A 28-year-old woman has had two episodes of depression, each lasting about 2 months. Last year she had 5 days of high mood, needing only 3 hours' sleep, starting many projects and talking fast. She kept working, was never admitted and had no psychotic symptoms. The most accurate diagnosis is:

Recurrent major depressive disorder

Both schizoid and avoidant personality disorders show social isolation. The feature that best distinguishes avoidant personality disorder is that the person:

Wants close relationships but fears criticism or rejection

Distrusts others and expects to be exploited

Shows no wish for close relationships at all

Has odd beliefs, magical thinking and eccentric speech

A 30-year-old man with mania is shouting, throwing chairs and threatening staff. Talking him down has failed and he refuses oral medicine. Which intramuscular regimen is well supported for rapid tranquillisation, including by trials in Indian emergency settings?

Olanzapine with lorazepam given together

Diazepam with intravenous haloperidol push

A 9-year-old boy often loses his temper, argues with adults, refuses rules and deliberately annoys his sister. He has never hurt people or animals, stolen or destroyed property. The best-fitting diagnosis is:

Attention deficit hyperactivity disorder

Intermittent explosive disorder

Psychiatric disorders and their nursing management

50 M.Sc Nursing Entrance (AIIMS, LBS, PGIMER, JIPMER) practice questions on Psychiatric disorders and their nursing management, part of Mental Health Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
A 28-year-old woman has had two episodes of depression, each lasting about 2 months. Last year she had 5 days of high mood, needing only 3 hours' sleep, starting many projects and talking fast. She kept working, was never admitted and had no psychotic symptoms. The most accurate diagnosis is:
1. ABipolar II disorder
2. BBipolar I disorder
3. CRecurrent major depressive disorder
4. DCyclothymic disorder
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Answer: A · Bipolar II disorder
Her period of elevated mood lasted at least 4 days without marked impairment, admission or psychosis, so it is hypomanic rather than manic. Hypomania plus at least one major depressive episode defines bipolar II disorder. One true manic episode would make it bipolar I. Recognising past hypomania matters, because antidepressants alone can trigger mania or rapid cycling, so a mood stabiliser is usually needed.
- B: Bipolar I needs a full manic episode with marked impairment, admission or psychosis.
- C: Recurrent depression is excluded once a hypomanic episode has occurred.
- D: Cyclothymia has mood swings below the threshold of major depression for 2 years; her depressions were full episodes.
Question 2 · Medium
Both schizoid and avoidant personality disorders show social isolation. The feature that best distinguishes avoidant personality disorder is that the person:
1. ADistrusts others and expects to be exploited
2. BWants close relationships but fears criticism or rejection
3. CShows no wish for close relationships at all
4. DHas odd beliefs, magical thinking and eccentric speech
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Answer: B · Wants close relationships but fears criticism or rejection
In avoidant personality disorder (Cluster C) the person longs for acceptance and closeness but avoids people out of intense fear of criticism, disapproval or rejection. The schizoid person (Cluster A) is detached and indifferent, with no desire for relationships. This difference guides nursing care: avoidant patients benefit from gradual, supportive social exposure and assertiveness training. Schizoid patients are not pushed into group closeness.
- A: Pervasive distrust and suspicion define paranoid personality disorder.
- C: Lack of any wish for closeness is the schizoid pattern, the opposite of the avoidant one.
- D: Odd beliefs and eccentric speech define schizotypal personality disorder.
Question 3 · Hard
A 30-year-old man with mania is shouting, throwing chairs and threatening staff. Talking him down has failed and he refuses oral medicine. Which intramuscular regimen is well supported for rapid tranquillisation, including by trials in Indian emergency settings?
1. AOlanzapine with lorazepam given together
2. BHigh-dose chlorpromazine alone
3. CDiazepam with intravenous haloperidol push
4. DHaloperidol with promethazine
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Answer: D · Haloperidol with promethazine
The TREC trials, including one in India, showed that IM haloperidol plus promethazine calms violent patients quickly and safely; promethazine adds sedation and reduces acute dystonia from haloperidol. IM olanzapine and IM lorazepam should not be given together because of the risk of hypotension and respiratory depression. After rapid tranquillisation, the nurse monitors pulse, blood pressure, breathing, oxygen saturation, temperature and consciousness regularly until he is fully alert.
- A: IM olanzapine with IM lorazepam together risks fatal hypotension and respiratory depression.
- B: High-dose IM chlorpromazine causes severe hypotension and is not recommended for this purpose.
