PSYCHIATRIC MENTAL HEALTH NURSING – 9TH
EDITION, VIDEBECK COMPREHENSIVE FINAL
EXAMINATION (100+ QUESTIONS) CHAPTERS 1–
36 | COMPLETE ANSWERS WITH RATIONALES
SECTION 1: FOUNDATIONS (Questions 1–10)
1. A nursing student asks why "therapeutic use of self" is important.
The best response is:
a) "It allows the nurse to share personal experiences to build rapport."
b) "It is a planned, goal-directed use of the nurse's personality and
skills."
c) "It helps the nurse become friends with the patient."
d) "It replaces the need for medication."
Answer: b
Rationale: Therapeutic use of self is intentional, based on self-
awareness and communication skills. It is not friendship, self-
disclosure, or a medication replacement (Chapter 1).
2. A client tells the nurse, "I can't go on anymore. Everyone would be
better off without me." The priority nursing action is:
,a) Ask, "Do you have a plan to hurt yourself?"
b) Say, "Tell me more about that feeling."
c) Notify the client's family immediately.
d) Place the client on one-to-one observation.
Answer: a
Rationale: Suicide risk assessment begins with directly asking about
plan, intent, and means. Observation follows, but assessment is priority
(Chapter 9).
3. Which statement best reflects understanding of milieu therapy?
a) "Unit rules are flexible based on each patient's diagnosis."
b) "Safety and structure are created through consistent routines and
limits."
c) "Patients should keep personal items to feel at home."
d) "Milieu therapy focuses only on group therapy."
Answer: b
Rationale: Milieu therapy uses the environment therapeutically —
structure, boundaries, safety, and social interactions are key (Chapter
7).
4. A patient with schizophrenia says, "The FBI is poisoning my water
because I know the truth." The nurse documents:
a) Hallucination
b) Delusion of persecution
,c) Idea of reference
d) Loose association
Answer: b
Rationale: A fixed false belief of being targeted or harmed is a
persecutory delusion (Chapter 13).
5. (Select all that apply) Components of a mental status exam (MSE)
include:
a) Appearance and behavior
b) Blood pressure and heart rate
c) Mood and affect
d) Thought process and content
e) Serum lithium level
Answer: a, c, d
Rationale: MSE includes appearance, behavior, speech, mood, affect,
thought process, thought content, perception, cognition,
insight/judgment. Vital signs and labs are separate (Chapter 6).
6. A client on fluoxetine (Prozac) reports nausea, headache, and
insomnia. The nurse's best response is:
a) "Stop the medication immediately."
b) "These symptoms are common initially and often improve in 1–2
weeks."
c) "You are having a severe allergic reaction."
d) "Increase your dose to make symptoms go away faster."
, Answer: b
Rationale: SSRIs commonly cause GI upset, headache, and sleep
disturbance early in treatment. Do not stop abruptly or adjust dose
without order (Chapter 4).
7. Which intervention demonstrates primary prevention for substance
use disorders?
a) Relapse prevention group for recovering alcoholics
b) Teaching middle school students about risks of vaping
c) Administering naltrexone for cravings
d) Referring a patient with cirrhosis to detox
Answer: b
Rationale: Primary prevention occurs before disorder develops —
education and health promotion. Secondary = early detection; Tertiary
= rehab/relapse prevention (Chapter 3).
8. A patient with borderline personality disorder says, "You're the only
nurse who understands me. The night nurse is cruel and incompetent."
This is:
a) Transference
b) Splitting
c) Countertransference
d) Projection
EDITION, VIDEBECK COMPREHENSIVE FINAL
EXAMINATION (100+ QUESTIONS) CHAPTERS 1–
36 | COMPLETE ANSWERS WITH RATIONALES
SECTION 1: FOUNDATIONS (Questions 1–10)
1. A nursing student asks why "therapeutic use of self" is important.
The best response is:
a) "It allows the nurse to share personal experiences to build rapport."
b) "It is a planned, goal-directed use of the nurse's personality and
skills."
c) "It helps the nurse become friends with the patient."
d) "It replaces the need for medication."
Answer: b
Rationale: Therapeutic use of self is intentional, based on self-
awareness and communication skills. It is not friendship, self-
disclosure, or a medication replacement (Chapter 1).
2. A client tells the nurse, "I can't go on anymore. Everyone would be
better off without me." The priority nursing action is:
,a) Ask, "Do you have a plan to hurt yourself?"
b) Say, "Tell me more about that feeling."
c) Notify the client's family immediately.
d) Place the client on one-to-one observation.
Answer: a
Rationale: Suicide risk assessment begins with directly asking about
plan, intent, and means. Observation follows, but assessment is priority
(Chapter 9).
3. Which statement best reflects understanding of milieu therapy?
a) "Unit rules are flexible based on each patient's diagnosis."
b) "Safety and structure are created through consistent routines and
limits."
c) "Patients should keep personal items to feel at home."
d) "Milieu therapy focuses only on group therapy."
Answer: b
Rationale: Milieu therapy uses the environment therapeutically —
structure, boundaries, safety, and social interactions are key (Chapter
7).
4. A patient with schizophrenia says, "The FBI is poisoning my water
because I know the truth." The nurse documents:
a) Hallucination
b) Delusion of persecution
,c) Idea of reference
d) Loose association
Answer: b
Rationale: A fixed false belief of being targeted or harmed is a
persecutory delusion (Chapter 13).
5. (Select all that apply) Components of a mental status exam (MSE)
include:
a) Appearance and behavior
b) Blood pressure and heart rate
c) Mood and affect
d) Thought process and content
e) Serum lithium level
Answer: a, c, d
Rationale: MSE includes appearance, behavior, speech, mood, affect,
thought process, thought content, perception, cognition,
insight/judgment. Vital signs and labs are separate (Chapter 6).
6. A client on fluoxetine (Prozac) reports nausea, headache, and
insomnia. The nurse's best response is:
a) "Stop the medication immediately."
b) "These symptoms are common initially and often improve in 1–2
weeks."
c) "You are having a severe allergic reaction."
d) "Increase your dose to make symptoms go away faster."
, Answer: b
Rationale: SSRIs commonly cause GI upset, headache, and sleep
disturbance early in treatment. Do not stop abruptly or adjust dose
without order (Chapter 4).
7. Which intervention demonstrates primary prevention for substance
use disorders?
a) Relapse prevention group for recovering alcoholics
b) Teaching middle school students about risks of vaping
c) Administering naltrexone for cravings
d) Referring a patient with cirrhosis to detox
Answer: b
Rationale: Primary prevention occurs before disorder develops —
education and health promotion. Secondary = early detection; Tertiary
= rehab/relapse prevention (Chapter 3).
8. A patient with borderline personality disorder says, "You're the only
nurse who understands me. The night nurse is cruel and incompetent."
This is:
a) Transference
b) Splitting
c) Countertransference
d) Projection
