomy
• C) Encourage the patient to express their feelings verbally
• D) Allow the patient to engage in spontaneous activities without restrictions
CORRECT ANSWER: A) Provide the patient with a quiet, low-stimulation
environment
Rationale:
During manic episodes, patients may exhibit impulsivity and lack of judgment,
heightening the risk of harm. A quiet, low-stimulation environment can help to regulate
mood and reduce agitation. While increasing autonomy is important, it may lead to
further disorganization and risk during a manic phase. Allowing unrestricted activities
can significantly increase safety risks.
Question 4:
In the care of a patient diagnosed with borderline personality disorder (BPD), which
approach would be most beneficial in fostering a therapeutic relationship?
• A) Maintaining consistent boundaries and limits
• B) Allowing the patient to direct their own care
• C) Offering reassurance and avoiding confrontation
• D) Engaging in social activities outside of therapy sessions
CORRECT ANSWER: A) Maintaining consistent boundaries and limits
Rationale:
Patients with BPD often struggle with issues regarding abandonment and emotional
dysregulation. Consistent boundaries and limits provide structure and safety, which are
crucial in establishing a therapeutic relationship. Allowing the patient to direct their
care may lead to manipulation or confusion about therapeutic roles. Offering
reassurance without addressing underlying issues can perpetuate dependency, while
engaging socially could blur professional boundaries.
, Question 5:
A nurse is educating a patient prescribed a selective serotonin reuptake inhibitor (SSRI)
about potential side effects. Which of the following should the nurse emphasize as a
common side effect of this medication class?
• A) Weight gain
• B) Sedation
• C) Dry mouth
• D) Insomnia
CORRECT ANSWER: C) Dry mouth
Rationale:
Dry mouth is a common side effect of SSRIs, resulting from serotonin's effect on
salivary glands. While weight gain and insomnia can occur with some SSRIs, they are
less universally reported than dry mouth. Sedation is more closely associated with
other antidepressants, such as tricyclics, rather than SSRIs.
Question 6:
A nurse is assessing a patient who has recently experienced a significant loss and is
exhibiting signs of grief. Which of the following observations would indicate
"complicated grief"?
• A) The patient expresses sadness and nostalgia while viewing old photographs.
• B) The patient demonstrates avoidance of reminders of the deceased.
• C) The patient finds comfort in talking about the deceased with family.
• D) The patient experiences occasional feelings of anger regarding the loss.
CORRECT ANSWER: B) The patient demonstrates avoidance of reminders of the
deceased.
Rationale:
Complicated grief is characterized by prolonged symptoms of grief that interfere with
daily functioning. Avoidance of reminders signifies an inability to process the loss
effectively, which is central to complicated grief. Expressing sadness and nostalgia or
finding comfort in discussions about the deceased are normal grief reactions, while
occasional anger is also typical and does not suggest complicated grief.
Question 7:
A patient diagnosed with obsessive-compulsive disorder (OCD) is undergoing cognitive-
behavioral therapy (CBT). Which intervention would the nurse expect to be most
prominently used during therapy?
mENtal hEalth & Psychiatric NursiNg rEviEw,
thEraPEutic commuNicatioN, PatiENt assEssmENt,
crisis iNtErvENtioN, PsychoPharmacology, lEgal
& Ethical coNsidEratioNs, NclEx-stylE PracticE
QuEstioNs, casE scENarios & high-yiEld Exam
PrEParatioN
Question 1:
A nurse is caring for a patient diagnosed with schizophrenia who exhibits command
hallucinations. Which of the following interventions is most appropriate for the nurse to
implement?
• A) Encourage the patient to dismiss the voices
• B) Ask the patient to describe the hallucinations in detail
• C) Establish a supportive relationship and engage the patient in reality-based
conversations
• D) Administer additional medication immediately
CORRECT ANSWER: C) Establish a supportive relationship and engage the patient
in reality-based conversations
Rationale:
Establishing a supportive relationship helps the patient feel safe and understood, which
is essential in managing psychotic symptoms. Engaging the patient in reality-based
conversations can help redirect their focus and reduce the intensity of hallucinations.
