Page 1 of 210
OPENSTAX PSYCHIATRIC–MENTAL HEALTH NURSING
EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED SOLUTIONS ALL WITH RATIONALES LATEST
THIS YEAR
Exam Coverage Summary – OpenStax Psychiatric–Mental Health Nursing
This comprehensive exam covers the full scope of psychiatric–mental health nursing as
presented in the OpenStax textbook. Foundational concepts include the distinction between
mental health and mental illness, the mental health continuum, risk and protective factors,
stigma, and the recovery model. Therapeutic communication and the nurse–client relationship
are central, including verbal and nonverbal techniques, active listening, empathy, boundaries,
and cultural considerations. The nursing process is applied throughout, with emphasis on
biopsychosocial assessment, diagnosis, planning, implementation, and evaluation.
Psychopharmacology covers major drug classes—antidepressants, antipsychotics, mood
stabilizers, anxiolytics—including mechanisms, side effects, adverse reactions, and nursing
implications. Legal and ethical principles include informed consent, confidentiality (HIPAA), duty
to warn, mandatory reporting, civil commitment, and the ANA Code of Ethics. Major psychiatric
disorders are addressed across the lifespan: schizophrenia spectrum (positive/negative
symptoms, antipsychotic management); depressive disorders (assessment, suicide risk,
antidepressants); bipolar disorders (mania, hypomania, mood stabilizers); anxiety disorders
(GAD, panic, phobias, PTSD, OCD); personality disorders (Clusters A, B, C with specific
interventions); substance use disorders; neurodevelopmental disorders; trauma-informed care;
crisis intervention; and community mental health. The exam emphasizes clinical judgment,
safety prioritization, therapeutic engagement, and evidence-based, culturally competent,
recovery-oriented nursing care across all settings.
300 Randomized Multiple-Choice Questions
1. A 45-year-old client with major depressive disorder tells the nurse, "I don't see the point in
going on anymore." What is the nurse's priority action?
, Page 2 of 210
A. Explore the client's feelings of hopelessness
B. Ask the client directly about suicidal thoughts and plan
C. Notify the health-care provider of the client's statement
D. Encourage the client to focus on positive aspects of life
Answer: B
Asking directly about suicidal ideation, intent, and plan is the priority when a client expresses
hopelessness; this direct assessment is essential for safety planning and does not increase
suicide risk.
2. A client with schizophrenia is experiencing auditory hallucinations commanding them to
harm others. Which nursing intervention is most appropriate initially?
A. Tell the client the voices are not real
B. Distract the client with a television show
C. Assess the content and command nature of the hallucinations
D. Place the client in seclusion for safety
Answer: C
, Page 3 of 210
Assessing the content of hallucinations, especially command hallucinations, determines
immediate safety risk; the nurse must evaluate whether the client intends to act on the
commands before implementing safety measures.
3. The nurse is caring for a client with bipolar disorder who is in a manic phase and has not slept
for three days. What is the priority nursing intervention?
A. Encourage the client to take a nap
B. Provide a structured, low-stimulation environment
C. Allow the client to exercise vigorously to expend energy
D. Engage the client in group therapy to promote socialization
Answer: B
Clients in a manic phase require reduced environmental stimulation to decrease agitation and
prevent exhaustion; a structured, calm environment with frequent high-calorie snacks and fluids
supports stabilization.
, Page 4 of 210
4. A client prescribed fluoxetine for depression reports gastrointestinal distress and insomnia.
What is the nurse's best response?
A. "Stop taking the medication immediately and call your provider"
B. "These side effects are common and often subside within a few weeks"
C. "Take the medication with food and in the morning to minimize these effects"
D. "Request a different medication from your provider"
Answer: C
Taking SSRIs with food reduces GI upset, and morning dosing minimizes insomnia; these are
standard nursing interventions for managing common SSRI side effects while supporting
medication adherence.
5. During a nurse–client interaction, the client states, "Everyone at work is out to get me."
Which therapeutic communication response is most appropriate?
A. "That sounds very frightening. Tell me more about what makes you feel that way."
B. "I'm sure that's not true; you're probably just being paranoid."
OPENSTAX PSYCHIATRIC–MENTAL HEALTH NURSING
EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED SOLUTIONS ALL WITH RATIONALES LATEST
THIS YEAR
Exam Coverage Summary – OpenStax Psychiatric–Mental Health Nursing
This comprehensive exam covers the full scope of psychiatric–mental health nursing as
presented in the OpenStax textbook. Foundational concepts include the distinction between
mental health and mental illness, the mental health continuum, risk and protective factors,
stigma, and the recovery model. Therapeutic communication and the nurse–client relationship
are central, including verbal and nonverbal techniques, active listening, empathy, boundaries,
and cultural considerations. The nursing process is applied throughout, with emphasis on
biopsychosocial assessment, diagnosis, planning, implementation, and evaluation.
Psychopharmacology covers major drug classes—antidepressants, antipsychotics, mood
stabilizers, anxiolytics—including mechanisms, side effects, adverse reactions, and nursing
implications. Legal and ethical principles include informed consent, confidentiality (HIPAA), duty
to warn, mandatory reporting, civil commitment, and the ANA Code of Ethics. Major psychiatric
disorders are addressed across the lifespan: schizophrenia spectrum (positive/negative
symptoms, antipsychotic management); depressive disorders (assessment, suicide risk,
antidepressants); bipolar disorders (mania, hypomania, mood stabilizers); anxiety disorders
(GAD, panic, phobias, PTSD, OCD); personality disorders (Clusters A, B, C with specific
interventions); substance use disorders; neurodevelopmental disorders; trauma-informed care;
crisis intervention; and community mental health. The exam emphasizes clinical judgment,
safety prioritization, therapeutic engagement, and evidence-based, culturally competent,
recovery-oriented nursing care across all settings.
300 Randomized Multiple-Choice Questions
1. A 45-year-old client with major depressive disorder tells the nurse, "I don't see the point in
going on anymore." What is the nurse's priority action?
, Page 2 of 210
A. Explore the client's feelings of hopelessness
B. Ask the client directly about suicidal thoughts and plan
C. Notify the health-care provider of the client's statement
D. Encourage the client to focus on positive aspects of life
Answer: B
Asking directly about suicidal ideation, intent, and plan is the priority when a client expresses
hopelessness; this direct assessment is essential for safety planning and does not increase
suicide risk.
2. A client with schizophrenia is experiencing auditory hallucinations commanding them to
harm others. Which nursing intervention is most appropriate initially?
A. Tell the client the voices are not real
B. Distract the client with a television show
C. Assess the content and command nature of the hallucinations
D. Place the client in seclusion for safety
Answer: C
, Page 3 of 210
Assessing the content of hallucinations, especially command hallucinations, determines
immediate safety risk; the nurse must evaluate whether the client intends to act on the
commands before implementing safety measures.
3. The nurse is caring for a client with bipolar disorder who is in a manic phase and has not slept
for three days. What is the priority nursing intervention?
A. Encourage the client to take a nap
B. Provide a structured, low-stimulation environment
C. Allow the client to exercise vigorously to expend energy
D. Engage the client in group therapy to promote socialization
Answer: B
Clients in a manic phase require reduced environmental stimulation to decrease agitation and
prevent exhaustion; a structured, calm environment with frequent high-calorie snacks and fluids
supports stabilization.
, Page 4 of 210
4. A client prescribed fluoxetine for depression reports gastrointestinal distress and insomnia.
What is the nurse's best response?
A. "Stop taking the medication immediately and call your provider"
B. "These side effects are common and often subside within a few weeks"
C. "Take the medication with food and in the morning to minimize these effects"
D. "Request a different medication from your provider"
Answer: C
Taking SSRIs with food reduces GI upset, and morning dosing minimizes insomnia; these are
standard nursing interventions for managing common SSRI side effects while supporting
medication adherence.
5. During a nurse–client interaction, the client states, "Everyone at work is out to get me."
Which therapeutic communication response is most appropriate?
A. "That sounds very frightening. Tell me more about what makes you feel that way."
B. "I'm sure that's not true; you're probably just being paranoid."
