The Therapeutic Compass: A
Comprehensive Questions &
Answers Guide to Psychiatric-Mental
Health Nursing Plus
Rationales/Instant Download Pdf
Level 1: Fundamentals & Communication
Q1: A patient with schizophrenia tells the nurse, "I am the
king of the universe. The FBI is after me because I have the
secret formula." What is the nurse’s BEST therapeutic
response?
• A) "You are not the king; you are in a hospital."
• B) "That sounds frightening. Tell me more about what is
happening right now."
• C) "The FBI is not after you. Let's take your medication."
• D) "I understand. I am the queen of England."
Answer: B
Rationale: Option B uses validation and exploring without
reinforcing the delusion. It focuses on the
patient's feeling (frightened) rather than the content of the
delusion. A and C are argumentative (reality orientation is not
helpful during active psychosis), and D is contraindicated
(colluding with the delusion).
,Q2: A patient is crying and states, "I don't want to live
anymore. My life is pointless." Which nursing action is the
priority?
• A) Tell the patient to "look on the bright side."
• B) Conduct a thorough suicide risk assessment.
• C) Leave the patient alone to calm down.
• D) Administer PRN Haloperidol immediately.
Answer: B
Rationale: The priority is patient safety. Any statement
indicating suicidal ideation requires an immediate, direct, and
non-judgmental assessment of intent, plan, and means. Options
A (false reassurance) and C (negligence) are unsafe.
Q3: During a group therapy session, a patient becomes
increasingly agitated and threatens to hit another patient.
What is the initial nursing intervention?
• A) Call security to physically restrain the patient.
• B) Use a calm voice and state, "You are very angry right
now. Let's step outside the group to talk."
• C) Ignore the behavior to avoid reinforcing it.
• D) Tell the patient to "stop that immediately or you will be
placed in seclusion."
Answer: B
Rationale: The least restrictive intervention should be used
first. Verbal de-escalation using a calm, firm voice and offering
a choice (leaving the group) is the initial step. Physical
,restraints/seclusion are last resorts (A). Ignoring (C) escalates
risk, and threatening (D) is a power struggle that can worsen
agitation.
Level 2: Clinical Conditions & Interventions
Q4: A patient diagnosed with Bipolar I Disorder is in the
manic phase. He is pacing, talking rapidly, and wearing a
heavy winter coat despite the warm weather. Which
nursing intervention is most appropriate?
• A) Engage the patient in a competitive card game to
channel his energy.
• B) Place the patient in seclusion to reduce environmental
stimuli.
• C) Provide high-calorie finger foods and frequent rest
periods.
• D) Encourage the patient to discuss his feelings about his
childhood.
Answer: C
Rationale: Manic patients expend enormous energy and often
forget to eat/drink. Finger foods allow them to eat while
moving, and frequent rest prevents exhaustion (which can lead
to death). Option A (competition) exacerbates agitation. Option
B (seclusion) is too restrictive initially. Option D (insight-
oriented therapy) is ineffective during acute mania due to the
patient's inability to focus.
, Q5: A patient with Major Depressive Disorder has been
taking Fluoxetine (Prozac) for 2 weeks. He reports, "I feel
more tired and nauseous, and I don't feel any better." What
is the nurse's best response?
• A) "We should stop the medication immediately due to
side effects."
• B) "This medication is clearly not working; you need a
different one."
• C) "These are common side effects initially. It can take 4-6
weeks to see therapeutic effects."
• D) "You are probably just resisting treatment."
Answer: C
Rationale: SSRIs like Fluoxetine have a delayed onset of action
(4-6 weeks). Side effects like nausea, headache, and
insomnia/fatigue are common in the first 1-2 weeks and often
subside. The nurse must provide psychoeducation to improve
medication adherence.
Q6: A patient with Alzheimer's disease is wandering into
other patients' rooms at night and is at risk for falls. Which
intervention is the safest and most therapeutic?
• A) Apply soft wrist restraints to prevent wandering.
• B) Place the patient in a locked seclusion room at bedtime.
• C) Offer the patient a warm glass of milk and redirect to a
supervised activity area.
• D) Tell the patient firmly to "stay in your own bed."
