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Psychiatric and Mental Health Nursing · Psychiatric Nursing NCLEX Practice Questions

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A client with major depressive disorder tells the nurse, 'I have saved enough pills to end my life tonight.' The client has a specific plan and access to the medication.

What is the nurse's priority action?

A. Maintain continuous observation and initiate immediate safety precautions
B. Document the statement and discuss it at the next team meeting
C. Ask the client to sign a promise not to self-harm
D. Encourage the client to attend group therapy
E. Arrange an unaccompanied walk to reduce anxiety

Expert Explanatory Rationale

Correct Answer: A. Maintain continuous observation and initiate immediate safety precautions

A specific plan, intent, and access to means indicate imminent suicide risk. Protect the client immediately and follow emergency safety procedures.

Question 2 of 15

Case excerpt

A client taking lithium reports vomiting, coarse hand tremors, unsteady gait, and new confusion after several days of diarrhea.

Which action should the nurse take?

A. Encourage strenuous exercise
B. Reassure the client that fine tremors are always harmless
C. Hold lithium and notify the prescriber for urgent assessment and a serum level
D. Restrict fluids
E. Give the next dose with food

Expert Explanatory Rationale

Correct Answer: C. Hold lithium and notify the prescriber for urgent assessment and a serum level

Gastrointestinal symptoms, coarse tremor, ataxia, and confusion suggest lithium toxicity, which requires withholding the medication and urgent evaluation.

Question 3 of 15

Case excerpt

A client experiencing a panic attack is pacing, trembling, and saying, 'I cannot breathe.' The client is unable to follow complex directions.

Which nursing response is most appropriate?

A. Provide several detailed choices at once
B. Ask the client to explain the childhood cause of the anxiety
C. Leave the client alone to regain control
D. Stay with the client and use short, calm statements
E. Challenge the client's belief that danger is present

Expert Explanatory Rationale

Correct Answer: D. Stay with the client and use short, calm statements

During severe panic, the nurse should remain with the client, reduce stimuli, and use brief, simple communication.

Question 4 of 15

Case excerpt

A client with schizophrenia says, 'The television announcer is sending me secret instructions.'

Which response demonstrates therapeutic communication?

A. The announcer may be communicating with you.'
B. I do not hear a message, but I can see that this feels real and frightening to you.'
C. That is impossible, so stop thinking about it.'
D. What did you do to make the announcer contact you?'
E. You should watch a different channel and ignore everything.'

Expert Explanatory Rationale

Correct Answer: B. I do not hear a message, but I can see that this feels real and frightening to you.'

Acknowledge the client's feelings without validating the delusion; present reality calmly and nonjudgmentally.

Question 5 of 15

Case excerpt

A client taking clozapine reports fever, sore throat, and mouth ulcers.

Which instruction is most important?

A. Take an extra dose to prevent infection
B. Seek prompt evaluation and a white blood cell/absolute neutrophil count as directed
C. Use an over-the-counter decongestant and continue as usual
D. Wait until the next routine appointment
E. Stop drinking water

Expert Explanatory Rationale

Correct Answer: B. Seek prompt evaluation and a white blood cell/absolute neutrophil count as directed

Fever and sore throat may indicate neutropenia or agranulocytosis associated with clozapine; urgent blood count assessment is needed.

Question 6 of 15

Case excerpt

A client admitted for alcohol withdrawal is increasingly restless, diaphoretic, and tremulous. The pulse is 124/min and blood pressure is 168/96 mm Hg.

Which intervention should the nurse anticipate?

A. Withdrawal assessment and prescribed benzodiazepine treatment
B. A stimulant to improve alertness
C. Fluid restriction and isolation without monitoring
D. Immediate discharge to avoid dependence
E. A sedative dose chosen by the nurse without an order

Expert Explanatory Rationale

Correct Answer: A. Withdrawal assessment and prescribed benzodiazepine treatment

Autonomic hyperactivity and tremor suggest alcohol withdrawal. Use a validated assessment protocol and administer prescribed medication to prevent seizures and delirium.

Question 7 of 15

Case excerpt

A client with anorexia nervosa has a heart rate of 42/min, blood pressure of 86/54 mm Hg, and dizziness on standing.

Which action takes priority?

A. Offer a large meal and leave the client alone
B. Encourage an unsupervised exercise routine
C. Weigh the client only at the next monthly visit
D. Discuss body image in a lengthy group session
E. Arrange urgent medical evaluation and cardiac monitoring as indicated

Expert Explanatory Rationale

Correct Answer: E. Arrange urgent medical evaluation and cardiac monitoring as indicated

Bradycardia, hypotension, and orthostatic symptoms indicate medical instability and require urgent assessment.

Question 8 of 15

Case excerpt

A client with post-traumatic stress disorder becomes visibly distressed when a staff member approaches from behind.

Which nursing action best supports trauma-informed care?

A. Insist that the client tolerate unexpected touch
B. Dismiss the reaction as attention-seeking
C. Approach from the front, explain actions before touching, and offer choices
D. Ask the client to describe the trauma in detail immediately
E. Block the doorway to prevent leaving

Expert Explanatory Rationale

Correct Answer: C. Approach from the front, explain actions before touching, and offer choices

Predictability, consent, personal space, and choice help promote safety and reduce retraumatization.

Question 9 of 15

Case excerpt

For Psychiatric Nursing NCLEX Practice Questions: A nurse is assessing a client at risk for suicide. Which findings increase immediate concern.

A nurse is assessing a client at risk for suicide. Which findings increase immediate concern? (Select all that apply)

A. A stated intention to act tonight
B. A specific plan with access to the method
C. Identifying reasons for living and agreeing to seek help
D. A recent attempt
E. Giving away valued possessions

Expert Explanatory Rationale

Correct Answer: A. A stated intention to act tonight; B. A specific plan with access to the method; D. A recent attempt; E. Giving away valued possessions

A specific plan, intent, access to means, giving away possessions, and a recent attempt are significant warning signs.

Question 10 of 15

Case excerpt

For Psychiatric Nursing NCLEX Practice Questions: A client taking lithium is being taught how to reduce toxicity risk. Which instructions should the nurse include.

A client taking lithium is being taught how to reduce toxicity risk. Which instructions should the nurse include? (Select all that apply)

A. Report vomiting or diarrhea
B. Maintain consistent fluid intake
C. Obtain serum levels as scheduled
D. Make major changes in salt intake without consulting the prescriber
E. Keep dietary sodium intake consistent

Expert Explanatory Rationale

Correct Answer: A. Report vomiting or diarrhea; B. Maintain consistent fluid intake; C. Obtain serum levels as scheduled; E. Keep dietary sodium intake consistent

Hydration, stable sodium intake, reporting fluid loss, and serum monitoring help reduce lithium toxicity risk.

Question 11 of 15

Case excerpt

For Psychiatric Nursing NCLEX Practice Questions: A client with schizophrenia is experiencing auditory hallucinations. Which nursing approaches are appropriate.

A client with schizophrenia is experiencing auditory hallucinations. Which nursing approaches are appropriate? (Select all that apply)

A. Offer a quiet activity or conversation to redirect attention
B. Validate the hallucination as an external fact
C. Ask what the voices are saying and whether they direct harm
D. Present reality without arguing
E. Assess the client's distress and safety

Expert Explanatory Rationale

Correct Answer: A. Offer a quiet activity or conversation to redirect attention; C. Ask what the voices are saying and whether they direct harm; D. Present reality without arguing; E. Assess the client's distress and safety

Assess content and risk, acknowledge distress, present reality, and use supportive redirection.

Question 12 of 15

Case excerpt

For Psychiatric Nursing NCLEX Practice Questions: A client is experiencing alcohol withdrawal. Which findings should the nurse monitor.

A client is experiencing alcohol withdrawal. Which findings should the nurse monitor? (Select all that apply)

A. Tremor
B. Seizures
C. Autonomic instability
D. Hallucinations
E. Improved coordination as the only expected sign

Expert Explanatory Rationale

Correct Answer: A. Tremor; B. Seizures; C. Autonomic instability; D. Hallucinations

Withdrawal can progress from tremor and autonomic symptoms to hallucinations, seizures, and delirium.

Question 13 of 15

Case excerpt

For Psychiatric Nursing NCLEX Practice Questions: A client taking clozapine receives medication teaching. Which points are important.

A client taking clozapine receives medication teaching. Which points are important? (Select all that apply)

A. Ignore mouth ulcers if there is no rash
B. Report fever or sore throat promptly
C. Keep required blood monitoring appointments
D. Do not stop or change the dose without prescriber guidance
E. Report symptoms of infection

Expert Explanatory Rationale

Correct Answer: B. Report fever or sore throat promptly; C. Keep required blood monitoring appointments; D. Do not stop or change the dose without prescriber guidance; E. Report symptoms of infection

Clozapine can cause severe neutropenia; blood monitoring and prompt reporting of infection symptoms are essential.

Question 14 of 15

Case excerpt

Psychiatric Nursing NCLEX Practice Questions: A client is prescribed 25 mg of a medication. Tablets available are 10 mg each. How many tablets should the nurse administer? Enter the number only.

A client is prescribed 25 mg of a medication. Tablets available are 10 mg each. How many tablets should the nurse administer? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 2.5

25 mg ÷ 10 mg/tablet = 2.5 tablets. Verify whether the tablet is appropriate to split before administration.

Question 15 of 15

Case excerpt

Psychiatric Nursing NCLEX Practice Questions: A client states an intention to die tonight and identifies a specific method. Place the nursing actions in the safest order.

A client states an intention to die tonight and identifies a specific method. Place the nursing actions in the safest order.

A. Recognize the statement as an imminent safety concern
B. Stay with the client and summon the appropriate team
C. Initiate observation and remove access to dangerous items according to policy
D. Complete urgent risk assessment and notify the prescriber/team
E. Document actions and establish the ongoing safety plan

Expert Explanatory Rationale

Correct Answer: A. Recognize the statement as an imminent safety concern; B. Stay with the client and summon the appropriate team; C. Initiate observation and remove access to dangerous items according to policy; D. Complete urgent risk assessment and notify the prescriber/team; E. Document actions and establish the ongoing safety plan

Protect the client immediately, activate support, reduce access to means, complete urgent evaluation, and plan ongoing safety.

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