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Test Your Psych Nursing Skills with Our NCLEX Practice Quiz

Sharpen your skills with mental health nursing practice questions - start now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration quiz concept psych nursing study NCLEX practice mental health icons on golden yellow background

This psych nursing practice questions quiz helps you prep for the NCLEX with items on therapeutic communication, psychopharmacology, and patient safety. Use it to check gaps before the exam and get instant scoring; for more practice, try our mental health nursing set.

A nurse is assessing a client with major depressive disorder. Which of the following findings is most characteristic of this condition?
Rapid speech and flight of ideas
Euphoric mood and grandiosity
Auditory hallucinations of voices
Anhedonia and persistent sadness
Clients with major depressive disorder commonly display anhedonia, which is the inability to feel pleasure, and persistent sadness. These core symptoms distinguish depression from mood elevations or psychotic disorders. Recognizing these features guides appropriate interventions.
Which intervention should the nurse implement first for a client expressing suicidal ideation?
Teach relaxation breathing exercises
Encourage journaling about feelings
Place the client on 1:1 observation
Discuss long-term treatment goals
When a client expresses suicidal ideation, the priority is safety. Placing the client on one-to-one observation ensures constant supervision to prevent self-harm. Once safety is assured, therapeutic interventions such as journaling and relaxation can be introduced.
A client says, "I don't know why I feel so anxious." Which therapeutic communication technique should the nurse use?
You should try to relax and breathe deeply.
Why are you anxious?
Tell me more about how you feel right now.
Don't worry, everything will be fine.
Using an open-ended statement like "Tell me more" invites the client to explore and articulate their feelings. Closed or leading questions and reassurances may block further communication. Therapeutic techniques foster deeper understanding and rapport.
A client uses denial to avoid acknowledging a painful reality. Which defense mechanism is this?
Regression
Sublimation
Denial
Projection
Denial is refusing to accept reality or fact, blocking external events from awareness because they are too threatening. Projection involves attributing one's own unacceptable feelings to others, while regression is reverting to earlier developmental behaviors.
Which common adverse effect should the nurse monitor for in a client taking an SSRI antidepressant?
Ototoxicity
Bradycardia
Sexual dysfunction
Hyperglycemia
Selective serotonin reuptake inhibitors often cause sexual dysfunction such as decreased libido, delayed ejaculation, or anorgasmia. These side effects are dose-related and may affect adherence. Other listed options are not typical of SSRIs.
A client on a hallucinogen reports seeing vivid colors and shapes. Which drug is most likely responsible?
Heroin
Lysergic acid diethylamide (LSD)
Methamphetamine
Cocaine
LSD is a potent hallucinogen that alters perception, mood, and thought, often causing vivid visual distortions. Opioids like heroin sedate, while stimulants like cocaine and methamphetamine increase alertness and energy.
Which symptom is most characteristic of a panic attack?
Chronic sadness
Compulsive hand washing
Auditory hallucinations
Pounding heart and sweating
Panic attacks are sudden episodes of intense fear with physical symptoms such as tachycardia, sweating, trembling, and shortness of breath. Chronic sadness suggests depression, hallucinations suggest psychosis, and compulsive behaviors suggest OCD.
When teaching a client about buspirone for generalized anxiety disorder, what should the nurse emphasize?
It is not addictive and has no sedation
It can be taken as needed for anxiety attacks
Avoid all carbohydrates when taking this drug
Expect immediate relief of symptoms
Buspirone is non-benzodiazepine anxiolytic that is non-sedating and has low abuse potential. It must be taken regularly to achieve effect, with onset in 2 - 4 weeks, and is not effective as PRN relief.
Which laboratory test is most important for monitoring a client on lithium therapy?
Fasting blood glucose
Serum lithium level
C-reactive protein
Liver enzymes
Lithium has a narrow therapeutic index, so regular monitoring of serum lithium levels is crucial to avoid toxicity. Other labs may be used for overall health, but lithium levels directly guide dosing.
A client on clozapine reports a sore throat and fever. What is the nurse's priority action?
Encourage increased fluid intake
Offer acetaminophen for fever
Assess white blood cell count immediately
Document and continue medication
Clozapine can cause agranulocytosis, presenting with fever and sore throat. The first action is to check the WBC to detect neutropenia. Supportive measures are secondary until WBC is known.
Which food should a client avoid while taking an MAOI for depression?
Steamed vegetables
Boiled rice
Aged cheese
Fresh apples
MAOIs inhibit breakdown of tyramine, and high-tyramine foods like aged cheese can precipitate a hypertensive crisis. Fresh produce and grains are safe. Patient education on dietary restrictions is critical.
Which pre-procedure instruction is essential for a client scheduled for electroconvulsive therapy (ECT)?
Encourage a heavy meal two hours before
Keep NPO status for at least 6 hours
Withhold all psychiatric medications on ECT day
Perform a physical workout prior to therapy
Clients undergoing ECT must remain NPO for at least 6 - 8 hours to reduce aspiration risk under anesthesia. Some medications may be held, but the primary safety precaution is fasting.
A client in a manic episode of bipolar disorder is extremely agitated. What is the nurse's priority?
Offer complex memory tasks
Engage in group activities
Encourage prolonged discussion about feelings
Provide a low-stimulation environment
Manic clients benefit from a quiet, low-stimulus environment to reduce agitation and risk of harm. Group activities or therapeutic discussions may overstimulate them. Safety and environment are primary.
A client with anorexia nervosa has a serum potassium of 2.8 mEq/L. Which sign should the nurse expect?
Bounding pulses
Elevated blood pressure
Muscle weakness and fatigue
Hyperactive deep tendon reflexes
Hypokalemia manifests as muscle weakness, cramps, fatigue, and decreased deep tendon reflexes. Bounding pulses and hypertension occur with hyperkalemia. Electrolyte monitoring is vital in eating disorders.
When a client experiences acute anxiety, which communication approach is most appropriate?
Encourage deep philosophical discussion
Offer multiple activity choices
Instruct them to write an essay on feelings
Use simple, clear statements
Clients in acute anxiety can only process simple, concise information. Clear, calm instructions help reduce confusion and anxiety. Complex choices or discussions can overwhelm them.
Disulfiram is prescribed for alcohol dependence. Which statement indicates the client understands the teaching?
I will flush and feel unwell if I drink
It will reduce my craving immediately
I only need to take it when I plan to drink
I can have red wine with dinner
Disulfiram causes an unpleasant reaction with alcohol, including flushing, nausea, and palpitations. It is taken daily to maintain deterrence and does not reduce cravings. Knowledge of the disulfiram - alcohol reaction indicates correct understanding.
For a child with Tourette's disorder, which medication is commonly prescribed to reduce tics?
Lorazepam
Haloperidol
Fluoxetine
Buspirone
Haloperidol, a typical antipsychotic, is FDA-approved for reduction of tics in Tourette's disorder. SSRIs like fluoxetine treat depression or OCD, benzodiazepines treat anxiety, and buspirone treats GAD.
A client on a typical antipsychotic develops akathisia. Which symptom best illustrates this extrapyramidal side effect?
Muscle rigidity and bradykinesia
Jerky movements of the face and neck
Sudden high fever and muscle breakdown
Inability to remain still and constant pacing
Akathisia is characterized by an inner sense of restlessness and inability to stay still, causing pacing and shifting. Dystonia involves sustained muscle contractions, parkinsonism causes rigidity and bradykinesia, and NMS involves fever and muscle breakdown.
Which finding differentiates neuroleptic malignant syndrome (NMS) from serotonin syndrome?
Severe muscle rigidity and bradykinesia
Onset within hours of medication change
Diaphoresis and hyperthermia
Hyperreflexia and clonus
NMS presents with "lead-pipe" rigidity and bradykinesia, developing over days to weeks. Serotonin syndrome has rapid onset, hyperreflexia, and clonus. Both share fever and diaphoresis but differ in neuromuscular signs.
A client with borderline personality disorder shifts from idealizing to devaluing the nurse. This behavior best represents which concept?
Projection
Reaction formation
Denial
Splitting
Splitting is a defense mechanism in borderline personality disorder where others are seen as all good or all bad. Projection attributes one's unacceptable feelings to others, whereas reaction formation is behaving opposite to feelings.
Which side effect should the nurse monitor in a child taking methylphenidate for ADHD?
Weight loss and appetite suppression
Excessive salivation
Dark urine
Hyperglycemia
Stimulants like methylphenidate commonly cause decreased appetite and weight loss. Excess salivation and dark urine are not typical, and hyperglycemia is unrelated. Monitoring growth parameters is essential.
When assessing suicide risk, which element is included in the SAD PERSONS scale?
Chronic pain
Eating patterns
Substance abuse
Marital satisfaction
Substance abuse is one of the ten factors in the SAD PERSONS mnemonic for suicide risk. The others include age, depression, prior attempt, ethanol use, rational thinking loss, sickness, organized plan, no spouse, and social support lacking.
Which cluster of signs best indicates serotonin syndrome in a client on an SSRI plus a MAOI?
Tardive dyskinesia and akathisia
Pancytopenia and sore throat
Bradykinesia, rigidity, mask-like facies
Agitation, hyperreflexia, clonus
Serotonin syndrome presents with mental status changes, autonomic hyperactivity, and neuromuscular abnormalities such as hyperreflexia and clonus. Parkinsonism features and blood dyscrasias are unrelated.
How does dysthymia differ from major depressive disorder?
Onset is always in childhood
Symptoms are milder but chronic over two years
Psychotic features are common
Manic episodes alternate with depression
Persistent depressive disorder (dysthymia) involves milder depressive symptoms lasting at least two years, whereas MDD is more severe and episodic. Psychosis is uncommon in dysthymia, and bipolar cycling involves mania.
A nurse realizes she has strong negative feelings toward a client after several failed community visits. Which concept does this illustrate?
Countertransference
Splitting
Transference
Introjection
Countertransference occurs when a nurse projects personal feelings onto a client, affecting the therapeutic relationship. Transference is the client's feelings toward the nurse. Understanding these concepts ensures professional boundaries.
Which mechanism describes how benzodiazepines reduce anxiety at the synaptic level?
Stimulating NMDA receptors to increase glutamate release
Blocking dopamine reuptake in the synaptic cleft
Enhancing GABA-A receptor activity and increasing chloride influx
Inhibiting monoamine oxidase in the presynaptic neuron
Benzodiazepines bind to GABA-A receptors, enhancing GABA's inhibitory effect by increasing chloride channel opening and hyperpolarizing the neuron. This reduces neuronal excitability and anxiety. Other options describe different neurotransmitter systems.
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Study Outcomes

  1. Understand core psychiatric nursing concepts -

    Master key mental health nursing principles to confidently tackle psych nursing practice questions on the NCLEX.

  2. Apply therapeutic communication strategies -

    Use effective psychiatric nursing communication techniques when engaging with patients, reinforcing knowledge for your psychiatric nursing exam prep.

  3. Analyze NCLEX psych nursing questions -

    Interpret question prompts, eliminate distractors, and select correct answers in a timed NCLEX-style quiz format.

  4. Evaluate patient scenarios for intervention prioritization -

    Assess clinical data and determine appropriate psychiatric nursing Q&A responses to prioritize care based on client needs.

  5. Track performance and identify knowledge gaps -

    Use instant scoring feedback from our mental health nursing quiz to pinpoint strengths and areas for further study.

Cheat Sheet

  1. SIG E CAPS Mnemonic for Depression -

    Use the SIG E CAPS mnemonic - Sleep disturbance, Interest loss, Guilt, Energy deficit, Concentration issues, Appetite change, Psychomotor shifts, Suicidal ideation - to swiftly assess major depressive episodes. This framework, drawn from the DSM-5 (American Psychiatric Association), streamlines your approach in psych nursing practice questions. Practicing with sample case vignettes helps cement each criterion and builds diagnostic confidence.

  2. ABCT Method for Mental Status Exam -

    Assess Appearance, Behavior, Cognition, and Thought processes (ABCT) to structure your mental status exam efficiently. This evidence-based format, taught in university psychiatric nursing courses, ensures comprehensive evaluation of patient presentation and mental functioning. Integrating ABCT into NCLEX psych nursing questions enhances accuracy and recall under exam conditions.

  3. SOLER Technique for Therapeutic Communication -

    Remember SOLER - Sit squarely, Open posture, Lean forward, Eye contact, Relax - to foster trust and rapport during patient interviews. Originating from Egan's Skilled Helper model, this method is endorsed by NANDA International for mental health nursing. Practicing SOLER in role-plays boosts your skills for psych nursing Q&A scenarios and real-world clinical encounters.

  4. Differentiate Serotonin Syndrome vs. NMS -

    Use this quick comparison: Serotonin syndrome presents with hyperreflexia and clonus, while Neuroleptic Malignant Syndrome (NMS) shows lead-pipe rigidity and bradyreflexia. Backed by UpToDate guidelines, distinguishing these emergencies is critical for safe psychopharmacology management. Flashcard repetition helps you tackle NCLEX psych nursing questions under time pressure.

  5. SAD PERSONS Scale for Suicide Risk -

    Apply the SAD PERSONS mnemonic - Sex, Age, Depression, Previous attempt, Ethanol abuse, Rational thinking loss, Social support lacking, Organized plan, No spouse, Sickness - to triage suicide risk efficiently. Recommended by the American Association of Suicidology, this scale guides your priority in care planning. Incorporate it into mental health nursing quiz drills to sharpen assessment speed and critical thinking.

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