- C: IV push in a struggling patient is unsafe, and IM diazepam is absorbed poorly.
Question 4 · Medium
A 9-year-old boy often loses his temper, argues with adults, refuses rules and deliberately annoys his sister. He has never hurt people or animals, stolen or destroyed property. The best-fitting diagnosis is:
1. AOppositional defiant disorder
2. BAttention deficit hyperactivity disorder
3. CIntermittent explosive disorder
4. DConduct disorder
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Answer: A · Oppositional defiant disorder
Oppositional defiant disorder is a pattern, for at least 6 months, of angry or irritable mood, argumentative and defiant behaviour, and vindictiveness, usually towards authority figures. Conduct disorder adds serious violations of others' rights or major social rules: aggression to people or animals, destruction of property, theft or serious rule-breaking. Parent management training is the main treatment. Some children with ODD go on to conduct disorder.
- B: ADHD centres on inattention and hyperactivity-impulsivity, not deliberate defiance.
- C: Intermittent explosive disorder is recurrent outbursts of aggression, not a pattern of defiance.
- D: Conduct disorder needs aggression, destruction, theft or serious rule violations, which he lacks.
Question 5 · Easy
An elderly man with severe depression says that his intestines have rotted away and that he is already dead. This nihilistic delusion is typical of:
1. ACotard syndrome
2. BKorsakoff syndrome
3. CMunchausen syndrome
4. DCapgras syndrome
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Answer: A · Cotard syndrome
Cotard syndrome is a nihilistic delusion in which the patient believes that he is dead, does not exist or that his organs have decayed. It is seen most often in severe (psychotic) depression in older people. Such patients may stop eating and drinking, so nutrition, hydration and suicide risk need close watch. Psychotic depression of this kind responds well to ECT.
- B: Korsakoff syndrome is an amnesic state with confabulation after thiamine deficiency.
- C: Munchausen syndrome is a severe factitious disorder in which illness is feigned to gain the sick role.
- D: Capgras syndrome is the belief that a familiar person has been replaced by a double.
Question 6 · Easy
A young woman firmly believes that a famous film actor is secretly in love with her and sends her coded signals through his films. This delusion is called:
1. ADelusion of infidelity
2. BDelusion of grandeur
3. CErotomania
4. DDelusion of reference
Answer and explanation in LearnFree account
Question 7 · Hard
A 20-year-old woman of normal weight has swollen parotid glands and eroded dental enamel. Results: pH 7.52, PaCO2 47 mmHg, HCO3- 36 mmol/L, potassium 2.7 mmol/L, chloride 86 mmol/L. Which interpretation fits best?
1. AMetabolic alkalosis from self-induced vomiting
2. BRespiratory acidosis from starvation weakness
3. CRespiratory alkalosis from anxious overbreathing
4. DMetabolic acidosis from laxative misuse
Answer and explanation in LearnFree account
Question 8 · Medium
On a geriatric ward, which nursing approach does most to prevent delirium in older inpatients?
1. AA routine night dose of a benzodiazepine for sleep
2. BKeeping lights on all night so staff can observe closely
3. COrientation, glasses and hearing aids, sleep, hydration and early mobility
4. DBedside rails up and wrist restraints applied for the whole night
Answer and explanation in LearnFree account
Question 9 · Medium
Suicide rates rose sharply in a town after a sudden economic collapse left many families without work and the usual social rules no longer applied. Durkheim called this type of suicide:
1. AFatalistic
2. BEgoistic
3. CAltruistic
4. DAnomic
Answer and explanation in LearnFree account
Question 10 · Hard
A man dependent on heroin is to start sublingual buprenorphine. His last heroin use was 4 hours ago and he shows no withdrawal signs. Why should the first dose be delayed?
1. ABuprenorphine would add to heroin and cause respiratory arrest
2. BBuprenorphine would displace heroin from receptors and precipitate withdrawal
3. CBuprenorphine would cause a hypertensive crisis with heroin
4. DBuprenorphine is not absorbed until heroin has been cleared
Answer and explanation in LearnFree account
Question 11 · Hard
A 30-year-old nurse is admitted for the third time with unexplained hypoglycaemia. She has no diabetes, no pending insurance claim and asks for no leave. During an episode: glucose 36 mg/dL, serum insulin very high, C-peptide low (undetectable). The most likely explanation is:
1. AFactitious disorder with secret insulin injection
2. BMalingering to avoid duties at work
3. CAn insulin-secreting tumour of the pancreas
4. DSecret ingestion of a sulfonylurea drug
Answer and explanation in LearnFree account
Question 12 · Hard
A 32-year-old man with chronic schizophrenia is found having a generalised seizure on the ward. Staff note that he drinks water from taps all day. Results: serum sodium 118 mmol/L (135-145), serum osmolality 250 mOsm/kg, urine osmolality 70 mOsm/kg, and his weight is 3 kg above his morning weight. The most likely cause is:
1. ALithium-induced nephrogenic diabetes insipidus
2. BNeuroleptic malignant syndrome
3. CSyndrome of inappropriate ADH secretion
4. DPrimary (psychogenic) polydipsia with water intoxication
Answer and explanation in LearnFree account
Question 13 · Medium
A 70-year-old woman has become forgetful over 6 weeks since her husband died. She often answers 'I don't know' without trying, complains a lot about her poor memory, and sleeps and eats poorly. This suggests:
1. ADepressive pseudodementia
2. BEarly Alzheimer disease
3. CVascular dementia
4. DHypoactive delirium
Answer and explanation in LearnFree account
Question 14 · Hard
A 2-year-old girl developed normally until 12 months, then lost her few words and the use of her hands for play. She now wrings her hands constantly, has irregular breathing and her head growth has slowed. The most likely diagnosis is:
1. ARett syndrome
2. BCerebral palsy
3. CChildhood disintegrative disorder
4. DAutism spectrum disorder
Answer and explanation in LearnFree account
Question 15 · Medium
Which feature best separates obsessive-compulsive personality disorder from obsessive-compulsive disorder?
1. AThe traits are ego-syntonic and felt as correct by the person
2. BThe person has intrusive thoughts that he resists as senseless
3. CThe person performs rituals to neutralise anxiety-provoking thoughts
4. DThe condition responds well to exposure and response prevention
Answer and explanation in LearnFree account
Question 16 · Hard
An 82-year-old woman with pneumonia, normal at home last week, has been 'very quiet' for 2 days. She dozes during talks, cannot name the months backwards, drifts between topics and is brighter in the morning than at night. She is not agitated. Using the Confusion Assessment Method, the nurse should record:
1. ADepression, as she is quiet and withdrawn
2. BNormal tiredness from infection, needing only rest
3. CEarly Alzheimer disease, needing memory testing later
4. DHypoactive delirium, so the cause is sought and reported
Answer and explanation in LearnFree account
Question 17 · Medium
A 35-year-old man has seen five doctors in a year, convinced that he has cancer. He has no real symptoms, and repeated tests and reassurance calm him for only a few days. The most likely diagnosis is:
1. AConversion disorder
2. BSomatic symptom disorder
3. CFactitious disorder
4. DIllness anxiety disorder
Answer and explanation in LearnFree account
Question 18 · Hard
During a panic attack, a woman breathes 32 times a minute and reports tingling lips and stiff fingers. Arterial gas: pH 7.53, PaCO2 26 mmHg, HCO3- 23 mmol/L. Which pairing of interpretation and nursing action is correct?
1. ARespiratory acidosis; give high-flow oxygen by mask
2. BCompensated respiratory alkalosis; give oral sodium bicarbonate
3. CAcute respiratory alkalosis; stay with her and coach slow breathing
4. DMetabolic alkalosis; start an infusion of normal saline
Answer and explanation in LearnFree account
Question 19 · Easy
Encopresis is diagnosed when a child repeatedly passes faeces in inappropriate places after reaching a developmental age of at least:
1. A5 years
2. B2 years
3. C7 years
4. D4 years
Answer and explanation in LearnFree account
Question 20 · Easy
By DSM-5-TR, excessive worry about many everyday matters must be present on more days than not for at least how long to diagnose generalised anxiety disorder?
1. A6 months
2. B3 months
3. C2 years
4. D2 weeks
Answer and explanation in LearnFree account
Question 21 · Medium
A 58-year-old engineer has become rude, sexually disinhibited and careless with money over a year, while his memory and orientation remain largely intact. Which dementia does this pattern suggest?
1. AAlzheimer disease
2. BFrontotemporal dementia
3. CDementia with Lewy bodies
4. DVascular dementia
Answer and explanation in LearnFree account
Question 22 · Medium
A woman with advanced Alzheimer disease says repeatedly, 'I must go home and cook for my children.' Her children are now in their forties. Which response reflects validation therapy?
1. A"All right, we will take you home after lunch today."
2. B"Don't worry about them; they can cook for themselves now."
3. C"You love looking after them. Tell me what you cooked for them."
4. D"Your children are grown up now, and today is Monday the 4th."
Answer and explanation in LearnFree account
Question 23 · Medium
A violinist has a tremor, pounding heart and sweating before every public concert but is otherwise well. Propranolol taken before performances helps mainly because it:
1. ARaises brain serotonin over several weeks
2. BActs on GABA receptors to sedate the brain
3. CReduces the fear by causing short-term amnesia for it
4. DBlocks the peripheral bodily effects of adrenaline
Answer and explanation in LearnFree account
Question 24 · Easy
Elevated mood with less need for sleep and more energy counts as a hypomanic episode, by DSM-5-TR, once it has lasted at least:
1. A24 hours
2. B2 consecutive weeks
3. C4 consecutive days
4. D7 consecutive days
Answer and explanation in LearnFree account
Question 25 · Easy
Persistent depressive disorder (dysthymia) in an adult requires depressed mood on most days for at least:
1. A2 weeks
2. B6 months
3. C1 year
4. D2 years
Answer and explanation in LearnFree account

25 more Psychiatric disorders and their nursing management questions

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Psychiatric disorders and their nursing management

A 28-year-old woman has had two episodes of depression, each lasting about 2 months. Last year she had 5 days of high mood, needing only 3 hours' sleep, starting many projects and talking fast. She kept working, was never admitted and had no psychotic symptoms. The most accurate diagnosis is:

Both schizoid and avoidant personality disorders show social isolation. The feature that best distinguishes avoidant personality disorder is that the person:

A 30-year-old man with mania is shouting, throwing chairs and threatening staff. Talking him down has failed and he refuses oral medicine. Which intramuscular regimen is well supported for rapid tranquillisation, including by trials in Indian emergency settings?

A 9-year-old boy often loses his temper, argues with adults, refuses rules and deliberately annoys his sister. He has never hurt people or animals, stolen or destroyed property. The best-fitting diagnosis is:

An elderly man with severe depression says that his intestines have rotted away and that he is already dead. This nihilistic delusion is typical of:

A young woman firmly believes that a famous film actor is secretly in love with her and sends her coded signals through his films. This delusion is called:

A 20-year-old woman of normal weight has swollen parotid glands and eroded dental enamel. Results: pH 7.52, PaCO2 47 mmHg, HCO3- 36 mmol/L, potassium 2.7 mmol/L, chloride 86 mmol/L. Which interpretation fits best?

On a geriatric ward, which nursing approach does most to prevent delirium in older inpatients?

Suicide rates rose sharply in a town after a sudden economic collapse left many families without work and the usual social rules no longer applied. Durkheim called this type of suicide:

A man dependent on heroin is to start sublingual buprenorphine. His last heroin use was 4 hours ago and he shows no withdrawal signs. Why should the first dose be delayed?

A 30-year-old nurse is admitted for the third time with unexplained hypoglycaemia. She has no diabetes, no pending insurance claim and asks for no leave. During an episode: glucose 36 mg/dL, serum insulin very high, C-peptide low (undetectable). The most likely explanation is:

A 70-year-old woman has become forgetful over 6 weeks since her husband died. She often answers 'I don't know' without trying, complains a lot about her poor memory, and sleeps and eats poorly. This suggests:

A 2-year-old girl developed normally until 12 months, then lost her few words and the use of her hands for play. She now wrings her hands constantly, has irregular breathing and her head growth has slowed. The most likely diagnosis is:

Which feature best separates obsessive-compulsive personality disorder from obsessive-compulsive disorder?

A 35-year-old man has seen five doctors in a year, convinced that he has cancer. He has no real symptoms, and repeated tests and reassurance calm him for only a few days. The most likely diagnosis is:

During a panic attack, a woman breathes 32 times a minute and reports tingling lips and stiff fingers. Arterial gas: pH 7.53, PaCO2 26 mmHg, HCO3- 23 mmol/L. Which pairing of interpretation and nursing action is correct?

Encopresis is diagnosed when a child repeatedly passes faeces in inappropriate places after reaching a developmental age of at least:

By DSM-5-TR, excessive worry about many everyday matters must be present on more days than not for at least how long to diagnose generalised anxiety disorder?

A 58-year-old engineer has become rude, sexually disinhibited and careless with money over a year, while his memory and orientation remain largely intact. Which dementia does this pattern suggest?

A woman with advanced Alzheimer disease says repeatedly, 'I must go home and cook for my children.' Her children are now in their forties. Which response reflects validation therapy?

A violinist has a tremor, pounding heart and sweating before every public concert but is otherwise well. Propranolol taken before performances helps mainly because it:

Elevated mood with less need for sleep and more energy counts as a hypomanic episode, by DSM-5-TR, once it has lasted at least:

Persistent depressive disorder (dysthymia) in an adult requires depressed mood on most days for at least: