Advanced Nursing Certifications ANCC Psychiatric-
Mental Health Nurse Exam Prep 2025 – WGU D120
OBJECTIVE ASSESSMENT ACTUAL EXAM STUDY
GUIDE 2025/2026 COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS <LATEST VERSION>
ANCC Psychiatric-Mental Health Nurse Exam Prep 2025: 100 Q&A
1. A client with schizophrenia who is prescribed clozapine reports a sore throat and fever. The
nurse's priority action is to:
A. Administer an over-the-counter analgesic.
B. Reassure the client that this is a common side effect.
C. Obtain a complete blood count (CBC) immediately. ✓
D. Encourage increased fluid intake.
Rationale: Clozapine carries a significant risk of agranulocytosis, a life-threatening drop in
neutrophils. A sore throat and fever are classic signs of infection secondary to neutropenia. An
immediate CBC is essential to check the white blood cell count.
2. The primary therapeutic goal during the initial phase of a nurse-client relationship is:
A. To establish a social, friendly rapport.
B. To build trust and establish a therapeutic contract. ✓
C. To explore the client's deepest fears and anxieties.
D. To set long-term goals for discharge.
Rationale: The orientation (initial) phase is centered on building trust, explaining roles and
confidentiality, and setting the terms of the relationship (contract). Without this foundation,
therapeutic progress is unlikely.
3. A client with Borderline Personality Disorder, upon learning their therapist will be on
vacation next week, angrily states, "You're just like everyone else, you're going to abandon
me!" This is an example of:
A. Projection.
B. Splitting. ✓
,C. Reaction formation.
D. Dissociation.
Rationale: Splitting is a defense mechanism common in BPD where a person views others as all-
good or all-bad. The therapist is being shifted from the "all-good" to the "all-bad" category due
to the perceived abandonment.
4. Which medication requires strict dietary avoidance of tyramine-rich foods?
A. Sertraline (Zoloft)
B. Lithium (Eskalith)
C. Phenelzine (Nardil) ✓
D. Valproic Acid (Depakote)
Rationale: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI). Consuming tyramine-rich
foods (e.g., aged cheeses, cured meats) while on an MAOI can cause a hypertensive crisis, which
is a medical emergency.
5. A client experiencing a manic episode is pacing rapidly, talking loudly, and is physically
agitated. The most appropriate nursing intervention is to:
A. Provide detailed instructions for a complex activity to focus their energy.
B. Offer a quiet, low-stimulation environment and simple choices. ✓
C. Confront the client firmly to de-escalate the situation.
D. Engage the client in a competitive game.
Rationale: During mania, clients are overwhelmed by internal stimulation. Reducing external
stimuli (noise, light, activity) helps prevent escalation. Simple choices prevent feelings of being
overwhelmed.
6. The concept of "recovery" in modern psychiatric care is best defined as:
A. The complete absence of psychiatric symptoms.
B. A process of change through which individuals improve their health and wellness, live a
self-directed life, and strive to reach their full potential. ✓
C. Adherence to a prescribed medication regimen.
D. The ability to maintain full-time employment.
Rationale: The recovery model is person-centered and focuses on hope, empowerment, and
living a meaningful life even with ongoing symptoms, moving beyond just symptom remission.
7. Tardive Dyskinesia (TD) is a potential side effect of which class of medications?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Mood Stabilizers
C. First-Generation (Typical) Antipsychotics ✓
D. Benzodiazepines
Rationale: TD is a potentially irreversible movement disorder characterized by involuntary,
,dyskinetic movements, most commonly associated with long-term use of typical antipsychotics
(e.g., haloperidol).
8. A nurse is using Motivational Interviewing (MI) with a client who has alcohol use disorder.
Which statement by the nurse reflects the spirit of MI?
A. "You need to stop drinking, or you will lose your job and your family."
B. "Let me explain the five stages of change to you."
C. "On a scale of 1 to 10, how important is it for you to reduce your drinking?" ✓
D. "I will schedule you for an intervention next week."
Rationale: MI is a collaborative, person-centered approach that evokes the client's own
motivation for change. Using scaling questions is a classic MI technique to explore ambivalence
and importance.
9. A client with Major Depressive Disorder states, "What's the point? I'm just a burden to
everyone." The most therapeutic response is:
A. "That's not true; you have a wonderful family."
B. "You shouldn't think that way."
C. "You're feeling hopeless and like you are a burden to others?" ✓
D. "Let's list all your positive qualities."
Rationale: This response uses reflective listening and validates the client's feelings without
judgment. It encourages further expression and shows the nurse is actively listening and trying
to understand.
10. Which finding is a primary indicator of Neuroleptic Malignant Syndrome (NMS)?
A. Orthostatic hypotension
B. Hyperthermia and muscle rigidity ✓
C. Fine hand tremors
D. Dry mouth and blurred vision
Rationale: NMS is a rare but life-threatening reaction to antipsychotics. Key symptoms include
high fever, severe muscle rigidity, altered mental status, and autonomic instability.
