Psychiatric Nursing Practice Test-1
Psychiatric Nursing • 30 Questions
Negative Marking • No
Passing marks • 25+
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Q1. A client repeatedly describes feeling watched by others, despite no objective evidence. Which symptom is most characteristic of this presentation?
✓ Correct Answer Rationale:
A delusion is a fixed false belief that persists despite evidence showing that the belief is not based in reality.
A delusion is a fixed false belief that persists despite evidence showing that the belief is not based in reality.
✕ Why Other Options Are Incorrect:
A. Echolalia:
Repetition of another person’s words.
B. Neologism:
Refers to invented or newly created words.
C. Perseveration:
Inappropriate repetition of a word, idea, or response.
Q2. Which term describes a patient’s inability to experience pleasure from activities that were previously enjoyable?
✓ Correct Answer Rationale:
Anhedonia means a reduced or absent ability to experience pleasure and is commonly associated with depressive disorders.
Anhedonia means a reduced or absent ability to experience pleasure and is commonly associated with depressive disorders.
✕ Why Other Options Are Incorrect:
B. Agnosia:
Inability to recognize familiar stimuli.
C. Apraxia:
Difficulty performing learned purposeful movements.
D. Aphasia:
Impaired language ability.
Q3. A nurse hears a client say, “The television is sending special messages directly to me.” Which type of thought disturbance is most consistent with this statement?
✓ Correct Answer Rationale:
Ideas of reference occur when a person believes ordinary events, remarks, or media messages have a special personal meaning.
Ideas of reference occur when a person believes ordinary events, remarks, or media messages have a special personal meaning.
✕ Why Other Options Are Incorrect:
A. Thought blocking:
Sudden interruption of thought.
C. Circumstantiality:
Includes excessive detail before reaching the point.
D. Loose association:
Involves weak or illogical connections between ideas.
Q4. Which defense mechanism involves unconsciously directing unacceptable feelings toward a safer substitute object or person?
✓ Correct Answer Rationale:
Displacement involves shifting an unacceptable emotion from its original target to a less threatening target.
Displacement involves shifting an unacceptable emotion from its original target to a less threatening target.
✕ Why Other Options Are Incorrect:
A. Sublimation:
Channels unacceptable impulses into socially acceptable activities.
C. Rationalization:
Provides acceptable explanations for unacceptable behavior.
D. Identification:
Involves adopting characteristics of another person.
Q5. Which neurotransmitter is most strongly associated with the positive symptoms of schizophrenia?
✓ Correct Answer Rationale:
Increased dopamine activity in certain brain pathways is strongly associated with positive symptoms such as hallucinations and delusions.
Increased dopamine activity in certain brain pathways is strongly associated with positive symptoms such as hallucinations and delusions.
✕ Why Other Options Are Incorrect:
B. GABA:
Has important inhibitory functions in the nervous system but is not the primary neurotransmitter associated with positive psychotic symptoms.
C. Acetylcholine:
Plays important roles in cognition, memory, and neuromuscular transmission.
D. Endorphin:
Involved mainly in pain modulation and other physiological functions.
Q6. A client with schizophrenia suddenly becomes silent during an interview and appears unable to continue expressing a thought. Which finding is this?
✓ Correct Answer Rationale:
Thought blocking is a sudden interruption in the flow of thought, often followed by a period of silence.
Thought blocking is a sudden interruption in the flow of thought, often followed by a period of silence.
✕ Why Other Options Are Incorrect:
A. Flight of ideas:
Involves rapidly shifting thoughts.
C. Clang association:
Is based on sounds or rhyming between words.
D. Word salad:
Consists of severely disorganized and incoherent speech.
Q7. Which feature most clearly distinguishes delirium from dementia?
✓ Correct Answer Rationale:
Delirium typically develops rapidly, often over hours to days, and fluctuates during the day. Dementia generally develops gradually.
Delirium typically develops rapidly, often over hours to days, and fluctuates during the day. Dementia generally develops gradually.
✕ Why Other Options Are Incorrect:
A. Memory loss:
Can occur in both delirium and dementia.
B. Older age:
Older adults can experience either condition.
D. Communication difficulty:
Can occur in both conditions.
Q8. A client with obsessive-compulsive disorder repeatedly checks whether the door is locked. The repeated checking is best described as a:
✓ Correct Answer Rationale:
A compulsion is a repetitive behavior performed to reduce anxiety associated with an obsession.
A compulsion is a repetitive behavior performed to reduce anxiety associated with an obsession.
✕ Why Other Options Are Incorrect:
A. Delusion:
Is a fixed false belief.
B. Obsession:
Is an intrusive thought or urge.
D. Phobia:
Is an excessive fear of a specific object or situation.
Q9. Which nursing communication technique is most appropriate when a client is experiencing severe anxiety and cannot process lengthy explanations?
✓ Correct Answer Rationale:
Severe anxiety narrows attention and reduces the ability to process information. Short, clear communication is easier to understand.
Severe anxiety narrows attention and reduces the ability to process information. Short, clear communication is easier to understand.
✕ Why Other Options Are Incorrect:
B. Ask several questions together:
Multiple questions can increase anxiety and make processing more difficult.
C. Encourage complex problem-solving:
Complex tasks may be difficult to process during severe anxiety.
D. Change the subject frequently:
Frequent topic changes may further confuse the client.
Q10. Which symptom is most characteristic of mania?
✓ Correct Answer Rationale:
Pressured speech is rapid, difficult-to-interrupt speech commonly seen during manic episodes.
Pressured speech is rapid, difficult-to-interrupt speech commonly seen during manic episodes.
✕ Why Other Options Are Incorrect:
A. Psychomotor retardation:
Is more commonly associated with depressive states.
B. Increased need for sleep:
Mania is usually associated with a decreased need for sleep.
D. Social withdrawal:
Is not a typical core feature of mania.
Q11. A client taking an antipsychotic develops a sustained upward deviation of the eyes and painful neck muscle spasms. Which adverse effect is most likely?
✓ Correct Answer Rationale:
Acute dystonia causes sudden, painful muscle contractions and may involve the eyes, neck, jaw, or tongue.
Acute dystonia causes sudden, painful muscle contractions and may involve the eyes, neck, jaw, or tongue.
✕ Why Other Options Are Incorrect:
A. Tardive dyskinesia:
Causes late involuntary repetitive movements.
B. Akathisia:
Causes inner restlessness and an inability to remain still.
D. Neuroleptic malignant syndrome:
Causes severe rigidity, fever, autonomic instability, and altered consciousness.
Q12. Which laboratory value is particularly important to monitor in a client receiving clozapine?
✓ Correct Answer Rationale:
Clozapine can cause severe neutropenia, so absolute neutrophil count (ANC) monitoring is essential.
Clozapine can cause severe neutropenia, so absolute neutrophil count (ANC) monitoring is essential.
✕ Why Other Options Are Incorrect:
A. Hemoglobin A1c:
May be monitored with antipsychotic therapy but is not the key clozapine-specific safety test.
B. Serum sodium:
Is not the primary laboratory value requiring specific clozapine monitoring.
C. Platelet count:
Is not the principal monitoring parameter for clozapine-associated neutropenia.
Q13. Which statement best describes therapeutic use of silence?
✓ Correct Answer Rationale:
Therapeutic silence gives the client time to organize thoughts and express feelings without pressure.
Therapeutic silence gives the client time to organize thoughts and express feelings without pressure.
✕ Why Other Options Are Incorrect:
B. It prevents the client from discussing feelings:
Therapeutic silence can actually encourage further expression.
C. It changes the subject when emotions arise:
Therapeutic silence does not involve avoiding emotional topics.
D. It indicates that the nurse is uninterested:
Silence can communicate acceptance and attentive presence when used therapeutically.
Q14. A client with PTSD becomes distressed when hearing a sound similar to one associated with a previous traumatic event. This response is best described as a:
✓ Correct Answer Rationale:
A trauma-related trigger is a stimulus that reminds the person of the traumatic experience and may produce distress or other PTSD symptoms.
A trauma-related trigger is a stimulus that reminds the person of the traumatic experience and may produce distress or other PTSD symptoms.
✕ Why Other Options Are Incorrect:
B. Delusion:
Is a fixed false belief.
C. Compulsion:
Is a repetitive behavior or mental act.
D. Neologism:
Refers to a newly created or invented word.
Q15. Which symptom is considered a negative symptom of schizophrenia?
✓ Correct Answer Rationale:
Avolition is reduced motivation and difficulty initiating goal-directed activities, making it a negative symptom.
Avolition is reduced motivation and difficulty initiating goal-directed activities, making it a negative symptom.
✕ Why Other Options Are Incorrect:
A. Hallucination:
Is a positive symptom involving sensory perception without an external stimulus.
C. Delusion:
Is a positive symptom involving a fixed false belief.
D. Agitation:
Is not a core negative symptom of schizophrenia.
Q16. Which finding is most consistent with a panic attack?
✓ Correct Answer Rationale:
Panic attacks are characterized by sudden episodes of intense fear or discomfort, often accompanied by physical symptoms such as palpitations, sweating, or shortness of breath.
Panic attacks are characterized by sudden episodes of intense fear or discomfort, often accompanied by physical symptoms such as palpitations, sweating, or shortness of breath.
✕ Why Other Options Are Incorrect:
A. Gradual relaxation:
Does not describe the sudden onset of a panic attack.
C. Persistent mild worry:
Is more typical of generalized anxiety.
D. Long-term memory loss:
Is not a defining feature of panic attacks.
Q17. Which medication is commonly used as a mood stabilizer in bipolar disorder?
✓ Correct Answer Rationale:
Lithium is a well-established mood stabilizer used in bipolar disorder, particularly for maintenance treatment and prevention of manic and depressive episodes.
Lithium is a well-established mood stabilizer used in bipolar disorder, particularly for maintenance treatment and prevention of manic and depressive episodes.
✕ Why Other Options Are Incorrect:
B. Fluoxetine:
Is an antidepressant.
C. Haloperidol:
Is an antipsychotic.
D. Lorazepam:
Is a benzodiazepine.
Q18. A client taking lithium develops coarse tremors, vomiting, diarrhea, and marked weakness. What should the nurse suspect?
✓ Correct Answer Rationale:
Gastrointestinal symptoms, coarse tremor, weakness, and neurological changes can indicate lithium toxicity and require prompt assessment.
Gastrointestinal symptoms, coarse tremor, weakness, and neurological changes can indicate lithium toxicity and require prompt assessment.
✕ Why Other Options Are Incorrect:
A. Therapeutic effect:
The described symptoms are concerning for toxicity rather than a desired therapeutic response.
C. Serotonin syndrome:
Is associated with serotonergic medications and findings such as hyperreflexia and clonus.
D. Anticholinergic effect:
Does not explain the typical pattern of lithium toxicity.
Q19. Which term refers to a false sensory perception occurring without an external stimulus?
✓ Correct Answer Rationale:
A hallucination is a sensory perception experienced without an external stimulus.
A hallucination is a sensory perception experienced without an external stimulus.
✕ Why Other Options Are Incorrect:
A. Illusion:
Is a misinterpretation of a real external stimulus.
C. Delusion:
Is a false fixed belief.
D. Confabulation:
Involves filling memory gaps with fabricated information, usually without conscious intent to deceive.
Q20. Which intervention is most appropriate when caring for a client who is acutely aggressive?
✓ Correct Answer Rationale:
A calm approach, adequate personal space, clear limits, and attention to safety can help reduce escalation.
A calm approach, adequate personal space, clear limits, and attention to safety can help reduce escalation.
✕ Why Other Options Are Incorrect:
A. Argue about the client’s beliefs:
Arguing can increase perceived threat and agitation.
C. Stand very close to the client:
Crowding the client may increase feelings of threat.
D. Challenge the client publicly:
Public confrontation can increase embarrassment and aggression.
Q21. Which term describes rapidly shifting from one topic to another with understandable but accelerated connections?
✓ Correct Answer Rationale:
Flight of ideas is characterized by rapid speech and quick shifts from one topic to another, often seen in mania.
Flight of ideas is characterized by rapid speech and quick shifts from one topic to another, often seen in mania.
✕ Why Other Options Are Incorrect:
B. Thought blocking:
Involves interruption of thought.
C. Neologism:
Involves invented or newly created words.
D. Echolalia:
Involves repeating another person’s words.
Q22. A client receiving an antipsychotic develops high fever, severe muscle rigidity, confusion, and autonomic instability. Which condition should the nurse suspect?
✓ Correct Answer Rationale:
Neuroleptic malignant syndrome is a serious reaction to dopamine-blocking medications characterized by hyperthermia, severe rigidity, altered mental status, and autonomic instability.
Neuroleptic malignant syndrome is a serious reaction to dopamine-blocking medications characterized by hyperthermia, severe rigidity, altered mental status, and autonomic instability.
✕ Why Other Options Are Incorrect:
A. Akathisia:
Causes restlessness and an inability to remain still.
C. Acute dystonia:
Causes focal or sustained muscle spasms.
D. Tardive dyskinesia:
Causes involuntary repetitive movements after longer exposure.
Q23. Which eating-disorder feature is most characteristic of anorexia nervosa?
✓ Correct Answer Rationale:
Anorexia nervosa includes restriction of energy intake and a disturbed perception or excessive influence of body weight and shape on self-evaluation.
Anorexia nervosa includes restriction of energy intake and a disturbed perception or excessive influence of body weight and shape on self-evaluation.
✕ Why Other Options Are Incorrect:
B. Recurrent bingeing only:
Is more characteristic of bulimia nervosa or binge-eating disorder.
