A man with schizophrenia is calm and polite at the clinic but says his neighbour plans to kill him and that he has bought a knife to defend himself. What is the nurse's priority?

Report the risk to others and ensure the knife is removed

Book a routine review for next month

Explain patiently that his neighbour has no plan to harm him

Accept his calm manner as a sign of low risk

A man with moderate dementia gets upset when given instructions. How should the nurse phrase them?

In short sentences, one idea at a time

As firm corrections of each mistake

As several choices offered together

Quickly, so as to hold his attention

Psychiatric disorders and their nursing care

55 Staff nurse recruitment practice questions on Psychiatric disorders and their nursing care, 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 · Easy
Which type of delirium is most often missed by ward staff?
1. AWithdrawal
2. BHypoactive
3. CHyperactive
4. DMixed
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Answer: B · Hypoactive
Hypoactive delirium shows as drowsiness, quietness and withdrawal, so the patient may simply seem tired or depressed. It is common in older people and carries a poor outcome. Hyperactive delirium, with agitation, is noticed quickly. Regular screening finds the quiet cases.
- A: Withdrawal delirium is usually agitated and noticeable.
- C: Hyperactive delirium causes agitation that staff notice at once.
- D: Mixed delirium has agitated periods that usually draw attention.
Question 2 · Hard
A man with schizophrenia is calm and polite at the clinic but says his neighbour plans to kill him and that he has bought a knife to defend himself. What is the nurse's priority?
1. ABook a routine review for next month
2. BExplain patiently that his neighbour has no plan to harm him
3. CAccept his calm manner as a sign of low risk
4. DReport the risk to others and ensure the knife is removed
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Answer: D · Report the risk to others and ensure the knife is removed
A fixed persecutory delusion with a named target and a weapon is a serious risk of violence, however calm the patient seems. The nurse must report this to the psychiatrist at once and work with the family to remove the weapon. Urgent review or admission may be needed. Calm behaviour at interview does not lower the risk.
- A: A routine review leaves an immediate risk unmanaged.
- B: Arguing with a delusion does not change it and does not reduce the danger.
- C: A calm manner does not cancel a plan, a target and a weapon.
Question 3 · Medium
Which ward activity is most suitable for a patient in an acute manic episode?
1. AReading a long novel
2. BA chess tournament
3. CA team volleyball match
4. DA walk with a nurse
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Answer: D · A walk with a nurse
In mania the patient is overactive, distractible and easily stimulated. Non-competitive physical activity, such as walking with a nurse or simple tasks like sweeping, uses up energy safely without overstimulation. Competitive games raise excitement and can lead to arguments. Activities needing long concentration end in frustration.
- A: Reading a novel needs attention a manic patient cannot keep up.
- B: Chess and tournaments need long concentration and add competition.
- C: A competitive team game increases stimulation and conflict.
Question 4 · Easy
An intense fear of places such as crowded markets or buses, where escape might be difficult, is called:
1. AAcrophobia
2. BAgoraphobia
3. CClaustrophobia
4. DSocial phobia
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Answer: B · Agoraphobia
Agoraphobia is fear and avoidance of situations where escape or help might be hard to get, such as crowds, public transport, open spaces or being outside alone. Many patients first had panic attacks in such places. Severe cases may become housebound. Treatment combines graded exposure, cognitive therapy and SSRIs.
- A: Acrophobia is fear of heights.
- C: Claustrophobia is fear of closed spaces such as lifts.
- D: Social phobia is fear of being watched and judged by others.
Question 5 · Medium
A man with moderate dementia gets upset when given instructions. How should the nurse phrase them?
1. AAs firm corrections of each mistake
2. BAs several choices offered together
3. CQuickly, so as to hold his attention
4. DIn short sentences, one idea at a time
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Answer: D · In short sentences, one idea at a time
A patient with dementia processes information slowly and loses track of long messages. Short, simple sentences with one idea or instruction at a time, given face to face, are best. The nurse allows time to answer and uses gestures. Arguing about errors causes distress without improving memory.
- A: Firm correction leads to arguments and agitation.
- B: Many choices at once overwhelm him and cause frustration.
- C: Fast speech is harder to follow.
Question 6 · Medium
Exposure and response prevention, the main psychological therapy for OCD, involves:
1. AFacing the feared trigger without doing the ritual
2. BTalking through the childhood events that lie behind the fear
3. CTaking medicine only when the urge appears
4. DRelaxing the muscles before going to sleep
Answer and explanation in LearnFree account
Question 7 · Medium
For a patient in alcohol withdrawal, the most suitable environment is:
1. AA busy area to keep him distracted
2. BA shared room with other confused, restless patients
3. CA quiet, well-lit room with frequent checks
4. DA dark, silent room with the door closed
Answer and explanation in LearnFree account
Question 8 · Medium
A patient with dementia keeps wandering towards the ward exit. The best nursing measure is to:
1. AAsk the doctor for regular sedation every evening
2. BProvide a safe area to walk, with supervision
3. CLock him alone in his room
4. DTie him to the bed at night
Answer and explanation in LearnFree account
Question 9 · Hard
