## Psychiatric Mental Health Nursing Exam
Prep: Questions
---
**1.** A patient with major depressive disorder is started on fluoxetine. The nurse should educate the
patient that therapeutic effects may take:
A) 24 to 48 hours
B) 3 to 5 days
C) 2 to 4 weeks
D) 6 to 8 weeks
💫ANSWER✔️✔️: **C** – SSRIs typically take 2–4 weeks for initial improvement and 6–8 weeks for full
effect. Early side effects (anxiety, insomnia) may occur before mood improvement.
---
**2.** A patient with bipolar disorder is prescribed lithium. Which serum level indicates a therapeutic
maintenance range?
A) 0.2–0.5 mEq/L
B) 0.6–1.2 mEq/L
C) 1.5–2.0 mEq/L
D) 2.5–3.0 mEq/L
💫ANSWER✔️✔️: **B** – Therapeutic lithium level is 0.6–1.2 mEq/L for maintenance and acute mania.
Levels >1.5 mEq/L cause toxicity (nausea, tremor, ataxia, confusion).
---
**3.** A patient with schizophrenia tells the nurse, “The CIA is monitoring my thoughts through a
microchip in my tooth.” Which term best describes this statement?
,A) Illusion
B) Delusion of persecution
C) Delusion of grandeur
D) Ideas of reference
💫ANSWER✔️✔️: **B** – A persecutory delusion involves a false belief that one is being harassed,
followed, or monitored. Ideas of reference are believing neutral events have personal meaning.
---
**4.** A patient with borderline personality disorder is admitted after a suicide attempt. The patient is
manipulative, splitting staff, and demanding. Which nursing intervention is most appropriate?
A) Allow the patient to choose which nurse cares for them each shift
B) Establish consistent, firm boundaries with all staff using a team approach
C) Give in to the patient’s demands to prevent escalation
D) Isolate the patient from other patients
💫ANSWER✔️✔️: **B** – Consistent boundaries and a unified team approach prevent splitting and
manipulation. Limit setting and clear expectations are essential.
---
**5.** A patient with generalized anxiety disorder is prescribed buspirone. Which statement indicates
correct understanding of this medication?
A) “I can take this medication as needed when I feel anxious.”
B) “This medication works immediately, like a benzodiazepine.”
C) “I need to take this medication daily for several weeks before it becomes effective.”
D) “Buspirone is habit-forming and should not be stopped abruptly.”
💫ANSWER✔️✔️: **C** – Buspirone is a non-benzodiazepine anxiolytic that requires daily dosing for 2–4
weeks to achieve effect. It is not PRN and not habit-forming.
---
,**6.** A patient with alcohol use disorder is admitted for detoxification. The nurse assesses a heart rate
of 130, blood pressure of 180/100, tremors, and hallucinations. What is the priority nursing diagnosis?
A) Risk for injury related to seizures
B) Ineffective coping related to substance use
C) Imbalanced nutrition: less than body requirements
D) Disturbed thought processes related to withdrawal
💫ANSWER✔️✔️: **A** – Severe alcohol withdrawal can progress to seizures and delirium tremens. Risk
for injury from seizures is the highest priority.
---
**7.** A patient with obsessive-compulsive disorder (OCD) spends 3 hours each day washing hands. The
nurse finds the patient with raw, bleeding hands. Which nursing intervention is most appropriate
initially?
A) Provide gloves to protect the patient’s hands
B) Set a limit of 15 minutes for handwashing
C) Encourage the patient to verbalize feelings about the behavior
D) Administer prescribed clomipramine and monitor for adherence
💫ANSWER✔️✔️: **D** – Pharmacotherapy (SSRIs or clomipramine) is first-line for OCD. Behavioral
interventions (response prevention) are implemented after medication has reduced anxiety.
---
**8.** A patient with post-traumatic stress disorder (PTSD) reports recurrent nightmares of a combat
experience. The nurse understands that this symptom is related to which aspect of PTSD?
A) Hyperarousal
B) Intrusive re-experiencing
C) Avoidance
D) Negative alterations in cognition and mood
, 💫ANSWER✔️✔️: **B** – Intrusive re-experiencing includes nightmares, flashbacks, and intrusive
thoughts. Hyperarousal includes hypervigilance and startle response.
---
**9.** A patient with bipolar disorder is in a manic episode. The patient is pacing, talking loudly, and
making grandiose plans. Which nursing intervention is most appropriate?
A) Place the patient in seclusion to reduce stimulation
B) Encourage the patient to attend group therapy to express feelings
C) Provide a low-stimulation environment with a calm, firm approach
D) Challenge the patient’s grandiose beliefs to reorient to reality
💫ANSWER✔️✔️: **C** – Low stimulation (quiet room, low lighting, calm staff) reduces manic energy.
Avoid arguing or challenging delusions. Seclusion is a last resort.
---
**10.** A patient with major depressive disorder has been taking phenelzine (MAOI) for 2 weeks. The
nurse should teach the patient to avoid which food?
A) Apples and bananas
B) Aged cheese and red wine
C) Chicken and fish
D) Rice and pasta
💫ANSWER✔️✔️: **B** – MAOIs require a low-tyramine diet to prevent hypertensive crisis. Tyramine-
rich foods include aged cheese, cured meats, fermented foods, and red wine.
---
**11.** A patient with schizophrenia is taking clozapine. Which laboratory finding requires immediate
notification of the provider?
