Comprehensive NCLEX Review for Psychiatric Nursing: 720 Questions with Detailed Rationales – Varcarolis 2025 Edition

,Comprehensive NCLEX Review for
Psychiatric Nursing: 720 Questions with
Detailed Rationales – Varcarolis 2025
Edition

A Guaranteed-Pass Resource for Nursing Students, Instructors, and
Exam Prep Aligned with the Latest Clinical Standards and NCLEX-RN
Test Plan.




UNIT I: Foundations in Theory

1. Mental Health and Mental Illness

 Definitions of mental health and mental illness

 Continuum of mental health

 Risk and protective factors

 Stigma and public perceptions

 Diagnostic classification systems (DSM-5-TR, ICD-11)

 Recovery-oriented care

2. Theories and Therapies

 Psychoanalytic theory (Freud)

 Developmental theories (Erikson, Piaget)

 Behavioral and cognitive theories (Pavlov, Skinner, Beck)

 Humanistic theories (Maslow, Rogers)

 Biological theories

,  Milieu therapy

 Therapeutic modalities (CBT, DBT, group therapy)

3. Psychobiology and Psychopharmacology

 Structure and function of the nervous system

 Neurotransmitters and psychiatric disorders

 Brain imaging techniques

 Psychotropic medications:

o Antidepressants

o Antipsychotics

o Mood stabilizers

o Anxiolytics

 Side effects and nursing implications

 Pharmacogenetics



UNIT II: Foundations for Practice

4. Treatment Settings

 Inpatient vs. outpatient care

 Roles in interdisciplinary teams

 Levels of prevention (primary, secondary, tertiary)

 Mental health parity and access to care

 Continuum of care

5. Cultural Implications

 Cultural competence and humility

 Transcultural nursing theories (e.g., Leininger)

 Impact of culture on mental health

 Culture-bound syndromes

 Communication barriers and strategies

6. Legal and Ethical Considerations

 Patients’ rights (informed consent, right to treatment/refusal)

,  Confidentiality and HIPAA

 Commitment procedures (voluntary, involuntary)

 Ethical principles (autonomy, beneficence, justice)

 Legal issues in mental health nursing

 Tarasoff ruling and duty to warn



UNIT III: Psychosocial Nursing Tools

7. The Nursing Process and Standards of Care

 ANA Psychiatric Nursing Standards

 Assessment, Diagnosis, Planning, Implementation, Evaluation

 Nursing diagnoses (NANDA)

 Documentation and evaluation tools

 Evidence-based practice

8. Therapeutic Relationships

 Phases of nurse–patient relationship (Peplau’s theory)

 Boundaries and transference/countertransference

 Empathy vs. sympathy

 Building trust and rapport

9. Therapeutic Communication

 Verbal and non-verbal communication

 Therapeutic vs. non-therapeutic techniques

 Active listening

 Motivational interviewing

 Communication with special populations

10. Stress Responses and Stress Management

 Physiological and psychological responses to stress

 General adaptation syndrome

 Coping strategies (adaptive and maladaptive)

 Stress reduction techniques (relaxation, mindfulness)

,UNIT IV: Psychobiological Disorders

11. Childhood and Neurodevelopmental Disorders

 Autism spectrum disorder

 ADHD

 Tic disorders (Tourette’s)

 Intellectual disabilities

 Assessment and treatment strategies

 Family involvement

12. Schizophrenia Spectrum Disorders

 Symptoms (positive, negative, cognitive)

 Phases of schizophrenia

 Risk factors and neurobiology

 Treatment (medications, therapy, psychoeducation)

 Nursing care plans

13. Bipolar and Related Disorders

 Bipolar I and II

 Cyclothymic disorder

 Mania and depression symptoms

 Pharmacologic and non-pharmacologic treatments

 Managing risk behaviors

14. Depressive Disorders

 Major depressive disorder

 Persistent depressive disorder (dysthymia)

 Grief vs. clinical depression

 Antidepressants and therapies (CBT, ECT)

 Suicide risk assessment

15. Anxiety and Obsessive-Compulsive Disorders

 Generalized anxiety disorder

,  Panic disorder

 Phobias

 OCD and related disorders

 Behavioral therapies (exposure, desensitization)

