A man who has stopped eating, hears voices telling him to kill himself and lacks capacity is brought by his wife, his nominated representative, who applies for supported admission under Section 89. A psychiatrist has examined him today and agrees. What else does the Act require before he is admitted?

A second independent examination by a mental health professional or doctor

Prior written approval of the Mental Health Review Board

A written order from the local magistrate approving the admission

His own signed consent to be admitted to the ward

The National Mental Health Programme (1982) planned to close the treatment gap mainly by:

Training PHC doctors and workers in basic mental health care

Making admission compulsory for all serious illness

Posting a trained psychiatrist at every primary health centre

Building a large mental hospital in every district

The therapeutic effect of electroconvulsive therapy depends on producing:

A generalised seizure of adequate duration

Loss of consciousness during the current

A short period of post-treatment amnesia

Visible muscle contractions in all four limbs

Therapeutic approaches, psychopharmacology and mental health law

40 M.Sc Nursing Entrance (AIIMS, LBS, PGIMER, JIPMER) practice questions on Therapeutic approaches, psychopharmacology and mental health law, 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 · Medium
A man recovering from schizophrenia is ready to leave hospital but is not yet able to live alone. A supervised residence where he lives for some months while learning daily living and work skills is a:
1. AHalfway home
2. BDay hospital
3. CSheltered workshop
4. DNight hospital
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Answer: A · Halfway home
A halfway home is a transitional residence between hospital and full community life. Residents live there for a limited period under supervision, learning self-care, budgeting and work habits before moving to independent living or back to family. It is a tertiary prevention and rehabilitation service. It also reduces the 'revolving door' of repeated readmission.
- B: A day hospital gives treatment by day while the patient sleeps at home.
- C: A sheltered workshop gives supervised work, not a place to live.
- D: A night hospital lets a patient work in the day and return to hospital at night.
Question 2 · Hard
A man who has stopped eating, hears voices telling him to kill himself and lacks capacity is brought by his wife, his nominated representative, who applies for supported admission under Section 89. A psychiatrist has examined him today and agrees. What else does the Act require before he is admitted?
1. AA second independent examination by a mental health professional or doctor
2. BPrior written approval of the Mental Health Review Board
3. CA written order from the local magistrate approving the admission
4. DHis own signed consent to be admitted to the ward
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Answer: A · A second independent examination by a mental health professional or doctor
Section 89 needs two independent examinations, on the day of admission or in the preceding 7 days: one by a psychiatrist, the other by a mental health professional or medical practitioner. Both must find a severe mental illness with recent self-harm or risk to others, or inability to care for himself, and that admission is the least restrictive option. The Board is told afterwards and hears any appeal, but its prior approval is not needed. He lacks capacity, so his consent cannot be the basis.
- B: The Board is informed and reviews admissions; it does not approve them in advance.
- C: A magistrate's order is not part of a supported admission under the 2017 Act.
- D: A person who lacks capacity cannot give valid consent, which is why Section 89 exists.
Question 3 · Medium
The National Mental Health Programme (1982) planned to close the treatment gap mainly by:
1. ATraining PHC doctors and workers in basic mental health care
2. BMaking admission compulsory for all serious illness
3. CPosting a trained psychiatrist at every primary health centre
4. DBuilding a large mental hospital in every district
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Answer: A · Training PHC doctors and workers in basic mental health care
India has very few psychiatrists, so the NMHP chose to integrate mental health into general health care. Medical officers and multipurpose workers at primary health centres were trained to recognise, treat and refer common and severe mental disorders. The District Mental Health Programme later put this into practice with a district team. The approach also reduces stigma by treating mental illness alongside physical illness.
- B: Compulsory admission goes against the community-based, rights-based approach.
- C: There are too few psychiatrists to post one at every PHC.
- D: The programme moved away from large institutions towards community care.
Question 4 · Medium
A patient in a mental health establishment is physically restrained to prevent imminent harm to others. Under the Mental Healthcare Act 2017, his nominated representative must be informed:
1. AOnly on discharge
2. BWithin 24 hours
3. CWithin 72 hours
4. DWithin 7 days
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Answer: B · Within 24 hours
Section 97 allows physical restraint only when it is the only way to prevent imminent harm, authorised by the psychiatrist in charge, and for no longer than necessary. Each instance is recorded in the notes, and the nominated representative is informed within 24 hours. The establishment also reports restraint to the Mental Health Review Board every month. The restrained person stays in full view of staff and is reviewed regularly.
- A: Informing only at discharge breaks the 24-hour requirement.
- C: 72 hours is the emergency treatment limit under Section 94, not the restraint rule.
- D: Seven days is far too late under the Act.
Question 5 · Easy
The therapeutic effect of electroconvulsive therapy depends on producing:
1. AA generalised seizure of adequate duration
2. BLoss of consciousness during the current
3. CA short period of post-treatment amnesia
4. DVisible muscle contractions in all four limbs
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Answer: A · A generalised seizure of adequate duration
The benefit of ECT comes from the generalised brain seizure the stimulus produces, not from the current itself or the body movements. A seizure that is too short, often taken as under about 20-25 seconds, is usually considered inadequate. Muscle relaxants abolish most movement without lessening the benefit. Memory loss is a side effect, not the mechanism.
- B: Anaesthesia produces unconsciousness; it is not the therapeutic element.
- C: Amnesia is an adverse effect, not what relieves depression.
- D: Muscle contraction is suppressed by succinylcholine and is not needed for benefit.
Question 6 · Medium
A patient with schizophrenia asks the nurse, 'You can hear that man shouting at me too, can't you?' The nurse replies, 'I don't hear anyone shouting, but I can see the voice is frightening you.' This technique is:
1. ARestating
2. BPresenting reality
3. CVoicing doubt
4. DGiving recognition
Answer and explanation in LearnFree account
Question 7 · Hard
A 58-year-old man with delirium and agitation in the ICU receives repeated IV haloperidol. Today's ECG shows a QTc of 540 ms (baseline 430 ms) and serum potassium is 3.0 mmol/L (normal 3.5-5.0). A further dose is due. What should the nurse do?
1. AGive the same dose orally instead of intravenously
2. BWithhold the dose and report the QTc and potassium
3. CGive the dose and recheck the ECG tomorrow
4. DGive the dose with a potassium supplement
Answer and explanation in LearnFree account
Question 8 · Hard
A 50-year-old woman with severe depression receives her second ECT session. The EEG seizure lasts only 12 seconds at the same dose that gave 35 seconds at the first session. Her notes show lorazepam 4 mg every night, started three days ago for insomnia. Atropine, propofol and succinylcholine doses are unchanged, and she was well oxygenated. What is the most likely cause of the short seizure?
1. ASuccinylcholine blocking the seizure itself
2. BAtropine shortening the cerebral seizure
3. CLorazepam raising the seizure threshold
4. DGood oxygenation suppressing the seizure
Answer and explanation in LearnFree account
Question 9 · Hard
A 16-year-old boy with severe depression has stopped eating and drinking and has made a serious suicide attempt. Drugs have failed and the psychiatrist recommends ECT. Under the Mental Healthcare Act 2017, ECT for him may be given only:
1. ANever, because the Act bans ECT in minors in all situations
2. BWith his guardian's informed consent and prior permission of the Review Board
3. CWith the written consent of two psychiatrists, without the Board
4. DWith the boy's own consent, since he is over 16 years of age
Answer and explanation in LearnFree account
Question 10 · Medium
Bupropion is avoided as an antidepressant for a patient with bulimia nervosa mainly because it:
1. ALowers the seizure threshold
2. BProlongs the QT interval markedly
3. CCauses severe sexual dysfunction
4. DCauses marked weight gain
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Question 11 · Medium
Interpersonal psychotherapy for depression focuses on which problem areas?
1. ARewards and punishments that maintain low mood
2. BUnconscious childhood conflicts revealed by dreams
3. CIrrational beliefs disputed by the therapist
4. DGrief, role disputes, role transitions and interpersonal deficits
Answer and explanation in LearnFree account
Question 12 · Medium
A patient acts out a painful scene with his father on a stage, while other group members play the father and his inner voice. This method is:
1. APsychodrama
2. BTransactional analysis
3. CGestalt therapy
4. DFamily therapy
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Question 13 · Hard
A 24-year-old woman with depression, whose mother has bipolar disorder, was started on escitalopram alone. Ten days later she sleeps 3 hours a night without tiredness, talks rapidly, has spent her savings on clothes and says she will start three companies. Thyroid tests are normal and she takes no other drugs. What is the most likely explanation?
1. AAgitated depression with poor drug response
2. BExpected early activation from the SSRI
3. CSerotonin syndrome from escitalopram
4. DAntidepressant-induced switch into mania
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Question 14 · Medium
Aversion therapy for alcohol dependence, in which drinking is repeatedly paired with a drug-induced nausea, is based mainly on:
1. AModelling
2. BOperant conditioning
3. CCognitive restructuring
4. DClassical conditioning
Answer and explanation in LearnFree account
Question 15 · Hard
During an ECT session for a 60-year-old man, the EEG shows the seizure still continuing at 180 seconds. He is being ventilated with oxygen by bag and mask and his saturation is 96%. What should the nurse anticipate next?
1. AGiving more succinylcholine to stop the seizure
2. BGiving a second electrical stimulus straight away
3. CEnding the seizure with an IV benzodiazepine or anaesthetic
4. DLetting the seizure end on its own however long it lasts
Answer and explanation in LearnFree account
Question 16 · Easy
In Peplau's original four phases of the nurse-patient relationship, the phase in which the patient makes full use of the help and services offered is:
1. AExploitation
2. BResolution
3. CIdentification
4. DOrientation
Answer and explanation in LearnFree account
Question 17 · Medium
Under the Mental Healthcare Act 2017, on what basis must health insurers cover the treatment of mental illness?
1. AOnly for inpatient admissions of over 30 days
2. BOnly after a 5-year waiting period
3. COn the same basis as for physical illness
4. DOnly for people below the poverty line
Answer and explanation in LearnFree account
Question 18 · Easy
Increased appetite with weight gain and marked sedation are the typical adverse effects of which antidepressant?
1. AVenlafaxine
2. BFluoxetine
3. CMirtazapine
4. DBupropion
Answer and explanation in LearnFree account
Question 19 · Easy
Who developed logotherapy, which helps a person find meaning in life even in suffering?
1. AViktor Frankl
2. BEric Berne
3. CAaron Beck
4. DFritz Perls
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Question 20 · Easy
Under the Mental Healthcare Act 2017, seclusion or solitary confinement of a person with mental illness is:
1. APermitted with the nominated representative's consent
2. BPermitted for up to 24 hours at a time
3. CNot permitted under any circumstances
4. DPermitted if a psychiatrist writes an order
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Question 21 · Hard
A 30-year-old man has been on haloperidol for 5 days. Today: temperature 40.2 °C, generalised lead-pipe rigidity, sweating, BP swinging between 150/100 and 100/60 mmHg, fluctuating consciousness, and CPK 9,800 IU/L (normal under 200). Haloperidol has been stopped and cooling started. Which drug is the doctor most likely to add to treat the underlying problem?
1. ABenztropine
2. BCyproheptadine
3. CBromocriptine
4. DPromethazine
Answer and explanation in LearnFree account
Question 22 · Easy
The ABC model, in which an Activating event leads to emotional Consequences through irrational Beliefs, is the basis of:
1. ATransactional analysis
2. BClient-centred therapy
3. CInterpersonal psychotherapy
4. DRational emotive behaviour therapy
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Question 23 · Easy
Which antipsychotic requires regular blood counts because it can cause agranulocytosis?
1. AAripiprazole
2. BRisperidone
3. CHaloperidol
4. DClozapine
Answer and explanation in LearnFree account
Question 24 · Medium
A woman's valid advance directive refuses all antipsychotic injections. She is brought in violent, and a single injection is given at once to prevent serious harm. Under the Mental Healthcare Act 2017, this is lawful because:
1. AAdvance directives are valid only for a year
2. BAdvance directives cover oral drugs only
3. CThe nominated representative can cancel it by phone
4. DAn advance directive does not apply to emergency treatment
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Question 25 · Hard
A 40-year-old man with schizophrenia is brought to a district hospital emergency room violent and threatening staff. The duty doctor gives emergency medication without consent. The psychiatrist wants to add ECT the same evening because he is refusing oral medication. Under the Mental Healthcare Act 2017, what is correct?
1. AECT is allowed if two doctors sign the order
2. BECT is allowed within the first 72 hours only
3. CECT cannot be given as emergency treatment
4. DECT is allowed if the relatives give consent
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Therapeutic approaches, psychopharmacology and mental health law

A man recovering from schizophrenia is ready to leave hospital but is not yet able to live alone. A supervised residence where he lives for some months while learning daily living and work skills is a:

The National Mental Health Programme (1982) planned to close the treatment gap mainly by:

A patient in a mental health establishment is physically restrained to prevent imminent harm to others. Under the Mental Healthcare Act 2017, his nominated representative must be informed:

The therapeutic effect of electroconvulsive therapy depends on producing:

A patient with schizophrenia asks the nurse, 'You can hear that man shouting at me too, can't you?' The nurse replies, 'I don't hear anyone shouting, but I can see the voice is frightening you.' This technique is:

A 58-year-old man with delirium and agitation in the ICU receives repeated IV haloperidol. Today's ECG shows a QTc of 540 ms (baseline 430 ms) and serum potassium is 3.0 mmol/L (normal 3.5-5.0). A further dose is due. What should the nurse do?

A 16-year-old boy with severe depression has stopped eating and drinking and has made a serious suicide attempt. Drugs have failed and the psychiatrist recommends ECT. Under the Mental Healthcare Act 2017, ECT for him may be given only:

Bupropion is avoided as an antidepressant for a patient with bulimia nervosa mainly because it:

Interpersonal psychotherapy for depression focuses on which problem areas?

A patient acts out a painful scene with his father on a stage, while other group members play the father and his inner voice. This method is:

Aversion therapy for alcohol dependence, in which drinking is repeatedly paired with a drug-induced nausea, is based mainly on:

During an ECT session for a 60-year-old man, the EEG shows the seizure still continuing at 180 seconds. He is being ventilated with oxygen by bag and mask and his saturation is 96%. What should the nurse anticipate next?

In Peplau's original four phases of the nurse-patient relationship, the phase in which the patient makes full use of the help and services offered is:

Under the Mental Healthcare Act 2017, on what basis must health insurers cover the treatment of mental illness?

Increased appetite with weight gain and marked sedation are the typical adverse effects of which antidepressant?

Who developed logotherapy, which helps a person find meaning in life even in suffering?

Under the Mental Healthcare Act 2017, seclusion or solitary confinement of a person with mental illness is:

The ABC model, in which an Activating event leads to emotional Consequences through irrational Beliefs, is the basis of:

Which antipsychotic requires regular blood counts because it can cause agranulocytosis?

A woman's valid advance directive refuses all antipsychotic injections. She is brought in violent, and a single injection is given at once to prevent serious harm. Under the Mental Healthcare Act 2017, this is lawful because: