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Psychiatric and Mental Health Nursing · Psychiatric Nursing Practice Test

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A client taking sertraline is newly prescribed linezolid for an infection. The client develops agitation, sweating, diarrhea, tremor, and hyperreflexia.

Which reaction should the nurse suspect?

A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Lithium-induced hypothyroidism
D. Serotonin syndrome
E. Anticholinergic toxicity

Expert Explanatory Rationale

Correct Answer: D. Serotonin syndrome

Combining serotonergic medication with linezolid can increase serotonin syndrome risk; agitation, autonomic symptoms, and hyperreflexia are concerning.

Question 2 of 15

Case excerpt

A client with depression has been taking an antidepressant for four days and reports no improvement.

Which response is appropriate?

A. Take it only on days with low mood
B. Double the dose without contacting the prescriber
C. Explain that many antidepressants require several weeks for full benefit and encourage taking it as prescribed
D. Stop treatment because it has failed
E. Add an over-the-counter stimulant

Expert Explanatory Rationale

Correct Answer: C. Explain that many antidepressants require several weeks for full benefit and encourage taking it as prescribed

Antidepressants often take several weeks to produce full therapeutic benefit; monitor response and adverse effects with the prescriber.

Question 3 of 15

Case excerpt

A client with a history of suicide attempt is being discharged after stabilization.

Which discharge element is most important?

A. Instructions to avoid discussing distress
B. A promise never to feel suicidal again
C. A collaborative safety plan with warning signs, coping steps, supports, and crisis contacts
D. A list of punishments for future suicidal thoughts
E. A plan to stop all follow-up visits

Expert Explanatory Rationale

Correct Answer: C. A collaborative safety plan with warning signs, coping steps, supports, and crisis contacts

A practical safety plan identifies warning signs, coping strategies, trusted contacts, professional resources, and emergency steps.

Question 4 of 15

Case excerpt

A client with alcohol use disorder is prescribed disulfiram.

Which statement indicates the need for further teaching?

A. If I drink alcohol, I may have a severe unpleasant reaction.
B. I can safely drink beer after taking the medication if I wait two hours.
C. I should avoid alcohol in foods, medicines, and personal-care products when relevant.
D. I will discuss any concerns with my prescriber.
E. I will check labels because some products may contain alcohol.

Expert Explanatory Rationale

Correct Answer: B. I can safely drink beer after taking the medication if I wait two hours.

Alcohol can cause a severe disulfiram reaction; avoidance is required during treatment and for the recommended period afterward.

Question 5 of 15

Case excerpt

A client with schizophrenia has difficulty organizing thoughts and completing daily hygiene.

Which nursing goal is most appropriate initially?

A. Demand independent completion of every task immediately
B. Break hygiene into simple, achievable steps with cues as needed
C. Remove all choices from the client's routine
D. Provide several complex instructions at once
E. Focus only on correcting delusional beliefs

Expert Explanatory Rationale

Correct Answer: B. Break hygiene into simple, achievable steps with cues as needed

Simple, structured instructions and achievable steps support functioning when thought organization and executive skills are impaired.

Question 6 of 15

Case excerpt

A client with post-traumatic stress disorder reports nightmares and avoids reminders of a traumatic event.

Which treatment approach should the nurse identify as evidence-based?

A. Trauma-focused psychotherapy such as cognitive processing therapy or prolonged exposure when appropriate
B. Punishment for nightmares
C. Forced detailed recounting without preparation
D. Avoidance of all discussion indefinitely
E. Unsupervised sedative use

Expert Explanatory Rationale

Correct Answer: A. Trauma-focused psychotherapy such as cognitive processing therapy or prolonged exposure when appropriate

Trauma-focused psychotherapies are evidence-based treatments; care should be collaborative, paced, and clinically appropriate.

Question 7 of 15

Case excerpt

A client taking valproate for bipolar disorder reports severe abdominal pain, persistent nausea, and vomiting.

Which complication should the nurse consider?

A. Tardive dyskinesia
B. Akathisia
C. Seasonal allergy
D. Expected mild dry mouth
E. Pancreatitis

Expert Explanatory Rationale

Correct Answer: E. Pancreatitis

Valproate can rarely cause serious pancreatitis; severe abdominal pain and vomiting require prompt medical evaluation.

Question 8 of 15

Case excerpt

A client with social anxiety avoids speaking in meetings despite wanting to participate.

Which intervention may help the client build skills gradually?

A. Practice graded exposure with coping skills in a collaborative treatment plan
B. Criticize the client for being shy
C. Require an unprepared speech in front of the entire unit
D. Encourage permanent avoidance
E. Use alcohol before social situations

Expert Explanatory Rationale

Correct Answer: A. Practice graded exposure with coping skills in a collaborative treatment plan

Gradual, planned exposure and cognitive behavioral strategies can help reduce avoidance and improve functioning.

Question 9 of 15

Case excerpt

For Psychiatric Nursing Practice Test: A client taking valproate is receiving medication teaching. Which symptoms should be reported promptly.