16. Trauma, Stressor-Related, and Dissociative Disorders

 PTSD and acute stress disorder

 Reactive attachment disorder

 Dissociative identity disorder

 Trauma-informed care

 Treatment options and nursing roles

17. Somatic Symptom Disorders

 Illness anxiety disorder

 Conversion disorder

 Factitious disorder

 Managing symptoms without reinforcing them

18. Eating and Feeding Disorders

 Anorexia nervosa

 Bulimia nervosa

 Binge-eating disorder

 Nutritional and psychological interventions

 Family therapy

19. Sleep-Wake Disorders

 Insomnia and hypersomnia

 Narcolepsy

 Sleep apnea

 Circadian rhythm disturbances

 Sleep hygiene

20. Sexual Dysfunction, Gender Dysphoria, and Paraphilic Disorders

 Types of sexual dysfunction

,  DSM-5 gender dysphoria criteria

 Paraphilic disorders (exhibitionism, pedophilia)

 Therapeutic approaches and ethical issues

21. Impulse Control Disorders

 Intermittent explosive disorder

 Kleptomania

 Pyromania

 Nursing interventions and behavioral management

22. Substance-Related and Addictive Disorders

 Alcohol, opioids, stimulants

 CAGE and SBIRT screening tools

 Detoxification and withdrawal management

 Relapse prevention

 12-step and other treatment programs

23. Neurocognitive Disorders

 Delirium vs. dementia

 Alzheimer’s disease and related dementias

 Pharmacologic management

 Safety and communication strategies

24. Personality Disorders

 Cluster A, B, and C disorders

 Borderline, antisocial, narcissistic traits

 Dialectical behavior therapy (DBT)

 Setting limits and managing manipulative behavior



UNIT V: Trauma Interventions

25. Suicide and Non-suicidal Self-Injury

 Risk factors and warning signs

 Suicide assessment tools (SAD PERSONS scale)

,  Levels of risk and interventions

 Safety planning and crisis intervention

 Managing self-harming behaviors

26. Crisis and Disaster

 Types of crisis (maturational, situational, adventitious)

 Phases of crisis intervention

 Psychological first aid

 Community disaster mental health

27. Anger, Aggression, and Violence

 Triggers and risk assessment

 De-escalation strategies

 Use of restraints and seclusion

 Staff safety and legal documentation

28. Child, Older Adult, and Intimate Partner Violence

 Forms and signs of abuse

 Mandatory reporting laws

 Trauma-informed assessment

 Safety planning

29. Sexual Assault

 Acute stress and rape trauma syndrome

 Sexual Assault Nurse Examiner (SANE) role

 Legal and ethical care considerations

 Emotional and psychological support



UNIT VI: Interventions for Special Populations

30. Dying, Death, and Grieving

 Theories of grief (Kubler-Ross, Worden)

 Anticipatory grief and complicated grief

 Culturally sensitive care

,  Supporting families and caregivers

31. Older Adults

 Normal vs. abnormal aging

 Polypharmacy concerns

 Cognitive and sensory changes

 Abuse and neglect in older adults

32. Serious Mental Illness

 Characteristics of SMI

 Stigma and social issues

 Recovery models and ACT teams

 Housing and employment supports

33. Forensic Nursing

 Roles in criminal justice system

 Competency and criminal responsibility

 Court testimony and documentation

 Ethical and legal issues



UNIT VII: Other Intervention Modalities

34. Therapeutic Groups

 Types of groups (psychoeducational, support, therapy)

 Group development and roles

 Facilitator responsibilities

 Managing group dynamics

35. Family Interventions

 Family systems theory

 Psychoeducation

 Family assessment tools

 Involving families in treatment planning

36. Integrative Care

,  Complementary and alternative therapies

 Mind-body practices (yoga, meditation)

 Herbal remedies and their risks

 Whole-person and holistic models



Unit I: Foundations in Theory from Varcarolis’ Foundations of
Psychiatric-Mental Health Nursing, 9th Ed.
Q1. Which of the following best defines mental health?
a. Complete absence of psychiatric symptoms
b. A state of well-being in which an individual realizes their
abilities, can cope with normal stress, work productively, and
contribute to the community
c. Consistently high levels of academic or job performance
d. Having no family history of mental illness
Correct answer: b
Rationale: Mental health is a positive state encompassing
coping, productivity, and community contribution, not merely
absence of symptoms.


Q2. A nurse explains mental illness as:
a. Any deviation from cultural norms
b. A biologic disorder only
c. A clinically significant disturbance in cognition, emotion
regulation, or behavior reflecting dysfunction in psychological,
biological, or developmental processes
d. A result of personal weakness