Options A and B may invalidate the patient's experience or encourage further fixation on
the hallucinations. Option D would only be appropriate if there were immediate safety
concerns or worsening symptoms.
Question 2:
A nurse is performing an assessment on a patient diagnosed with major depressive
disorder (MDD). Which symptom would the nurse consider as a core feature of this
disorder?
• A) Increased energy levels
• B) Apathy and lack of interest in previously enjoyed activities
• C) Elevated mood and euphoria
• D) Rapid speech and excessive talkativeness
CORRECT ANSWER: B) Apathy and lack of interest in previously enjoyed activities
Rationale:
Apathy and anhedonia (lack of pleasure in activities) are core symptoms of major
,depressive disorder and critical for diagnosis. Increased energy levels and elevated
moods typically align with hypomanic or manic episodes, not depression. Rapid speech
and excessive talkativeness are characteristic of manic or hypomanic states, not MDD.
Question 3:
A patient with bipolar disorder is experiencing a manic episode. Which of the following
nursing interventions is most effective in ensuring patient safety?
• A) Provide the patient with a quiet, low-stimulation environment
• B) Offer choices in their daily schedule to promote autonomy
• C) Encourage the patient to express their feelings verbally
• D) Allow the patient to engage in spontaneous activities without restrictions
CORRECT ANSWER: A) Provide the patient with a quiet, low-stimulation
environment
Rationale:
During manic episodes, patients may exhibit impulsivity and lack of judgment,
heightening the risk of harm. A quiet, low-stimulation environment can help to regulate
mood and reduce agitation. While increasing autonomy is important, it may lead to
further disorganization and risk during a manic phase. Allowing unrestricted activities
can significantly increase safety risks.
Question 4:
In the care of a patient diagnosed with borderline personality disorder (BPD), which
approach would be most beneficial in fostering a therapeutic relationship?
• A) Maintaining consistent boundaries and limits
• B) Allowing the patient to direct their own care
• C) Offering reassurance and avoiding confrontation
• D) Engaging in social activities outside of therapy sessions
CORRECT ANSWER: A) Maintaining consistent boundaries and limits
Rationale:
Patients with BPD often struggle with issues regarding abandonment and emotional
dysregulation. Consistent boundaries and limits provide structure and safety, which are
crucial in establishing a therapeutic relationship. Allowing the patient to direct their
care may lead to manipulation or confusion about therapeutic roles. Offering
reassurance without addressing underlying issues can perpetuate dependency, while
engaging socially could blur professional boundaries.
, Question 5:
A nurse is educating a patient prescribed a selective serotonin reuptake inhibitor (SSRI)
about potential side effects. Which of the following should the nurse emphasize as a
common side effect of this medication class?
• A) Weight gain
• B) Sedation
• C) Dry mouth
• D) Insomnia
CORRECT ANSWER: C) Dry mouth
Rationale:
Dry mouth is a common side effect of SSRIs, resulting from serotonin's effect on
salivary glands. While weight gain and insomnia can occur with some SSRIs, they are
less universally reported than dry mouth. Sedation is more closely associated with
other antidepressants, such as tricyclics, rather than SSRIs.
Question 6:
A nurse is assessing a patient who has recently experienced a significant loss and is
exhibiting signs of grief. Which of the following observations would indicate
"complicated grief"?
• A) The patient expresses sadness and nostalgia while viewing old photographs.
• B) The patient demonstrates avoidance of reminders of the deceased.
• C) The patient finds comfort in talking about the deceased with family.
• D) The patient experiences occasional feelings of anger regarding the loss.
CORRECT ANSWER: B) The patient demonstrates avoidance of reminders of the
deceased.
Rationale:
Complicated grief is characterized by prolonged symptoms of grief that interfere with
daily functioning. Avoidance of reminders signifies an inability to process the loss
effectively, which is central to complicated grief. Expressing sadness and nostalgia or
finding comfort in discussions about the deceased are normal grief reactions, while
occasional anger is also typical and does not suggest complicated grief.
Question 7:
A patient diagnosed with obsessive-compulsive disorder (OCD) is undergoing cognitive-
behavioral therapy (CBT). Which intervention would the nurse expect to be most
prominently used during therapy?
