Mental Health 1 Exam 2026 - Practice
Questions with Answers & Rationales
Rasmussen University
Question 1
A client newly admitted to the psychiatric unit says, "I just don't see the point in living anymore." Which
response by the nurse is the most therapeutic?
A) "You have so much to live for, think about your family."
B) "You are feeling hopeless about your future right now."
C) "Why do you feel that your life has no point?"
D) "Let's talk about something more pleasant to cheer you up."
ANSWER: B
Rationale: A is incorrect because it offers false reassurance and dismisses the client's feelings. B is
correct because it uses the therapeutic technique of reflection, acknowledging and validating the client's
emotion. C is incorrect because asking "why" is non-therapeutic and can make the client defensive. D is
incorrect because changing the subject blocks communication and ignores a potential safety risk.
Question 2
During the orientation phase of the nurse-client relationship, what is the primary goal of the nurse?
A) Work through client resistance and transference.
B) Establish trust, rapport, and mutual goals.
C) Evaluate the outcomes of the nursing care plan.
D) Explore the nurse's own feelings and biases about the client.
ANSWER: B
,Rationale: A is incorrect because working through resistance occurs in the working phase. B is correct
because the orientation phase focuses on building trust, setting boundaries, and establishing goals. C is
incorrect because evaluating outcomes is part of the termination phase. D is incorrect because exploring
the nurse's own feelings occurs in the pre-interaction phase.
Question 3
A client taking phenelzine (an MAOI) for depression asks the nurse about dietary restrictions. Which
food should the nurse instruct the client to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Skim milk
D) Whole wheat bread
ANSWER: B
Rationale: A is incorrect because fresh fruits are low in tyramine and safe to consume. B is correct
because aged cheeses are high in tyramine, which can cause a hypertensive crisis when combined with
an MAOI. C is incorrect because fresh milk products are safe. D is incorrect because fresh bread does not
contain dangerous levels of tyramine.
Question 4
A client with schizophrenia is heard saying, "The CIA planted a microchip in my brain to control my
thoughts." The nurse recognizes this as which type of delusion?
A) Delusion of persecution
B) Delusion of grandeur
C) Somatic delusion
D) Delusion of control/insertion
ANSWER: D
Rationale: A is incorrect because persecution involves beliefs of being harmed or spied on, not
specifically having thoughts controlled. B is incorrect because grandeur involves beliefs of having
immense power or identity. C is incorrect because somatic delusions involve beliefs about bodily
functions or structures. D is correct because thought insertion/control is the false belief that external
forces are controlling one's mind.
Question 5
A client is prescribed lithium carbonate for bipolar disorder. Which laboratory value must the nurse
monitor regularly to prevent toxicity?
A) Complete blood count (CBC)
,B) Liver function tests (LFTs)
C) Serum lithium levels
D) Thyroid stimulating hormone (TSH)
ANSWER: C
Rationale: A is incorrect because while CBC is monitored for some psychotropics like clozapine, it is not
the primary concern for lithium. B is incorrect because LFTs are not the primary monitoring parameter
for lithium. C is correct because lithium has a narrow therapeutic index (0.6–1.2 mEq/L), and regular
serum levels are critical to avoid toxicity. D is incorrect because while lithium can affect the thyroid,
serum lithium levels are the priority for preventing acute toxicity.
Question 6
Which action by the nurse demonstrates the use of "milieu therapy" on an inpatient psychiatric unit?
A) Administering PRN medication for acute anxiety.
B) Structuring the environment to promote safety and therapeutic interactions.
C) Conducting individual psychoanalysis with the client.
D) Teaching the client deep breathing exercises.
ANSWER: B
Rationale: A is incorrect because this is a pharmacological intervention. B is correct because milieu
therapy involves using the entire environment, community, and structure as a therapeutic tool to
promote healing and social skills. C is incorrect because this is an individual therapy modality. D is
incorrect because this is a specific coping skill intervention, not milieu therapy.
Question 7
A client with major depressive disorder is admitted to the unit. Which assessment is the nurse's absolute
highest priority?
A) Assessing the client's sleep patterns.
B) Evaluating the client's nutritional intake.
C) Conducting a suicide risk assessment.
D) Determining the client's activity level.
ANSWER: C
Rationale: A is incorrect because while sleep is important, it is not the immediate priority. B is incorrect
because nutrition is a physiological need but secondary to immediate survival. C is correct because
safety is the highest priority in Maslow's hierarchy and nursing practice; clients with severe depression
are at high risk for suicide. D is incorrect because activity level is important but not life-threatening.
Question 8
, A client experiencing a panic attack says, "I can't breathe, I'm going to die!" What is the nurse's best
initial intervention?
A) Encourage the client to talk about what caused the panic.
B) Stay with the client, use a calm voice, and guide deep breathing.
C) Administer an oral antidepressant immediately.
D) Leave the client alone in a quiet room to calm down.
ANSWER: B
Rationale: A is incorrect because exploring causes during acute panic is ineffective as the client's
cognitive ability is severely impaired. B is correct because staying with the client ensures safety, and a
calm presence with breathing exercises helps reduce hyperventilation and anxiety. C is incorrect
because antidepressants take weeks to work and are not for acute panic relief. D is incorrect because
leaving a terrified client alone can increase feelings of abandonment and panic.
Question 9
A client with borderline personality disorder attempts to manipulate the staff by saying, "The night
nurse is the only one who cares about me; you are all cruel." The nurse recognizes this behavior as:
A) Projection
B) Splitting
C) Displacement
D) Sublimation
ANSWER: B
Rationale: A is incorrect because projection is attributing one's own unacceptable feelings to others. B is
correct because splitting is a defense mechanism common in borderline personality disorder where
people or situations are viewed as all good or all bad. C is incorrect because displacement is transferring
feelings to a less threatening target. D is incorrect because sublimation is channeling unacceptable
impulses into socially acceptable activities.
Question 10
A client is prescribed clozapine for treatment-resistant schizophrenia. Which adverse effect requires the
nurse to immediately withhold the medication and notify the provider?
A) Mild drowsiness
B) Drooling during sleep
C) Fever, sore throat, and malaise
D) Increased appetite
ANSWER: C
Questions with Answers & Rationales
Rasmussen University
Question 1
A client newly admitted to the psychiatric unit says, "I just don't see the point in living anymore." Which
response by the nurse is the most therapeutic?
A) "You have so much to live for, think about your family."
B) "You are feeling hopeless about your future right now."
C) "Why do you feel that your life has no point?"
D) "Let's talk about something more pleasant to cheer you up."
ANSWER: B
Rationale: A is incorrect because it offers false reassurance and dismisses the client's feelings. B is
correct because it uses the therapeutic technique of reflection, acknowledging and validating the client's
emotion. C is incorrect because asking "why" is non-therapeutic and can make the client defensive. D is
incorrect because changing the subject blocks communication and ignores a potential safety risk.
Question 2
During the orientation phase of the nurse-client relationship, what is the primary goal of the nurse?
A) Work through client resistance and transference.
B) Establish trust, rapport, and mutual goals.
C) Evaluate the outcomes of the nursing care plan.
D) Explore the nurse's own feelings and biases about the client.
ANSWER: B
,Rationale: A is incorrect because working through resistance occurs in the working phase. B is correct
because the orientation phase focuses on building trust, setting boundaries, and establishing goals. C is
incorrect because evaluating outcomes is part of the termination phase. D is incorrect because exploring
the nurse's own feelings occurs in the pre-interaction phase.
Question 3
A client taking phenelzine (an MAOI) for depression asks the nurse about dietary restrictions. Which
food should the nurse instruct the client to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Skim milk
D) Whole wheat bread
ANSWER: B
Rationale: A is incorrect because fresh fruits are low in tyramine and safe to consume. B is correct
because aged cheeses are high in tyramine, which can cause a hypertensive crisis when combined with
an MAOI. C is incorrect because fresh milk products are safe. D is incorrect because fresh bread does not
contain dangerous levels of tyramine.
Question 4
A client with schizophrenia is heard saying, "The CIA planted a microchip in my brain to control my
thoughts." The nurse recognizes this as which type of delusion?
