NUR 4535 – Psychiatric-Mental Health
Nursing Final Exam 2025/2026 Edition Verified
Questions and Answers
Questions 1-20: Psychiatric Disorders
Question 1: Psychiatric Disorders
A 25-year-old client presents with persistent sadness, anhedonia, and passive suicidal ideation
for 6 weeks. Sleep is disturbed, and appetite decreased with 10 lb weight loss. The nurse
recognizes this as indicative of:
A. Adjustment disorder
B. Major depressive disorder
C. Bipolar II disorder
D. Generalized anxiety disorder
B. Major depressive disorder
Rationale: DSM-5 criteria for MDD require 5+ symptoms for 2 weeks, including depressed
mood or anhedonia; this vignette meets core features, prioritizing suicide risk assessment and
safety planning per APA guidelines to prevent self-harm in primary care settings.
Question 2: Psychiatric Disorders
A client in the ED after a manic episode with grandiosity, decreased sleep (3 hours/night), and
impulsive spending of $5,000 reports, "I am the next Elon Musk." The diagnosis is:
A. Schizoaffective disorder
B. Bipolar I disorder
C. Narcissistic personality disorder
D. Substance-induced mood disorder
B. Bipolar I disorder
,Rationale: DSM-5 bipolar I requires one manic episode with marked impairment; grandiosity
and decreased need for sleep are hallmark symptoms, necessitating mood stabilization and safety
measures like financial oversight to mitigate risks of exploitation or harm.
Question 3: Psychiatric Disorders
A 30-year-old client experiences flashbacks, hypervigilance, and avoidance of crowds 3 months
after a car accident. Nightmares disrupt sleep. This aligns with:
A. Acute stress disorder
B. Posttraumatic stress disorder (PTSD)
C. Obsessive-compulsive disorder
D. Dissociative identity disorder
B. Posttraumatic stress disorder (PTSD)
Rationale: PTSD per DSM-5 involves intrusion, avoidance, negative cognitions, and arousal
lasting >1 month; early intervention with trauma-focused CBT per VA/DoD guidelines promotes
recovery, addressing safety through grounding techniques to interrupt re-experiencing.
Question 4: Psychiatric Disorders
A client whispers, "The government is monitoring my thoughts through the TV." The nurse
identifies this as:
A. Hallucination
B. Delusion
C. Loose association
D. Flight of ideas
B. Delusion
Rationale: Fixed false belief resistant to evidence defines delusion in schizophrenia spectrum;
therapeutic engagement without confrontation per APA builds trust, ensuring safety by assessing
command elements for harm potential.
Question 5: Psychiatric Disorders
An elderly client exhibits memory loss, disorientation, and wandering, with gradual onset over 2
years. MRI shows cortical atrophy. The likely diagnosis is:
A. Delirium
, B. Alzheimer's disease
C. Vascular dementia
D. Depression
B. Alzheimer's disease
Rationale: Progressive neurodegeneration with amyloid plaques; NIA guidelines emphasize
non-pharmacologic supports like structured routines for safety, reducing fall risks and caregiver
burden through early diagnosis.
Question 6: Psychiatric Disorders
A client with rapid cycling mood swings (4 episodes/year) between depression and hypomania is
diagnosed with:
A. Cyclothymic disorder
B. Bipolar I disorder with rapid cycling
C. Borderline personality disorder
D. Schizoaffective disorder
B. Bipolar I disorder with rapid cycling
Rationale: DSM-5 specifier for 4+ episodes/year; APA lithium/valproate monitoring prevents
decompensation, prioritizing safety contracts during switches to avert impulsivity-related harm.
Question 7: Psychiatric Disorders
A client reports intrusive thoughts of harming others and compulsive handwashing 2 hours/day.
This is characteristic of:
A. Panic disorder
B. Obsessive-compulsive disorder (OCD)
C. Body dysmorphic disorder
D. Hoarding disorder
B. Obsessive-compulsive disorder (OCD)
Rationale: Ego-dystonic obsessions/compulsions per DSM-5; APA ERP therapy reduces rituals,
enhancing functional safety by addressing time loss and skin breakdown from washing.
