**Psychiatric Mental Health Nursing Exam Prep:
Questions**
---
1. A client with major depressive disorder reports feeling hopeless and states, "I don't see the point in
living anymore." What is the nurse's priority action?
A) Ask the client, "Do you have a plan to hurt yourself?"
B) Tell the client, "You have so much to live for"
C) Notify the healthcare provider immediately
D) Place the client on suicide precautions
💫RATIONALE✔️✔️: The priority is to assess for suicidal ideation, including asking directly about thoughts,
plan, means, and intent. Asking about a plan is a direct suicide risk assessment. Never leave the client
alone. Notifying the provider and placing precautions follow assessment.
💫ANSWER✔️✔️: A) Ask the client, "Do you have a plan to hurt yourself?"
---
2. A client with bipolar disorder is in the manic phase. The client is pacing, talking rapidly, and has not
slept for 2 days. Which intervention should the nurse implement FIRST?
A) Administer prescribed lithium
B) Provide a quiet, low-stimulation environment
C) Encourage the client to take a shower
D) Offer high-calorie finger foods
,💫RATIONALE✔️✔️: Providing a quiet, low-stimulation environment reduces sensory overload and
decreases agitation. This is the first non-pharmacologic intervention. Medications, hygiene, and
nutrition are important but the environment is the priority to prevent escalation.
💫ANSWER✔️✔️: B) Provide a quiet, low-stimulation environment
---
3. A client with schizophrenia tells the nurse, "The FBI is watching me through the television." What is
the best response?
A) "That's not true; no one is watching you"
B) "I don't see anyone watching you, but that must be frightening"
C) "The FBI has better things to do than watch you"
D) "You're being paranoid; let's talk about something else"
💫RATIONALE✔️✔️: Acknowledging the client's feelings without validating the delusion is therapeutic. "I
don't see anyone watching you, but that must be frightening" validates the emotion while presenting
reality. Arguing or dismissing the delusion damages the therapeutic relationship.
💫ANSWER✔️✔️: B) "I don't see anyone watching you, but that must be frightening"
---
4. A client with post-traumatic stress disorder (PTSD) reports recurrent nightmares and flashbacks of a
military combat experience. Which medication does the nurse anticipate the provider will prescribe?
A) Sertraline (SSRI)
B) Haloperidol (antipsychotic)
C) Lorazepam (benzodiazepine)
D) Lithium (mood stabilizer)
,💫RATIONALE✔️✔️: SSRIs (sertraline, paroxetine, fluoxetine) are first-line pharmacologic treatment for
PTSD. They reduce core symptoms including nightmares, hyperarousal, and avoidance. Benzodiazepines
are not recommended due to abuse potential. Antipsychotics are adjunctive.
💫ANSWER✔️✔️: A) Sertraline (SSRI)
---
5. A client with alcohol use disorder is admitted for detoxification. The nurse assesses tremors,
diaphoresis, and a heart rate of 120 bpm. Which medication does the nurse anticipate administering?
A) Disulfiram (Antabuse)
B) Naltrexone
C) Lorazepam (Ativan)
D) Methadone
💫RATIONALE✔️✔️: Lorazepam (benzodiazepine) is first-line for alcohol withdrawal to prevent seizures
and delirium tremens. It reduces autonomic instability (tachycardia, hypertension, diaphoresis,
tremors). Disulfiram and naltrexone are for relapse prevention, not detoxification.
💫ANSWER✔️✔️: C) Lorazepam (Ativan)
---
6. A client with borderline personality disorder has a history of self-harm (cutting). The nurse finds the
client with superficial cuts on the forearm. What is the priority action?
A) Ask the client why they cut themselves
B) Clean and dress the wounds
C) Place the client in restraints
, D) Notify the healthcare provider
💫RATIONALE✔️✔️: Physical safety is the priority. The nurse should first clean and dress the wounds to
prevent infection and ensure physical well-being. After physical care, assess the client's emotional state
and triggers. Restraint is not indicated for superficial self-harm.
💫ANSWER✔️✔️: B) Clean and dress the wounds
---
7. A client with generalized anxiety disorder (GAD) is prescribed buspirone. Which instruction should the
nurse include?
A) "This medication works immediately for anxiety attacks"
B) "It may take 2-4 weeks to feel the full effect"
C) "This medication is addictive and should be used sparingly"
D) "Take this medication only when you feel anxious"
💫RATIONALE✔️✔️: Buspirone (non-benzodiazepine anxiolytic) has a delayed onset of action (2-4 weeks).
It is not effective for acute anxiety attacks (PRN use). It has low abuse potential and is not addictive. It
must be taken daily, not PRN.
💫ANSWER✔️✔️: B) "It may take 2-4 weeks to feel the full effect"
---
8. A client with dementia is wandering into other clients' rooms. Which intervention should the nurse
implement FIRST?