C. Loss of appetite from infection:
Does not define anorexia nervosa.
D. Increased body acceptance:
Is inconsistent with the body-image disturbance associated with anorexia nervosa.
Q24. Which finding is most suggestive of delirium tremens in a client withdrawing from alcohol?
✓ Correct Answer Rationale:
Delirium tremens can involve confusion, agitation, visual hallucinations, sweating, tremor, tachycardia, and hypertension.
Delirium tremens can involve confusion, agitation, visual hallucinations, sweating, tremor, tachycardia, and hypertension.
✕ Why Other Options Are Incorrect:
A. Mild boredom:
Is not a characteristic finding of severe alcohol withdrawal.
C. Increased appetite:
Is not a typical feature of delirium tremens.
D. Slow pulse:
Severe alcohol withdrawal commonly produces autonomic hyperactivity such as tachycardia.
Q25. Which response is most therapeutic when a client says, “Nobody understands what I am going through”?
✓ Correct Answer Rationale:
This response encourages the client to explore feelings and communicates acceptance without giving false reassurance or minimizing distress.
This response encourages the client to explore feelings and communicates acceptance without giving false reassurance or minimizing distress.
✕ Why Other Options Are Incorrect:
A. “You should stay positive.”:
Gives advice rather than encouraging emotional expression.
B. “Others have worse problems.”:
Compares and minimizes the client’s distress.
D. “You will feel better soon.”:
Provides reassurance without exploring the client’s feelings.
Q26. Which symptom is commonly associated with generalized anxiety disorder?
✓ Correct Answer Rationale:
Generalized anxiety disorder involves excessive and difficult-to-control worry about multiple areas of life, accompanied by associated symptoms.
Generalized anxiety disorder involves excessive and difficult-to-control worry about multiple areas of life, accompanied by associated symptoms.
✕ Why Other Options Are Incorrect:
B. Fixed false beliefs:
Suggest delusions and are associated with psychotic disorders.
C. Complete loss of consciousness:
Is not a defining feature of generalized anxiety disorder.
D. Repetitive involuntary movements:
May indicate a neurological or medication-related problem.
Q27. A client repeatedly says, “The nurses can hear my private thoughts.” Which psychotic symptom does this statement represent?
✓ Correct Answer Rationale:
Thought broadcasting is the belief that one’s thoughts are accessible to or heard by other people.
Thought broadcasting is the belief that one’s thoughts are accessible to or heard by other people.
✕ Why Other Options Are Incorrect:
A. Thought insertion:
Is the belief that thoughts are being placed into one’s mind.
C. Thought withdrawal:
Is the belief that thoughts are being removed from one’s mind.
D. Obsession:
Is an intrusive, unwanted thought or urge.
Q28. Which nursing action is most appropriate when assessing a client at risk for suicide?
✓ Correct Answer Rationale:
Direct, calm questioning about suicidal thoughts helps identify risk and does not cause suicide. Safety assessment should be clear and systematic.
Direct, calm questioning about suicidal thoughts helps identify risk and does not cause suicide. Safety assessment should be clear and systematic.
✕ Why Other Options Are Incorrect:
A. Leave the client alone to promote privacy:
A client at significant risk should not be left alone.
C. Avoid discussing suicide:
Avoiding the subject can cause important risk information to be missed.
D. Promise absolute confidentiality:
Absolute confidentiality cannot be promised when safety is at risk.
Q29. A client taking an antipsychotic repeatedly paces and reports, “I cannot sit still.” Which adverse effect is most likely?
✓ Correct Answer Rationale:
Akathisia is a medication-related movement disorder characterized by subjective inner restlessness and an inability to remain still.
Akathisia is a medication-related movement disorder characterized by subjective inner restlessness and an inability to remain still.
✕ Why Other Options Are Incorrect:
B. Acute dystonia:
Causes sustained or painful muscle contractions.
C. Tardive dyskinesia:
Causes repetitive involuntary movements, often involving the mouth and tongue.
D. Apathy:
Refers to a lack of interest or emotional responsiveness.
Q30. Which defense mechanism involves unconsciously returning to behavior associated with an earlier developmental stage when under stress?
✓ Correct Answer Rationale:
Regression occurs when a person responds to stress by reverting to behaviors associated with an earlier developmental stage.
Regression occurs when a person responds to stress by reverting to behaviors associated with an earlier developmental stage.
✕ Why Other Options Are Incorrect:
A. Projection:
Attributes one’s unacceptable feelings to another person.
C. Compensation:
Involves emphasizing strengths in one area to offset a perceived weakness in another.
D. Suppression:
Is the conscious postponement of distressing thoughts or feelings.
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