A) Delusion of persecution
B) Delusion of grandeur
C) Somatic delusion
D) Delusion of control/insertion
ANSWER: D
Rationale: A is incorrect because persecution involves beliefs of being harmed or spied on, not
specifically having thoughts controlled. B is incorrect because grandeur involves beliefs of having
immense power or identity. C is incorrect because somatic delusions involve beliefs about bodily
functions or structures. D is correct because thought insertion/control is the false belief that external
forces are controlling one's mind.
Question 5
A client is prescribed lithium carbonate for bipolar disorder. Which laboratory value must the nurse
monitor regularly to prevent toxicity?
A) Complete blood count (CBC)
,B) Liver function tests (LFTs)
C) Serum lithium levels
D) Thyroid stimulating hormone (TSH)
ANSWER: C
Rationale: A is incorrect because while CBC is monitored for some psychotropics like clozapine, it is not
the primary concern for lithium. B is incorrect because LFTs are not the primary monitoring parameter
for lithium. C is correct because lithium has a narrow therapeutic index (0.6–1.2 mEq/L), and regular
serum levels are critical to avoid toxicity. D is incorrect because while lithium can affect the thyroid,
serum lithium levels are the priority for preventing acute toxicity.
Question 6
Which action by the nurse demonstrates the use of "milieu therapy" on an inpatient psychiatric unit?
A) Administering PRN medication for acute anxiety.
B) Structuring the environment to promote safety and therapeutic interactions.
C) Conducting individual psychoanalysis with the client.
D) Teaching the client deep breathing exercises.
ANSWER: B
Rationale: A is incorrect because this is a pharmacological intervention. B is correct because milieu
therapy involves using the entire environment, community, and structure as a therapeutic tool to
promote healing and social skills. C is incorrect because this is an individual therapy modality. D is
incorrect because this is a specific coping skill intervention, not milieu therapy.
Question 7
A client with major depressive disorder is admitted to the unit. Which assessment is the nurse's absolute
highest priority?
A) Assessing the client's sleep patterns.
B) Evaluating the client's nutritional intake.
C) Conducting a suicide risk assessment.
D) Determining the client's activity level.
ANSWER: C
Rationale: A is incorrect because while sleep is important, it is not the immediate priority. B is incorrect
because nutrition is a physiological need but secondary to immediate survival. C is correct because
safety is the highest priority in Maslow's hierarchy and nursing practice; clients with severe depression
are at high risk for suicide. D is incorrect because activity level is important but not life-threatening.
Question 8
, A client experiencing a panic attack says, "I can't breathe, I'm going to die!" What is the nurse's best
initial intervention?
A) Encourage the client to talk about what caused the panic.
B) Stay with the client, use a calm voice, and guide deep breathing.
C) Administer an oral antidepressant immediately.
D) Leave the client alone in a quiet room to calm down.
ANSWER: B
Rationale: A is incorrect because exploring causes during acute panic is ineffective as the client's
cognitive ability is severely impaired. B is correct because staying with the client ensures safety, and a
calm presence with breathing exercises helps reduce hyperventilation and anxiety. C is incorrect
because antidepressants take weeks to work and are not for acute panic relief. D is incorrect because
leaving a terrified client alone can increase feelings of abandonment and panic.
Question 9
A client with borderline personality disorder attempts to manipulate the staff by saying, "The night
nurse is the only one who cares about me; you are all cruel." The nurse recognizes this behavior as:
A) Projection
B) Splitting
C) Displacement
D) Sublimation
ANSWER: B
Rationale: A is incorrect because projection is attributing one's own unacceptable feelings to others. B is
correct because splitting is a defense mechanism common in borderline personality disorder where
people or situations are viewed as all good or all bad. C is incorrect because displacement is transferring
feelings to a less threatening target. D is incorrect because sublimation is channeling unacceptable
impulses into socially acceptable activities.
Question 10
A client is prescribed clozapine for treatment-resistant schizophrenia. Which adverse effect requires the
nurse to immediately withhold the medication and notify the provider?
A) Mild drowsiness
B) Drooling during sleep
C) Fever, sore throat, and malaise
D) Increased appetite
ANSWER: C
