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Psychiatric and Mental Health Nursing · Psychiatric Nursing Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A client with command hallucinations says a voice is telling them to stab a roommate. The client is holding a sharp object.

What should the nurse do first?

A. Maintain safety, summon assistance, and separate the client from potential victims and weapons
B. Wait for the next psychiatric round
C. Ask the client to write down the voice's message
D. Leave the client alone to calm down
E. Debate whether the voice is real

Expert Explanatory Rationale

Correct Answer: A. Maintain safety, summon assistance, and separate the client from potential victims and weapons

Command hallucinations with a weapon and a named target create immediate danger. Activate safety procedures and protect everyone involved.

Question 2 of 15

Case excerpt

A client taking an MAOI asks which lunch choice is safest.

Which food should the nurse identify as appropriate?

A. Fermented soy products
B. Aged cheddar and salami sandwich
C. Fresh grilled chicken with rice and steamed vegetables
D. Tap beer and aged cheese
E. Cured sausage with sauerkraut

Expert Explanatory Rationale

Correct Answer: C. Fresh grilled chicken with rice and steamed vegetables

Fresh, unaged foods are generally safer with MAOIs; tyramine-rich aged, cured, fermented foods can precipitate hypertensive crisis.

Question 3 of 15

Case excerpt

A client with acute mania attempts to give away personal belongings and says, 'I am starting a new company tomorrow with no money.'

Which assessment is most important?

A. Preference for television programs
B. Risk-taking, judgment, sleep, and ability to meet basic needs
C. Hand dominance
D. Whether the client likes the hospital menu
E. Long-term career interests only

Expert Explanatory Rationale

Correct Answer: B. Risk-taking, judgment, sleep, and ability to meet basic needs

Mania can impair judgment and increase risky behavior; assess safety, sleep, impulsivity, and basic functioning.

Question 4 of 15

Case excerpt

A client with a history of opioid use disorder is prescribed methadone maintenance.

Which teaching is essential?

A. Share doses with peers who are withdrawing
B. Double the dose after a missed appointment
C. Take only the prescribed dose and avoid alcohol or other sedatives unless approved
D. Stop methadone whenever cravings improve
E. Use sedatives to improve the medication's effect

Expert Explanatory Rationale

Correct Answer: C. Take only the prescribed dose and avoid alcohol or other sedatives unless approved

Methadone must be taken as prescribed; combining it with alcohol or sedatives increases the risk of respiratory depression.

Question 5 of 15

Case excerpt

A client experiencing grief says, 'I should have noticed the signs before my partner died.'

Which response is most therapeutic?

A. You should not feel guilty.'
B. Everything happens for a reason.'
C. At least you had many years together.'
D. You need to move on.'
E. It sounds like you are carrying a lot of responsibility. Would you like to talk about what has been hardest?'

Expert Explanatory Rationale

Correct Answer: E. It sounds like you are carrying a lot of responsibility. Would you like to talk about what has been hardest?'

Reflecting the client's feelings and inviting further expression is more therapeutic than minimizing, judging, or offering clichés.

Question 6 of 15

Case excerpt

A client with delirium becomes suddenly disoriented and pulls at an IV line after surgery.

Which nursing action is the priority?

A. Assess for reversible causes such as hypoxia, infection, medication effects, and metabolic changes
B. Move the client to a dark room without observation
C. Tell the client to remember where they are
D. Apply restraints before assessment
E. Assume the behavior is a chronic psychiatric disorder

Expert Explanatory Rationale

Correct Answer: A. Assess for reversible causes such as hypoxia, infection, medication effects, and metabolic changes

Acute fluctuating confusion is delirium until evaluated; identify and treat underlying medical causes promptly.

Question 7 of 15

Case excerpt

A client taking an antipsychotic reports an irresistible need to pace and cannot sit still.

Which adverse effect should the nurse suspect?

A. Lithium toxicity
B. Agranulocytosis
C. Serotonin syndrome
D. Akathisia
E. Tardive dyskinesia

Expert Explanatory Rationale

Correct Answer: D. Akathisia

Akathisia causes subjective inner restlessness and observable pacing or inability to remain seated.

Question 8 of 15

Case excerpt

A client with panic disorder says they have begun avoiding buses and crowded stores because escape feels difficult.

Which condition is consistent with this pattern?

A. Dissociative amnesia
B. Agoraphobia
C. Delirium
D. Somatic symptom disorder
E. Specific phobia of animals

Expert Explanatory Rationale

Correct Answer: B. Agoraphobia

Fear or avoidance of situations where escape may be difficult or help unavailable is characteristic of agoraphobia.

Question 9 of 15

Case excerpt

For Psychiatric Nursing Quiz: A client taking an antipsychotic reports new involuntary lip smacking and tongue movements. Which actions are appropriate.

A client taking an antipsychotic reports new involuntary lip smacking and tongue movements. Which actions are appropriate? (Select all that apply)

A. Assume the movements are intentional
B. Use a structured movement assessment as indicated
C. Review medication history and onset
D. Notify the prescriber
E. Assess and document the movements

Expert Explanatory Rationale

Correct Answer: B. Use a structured movement assessment as indicated; C. Review medication history and onset; D. Notify the prescriber; E. Assess and document the movements

New involuntary movements may indicate tardive dyskinesia or another movement disorder and require assessment and medication review.

Question 10 of 15

Case excerpt

For Psychiatric Nursing Quiz: A client with post-traumatic stress disorder is having a flashback. Which nursing responses are appropriate.

A client with post-traumatic stress disorder is having a flashback. Which nursing responses are appropriate? (Select all that apply)

A. Demand an immediate detailed account of the trauma
B. Remain with the client if safe
C. Orient the client to the present using calm, simple statements
D. Reduce environmental triggers when possible
E. Ask permission before approaching or touching

Expert Explanatory Rationale

Correct Answer: B. Remain with the client if safe; C. Orient the client to the present using calm, simple statements; D. Reduce environmental triggers when possible; E. Ask permission before approaching or touching

Grounding, consent, reduced stimulation, and supportive presence promote safety during flashbacks.

Question 11 of 15

Case excerpt

For Psychiatric Nursing Quiz: A client taking an MAOI is reviewing food choices. Which foods should the client avoid because of tyramine content.

A client taking an MAOI is reviewing food choices. Which foods should the client avoid because of tyramine content? (Select all that apply)

A. Fresh apple
B. Fermented soy paste
C. Cured salami
D. Aged cheddar
E. Aged blue cheese

Expert Explanatory Rationale

Correct Answer: B. Fermented soy paste; C. Cured salami; D. Aged cheddar; E. Aged blue cheese

Aged cheeses, cured meats, and fermented soy products can contain tyramine and may trigger hypertensive crisis with MAOIs.

Question 12 of 15

Case excerpt

For Psychiatric Nursing Quiz: A client is being evaluated for serotonin syndrome. Which findings support this concern.

A client is being evaluated for serotonin syndrome. Which findings support this concern? (Select all that apply)

A. Agitation
B. Markedly reduced reflexes with lead-pipe rigidity as the defining pattern
C. Hyperreflexia or clonus
D. Diarrhea
E. Diaphoresis and fever

Expert Explanatory Rationale

Correct Answer: A. Agitation; C. Hyperreflexia or clonus; D. Diarrhea; E. Diaphoresis and fever

Serotonin syndrome commonly includes mental-status changes, autonomic activation, gastrointestinal symptoms, and neuromuscular hyperactivity.

Question 13 of 15

Case excerpt

For Psychiatric Nursing Quiz: A client with depression is preparing a safety plan. Which elements should be included.

A client with depression is preparing a safety plan. Which elements should be included? (Select all that apply)

A. Internal coping strategies
B. Professional and crisis contacts
C. A promise that suicidal thoughts will never return
D. Personal warning signs
E. Trusted people and places for distraction or support

Expert Explanatory Rationale

Correct Answer: A. Internal coping strategies; B. Professional and crisis contacts; D. Personal warning signs; E. Trusted people and places for distraction or support

A safety plan includes warning signs, coping strategies, supportive contacts, professional resources, and steps to reduce access to lethal means.

Question 14 of 15

Case excerpt

Psychiatric Nursing Quiz: A client is prescribed 300 mg of a medication. Capsules available contain 150 mg each. How many capsules are needed for one dose? Enter the number only.

A client is prescribed 300 mg of a medication. Capsules available contain 150 mg each. How many capsules are needed for one dose? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 2

300 mg ÷ 150 mg/capsule = 2 capsules.

Question 15 of 15

Case excerpt

Psychiatric Nursing Quiz: A client experiencing a panic attack is unable to process complex instructions. Place the nursing responses in the safest order.

A client experiencing a panic attack is unable to process complex instructions. Place the nursing responses in the safest order.

A. Stay with the client and assess immediate safety
B. Reduce noise and unnecessary stimulation
C. Use short, calm statements and simple directions
D. Coach slow breathing or grounding as the client can tolerate
E. Reassess distress and remain present until the episode subsides

Expert Explanatory Rationale

Correct Answer: A. Stay with the client and assess immediate safety; B. Reduce noise and unnecessary stimulation; C. Use short, calm statements and simple directions; D. Coach slow breathing or grounding as the client can tolerate; E. Reassess distress and remain present until the episode subsides

Presence and safety come first, followed by reduced stimulation, simple communication, coping support, and reassessment.

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