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Quizzes > Health & Medicine

Psychiatric Nursing Practice Test: Check Your Knowledge

Quick quiz on psych nursing exam questions. Instant results with answer key PDF.

Editorial: Review CompletedCreated By: Juon TanUpdated Aug 23, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art quiz for psychiatric nursing practice test with downloadable answer key PDF on golden yellow background

This psychiatric nursing practice test helps you check core concepts and care scenarios before the exam. Get instant scoring, then download the answer key PDF to review your choices. For more practice, try our psychiatric nursing quiz and psych nursing practice questions for extra drills, or focus on conditions with a personality disorders assessment quiz.

Which of the following neurotransmitters is most closely associated with mood regulation and is commonly implicated in depression?
GABA
Serotonin
Norepinephrine
Dopamine
Serotonin is a key neurotransmitter that regulates mood and is often targeted by antidepressant medications such as SSRIs. Imbalances in serotonin levels have been linked to major depressive disorder. Awareness of serotonin's role helps psychiatric nurses understand medication effects. For more details, see .
What is the term for the structured clinical assessment that evaluates a client's appearance, behavior, cognition, and thought processes?
Biopsychosocial history
Psychosocial assessment
Mental status examination
Cognitive screening
A Mental Status Examination (MSE) is a systematic evaluation of a client's current mental functioning, covering appearance, behavior, mood, thought content, and cognition. It is essential for forming a baseline and guiding diagnostic decisions. Nurses use the MSE to document changes and communicate clinical findings. See for further information.
Which DSM-5 category includes schizophrenia?
Schizophrenia spectrum and other psychotic disorders
Neurodevelopmental disorders
Anxiety disorders
Mood disorders
Schizophrenia falls under the DSM-5 category 'Schizophrenia spectrum and other psychotic disorders,' which includes conditions characterized by delusions, hallucinations, and disorganized thinking. Correct categorization ensures accurate diagnosis and treatment planning. Nursing care is tailored to symptom management within this spectrum. More information is available at .
A client displays fluctuating levels of awareness and attention over a short period. Which term best describes this condition?
Psychosis
Catatonia
Delirium
Dementia
Delirium is characterized by an acute onset of fluctuating consciousness, attention deficits, and disorientation. It contrasts with dementia, which is chronic and progressive. Prompt recognition by nurses is crucial for identifying underlying causes and initiating treatment. For clinical guidelines, see .
Which therapeutic communication technique involves restating the client's words in your own words to confirm understanding?
Summarization
Paraphrasing
Interpretation
Confrontation
Paraphrasing involves restating what the client has said to ensure clarity and demonstrate active listening. This technique helps build rapport and validates the client's feelings. It is a fundamental skill in therapeutic communication for psychiatric nursing. Learn more at .
Which of the following is considered a positive symptom of schizophrenia?
Poor grooming
Hallucinations
Flat affect
Apathy
Positive symptoms of schizophrenia refer to excesses or distortions of normal function, such as hallucinations and delusions. Hallucinations involve sensing voices or images that are not present. Negative symptoms include flat affect and social withdrawal. For a detailed overview, visit .
Which class of medications is considered first-line treatment for major depressive disorder?
Selective serotonin reuptake inhibitors (SSRIs)
Benzodiazepines
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)
SSRIs are first-line antidepressants due to their favorable side-effect profile and safety in overdose. They work by blocking the reuptake of serotonin in the synaptic cleft. Nurses monitor for side effects such as gastrointestinal upset and sexual dysfunction. More information at .
Lithium is primarily used in psychiatric practice to treat which condition?
Major depressive disorder
Schizophrenia
Bipolar mania
Generalized anxiety disorder
Lithium is the gold-standard mood stabilizer for treating acute mania and preventing recurrent manic and depressive episodes in bipolar disorder. Therapeutic drug monitoring is essential due to its narrow therapeutic index. Nurses must educate clients about signs of toxicity. See .
What is the primary goal of milieu therapy in a psychiatric setting?
Promoting maximum client dependency
Encouraging extended periods of solitude
Providing a structured, therapeutic environment
Conducting formal psychoanalysis
Milieu therapy uses the therapeutic environment, including structured activities and social interactions, to support clients' recovery. It focuses on safety, community, and patient participation. This approach empowers clients and fosters coping skills. For more, visit .
What is the mechanism of action of selective serotonin reuptake inhibitors (SSRIs)?
Blocking dopamine receptors
Enhancing GABA activity
Increasing norepinephrine release
Blocking serotonin reuptake
SSRIs selectively inhibit the reuptake of serotonin into presynaptic neurons, increasing its availability in the synaptic cleft. This mechanism helps alleviate depressive symptoms. Nurses educate clients about delayed onset of therapeutic effects. More details at .
Which of the following is a well-established risk factor for suicide?
Strong family support
Positive peer relationships
History of a previous suicide attempt
Stable employment
A previous suicide attempt is the single strongest predictor of future suicide risk. Other protective factors include strong support systems and stable environments. Mental health nurses assess safety on every encounter. See for more.
Which immediate intervention is most appropriate for a client experiencing acute anxiety?
Psychoanalytic interpretation
Long-term talk therapy
Electroconvulsive therapy
Guided deep breathing exercises
Guided deep breathing helps reduce physiological arousal quickly and can alleviate acute anxiety symptoms. It is a nonpharmacologic, first-line intervention in crisis situations. Nurses teach clients these techniques to use independently. Learn more at .
Which symptom is a hallmark feature of post-traumatic stress disorder (PTSD)?
Disorganized speech
Elevated mood
Recurrent, intrusive flashbacks of the traumatic event
Compulsive hand washing
Intrusive flashbacks are a core symptom of PTSD, where the individual re-experiences the traumatic event vividly. Other symptoms include avoidance, negative cognition, and hyperarousal. Early recognition and intervention improve outcomes. For guidelines, visit .
A nurse documents that a client's thought process is characterized by 'flight of ideas.' What does this term describe?
Rapid shifting between loosely related topics
Difficulty recalling recent events
Slowed thought progression
Fixed, irrational beliefs
Flight of ideas involves rapid, continuous speech that jumps from one idea to another, often seen in manic episodes. It reflects accelerated thought processes. Recognizing this aids in diagnosing bipolar mania. More on thought disorders at .
Electroconvulsive therapy (ECT) is most effective in which of the following conditions?
Mild anxiety
Personality disorders
Specific phobias
Severe, treatment-resistant depression
ECT is highly effective for severe major depression that has not responded to medications or psychotherapy. It may also be used in catatonia and treatment-resistant mania. Nurses monitor vital signs and manage side effects during treatment. For protocols, see .
A client receiving haloperidol reports muscle stiffness and difficulty swallowing. These symptoms most likely indicate which adverse reaction?
Serotonin syndrome
Neuroleptic malignant syndrome
Tardive dyskinesia
Acute extrapyramidal symptoms
Acute extrapyramidal symptoms (EPS), such as dystonia, present with muscle stiffness, spasms, and dysphagia soon after starting antipsychotics. They differ from tardive dyskinesia, which involves late-onset involuntary movements. Prompt treatment with anticholinergic agents is required. Learn more at .
What is the therapeutic plasma concentration range of lithium for maintenance therapy in bipolar disorder?
0.2 - 0.5 mEq/L
2.5 - 3.5 mEq/L
1.5 - 2.5 mEq/L
0.6 - 1.2 mEq/L
The maintenance lithium level is usually kept between 0.6 and 1.2 mEq/L to balance efficacy and toxicity risk. Regular monitoring is essential due to lithium's narrow therapeutic index. Nurses schedule and interpret serum levels to guide dosing. More details at .
A client prescribed clozapine requires frequent monitoring of which laboratory value to detect a serious potential adverse effect?
Thyroid-stimulating hormone
Serum creatinine
Amylase
White blood cell count
Clozapine carries a risk of agranulocytosis, so weekly white blood cell and absolute neutrophil counts are required for the first six months. Early detection prevents severe infection risk. Nurses coordinate lab draws and report critical values immediately. See .
Which clinical sign is more characteristic of serotonin syndrome than neuroleptic malignant syndrome?
Lead-pipe rigidity
Hyperreflexia with clonus
Bradykinesia
Hyporeflexia
Serotonin syndrome typically presents with hyperreflexia, clonus, and neuromuscular agitation, whereas neuroleptic malignant syndrome features rigidity and hyporeflexia. Both are life-threatening and require prompt recognition. Nurses assess reflexes and recent medication changes. For comparison, see .
Which of the following is considered the first-line psychotherapy for borderline personality disorder?
Interpersonal therapy
Psychoanalytic therapy
Cognitive behavioral therapy (CBT)
Dialectical behavior therapy (DBT)
DBT is the evidence-based first-line treatment for borderline personality disorder, focusing on emotion regulation, distress tolerance, and interpersonal effectiveness. It combines individual therapy with skills training groups. Nurses support clients by reinforcing DBT techniques in the milieu. More at .
A client is involuntarily committed and refuses medication. Which statement best describes a nurse's obligation?
Respect refusal and withhold treatment indefinitely
Discharge the client for noncompliance
Obtain family consent to override the client's refusal
Treat the client if court-ordered, even without consent
When a client is involuntarily committed, a court order may mandate treatment despite refusal. Nurses must follow legal directives while advocating for client rights. Documentation of all actions and rationales is critical. For legal guidelines, see .
A client with anorexia nervosa presents with bradycardia. What is the nurse's priority intervention?
Encourage increased caloric intake immediately
Administer prescribed anxiolytics
Initiate continuous cardiac monitoring
Schedule a psychotherapy session
Bradycardia in clients with anorexia nervosa indicates serious malnutrition and possible cardiac compromise. Continuous cardiac monitoring is the priority to detect arrhythmias. Nutritional and psychiatric interventions follow stabilization. See .
Which laboratory test should be monitored routinely in a client taking valproic acid?
Fasting glucose
Serum amylase
Thyroid panel
Liver function tests
Valproic acid can cause hepatotoxicity, so periodic liver function tests (AST, ALT) are essential. Baseline and ongoing monitoring help prevent severe liver injury. Nurses coordinate lab draws and educate clients about signs of liver dysfunction. More at .
A client with schizophrenia exhibits avolition. What does this symptom refer to?
Disorganized speech
Lack of motivation to initiate activities
Presence of delusions
Involuntary muscle movements
Avolition is a negative symptom of schizophrenia, characterized by decreased motivation and inability to start or finish tasks. It significantly impairs daily functioning. Nursing interventions focus on structured routines and positive reinforcement. See .
After an electroconvulsive therapy (ECT) session, what is the nurse's first priority action?
Assess the client's vital signs and level of orientation
Immediately ambulate the client
Allow the client to sleep off sedation
Offer a high-protein snack
Post-ECT, monitoring vital signs and orientation is critical to detect complications such as hypotension or confusion. Safe recovery includes airway protection and neurological checks. Early assessment guides further care. Guidelines at .
Which ethical principle is breached when a nurse discloses a client's confidential information without consent?
Beneficence
Justice
Autonomy
Fidelity
Fidelity involves keeping promises, including maintaining confidentiality. Breaching client privacy violates trust and professional ethics. Nurses safeguard information unless legally mandated to disclose. For ethics guidelines, see .
Buspirone is often chosen for generalized anxiety disorder because it:
Does not cause dependence or sedation
Is effective in a single dose
Potentiates GABA receptors
Acts immediately to relieve panic
Buspirone is a nonbenzodiazepine anxiolytic that does not produce sedation, tolerance, or dependence. It has a delayed onset and is suitable for long-term management of generalized anxiety disorder. Nurses counsel clients on adherence for optimal effect. See .
Which defense mechanism involves attributing one's own unacceptable thoughts to someone else?
Sublimation
Displacement
Projection
Rationalization
Projection is a defense mechanism where an individual unconsciously attributes personal unacceptable feelings or impulses onto another person. It protects the ego by denying one's own feelings. Recognizing defense mechanisms aids in therapeutic planning. For more, visit .
Countertransference occurs when the nurse:
Maintains professional boundaries
Interprets the client's transference
Encourages client dependency
Projects personal feelings onto the client
Countertransference is the nurse's emotional reaction to a client, often rooted in the nurse's own experiences. It can cloud objectivity and affect care. Awareness and supervision help manage countertransference. More at .
What is the most common presenting symptom of attention-deficit/hyperactivity disorder (ADHD) in school-aged children?
Hypervigilance
Inattention
Hallucinations
Psychomotor retardation
Inattention, including difficulty sustaining focus, careless mistakes, and poor organization, is the most common symptom cluster in school-aged children with ADHD. Hyperactivity and impulsivity are also key features. Early identification allows timely intervention. See .
Which medication is FDA-approved for treatment of tardive dyskinesia?
Valbenazine
Haloperidol
Risperidone
Benztropine
Valbenazine is a vesicular monoamine transporter 2 inhibitor specifically approved for tardive dyskinesia. It reduces involuntary movements associated with long-term antipsychotic use. Nurses monitor for side effects like somnolence. Details at .
Which laboratory finding supports a diagnosis of neuroleptic malignant syndrome (NMS)?
Hypoglycemia
Elevated creatine kinase (CK)
Decreased white blood cell count
Elevated thyroid-stimulating hormone
NMS is characterized by muscle rigidity and hyperthermia leading to rhabdomyolysis, which elevates CK levels. Early recognition and treatment, including discontinuing antipsychotics and supportive care, are critical. Nurses monitor vital signs and lab values closely. For pathophysiology, see .
Which cognitive distortion involves anticipating that the worst possible outcome will occur?
Overgeneralization
Personalization
Minimization
Catastrophizing
Catastrophizing is a cognitive distortion where individuals assume a situation will have the worst possible outcome. It contributes to anxiety and depression. Cognitive-behavioral interventions target these thought patterns. More at .
Which laboratory study should be monitored in a client taking carbamazepine for bipolar disorder?
Complete blood count for agranulocytosis
Thyroid panel
Serum glucose
Renal function tests
Carbamazepine can cause bone marrow suppression and agranulocytosis. Regular complete blood counts are required to detect leukopenia or thrombocytopenia. Nurses schedule lab work and assess for infection signs. Guidelines at .
Which SSRI is considered the most activating and may worsen insomnia if administered late in the day?
Citalopram
Fluoxetine
Paroxetine
Sertraline
Fluoxetine has a longer half-life and more activating properties, which can lead to insomnia if taken late. Paroxetine and citalopram are more sedating by comparison. Nurses advise morning dosing to minimize sleep disturbances. For pharmacokinetics, see .
In dialectical behavior therapy (DBT), which skill set focuses primarily on managing and regulating intense emotions?
Emotion regulation skills
Distress tolerance skills
Interpersonal effectiveness skills
Mindfulness skills
Emotion regulation skills in DBT teach clients to understand and modulate intense emotions effectively. This includes identifying emotions, reducing vulnerability, and applying opposite action. It is critical for borderline personality disorder treatment. See .
After discontinuing a monoamine oxidase inhibitor (MAOI), how long should a clinician wait before initiating an SSRI to avoid serotonin syndrome?
7 days
3 days
30 days
14 days
A 14-day washout period after stopping an MAOI is required before starting an SSRI to prevent serotonin syndrome due to excess serotonergic activity. Shorter intervals risk potentially life-threatening interactions. Nurses ensure medication safety by verifying treatment history. More at .
Which medication is considered first-line for nightmares associated with post-traumatic stress disorder (PTSD)?
Diazepam
Propranolol
Prazosin
Sertraline
Prazosin, an alpha-1 blocker, is effective for reducing nightmares and sleep disturbances in PTSD. It crosses the blood-brain barrier to mitigate hyperadrenergic symptoms. Nurses assess blood pressure and watch for orthostatic hypotension. For clinical evidence, see .
During a mental status examination, which question best assesses thought content?
"Do you ever feel that people are watching or controlling your thoughts?"
"Can you recall what you had for breakfast?"
"What day of the week is it today?"
"Could you follow these three steps: lift your finger, touch your nose, then clap?"
Asking about perceived control or surveillance experiences assesses thought content for delusions and paranoia. Thought process and content are distinct MSE domains. Nurses use targeted questions to identify delusional beliefs. For MSE details, see .
An inability to recognize one's own mental illness is termed:
Agnosia
Anosognosia
Alexithymia
Aphasia
Anosognosia is a lack of insight into one's own mental health condition, often seen in psychotic disorders and severe brain injury. It can impede treatment adherence. Psychiatric nurses work on insight-building interventions. More at .
Which imaging modality is most sensitive for evaluating regional brain metabolism?
Computed tomography (CT)
Electroencephalography (EEG)
Positron emission tomography (PET)
Magnetic resonance imaging (MRI)
PET scans measure metabolic activity by detecting radioactive tracer uptake, allowing visualization of functional brain changes. CT and MRI provide structural detail, while EEG records electrical activity. Nurses assist clients with preparation for imaging studies. For more, see .
In schizoaffective disorder, the DSM-5 requires what minimum duration of psychotic symptoms without a major mood episode?
Four weeks
Six months
One week
Two weeks
DSM-5 criteria for schizoaffective disorder specify at least two weeks of psychotic symptoms without major mood episodes, in addition to periods of mood symptoms concurrent with psychosis. This distinguishes it from mood disorders with psychotic features. Nurses gather thorough history for accurate diagnosis. See .
What is the approximate half-life of haloperidol decanoate depot injection?
One week
One month
Seven days
Three weeks
Haloperidol decanoate has a half-life of approximately three weeks, allowing for once-monthly intramuscular dosing. Understanding pharmacokinetics aids in scheduling and monitoring. Nurses educate clients about delayed onset and potential side effects. More at .
Which laboratory parameter warrants immediate intervention in a client receiving clozapine?
Hemoglobin of 13 g/dL
Platelet count above 400,000/µL
Serum sodium of 140 mEq/L
Absolute neutrophil count below 1500/µL
An absolute neutrophil count (ANC) below 1500/µL signals risk of agranulocytosis in clients on clozapine, requiring drug discontinuation and close monitoring. Timely recognition prevents life-threatening infection. Nurses follow REMS guidelines strictly. For protocols, see .
Which of the following is the initial treatment of choice for acute dystonic reactions induced by antipsychotics?
Increase antipsychotic dosage
Oral diphenhydramine
Oral lorazepam
Intramuscular benztropine
Acute dystonic reactions are treated promptly with intramuscular anticholinergic agents like benztropine. They rapidly reverse muscle spasms and oculogyric crises. Delayed treatment can lead to airway compromise. For management guidelines, see .
At a lithium serum level of 2.0 mEq/L, a client is most likely to exhibit which clinical sign?
Weight gain
Heightened alertness
Increased coordination
Coarse tremors
Lithium levels above 1.5 mEq/L can cause toxicity manifesting as coarse tremors, ataxia, and confusion. Early detection and dose adjustment are essential. Nurses monitor serum levels and assess for adverse effects regularly. For toxicity signs, see .
Which of the following is an absolute contraindication to electroconvulsive therapy (ECT)?
Malignant neuroleptic syndrome
Unstable increased intracranial pressure
Parkinson's disease
Major depressive disorder
Unstable increased intracranial pressure is an absolute contraindication to ECT due to risk of herniation during induced seizures. Relative risks must be weighed for other conditions. Nurses collaborate with anesthesiology to ensure safety. For ECT contraindications, see .
Which electrode placement in electroconvulsive therapy (ECT) is associated with fewer cognitive side effects?
Bilateral
Left unilateral
Bifrontal
Right unilateral
Right unilateral ECT placement is associated with fewer cognitive side effects, particularly memory loss, compared to bilateral placement, while maintaining efficacy. Electrode placement choice is tailored to clinical need. Nurses monitor cognitive function throughout treatment. Read more at .
A client with treatment-resistant schizophrenia remains symptomatic on clozapine. What is the next evidence-based intervention?
Augment with electroconvulsive therapy
Add a benzodiazepine
Increase clozapine dose above 900 mg
Discontinue clozapine and switch to risperidone
Augmentation of clozapine with ECT has shown efficacy in clozapine-resistant schizophrenia, improving positive and negative symptoms. Switching antipsychotics alone often fails after clozapine. Nurses prepare clients for combined treatment protocols. See .
Which nonpharmacologic intervention is most effective in managing sundowning in an elderly client with dementia?
Encouraging daytime napping
Administering melatonin nightly
Reducing evening fluid intake
Maintaining consistent lighting and routine
Consistent environmental cues, such as adequate lighting and predictable routines, help reduce sundowning symptoms in dementia. While melatonin may assist sleep, nonpharmacologic strategies are first-line. Nurses design structured activities for daytime engagement. More at .
A nurse receives a subpoena for a client's psychiatric records. The client refuses release. The nurse's best action is to:
Release records with verbal client refusal
Let the client decide after seeing the subpoena
Comply only after obtaining a court order
Refuse to release records under any circumstance
Psychiatric records are highly confidential. A subpoena alone does not override client consent; a court order is required for release. Nurses consult legal counsel and follow institutional policy. Documentation of the process is essential. For legal guidance, see .
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Study Outcomes

  1. Analyze psychiatric nursing practice test questions -

    Identify common question formats and key mental health concepts featured in the practice test to improve your critical thinking skills.

  2. Apply DSM-5 diagnostic criteria -

    Match clinical scenarios to appropriate mental health diagnoses, reinforcing your understanding of psychiatric nursing standards.

  3. Implement evidence-based nursing interventions -

    Select and justify best-practice interventions for various psychiatric conditions, enhancing your clinical decision-making.

  4. Utilize the downloadable answer key PDF -

    Leverage instant feedback from the answer key to pinpoint knowledge gaps and guide focused study sessions.

  5. Strengthen exam readiness and confidence -

    Track your performance using self-assessment strategies, building assurance and familiarity with nursing exam formats.

Cheat Sheet

  1. Mental Status Examination (MSE) Framework -

    The MSE assesses appearance, behavior, cognition, thought processes, mood, and perception, ensuring a comprehensive overview of mental health. Use the mnemonic "ABC-T" (Appearance, Behavior, Cognition, Thought) to remember key domains during psychiatric nursing practice questions. This structure is outlined in the DSM-5 guidelines (American Psychiatric Association).

  2. Therapeutic Communication Techniques -

    Effective techniques such as open-ended questions, reflective listening, and validation foster trust and facilitate accurate assessments in patient interviews. For instance, starting with "Tell me more about…" encourages elaboration and demonstrates empathy (American Nurses Association). Practicing these in your nursing exam practice test scenarios sharpens both skills and confidence.

  3. Psychotropic Medication Side Effects -

    Understanding EPS - Dystonia, Akathisia, Pseudoparkinsonism, Tardive dyskinesia - is critical; use the acronym "DAPT" to quiz yourself on antipsychotic adverse effects. Be aware that SSRIs commonly cause gastrointestinal upset and sexual dysfunction (National Institute of Mental Health). Reviewing these in your psychiatric nursing test PDF ensures you can match drugs with side effect profiles.

  4. Crisis Intervention Model Steps -

    The five-step model (Define the problem, Ensure safety, Provide support, Explore alternatives, Plan follow-up) offers a systematic approach to psychiatric emergencies (Aguilera & Meschede). Memorize this sequence to handle acute crises confidently during both clinical practice and answer key psychiatric nursing questions PDF reviews. Role-playing scenarios reinforces application under pressure.

  5. Legal and Ethical Standards -

    Master HIPAA confidentiality rules, the Tarasoff duty to warn, and informed consent to uphold patient rights and avoid legal pitfalls (The Joint Commission). Integrating these principles into case studies from your psychiatric nursing practice test questions with answer key PDF solidifies understanding. Ethical competence is frequently tested on licensing examinations and in real-world care settings.

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