11. When a client discloses plans to harm a specific, identifiable individual, the nurse's
primary ethical and legal responsibility is to:
A. Maintain confidentiality to preserve the therapeutic relationship.
B. Increase the client's medication dosage.
C. Protect the intended victim through a duty to warn. ✓
D. Document the threat in the client's chart.
Rationale: Based on the Tarasoff ruling, mental health professionals have a duty to protect
identifiable third parties from threats made by a client. This may involve warning the victim and
notifying law enforcement.
, 12. A client with Obsessive-Compulsive Disorder (OCD) spends hours each day washing their
hands. The nurse understands that the compulsive hand-washing serves which function?
A. It provides a source of physical pleasure.
B. It reduces the anxiety caused by obsessive thoughts of contamination. ✓
C. It is a voluntary behavior to gain attention.
D. It is a psychotic response to internal stimuli.
Rationale: In OCD, compulsions are repetitive behaviors (like hand-washing) or mental acts that
a person feels driven to perform in response to an obsession, with the goal of reducing distress
or preventing a dreaded event.
13. The most critical component of a suicide assessment is:
A. The client's past psychiatric history.
B. Determining the client's specific plan, intent, and means. ✓
C. The client's level of social support.
D. Whether the client has a substance use disorder.
Rationale: While all factors are important, the most critical is assessing the specificity of the
plan, the lethality of the intended means, and the client's stated intent to act on the plan. This
directly informs the level of risk and intervention needed.
14. A client taking lithium reports nausea, diarrhea, and coarse hand tremors. The nurse
should suspect:
A. An allergic reaction.
B. Extrapyramidal symptoms (EPS).
C. Lithium toxicity. ✓
D. Serotonin syndrome.
Rationale: Gastrointestinal symptoms (nausea, diarrhea) and neurological symptoms (coarse
tremors, ataxia, slurred speech) are classic signs of lithium toxicity, which requires immediate
medical attention.
15. A veteran diagnosed with PTSD startles and drops to the floor when a book falls off a
shelf. The nurse documents this as:
A. A flashback.
B. An exaggerated startle response. ✓
C. Hypervigilance.
D. Dissociation.
Rationale: An exaggerated startle response is a hallmark symptom of PTSD, involving a
pronounced physical reaction to unexpected stimuli. A flashback would involve re-experiencing
the traumatic event itself.
Mental Health Nurse Exam Prep 2025 – WGU D120
OBJECTIVE ASSESSMENT ACTUAL EXAM STUDY
GUIDE 2025/2026 COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS <LATEST VERSION>
ANCC Psychiatric-Mental Health Nurse Exam Prep 2025: 100 Q&A
1. A client with schizophrenia who is prescribed clozapine reports a sore throat and fever. The
nurse's priority action is to:
A. Administer an over-the-counter analgesic.
B. Reassure the client that this is a common side effect.
C. Obtain a complete blood count (CBC) immediately. ✓
D. Encourage increased fluid intake.
Rationale: Clozapine carries a significant risk of agranulocytosis, a life-threatening drop in
neutrophils. A sore throat and fever are classic signs of infection secondary to neutropenia. An
immediate CBC is essential to check the white blood cell count.
2. The primary therapeutic goal during the initial phase of a nurse-client relationship is:
A. To establish a social, friendly rapport.
B. To build trust and establish a therapeutic contract. ✓
C. To explore the client's deepest fears and anxieties.
D. To set long-term goals for discharge.
Rationale: The orientation (initial) phase is centered on building trust, explaining roles and
confidentiality, and setting the terms of the relationship (contract). Without this foundation,
therapeutic progress is unlikely.
3. A client with Borderline Personality Disorder, upon learning their therapist will be on
vacation next week, angrily states, "You're just like everyone else, you're going to abandon
me!" This is an example of:
A. Projection.
B. Splitting. ✓
,C. Reaction formation.
D. Dissociation.
Rationale: Splitting is a defense mechanism common in BPD where a person views others as all-
good or all-bad. The therapist is being shifted from the "all-good" to the "all-bad" category due
to the perceived abandonment.
4. Which medication requires strict dietary avoidance of tyramine-rich foods?
A. Sertraline (Zoloft)
B. Lithium (Eskalith)
C. Phenelzine (Nardil) ✓
D. Valproic Acid (Depakote)
Rationale: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI). Consuming tyramine-rich
foods (e.g., aged cheeses, cured meats) while on an MAOI can cause a hypertensive crisis, which
is a medical emergency.