Answer: C
Rationale: Wandering is common in dementia. The goal
Comprehensive Questions &
Answers Guide to Psychiatric-Mental
Health Nursing Plus
Rationales/Instant Download Pdf
Level 1: Fundamentals & Communication
Q1: A patient with schizophrenia tells the nurse, "I am the
king of the universe. The FBI is after me because I have the
secret formula." What is the nurse’s BEST therapeutic
response?
• A) "You are not the king; you are in a hospital."
• B) "That sounds frightening. Tell me more about what is
happening right now."
• C) "The FBI is not after you. Let's take your medication."
• D) "I understand. I am the queen of England."
Answer: B
Rationale: Option B uses validation and exploring without
reinforcing the delusion. It focuses on the
patient's feeling (frightened) rather than the content of the
delusion. A and C are argumentative (reality orientation is not
helpful during active psychosis), and D is contraindicated
(colluding with the delusion).
,Q2: A patient is crying and states, "I don't want to live
anymore. My life is pointless." Which nursing action is the
priority?
• A) Tell the patient to "look on the bright side."
• B) Conduct a thorough suicide risk assessment.
• C) Leave the patient alone to calm down.
• D) Administer PRN Haloperidol immediately.
Answer: B
Rationale: The priority is patient safety. Any statement
indicating suicidal ideation requires an immediate, direct, and
non-judgmental assessment of intent, plan, and means. Options
A (false reassurance) and C (negligence) are unsafe.
Q3: During a group therapy session, a patient becomes
increasingly agitated and threatens to hit another patient.
What is the initial nursing intervention?
• A) Call security to physically restrain the patient.
• B) Use a calm voice and state, "You are very angry right
now. Let's step outside the group to talk."
• C) Ignore the behavior to avoid reinforcing it.
• D) Tell the patient to "stop that immediately or you will be
placed in seclusion."
Answer: B
Rationale: The least restrictive intervention should be used
first. Verbal de-escalation using a calm, firm voice and offering
a choice (leaving the group) is the initial step. Physical
,restraints/seclusion are last resorts (A). Ignoring (C) escalates
risk, and threatening (D) is a power struggle that can worsen
agitation.
Level 2: Clinical Conditions & Interventions
Q4: A patient diagnosed with Bipolar I Disorder is in the
manic phase. He is pacing, talking rapidly, and wearing a
heavy winter coat despite the warm weather. Which
nursing intervention is most appropriate?
• A) Engage the patient in a competitive card game to
channel his energy.
• B) Place the patient in seclusion to reduce environmental
stimuli.
• C) Provide high-calorie finger foods and frequent rest
periods.
• D) Encourage the patient to discuss his feelings about his
childhood.
Answer: C
Rationale: Manic patients expend enormous energy and often
forget to eat/drink. Finger foods allow them to eat while
moving, and frequent rest prevents exhaustion (which can lead
to death). Option A (competition) exacerbates agitation. Option
B (seclusion) is too restrictive initially. Option D (insight-
oriented therapy) is ineffective during acute mania due to the
patient's inability to focus.
, Q5: A patient with Major Depressive Disorder has been
taking Fluoxetine (Prozac) for 2 weeks. He reports, "I feel
more tired and nauseous, and I don't feel any better." What
is the nurse's best response?
• A) "We should stop the medication immediately due to
side effects."
• B) "This medication is clearly not working; you need a
different one."
• C) "These are common side effects initially. It can take 4-6
weeks to see therapeutic effects."
• D) "You are probably just resisting treatment."
Answer: C
Rationale: SSRIs like Fluoxetine have a delayed onset of action
(4-6 weeks). Side effects like nausea, headache, and
insomnia/fatigue are common in the first 1-2 weeks and often
subside. The nurse must provide psychoeducation to improve
medication adherence.
Q6: A patient with Alzheimer's disease is wandering into
other patients' rooms at night and is at risk for falls. Which
intervention is the safest and most therapeutic?
• A) Apply soft wrist restraints to prevent wandering.
• B) Place the patient in a locked seclusion room at bedtime.
• C) Offer the patient a warm glass of milk and redirect to a
supervised activity area.
• D) Tell the patient firmly to "stay in your own bed."
Answer: C
Rationale: Wandering is common in dementia. The goal