A man with OCD checks the gas stove about 20 times before leaving home and now reaches work 2 hours late. He agrees to treatment. Which goal is most suitable for his first week?
1. AHe will understand the childhood cause of his checking
2. BHe will stop all checking from the first day
3. CHe will stay at home until the urge to check goes away
4. DHe will cut down his checking step by step to an agreed limit
Answer and explanation in LearnFree account
Question 10 · Easy
By DSM-5, the symptoms of a major depressive episode must be present for at least:
1. A2 years
2. B4 days
3. C2 weeks
4. D1 week
Answer and explanation in LearnFree account
Question 11 · Hard
A patient who has been in catatonic stupor for 3 days suddenly jumps up, shouts and starts hitting anyone near him. What should the nurse do first?
1. AAsk him to explain why he is angry
2. BMove others away and call for help before approaching
3. CApproach him alone and hold both arms firmly to calm him
4. DLeave him to settle as stupor will return
Answer and explanation in LearnFree account
Question 12 · Medium
Which set of findings suggests recent cannabis intoxication?
1. ASmell of alcohol and unsteady gait
2. BDilated pupils, high fever and generalised seizures
3. CRed eyes, increased appetite and dry mouth
4. DPinpoint pupils and slow breathing
Answer and explanation in LearnFree account
Question 13 · Medium
A delirious elderly patient keeps pulling at his IV cannula. Before restraint is considered, the nurse should first:
1. AReorient him, cover the line and ask family to stay
2. BTie both his wrists to the bed rails
3. CGive the ordered PRN sedative straight away to calm him
4. DRemove the cannula and stop all IV fluids
Answer and explanation in LearnFree account
Question 14 · Hard
Four women are assessed for depression. By DSM-5, which one meets the criteria for a major depressive episode?
1. ALow mood and poor sleep for 3 weeks, otherwise working as usual
2. BFatigue, poor sleep, poor focus and weight loss for 3 weeks, without low mood or loss of interest
3. CLow mood, poor sleep, guilt, poor focus and fatigue for 10 days; she has stopped working
4. DLow mood, poor sleep, guilt, poor focus and fatigue for 3 weeks; she has stopped working
Answer and explanation in LearnFree account
Question 15 · Medium
A patient in catatonic stupor lies still and has not eaten or passed urine since yesterday. The nurse's main focus is:
1. AExploring the content of his delusions
2. BTeaching him social skills
3. CEncouraging group activities
4. DHis nutrition, fluids and elimination
Answer and explanation in LearnFree account
Question 16 · Medium
An alcohol-dependent patient says he often cannot remember what happened during a drinking session, though friends say he stayed awake and talked. This is called:
1. ADelirium tremens
2. BKorsakoff psychosis
3. CA hangover
4. DA blackout
Answer and explanation in LearnFree account
Question 17 · Medium
A patient cannot think logically, speaks incoherently, runs about without purpose and feels terror. By Peplau's levels, his anxiety is:
1. ASevere
2. BMild
3. CPanic
4. DModerate
Answer and explanation in LearnFree account
Question 18 · Medium
A woman in a manic episode wears heavy make-up and revealing clothes and flirts with male patients. The nurse should:
1. ASet limits calmly and help her choose suitable clothes
2. BIgnore the behaviour, as it is part of her manic illness
3. CLaugh with her to keep the mood light
4. DScold her in front of the other patients
Answer and explanation in LearnFree account
Question 19 · Easy
The psychiatric disorder most often found in people who die by suicide is:
1. AObsessive-compulsive disorder
2. BIntellectual disability
3. CSpecific phobia
4. DDepression
Answer and explanation in LearnFree account
Question 20 · Hard
A young man is brought from a party agitated and sweating after using cocaine. BP 190/110 mmHg, pulse 140/min, temperature 39.4 °C and pupils dilated. Which ordered treatment should the nurse give first?
1. AAn IV benzodiazepine, with active cooling
2. BOral haloperidol to settle the agitation
3. CIV naloxone to reverse the drug
4. DPhysical restraint lying face down
Answer and explanation in LearnFree account
Question 21 · Hard
A woman's PHQ-9 item scores are 2, 3, 2, 2, 1, 2, 3, 2 and 1; the last item asks about thoughts of being better off dead or of self-harm. Bands: 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. What are her result and the correct action?
1. A17, moderately severe; repeat the scale next month
2. B18, severe; arrange admission for ECT
3. C18, moderately severe; assess her suicide risk today
4. D18, moderately severe; repeat the scale next month
Answer and explanation in LearnFree account
Question 22 · Medium
For a withdrawn patient with schizophrenia who avoids people, the most helpful early nursing approach is:
1. ABrief, frequent contacts by the same nurse
2. BLong sessions exploring his childhood
3. CWaiting until he chooses to approach the staff himself
4. DPlacing him at once in a large group
Answer and explanation in LearnFree account
Question 23 · Medium
A patient with schizophrenia tells the nurse that voices are ordering him to hit the man in the next bed. The priority nursing action is to:
1. AAsk him to ignore the voices and rest
2. BIncrease observation and keep other patients safe
3. CRecord the statement for the morning round
4. DTell him firmly that the voices he hears are not real
Answer and explanation in LearnFree account
Question 24 · Easy
In obsessive-compulsive disorder, a repetitive act performed to reduce the anxiety caused by an obsession is a:
1. ACompulsion
2. BTic
3. CPhobia
4. DDelusion
Answer and explanation in LearnFree account
Question 25 · Easy
Anhedonia, a core symptom of depression, means:
1. ALoss of appetite and weight
2. BA feeling of being worthless
3. CLoss of interest or pleasure in activities
4. DInability to fall asleep at night
Answer and explanation in LearnFree account