5. A client experiencing a manic episode is pacing rapidly, talking loudly, and is physically
agitated. The most appropriate nursing intervention is to:
A. Provide detailed instructions for a complex activity to focus their energy.
B. Offer a quiet, low-stimulation environment and simple choices. ✓
C. Confront the client firmly to de-escalate the situation.
D. Engage the client in a competitive game.
Rationale: During mania, clients are overwhelmed by internal stimulation. Reducing external
stimuli (noise, light, activity) helps prevent escalation. Simple choices prevent feelings of being
overwhelmed.
6. The concept of "recovery" in modern psychiatric care is best defined as:
A. The complete absence of psychiatric symptoms.
B. A process of change through which individuals improve their health and wellness, live a
self-directed life, and strive to reach their full potential. ✓
C. Adherence to a prescribed medication regimen.
D. The ability to maintain full-time employment.
Rationale: The recovery model is person-centered and focuses on hope, empowerment, and
living a meaningful life even with ongoing symptoms, moving beyond just symptom remission.
7. Tardive Dyskinesia (TD) is a potential side effect of which class of medications?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Mood Stabilizers
C. First-Generation (Typical) Antipsychotics ✓
D. Benzodiazepines
Rationale: TD is a potentially irreversible movement disorder characterized by involuntary,
,dyskinetic movements, most commonly associated with long-term use of typical antipsychotics
(e.g., haloperidol).
8. A nurse is using Motivational Interviewing (MI) with a client who has alcohol use disorder.
Which statement by the nurse reflects the spirit of MI?
A. "You need to stop drinking, or you will lose your job and your family."
B. "Let me explain the five stages of change to you."
C. "On a scale of 1 to 10, how important is it for you to reduce your drinking?" ✓
D. "I will schedule you for an intervention next week."
Rationale: MI is a collaborative, person-centered approach that evokes the client's own
motivation for change. Using scaling questions is a classic MI technique to explore ambivalence
and importance.
9. A client with Major Depressive Disorder states, "What's the point? I'm just a burden to
everyone." The most therapeutic response is:
A. "That's not true; you have a wonderful family."
B. "You shouldn't think that way."
C. "You're feeling hopeless and like you are a burden to others?" ✓
D. "Let's list all your positive qualities."
Rationale: This response uses reflective listening and validates the client's feelings without
judgment. It encourages further expression and shows the nurse is actively listening and trying
to understand.
10. Which finding is a primary indicator of Neuroleptic Malignant Syndrome (NMS)?
A. Orthostatic hypotension
B. Hyperthermia and muscle rigidity ✓
C. Fine hand tremors
D. Dry mouth and blurred vision
Rationale: NMS is a rare but life-threatening reaction to antipsychotics. Key symptoms include
high fever, severe muscle rigidity, altered mental status, and autonomic instability.
11. When a client discloses plans to harm a specific, identifiable individual, the nurse's
primary ethical and legal responsibility is to:
A. Maintain confidentiality to preserve the therapeutic relationship.
B. Increase the client's medication dosage.
C. Protect the intended victim through a duty to warn. ✓
D. Document the threat in the client's chart.
Rationale: Based on the Tarasoff ruling, mental health professionals have a duty to protect
identifiable third parties from threats made by a client. This may involve warning the victim and
notifying law enforcement.
, 12. A client with Obsessive-Compulsive Disorder (OCD) spends hours each day washing their
hands. The nurse understands that the compulsive hand-washing serves which function?
A. It provides a source of physical pleasure.
B. It reduces the anxiety caused by obsessive thoughts of contamination. ✓
C. It is a voluntary behavior to gain attention.
D. It is a psychotic response to internal stimuli.
Rationale: In OCD, compulsions are repetitive behaviors (like hand-washing) or mental acts that
a person feels driven to perform in response to an obsession, with the goal of reducing distress
or preventing a dreaded event.
13. The most critical component of a suicide assessment is:
A. The client's past psychiatric history.
B. Determining the client's specific plan, intent, and means. ✓
C. The client's level of social support.
D. Whether the client has a substance use disorder.
Rationale: While all factors are important, the most critical is assessing the specificity of the
plan, the lethality of the intended means, and the client's stated intent to act on the plan. This
directly informs the level of risk and intervention needed.
14. A client taking lithium reports nausea, diarrhea, and coarse hand tremors. The nurse
should suspect:
A. An allergic reaction.
B. Extrapyramidal symptoms (EPS).
C. Lithium toxicity. ✓
D. Serotonin syndrome.
Rationale: Gastrointestinal symptoms (nausea, diarrhea) and neurological symptoms (coarse
tremors, ataxia, slurred speech) are classic signs of lithium toxicity, which requires immediate
medical attention.
15. A veteran diagnosed with PTSD startles and drops to the floor when a book falls off a
shelf. The nurse documents this as:
A. A flashback.
B. An exaggerated startle response. ✓
C. Hypervigilance.
D. Dissociation.
Rationale: An exaggerated startle response is a hallmark symptom of PTSD, involving a
pronounced physical reaction to unexpected stimuli. A flashback would involve re-experiencing
the traumatic event itself.