Question 8: Psychiatric Disorders
Nursing Final Exam 2025/2026 Edition Verified
Questions and Answers
Questions 1-20: Psychiatric Disorders
Question 1: Psychiatric Disorders
A 25-year-old client presents with persistent sadness, anhedonia, and passive suicidal ideation
for 6 weeks. Sleep is disturbed, and appetite decreased with 10 lb weight loss. The nurse
recognizes this as indicative of:
A. Adjustment disorder
B. Major depressive disorder
C. Bipolar II disorder
D. Generalized anxiety disorder
B. Major depressive disorder
Rationale: DSM-5 criteria for MDD require 5+ symptoms for 2 weeks, including depressed
mood or anhedonia; this vignette meets core features, prioritizing suicide risk assessment and
safety planning per APA guidelines to prevent self-harm in primary care settings.
Question 2: Psychiatric Disorders
A client in the ED after a manic episode with grandiosity, decreased sleep (3 hours/night), and
impulsive spending of $5,000 reports, "I am the next Elon Musk." The diagnosis is:
A. Schizoaffective disorder
B. Bipolar I disorder
C. Narcissistic personality disorder
D. Substance-induced mood disorder
B. Bipolar I disorder
,Rationale: DSM-5 bipolar I requires one manic episode with marked impairment; grandiosity
and decreased need for sleep are hallmark symptoms, necessitating mood stabilization and safety
measures like financial oversight to mitigate risks of exploitation or harm.
Question 3: Psychiatric Disorders
A 30-year-old client experiences flashbacks, hypervigilance, and avoidance of crowds 3 months
after a car accident. Nightmares disrupt sleep. This aligns with:
A. Acute stress disorder
B. Posttraumatic stress disorder (PTSD)
C. Obsessive-compulsive disorder
D. Dissociative identity disorder
B. Posttraumatic stress disorder (PTSD)
Rationale: PTSD per DSM-5 involves intrusion, avoidance, negative cognitions, and arousal
lasting >1 month; early intervention with trauma-focused CBT per VA/DoD guidelines promotes
recovery, addressing safety through grounding techniques to interrupt re-experiencing.
Question 4: Psychiatric Disorders
A client whispers, "The government is monitoring my thoughts through the TV." The nurse
identifies this as:
A. Hallucination
B. Delusion
C. Loose association
D. Flight of ideas
B. Delusion
Rationale: Fixed false belief resistant to evidence defines delusion in schizophrenia spectrum;
therapeutic engagement without confrontation per APA builds trust, ensuring safety by assessing
command elements for harm potential.
Question 5: Psychiatric Disorders
An elderly client exhibits memory loss, disorientation, and wandering, with gradual onset over 2
years. MRI shows cortical atrophy. The likely diagnosis is:
A. Delirium
, B. Alzheimer's disease
C. Vascular dementia
D. Depression
B. Alzheimer's disease
Rationale: Progressive neurodegeneration with amyloid plaques; NIA guidelines emphasize
non-pharmacologic supports like structured routines for safety, reducing fall risks and caregiver
burden through early diagnosis.
Question 6: Psychiatric Disorders
A client with rapid cycling mood swings (4 episodes/year) between depression and hypomania is
diagnosed with:
A. Cyclothymic disorder
B. Bipolar I disorder with rapid cycling
C. Borderline personality disorder
D. Schizoaffective disorder
B. Bipolar I disorder with rapid cycling
Rationale: DSM-5 specifier for 4+ episodes/year; APA lithium/valproate monitoring prevents
decompensation, prioritizing safety contracts during switches to avert impulsivity-related harm.
Question 7: Psychiatric Disorders
A client reports intrusive thoughts of harming others and compulsive handwashing 2 hours/day.
This is characteristic of:
A. Panic disorder
B. Obsessive-compulsive disorder (OCD)
C. Body dysmorphic disorder
D. Hoarding disorder
B. Obsessive-compulsive disorder (OCD)
Rationale: Ego-dystonic obsessions/compulsions per DSM-5; APA ERP therapy reduces rituals,
enhancing functional safety by addressing time loss and skin breakdown from washing.
Question 8: Psychiatric Disorders
