D449 Objective Assessment – WGU Psychiatric &
Mental Health OA – (2026/2027) Actual Questions &
Study Guide | Guarantee Pass – New Update
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Therapeutic Communication
2 Psychiatric Disorders
3 Psychopharmacology
4 Suicide Risk Assessment
5 Defense Mechanisms
6 Legal & Ethical Issues
7 Crisis Intervention & De-escalation
8 Substance Use Disorders
9 Eating Disorders
,Q1
A client with depression states, "I'm so stupid, I can't do anything right." Which nursing response
demonstrates therapeutic communication?
A) "You are not stupid; you have many talents."
B) *"You seem to be feeling very down on yourself today." CORRECT
C) "Let's make a list of things you are good at."
D) "Why do you put yourself down?"
Rationale
Reflection acknowledges the client's feelings without arguing or giving false reassurance.
Q2
A client with schizophrenia is hearing voices telling him to hurt himself. What is the nurse's first
action?
A) Ask the client to describe the voices
B) *Initiate suicide precautions and notify the provider CORRECT
C) Tell the client the voices are not real
D) Administer a PRN antipsychotic
Rationale
Command hallucinations to self-harm require immediate safety interventions.
Q3
A client in a manic episode is rapidly pacing and speaking loudly. Which nursing intervention is
priority?
A) Place the client in seclusion
B) *Reduce environmental stimuli CORRECT
C) Confront the client about the behavior
D) Restrain the client
2
,Rationale
A low-stimulation environment helps decrease agitation and manic behavior.
Q4
A client with borderline personality disorder says, "I want to cut myself." What should the nurse
do first?
A) Restrict the client to her room
B) *Assess the urge and review the safety plan CORRECT
C) Apply restraints
D) Administer a sedative
Rationale
First, assess the risk and use de-escalation, including alternative coping strategies.
Q5
A client in alcohol withdrawal is 10 hours from last drink. Which finding is expected?
A) Seizures
B) *Tremors, anxiety, and diaphoresis CORRECT
C) Delirium tremens
D) Hallucinations
Rationale
Early withdrawal (6-12 hours) includes tremors, anxiety, and tachycardia.
Q6
A client tells the nurse, "I'm going to kill myself tonight." What is the priority action?
A) Document and inform the next shift
B) *One-to-one observation and notify the provider CORRECT
C) Tell the client it is not allowed
3
, D) Remove sharp objects
Rationale
Immediate safety includes constant observation and provider notification.
Q7
A client on paroxetine asks, "When will I feel better?" Which response is correct?
A) "Within 24 hours."
B) *"It may take 4-6 weeks for full effect." CORRECT
C) "You can stop when you feel less anxious."
D) "This medication is addictive."
Rationale
SSRIs have delayed onset; full therapeutic effect takes several weeks.
Q8
A client on haloperidol develops stiff neck, fever, and confusion. Which condition is suspected?
A) Tardive dyskinesia
B) *Neuroleptic malignant syndrome (NMS) CORRECT
C) Acute dystonia
D) Serotonin syndrome
Rationale
NMS presents with fever, rigidity, altered mental status, and autonomic instability.
Q9
A client on fluoxetine reports increased fatigue and nausea. Which response is best?
A) "The medication is not working."
B) *"These side effects often improve. Try taking it with food." CORRECT
4
Mental Health OA – (2026/2027) Actual Questions &
Study Guide | Guarantee Pass – New Update
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Therapeutic Communication
2 Psychiatric Disorders
3 Psychopharmacology
4 Suicide Risk Assessment
5 Defense Mechanisms
6 Legal & Ethical Issues
7 Crisis Intervention & De-escalation
8 Substance Use Disorders
9 Eating Disorders
,Q1
A client with depression states, "I'm so stupid, I can't do anything right." Which nursing response
demonstrates therapeutic communication?
A) "You are not stupid; you have many talents."
B) *"You seem to be feeling very down on yourself today." CORRECT
C) "Let's make a list of things you are good at."
D) "Why do you put yourself down?"
Rationale
Reflection acknowledges the client's feelings without arguing or giving false reassurance.
Q2
A client with schizophrenia is hearing voices telling him to hurt himself. What is the nurse's first
action?
A) Ask the client to describe the voices
B) *Initiate suicide precautions and notify the provider CORRECT
C) Tell the client the voices are not real
D) Administer a PRN antipsychotic
Rationale
Command hallucinations to self-harm require immediate safety interventions.
Q3
A client in a manic episode is rapidly pacing and speaking loudly. Which nursing intervention is
priority?
A) Place the client in seclusion
B) *Reduce environmental stimuli CORRECT
C) Confront the client about the behavior
D) Restrain the client
2
,Rationale
A low-stimulation environment helps decrease agitation and manic behavior.
Q4
A client with borderline personality disorder says, "I want to cut myself." What should the nurse
do first?
A) Restrict the client to her room
B) *Assess the urge and review the safety plan CORRECT
C) Apply restraints
D) Administer a sedative
Rationale
First, assess the risk and use de-escalation, including alternative coping strategies.
Q5
A client in alcohol withdrawal is 10 hours from last drink. Which finding is expected?
A) Seizures
B) *Tremors, anxiety, and diaphoresis CORRECT
C) Delirium tremens
D) Hallucinations
Rationale
Early withdrawal (6-12 hours) includes tremors, anxiety, and tachycardia.
Q6
A client tells the nurse, "I'm going to kill myself tonight." What is the priority action?
A) Document and inform the next shift
B) *One-to-one observation and notify the provider CORRECT
C) Tell the client it is not allowed
3
, D) Remove sharp objects
Rationale
Immediate safety includes constant observation and provider notification.
Q7
A client on paroxetine asks, "When will I feel better?" Which response is correct?
A) "Within 24 hours."
B) *"It may take 4-6 weeks for full effect." CORRECT
C) "You can stop when you feel less anxious."
D) "This medication is addictive."
Rationale
SSRIs have delayed onset; full therapeutic effect takes several weeks.
Q8
A client on haloperidol develops stiff neck, fever, and confusion. Which condition is suspected?
A) Tardive dyskinesia
B) *Neuroleptic malignant syndrome (NMS) CORRECT
C) Acute dystonia
D) Serotonin syndrome
Rationale
NMS presents with fever, rigidity, altered mental status, and autonomic instability.
Q9
A client on fluoxetine reports increased fatigue and nausea. Which response is best?
A) "The medication is not working."
B) *"These side effects often improve. Try taking it with food." CORRECT
4