A client taking valproate is receiving medication teaching. Which symptoms should be reported promptly? (Select all that apply)

A. Unusual bruising or bleeding
B. Persistent vomiting
C. Yellowing of the skin or eyes
D. Severe abdominal pain
E. Mild temporary thirst after exercise

Expert Explanatory Rationale

Correct Answer: A. Unusual bruising or bleeding; B. Persistent vomiting; C. Yellowing of the skin or eyes; D. Severe abdominal pain

Severe abdominal pain may indicate pancreatitis; jaundice or bleeding can signal serious hepatic or hematologic effects.

Question 10 of 15

Case excerpt

For Psychiatric Nursing Practice Test: A client with opioid use disorder is starting buprenorphine. Which teaching points are appropriate.

A client with opioid use disorder is starting buprenorphine. Which teaching points are appropriate? (Select all that apply)

A. Avoid combining it with alcohol or sedatives unless specifically directed
B. Take it exactly as prescribed
C. Share unused doses with another person in withdrawal
D. Store it securely away from children
E. Discuss timing of the first dose to avoid precipitated withdrawal

Expert Explanatory Rationale

Correct Answer: A. Avoid combining it with alcohol or sedatives unless specifically directed; B. Take it exactly as prescribed; D. Store it securely away from children; E. Discuss timing of the first dose to avoid precipitated withdrawal

Safe buprenorphine use requires prescribed dosing, appropriate induction timing, avoidance of dangerous depressant combinations, and secure storage.

Question 11 of 15

Case excerpt

For Psychiatric Nursing Practice Test: A client with delirium is being cared for on a medical unit. Which nursing interventions are appropriate.

A client with delirium is being cared for on a medical unit. Which nursing interventions are appropriate? (Select all that apply)

A. Support hydration and sleep-wake routine as appropriate
B. Assess oxygenation and possible infection
C. Review medications and metabolic abnormalities
D. Assume the confusion is permanent dementia
E. Provide frequent calm reorientation

Expert Explanatory Rationale

Correct Answer: A. Support hydration and sleep-wake routine as appropriate; B. Assess oxygenation and possible infection; C. Review medications and metabolic abnormalities; E. Provide frequent calm reorientation

Delirium is often acute and potentially reversible; assess underlying causes and provide supportive orientation and basic care.

Question 12 of 15

Case excerpt

For Psychiatric Nursing Practice Test: A client receiving ECT is preparing for treatment. Which actions should the nurse anticipate.

A client receiving ECT is preparing for treatment. Which actions should the nurse anticipate? (Select all that apply)

A. Assess vital signs and baseline status
B. Allow an unrestricted meal immediately before anesthesia
C. Review medications and medical history
D. Confirm preprocedure fasting instructions
E. Verify informed consent according to policy

Expert Explanatory Rationale

Correct Answer: A. Assess vital signs and baseline status; C. Review medications and medical history; D. Confirm preprocedure fasting instructions; E. Verify informed consent according to policy

ECT preparation includes consent verification, fasting per anesthesia guidance, medication review, and baseline assessment.

Question 13 of 15

Case excerpt

For Psychiatric Nursing Practice Test: A client with borderline personality disorder is admitted after self-injury. Which approaches support safe, consistent care.

A client with borderline personality disorder is admitted after self-injury. Which approaches support safe, consistent care? (Select all that apply)

A. Make special exceptions in response to threats
B. Use a nonjudgmental approach
C. Communicate the treatment plan across the team
D. Set clear, consistent limits
E. Assess the injury and current suicide risk

Expert Explanatory Rationale

Correct Answer: B. Use a nonjudgmental approach; C. Communicate the treatment plan across the team; D. Set clear, consistent limits; E. Assess the injury and current suicide risk

Safety assessment, consistent boundaries, nonjudgmental care, and team communication reduce risk and splitting.

Question 14 of 15

Case excerpt

Psychiatric Nursing Practice Test: A client is prescribed 75 mg of a medication. Tablets available contain 25 mg each. How many tablets should be administered? Enter the number only.

A client is prescribed 75 mg of a medication. Tablets available contain 25 mg each. How many tablets should be administered? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 3

75 mg ÷ 25 mg/tablet = 3 tablets.

Question 15 of 15

Case excerpt

Psychiatric Nursing Practice Test: A client with alcohol withdrawal develops tremors and autonomic symptoms. Place the nursing actions in the safest order.

A client with alcohol withdrawal develops tremors and autonomic symptoms. Place the nursing actions in the safest order.

A. Recognize and assess withdrawal symptoms using the approved scale
B. Check vital signs, orientation, hydration, and seizure risk
C. Notify the prescriber/team and follow the withdrawal protocol
D. Administer prescribed medication and supportive care
E. Reassess symptoms and monitor for progression

Expert Explanatory Rationale

Correct Answer: A. Recognize and assess withdrawal symptoms using the approved scale; B. Check vital signs, orientation, hydration, and seizure risk; C. Notify the prescriber/team and follow the withdrawal protocol; D. Administer prescribed medication and supportive care; E. Reassess symptoms and monitor for progression

Assess severity and risk, escalate through the protocol, provide prescribed treatment, and monitor response.

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