A) White blood cell count 3,500/mm³ (absolute neutrophil count <1,500)
B) Hemoglobin 12 g/dL
Prep: Questions
---
**1.** A patient with major depressive disorder is started on fluoxetine. The nurse should educate the
patient that therapeutic effects may take:
A) 24 to 48 hours
B) 3 to 5 days
C) 2 to 4 weeks
D) 6 to 8 weeks
💫ANSWER✔️✔️: **C** – SSRIs typically take 2–4 weeks for initial improvement and 6–8 weeks for full
effect. Early side effects (anxiety, insomnia) may occur before mood improvement.
---
**2.** A patient with bipolar disorder is prescribed lithium. Which serum level indicates a therapeutic
maintenance range?
A) 0.2–0.5 mEq/L
B) 0.6–1.2 mEq/L
C) 1.5–2.0 mEq/L
D) 2.5–3.0 mEq/L
💫ANSWER✔️✔️: **B** – Therapeutic lithium level is 0.6–1.2 mEq/L for maintenance and acute mania.
Levels >1.5 mEq/L cause toxicity (nausea, tremor, ataxia, confusion).
---
**3.** A patient with schizophrenia tells the nurse, “The CIA is monitoring my thoughts through a
microchip in my tooth.” Which term best describes this statement?
,A) Illusion
B) Delusion of persecution
C) Delusion of grandeur
D) Ideas of reference
💫ANSWER✔️✔️: **B** – A persecutory delusion involves a false belief that one is being harassed,
followed, or monitored. Ideas of reference are believing neutral events have personal meaning.
---
**4.** A patient with borderline personality disorder is admitted after a suicide attempt. The patient is
manipulative, splitting staff, and demanding. Which nursing intervention is most appropriate?
A) Allow the patient to choose which nurse cares for them each shift
B) Establish consistent, firm boundaries with all staff using a team approach
C) Give in to the patient’s demands to prevent escalation
D) Isolate the patient from other patients
💫ANSWER✔️✔️: **B** – Consistent boundaries and a unified team approach prevent splitting and
manipulation. Limit setting and clear expectations are essential.
---
**5.** A patient with generalized anxiety disorder is prescribed buspirone. Which statement indicates
correct understanding of this medication?
A) “I can take this medication as needed when I feel anxious.”
B) “This medication works immediately, like a benzodiazepine.”
C) “I need to take this medication daily for several weeks before it becomes effective.”
D) “Buspirone is habit-forming and should not be stopped abruptly.”
💫ANSWER✔️✔️: **C** – Buspirone is a non-benzodiazepine anxiolytic that requires daily dosing for 2–4
weeks to achieve effect. It is not PRN and not habit-forming.
---
,**6.** A patient with alcohol use disorder is admitted for detoxification. The nurse assesses a heart rate
of 130, blood pressure of 180/100, tremors, and hallucinations. What is the priority nursing diagnosis?
A) Risk for injury related to seizures
B) Ineffective coping related to substance use
C) Imbalanced nutrition: less than body requirements
D) Disturbed thought processes related to withdrawal
💫ANSWER✔️✔️: **A** – Severe alcohol withdrawal can progress to seizures and delirium tremens. Risk
for injury from seizures is the highest priority.
---
**7.** A patient with obsessive-compulsive disorder (OCD) spends 3 hours each day washing hands. The
nurse finds the patient with raw, bleeding hands. Which nursing intervention is most appropriate
initially?
A) Provide gloves to protect the patient’s hands
B) Set a limit of 15 minutes for handwashing
C) Encourage the patient to verbalize feelings about the behavior
D) Administer prescribed clomipramine and monitor for adherence
💫ANSWER✔️✔️: **D** – Pharmacotherapy (SSRIs or clomipramine) is first-line for OCD. Behavioral
interventions (response prevention) are implemented after medication has reduced anxiety.
---
**8.** A patient with post-traumatic stress disorder (PTSD) reports recurrent nightmares of a combat
experience. The nurse understands that this symptom is related to which aspect of PTSD?
A) Hyperarousal
B) Intrusive re-experiencing
C) Avoidance
D) Negative alterations in cognition and mood
, 💫ANSWER✔️✔️: **B** – Intrusive re-experiencing includes nightmares, flashbacks, and intrusive
thoughts. Hyperarousal includes hypervigilance and startle response.
---
**9.** A patient with bipolar disorder is in a manic episode. The patient is pacing, talking loudly, and
making grandiose plans. Which nursing intervention is most appropriate?
A) Place the patient in seclusion to reduce stimulation
B) Encourage the patient to attend group therapy to express feelings
C) Provide a low-stimulation environment with a calm, firm approach
D) Challenge the patient’s grandiose beliefs to reorient to reality
💫ANSWER✔️✔️: **C** – Low stimulation (quiet room, low lighting, calm staff) reduces manic energy.
Avoid arguing or challenging delusions. Seclusion is a last resort.
---
**10.** A patient with major depressive disorder has been taking phenelzine (MAOI) for 2 weeks. The
nurse should teach the patient to avoid which food?
A) Apples and bananas
B) Aged cheese and red wine
C) Chicken and fish
D) Rice and pasta
💫ANSWER✔️✔️: **B** – MAOIs require a low-tyramine diet to prevent hypertensive crisis. Tyramine-
rich foods include aged cheese, cured meats, fermented foods, and red wine.
---
**11.** A patient with schizophrenia is taking clozapine. Which laboratory finding requires immediate
notification of the provider?
A) White blood cell count 3,500/mm³ (absolute neutrophil count <1,500)
B) Hemoglobin 12 g/dL