A) Apply a vest restraint to prevent wandering
B) Place the client in a room near the nurses' station
Questions**
---
1. A client with major depressive disorder reports feeling hopeless and states, "I don't see the point in
living anymore." What is the nurse's priority action?
A) Ask the client, "Do you have a plan to hurt yourself?"
B) Tell the client, "You have so much to live for"
C) Notify the healthcare provider immediately
D) Place the client on suicide precautions
💫RATIONALE✔️✔️: The priority is to assess for suicidal ideation, including asking directly about thoughts,
plan, means, and intent. Asking about a plan is a direct suicide risk assessment. Never leave the client
alone. Notifying the provider and placing precautions follow assessment.
💫ANSWER✔️✔️: A) Ask the client, "Do you have a plan to hurt yourself?"
---
2. A client with bipolar disorder is in the manic phase. The client is pacing, talking rapidly, and has not
slept for 2 days. Which intervention should the nurse implement FIRST?
A) Administer prescribed lithium
B) Provide a quiet, low-stimulation environment
C) Encourage the client to take a shower
D) Offer high-calorie finger foods
,💫RATIONALE✔️✔️: Providing a quiet, low-stimulation environment reduces sensory overload and
decreases agitation. This is the first non-pharmacologic intervention. Medications, hygiene, and
nutrition are important but the environment is the priority to prevent escalation.
💫ANSWER✔️✔️: B) Provide a quiet, low-stimulation environment
---
3. A client with schizophrenia tells the nurse, "The FBI is watching me through the television." What is
the best response?
A) "That's not true; no one is watching you"
B) "I don't see anyone watching you, but that must be frightening"
C) "The FBI has better things to do than watch you"
D) "You're being paranoid; let's talk about something else"
💫RATIONALE✔️✔️: Acknowledging the client's feelings without validating the delusion is therapeutic. "I
don't see anyone watching you, but that must be frightening" validates the emotion while presenting
reality. Arguing or dismissing the delusion damages the therapeutic relationship.
💫ANSWER✔️✔️: B) "I don't see anyone watching you, but that must be frightening"
---
4. A client with post-traumatic stress disorder (PTSD) reports recurrent nightmares and flashbacks of a
military combat experience. Which medication does the nurse anticipate the provider will prescribe?
A) Sertraline (SSRI)
B) Haloperidol (antipsychotic)
C) Lorazepam (benzodiazepine)
D) Lithium (mood stabilizer)
,💫RATIONALE✔️✔️: SSRIs (sertraline, paroxetine, fluoxetine) are first-line pharmacologic treatment for
PTSD. They reduce core symptoms including nightmares, hyperarousal, and avoidance. Benzodiazepines
are not recommended due to abuse potential. Antipsychotics are adjunctive.
💫ANSWER✔️✔️: A) Sertraline (SSRI)
---
5. A client with alcohol use disorder is admitted for detoxification. The nurse assesses tremors,
diaphoresis, and a heart rate of 120 bpm. Which medication does the nurse anticipate administering?
A) Disulfiram (Antabuse)
B) Naltrexone
C) Lorazepam (Ativan)
D) Methadone
💫RATIONALE✔️✔️: Lorazepam (benzodiazepine) is first-line for alcohol withdrawal to prevent seizures
and delirium tremens. It reduces autonomic instability (tachycardia, hypertension, diaphoresis,
tremors). Disulfiram and naltrexone are for relapse prevention, not detoxification.
💫ANSWER✔️✔️: C) Lorazepam (Ativan)
---
6. A client with borderline personality disorder has a history of self-harm (cutting). The nurse finds the
client with superficial cuts on the forearm. What is the priority action?
A) Ask the client why they cut themselves
B) Clean and dress the wounds
C) Place the client in restraints
, D) Notify the healthcare provider
💫RATIONALE✔️✔️: Physical safety is the priority. The nurse should first clean and dress the wounds to
prevent infection and ensure physical well-being. After physical care, assess the client's emotional state
and triggers. Restraint is not indicated for superficial self-harm.
💫ANSWER✔️✔️: B) Clean and dress the wounds
---
7. A client with generalized anxiety disorder (GAD) is prescribed buspirone. Which instruction should the
nurse include?
A) "This medication works immediately for anxiety attacks"
B) "It may take 2-4 weeks to feel the full effect"
C) "This medication is addictive and should be used sparingly"
D) "Take this medication only when you feel anxious"
💫RATIONALE✔️✔️: Buspirone (non-benzodiazepine anxiolytic) has a delayed onset of action (2-4 weeks).
It is not effective for acute anxiety attacks (PRN use). It has low abuse potential and is not addictive. It
must be taken daily, not PRN.
💫ANSWER✔️✔️: B) "It may take 2-4 weeks to feel the full effect"
---
8. A client with dementia is wandering into other clients' rooms. Which intervention should the nurse
implement FIRST?
A) Apply a vest restraint to prevent wandering
B) Place the client in a room near the nurses' station