30 more Psychiatric disorders and their nursing care questions

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Psychiatric disorders and their nursing care

Which type of delirium is most often missed by ward staff?

A man with schizophrenia is calm and polite at the clinic but says his neighbour plans to kill him and that he has bought a knife to defend himself. What is the nurse's priority?

Which ward activity is most suitable for a patient in an acute manic episode?

An intense fear of places such as crowded markets or buses, where escape might be difficult, is called:

A man with moderate dementia gets upset when given instructions. How should the nurse phrase them?

Exposure and response prevention, the main psychological therapy for OCD, involves:

For a patient in alcohol withdrawal, the most suitable environment is:

A patient with dementia keeps wandering towards the ward exit. The best nursing measure is to:

A man with OCD checks the gas stove about 20 times before leaving home and now reaches work 2 hours late. He agrees to treatment. Which goal is most suitable for his first week?

By DSM-5, the symptoms of a major depressive episode must be present for at least:

A patient who has been in catatonic stupor for 3 days suddenly jumps up, shouts and starts hitting anyone near him. What should the nurse do first?

Which set of findings suggests recent cannabis intoxication?

A delirious elderly patient keeps pulling at his IV cannula. Before restraint is considered, the nurse should first:

Four women are assessed for depression. By DSM-5, which one meets the criteria for a major depressive episode?

A patient in catatonic stupor lies still and has not eaten or passed urine since yesterday. The nurse's main focus is:

An alcohol-dependent patient says he often cannot remember what happened during a drinking session, though friends say he stayed awake and talked. This is called:

A patient cannot think logically, speaks incoherently, runs about without purpose and feels terror. By Peplau's levels, his anxiety is:

A woman in a manic episode wears heavy make-up and revealing clothes and flirts with male patients. The nurse should:

The psychiatric disorder most often found in people who die by suicide is:

A young man is brought from a party agitated and sweating after using cocaine. BP 190/110 mmHg, pulse 140/min, temperature 39.4 °C and pupils dilated. Which ordered treatment should the nurse give first?

A woman's PHQ-9 item scores are 2, 3, 2, 2, 1, 2, 3, 2 and 1; the last item asks about thoughts of being better off dead or of self-harm. Bands: 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. What are her result and the correct action?

For a withdrawn patient with schizophrenia who avoids people, the most helpful early nursing approach is:

A patient with schizophrenia tells the nurse that voices are ordering him to hit the man in the next bed. The priority nursing action is to:

In obsessive-compulsive disorder, a repetitive act performed to reduce the anxiety caused by an obsession is a:

Anhedonia, a core symptom of depression, means: