Mental Health Nursing Quiz

Questions: 16 · 10 minutes
1. A patient is having a panic attack and says, “I can’t breathe—I’m dying.” What should the nurse do first?
Stay nearby, speak calmly in short sentences, and guide slower breathing in a quieter setting
Leave briefly so the patient can regain control independently
Correct the patient by stating that panic cannot cause physical sensations
Ask the patient to explain what triggered the attack in detail
2. Which is considered a negative symptom of schizophrenia?
A fixed false belief that others are monitoring the person
Hearing a voice comment on one’s actions
Disorganized speech that is difficult to follow
Reduced emotional expression and diminished motivation
3. An agitated patient is shouting and pacing but has not attacked anyone. The environment can still be managed safely. Which intervention best reflects the least-restrictive principle?
Move immediately to seclusion to prevent possible escalation
Administer emergency medication before attempting conversation
Use calm verbal de-escalation, offer space and choices, and reduce stimulation
Apply restraints while enough staff members are available
4. Which finding most strongly distinguishes delirium from a typical dementia presentation?
Consistent difficulty recalling recent events
A gradual decline in memory over several years
An acute, fluctuating disturbance in attention and awareness
Progressive loss of independent daily functioning
5. A patient who recently stopped heavy alcohol use becomes disoriented, sees things that are not present, has a rapid pulse, and develops a seizure. What is the appropriate interpretation?
Severe alcohol withdrawal is possible and requires urgent medical management
These symptoms show uncomplicated anxiety after stopping alcohol
The patient is probably experiencing only alcohol craving
This is a routine hangover that mainly requires sleep
6. During an assessment, a patient says, “Everyone would be better off without me.” What is the most appropriate next step?
Ask directly about suicidal thoughts, intent, a plan, and access to means
Reassure the patient that family members would miss them
Wait to see whether the patient repeats the statement
Ask the patient to promise not to harm themselves
7. Which statement about decision-making capacity is most accurate?
A psychiatric diagnosis automatically means a patient lacks capacity
Once capacity is lost, it cannot return during the same admission
Capacity depends mainly on whether the patient agrees with the clinical team
Capacity is specific to a decision and can change with time or circumstances
8. A patient taking an antipsychotic develops a high fever, severe muscle rigidity, confusion, and unstable blood pressure. What is the safest interpretation?
These are expected early effects that can be monitored routinely
Neuroleptic malignant syndrome is possible and urgent medical evaluation is needed
The symptoms most likely show improvement in psychosis
This is typical mild restlessness that should resolve with exercise
9. Which cluster in a patient taking lithium is most concerning for possible toxicity?
Mild thirst and a fine hand tremor without other changes
Increased appetite and occasional difficulty falling asleep
Dry mouth and brief dizziness when standing quickly
Vomiting, coarse tremor, unsteady walking, and increasing confusion
10. A patient points to an empty corner and says, “That man is threatening me.” Which response is most therapeutic?
“Yes, I see him too, but he cannot hurt you here.”
“I don’t see anyone there, but I understand that this feels real and frightening to you.”
“There is nobody there, and you need to accept that.”
“Tell the man to leave, and he may stop bothering you.”
11. Which term describes a marked loss of interest or pleasure in activities that a person previously enjoyed?
Avolition
Anhedonia
Echolalia
Derealization
12. Before a physical assessment, a patient with a trauma history appears tense and asks what will happen. Which response is most trauma-informed?
“It is a routine assessment, so there is no reason to worry.”
“I’ll explain each step, ask permission, and discuss choices about how we proceed.”
“It will be easier if we complete everything without stopping.”
“You can tell me about the trauma first so I know whether the assessment is necessary.”
13. A patient experiencing acute mania is pacing rapidly, interrupting others, and has barely eaten or slept. Which nursing approach is the priority?
Invite the patient to a lively group activity to use excess energy
Begin a detailed discussion about the consequences of the behavior
Allow unrestricted activity until the patient reports feeling tired
Reduce stimulation and address safety, hydration, nutrition, and rest with brief directions
14. Soon after serotonergic medicines are combined, a patient develops agitation, sweating, diarrhea, fever, and marked hyperreflexia with ankle clonus. Which condition should be suspected?
Anticholinergic effects
Acute dystonia
Serotonin syndrome
Neuroleptic malignant syndrome
15. A patient says, “The voices are getting louder, and they’re frightening me.” Which initial response best combines therapeutic communication with safety assessment?
“That sounds frightening. Are the voices telling you to hurt yourself or anyone else?”
“The voices are not real, so try to ignore them.”
“Why do you think you started hearing them today?”
“Let’s discuss something pleasant to distract you from them.”
16. A patient refuses a prescribed oral psychiatric medication. There is no immediate emergency. What is the best initial nursing response?
Document the refusal and end the discussion without further assessment
Ask the prescriber to replace it immediately with an injectable form
Explore the patient’s concerns, assess decision-making capacity, provide relevant information, and respect informed refusal within applicable law and policy
Explain that cooperation is required before discharge can be considered
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