🧩 Introduction
Mental health nursing is one of the most critical and sensitive parts of the NCLEX exam. It evaluates a nurse’s ability to provide compassionate care, maintain patient safety, and apply therapeutic communication in psychiatric settings.
This free NCLEX Mental Health practice test includes 100 high-yield questions focused on disorders like depression, anxiety, schizophrenia, bipolar disorder, and personality disorders. Each question is carefully written to reflect real NCLEX exam standards and includes rationales to help you learn the reasoning behind each answer.
🧠 NCLEX Mental Health Practice Questions (1–25)
1. A client with schizophrenia tells the nurse, “The FBI has installed cameras in my room.” The nurse’s best response is:
A. “That’s not true, no one has installed cameras.”
B. “You seem frightened. Tell me more about how you feel.”
C. “Why do you think the FBI is watching you?”
D. “You should not talk about such things.”
✅ Correct Answer: B
💡 Rationale: The therapeutic response focuses on the client’s feelings, not the delusion. It helps build trust and reduces anxiety.
2. A client with major depression says, “I have no reason to live.” What should the nurse do first?
A. Ask if the client has a specific plan to commit suicide.
B. Offer reassurance that things will get better.
C. Notify the physician immediately.
D. Encourage the client to think positively.
✅ Correct Answer: A
💡 Rationale: Always assess for suicidal intent and plan to determine risk and ensure patient safety.
3. Which statement indicates a nurse understands therapeutic communication?
A. “I understand exactly how you feel.”
B. “Tell me more about what’s troubling you.”
C. “You should not feel that way.”
D. “Let’s change the topic.”
✅ Correct Answer: B
💡 Rationale: Open-ended questions promote expression of thoughts and feelings, a core aspect of therapeutic communication.
4. A client with bipolar disorder is in a manic phase. What is the priority nursing intervention?
A. Encourage group therapy participation.
B. Offer frequent, high-calorie snacks.
C. Discuss delusional beliefs in detail.
D. Limit fluids to reduce hyperactivity.
✅ Correct Answer: B
💡 Rationale: Manic clients have increased energy and poor concentration — finger foods and fluids prevent exhaustion.
5. The nurse observes a client pacing and clenching fists. What should the nurse do first?
A. Leave the client alone.
B. Ask the client to stop pacing.
C. Speak calmly and maintain a safe distance.
D. Call for security.
✅ Correct Answer: C
💡 Rationale: The first response to potential aggression is de-escalation — speak calmly, stay safe, and use non-threatening posture.
6. A patient with obsessive-compulsive disorder (OCD) spends hours cleaning. What is the best nursing action?
A. Prevent the ritual completely.
B. Allow extra time for the ritual initially.
C. Ignore the behavior.
D. Confront the patient about the ritual.
✅ Correct Answer: B
💡 Rationale: Initially allowing rituals helps reduce anxiety. Gradual limitation can be introduced later during therapy.
7. A client with generalized anxiety disorder is prescribed buspirone (Buspar). The nurse teaches that:
A. It may cause dependence.
B. It provides immediate relief.
C. It may take several weeks to work.
D. It causes sedation.
✅ Correct Answer: C
💡 Rationale: Buspirone is a non-benzodiazepine anxiolytic with delayed therapeutic effects (2–4 weeks) and no dependency risk.
8. Which statement by a client taking lithium indicates the need for further teaching?
A. “I’ll drink plenty of water every day.”
B. “I can take ibuprofen for my headaches.”
C. “I’ll have my blood levels checked regularly.”
D. “I’ll call my provider if I have diarrhea.”
✅ Correct Answer: B
💡 Rationale: NSAIDs like ibuprofen can increase lithium levels and lead to toxicity. Acetaminophen is safer.
9. The nurse is caring for a client with panic disorder. What is the priority action during a panic attack?
A. Discuss relaxation techniques.
B. Stay with the client and remain calm.
C. Teach cognitive restructuring.
D. Explore past panic experiences.
✅ Correct Answer: B
💡 Rationale: During a panic attack, the nurse must stay with the patient to ensure safety and provide reassurance.
10. A client states, “I feel like ending it all.” What is the nurse’s first action?
A. Ask, “Do you have a plan to harm yourself?”
B. Tell the client not to think negatively.
C. Offer to distract the client with an activity.
D. Document the statement and continue rounds.
✅ Correct Answer: A
💡 Rationale: Suicide assessment always begins with asking direct, clear questions about intent, plan, and means.
11. A patient with anorexia nervosa says, “I’m so fat.” What is the best response?
A. “You’re not fat at all.”
B. “You seem to see yourself as overweight.”
C. “That’s not true; you’re underweight.”
D. “You need to stop thinking that way.”
✅ Correct Answer: B
💡 Rationale: Reflecting feelings encourages discussion without arguing or denying the client’s perception.
12. Which statement by the nurse is therapeutic when a client is silent?
A. “You must be angry with me.”
B. “Are you thinking about something?”
C. “Take your time; I’m here when you’re ready to talk.”
D. “Why aren’t you answering?”
✅ Correct Answer: C
💡 Rationale: Silence can be therapeutic — it allows clients to process their feelings while showing support.
13. The nurse should monitor for which side effect of clozapine (Clozaril)?
A. Weight loss
B. Agranulocytosis
C. Hypertension
D. Tremors
✅ Correct Answer: B
💡 Rationale: Clozapine can cause agranulocytosis (low WBC count), increasing infection risk. CBC monitoring is required.
14. A client refuses to take medication. What should the nurse do?
A. Force the client to take it.
B. Document refusal and notify the provider.
C. Hide it in food.
D. Ask another nurse to administer it.
✅ Correct Answer: B
💡 Rationale: Patients have the right to refuse medication. The nurse must document and report, not coerce.
15. The nurse observes a client responding to unseen stimuli. What is the best response?
A. “I don’t see anyone, but you seem scared.”
B. “Stop talking to yourself.”
C. “That’s not real.”
D. “Why are you seeing things?”
✅ Correct Answer: A
💡 Rationale: Acknowledge the client’s feelings without reinforcing the hallucination.
16. Which intervention is most appropriate for a client experiencing auditory hallucinations?
A. Tell the client the voices are not real.
B. Encourage the client to ignore the voices.
C. Ask the client what the voices are saying.
D. Tell the client to listen carefully to the voices.
✅ Correct Answer: C
💡 Rationale: Asking about the content of hallucinations assesses risk of harm to self or others and helps guide interventions.
17. A client with depression spends most of the day in bed and refuses meals. The nurse should first:
A. Leave the client alone to rest.
B. Encourage small, frequent meals.
C. Force the client to eat.
D. Ask why the client doesn’t want to eat.
✅ Correct Answer: B
💡 Rationale: Clients with depression often lack appetite and energy. Offering small, frequent meals increases intake and supports recovery.
18. Which nursing intervention is most effective for a client experiencing mild anxiety?
A. Use simple explanations and calm communication.
B. Provide immediate medication.
C. Isolate the client in a quiet room.
D. Ignore the symptoms.
✅ Correct Answer: A
💡 Rationale: Mild anxiety can be managed through therapeutic communication and reassurance without medication.
19. The nurse is caring for a patient with post-traumatic stress disorder (PTSD). Which approach is best?
A. Encourage the client to describe traumatic events in detail.
B. Provide a calm, non-threatening environment.
C. Expose the client to triggers to build tolerance.
D. Ignore flashbacks when they occur.
✅ Correct Answer: B
💡 Rationale: Creating a safe, calm environment helps minimize anxiety and build trust before exploring trauma.
20. A client with borderline personality disorder says, “You’re the only good nurse here; everyone else is bad.” This reflects:
A. Delusional thinking
B. Splitting behavior
C. Projection
D. Denial
✅ Correct Answer: B
💡 Rationale: Splitting is a defense mechanism where people view others as all good or all bad — common in borderline personality disorder.
21. The nurse finds a client crying alone and states, “You look upset. Would you like to talk about it?” This is an example of:
A. Giving advice
B. Offering self
C. Focusing
D. Confrontation
✅ Correct Answer: B
💡 Rationale: “Offering self” shows empathy and presence, encouraging the client to express emotions safely.
22. Which of the following is an example of a therapeutic communication technique?
A. “You should be grateful you’re alive.”
B. “That’s not something we should talk about.”
C. “Tell me what you were feeling when that happened.”
D. “You need to stop worrying.”
✅ Correct Answer: C
💡 Rationale: Encouraging expression of feelings promotes self-awareness and healing, making it therapeutic.
23. A patient with alcohol use disorder is experiencing tremors, anxiety, and sweating. The nurse suspects:
A. Liver failure
B. Alcohol withdrawal
C. Delirium tremens
D. Depression
✅ Correct Answer: B
💡 Rationale: Early withdrawal symptoms (6–24 hours after last drink) include tremors, anxiety, sweating, and restlessness.
24. Which statement by the nurse promotes trust with a paranoid client?
A. “I’ll keep your secrets safe.”
B. “I’ll explain all procedures before I do them.”
C. “You can trust me completely.”
D. “Let’s talk about your suspicions.”
✅ Correct Answer: B
💡 Rationale: Explaining procedures before performing them reduces fear and builds trust in paranoid clients.
25. A client says, “I feel hopeless and worthless.” Which response by the nurse is most therapeutic?
A. “You shouldn’t feel that way.”
B. “Everyone feels down sometimes.”
C. “It sounds like you’re feeling very sad right now.”
D. “You need to think more positively.”
✅ Correct Answer: C
💡 Rationale: Reflecting feelings helps the client verbalize emotions and shows the nurse’s empathy without judgment.
🧠 NCLEX Mental Health Practice Questions (26–50)
26. A client says, “I’m a terrible person and deserve to die.” The nurse’s best response is:
A. “You’re not a terrible person.”
B. “Tell me what makes you feel that way.”
C. “You shouldn’t say that.”
D. “You have a lot to live for.”
✅ Correct Answer: B
💡 Rationale: Asking the client to elaborate encourages verbalization of feelings and helps the nurse assess suicidal ideation.
27. A client with depression is prescribed sertraline (Zoloft). The nurse should teach that:
A. The medication may cause addiction.
B. It may take 2–4 weeks to notice improvement.
C. The drug should be stopped immediately if mood improves.
D. Sedation is a major side effect.
✅ Correct Answer: B
💡 Rationale: SSRIs like sertraline take several weeks for full therapeutic effect and must not be stopped abruptly.
28. Which of the following is an example of active listening?
A. Asking frequent questions
B. Maintaining eye contact and nodding
C. Changing the subject
D. Interrupting for clarification
✅ Correct Answer: B
💡 Rationale: Non-verbal cues such as nodding and eye contact show engagement and empathy — essential in therapeutic communication.
29. The nurse is caring for a patient with schizophrenia who states, “The doctor is plotting to harm me.” What should the nurse do?
A. Confront the delusion directly.
B. Acknowledge the feeling and provide reassurance of safety.
C. Ask for evidence of the claim.
D. Agree with the patient to gain trust.
✅ Correct Answer: B
💡 Rationale: Recognize the emotion behind the delusion, not the content, and reassure the patient of safety.
30. A client with bipolar disorder is agitated and pacing. The priority nursing action is to:
A. Ask the client to sit quietly.
B. Offer a calm environment and reduce stimuli.
C. Encourage discussion of feelings.
D. Explain the consequences of behavior.
✅ Correct Answer: B
💡 Rationale: Reducing environmental stimuli helps decrease agitation and prevent escalation during manic episodes.
31. Which behavior suggests improvement in a depressed patient?
A. The client isolates from others.
B. The client begins to express emotions.
C. The client sleeps most of the day.
D. The client refuses meals.
✅ Correct Answer: B
💡 Rationale: Verbalizing emotions indicates recovery progress in depression, as the client starts to reconnect emotionally.
32. A client says, “Everyone would be better off without me.” What should the nurse do first?
A. Ask, “Are you thinking about killing yourself?”
B. Tell the client not to say such things.
C. Distract the client with activities.
D. Suggest deep breathing exercises.
✅ Correct Answer: A
💡 Rationale: Always directly assess suicidal intent when warning signs appear. Early intervention saves lives.
33. A patient with anxiety asks for medication “right now.” The nurse should:
A. Give the medication immediately.
B. Encourage the client to use relaxation techniques first.
C. Refuse medication completely.
D. Delay medication for an hour.
✅ Correct Answer: B
💡 Rationale: Non-pharmacological interventions like deep breathing should be encouraged before relying on medication.
34. A client with schizophrenia makes up new words. The nurse documents this as:
A. Echolalia
B. Neologism
C. Word salad
D. Clang association
✅ Correct Answer: B
💡 Rationale: Neologisms are made-up words unique to the individual — a symptom of disorganized thought in schizophrenia.
35. A nurse is caring for a client with antisocial personality disorder. The priority intervention is:
A. Set firm and consistent limits.
B. Encourage emotional sharing.
C. Offer frequent praise.
D. Allow total independence.
✅ Correct Answer: A
💡 Rationale: Clients with antisocial traits manipulate and violate rules; clear boundaries are essential for safety and control.
36. A client states, “I can’t sleep because I keep thinking about my problems.” The nurse’s best response is:
A. “You should try to stop thinking about it.”
B. “Tell me more about what’s keeping you awake.”
C. “You can take medication for that.”
D. “Don’t worry, it will pass.”
✅ Correct Answer: B
💡 Rationale: Exploring the source of anxiety helps identify coping strategies and builds therapeutic rapport.
37. A nurse suspects a client has developed tardive dyskinesia. What should the nurse do first?
A. Continue medication and observe.
B. Notify the healthcare provider immediately.
C. Increase fluid intake.
D. Document findings at the end of shift.
✅ Correct Answer: B
💡 Rationale: Tardive dyskinesia (involuntary movements) is an adverse effect of antipsychotics and must be reported promptly.
38. Which nursing action promotes trust in a client with paranoia?
A. Touch the client’s arm when speaking.
B. Maintain consistency and explain all actions.
C. Stand very close to the client.
D. Argue to correct delusional beliefs.
✅ Correct Answer: B
💡 Rationale: Predictable behavior and consistent routines reduce fear and suspicion in paranoid clients.
39. The nurse should suspect neuroleptic malignant syndrome (NMS) when a client on haloperidol develops:
A. Tremors and shuffling gait
B. Sudden high fever and muscle rigidity
C. Sedation and dry mouth
D. Weight gain and constipation
✅ Correct Answer: B
💡 Rationale: NMS is a rare but life-threatening reaction to antipsychotics — symptoms include fever, rigidity, and altered mental status.
40. A patient with depression refuses to attend group therapy. The nurse should:
A. Insist the client participate.
B. Respect the client’s choice but encourage attendance later.
C. Ignore the behavior.
D. Report to the psychiatrist immediately.
✅ Correct Answer: B
💡 Rationale: Respecting autonomy while encouraging gradual involvement supports trust and motivation.
41. Which side effect is most concerning for a client taking MAO inhibitors?
A. Headache after eating aged cheese
B. Dry mouth
C. Drowsiness
D. Weight gain
✅ Correct Answer: A
💡 Rationale: Aged foods cause hypertensive crisis in clients on MAOIs due to excess tyramine.
42. A client says, “I can’t talk to anyone; nobody understands me.” The nurse’s best response is:
A. “I understand how you feel.”
B. “You seem lonely. Tell me more.”
C. “You’re overthinking.”
D. “That’s not true.”
✅ Correct Answer: B
💡 Rationale: Reflecting feelings builds trust and promotes open communication.
43. Which nursing diagnosis is most appropriate for a client with schizophrenia experiencing hallucinations?
A. Risk for injury
B. Ineffective airway clearance
C. Fluid volume deficit
D. Impaired physical mobility
✅ Correct Answer: A
💡 Rationale: Hallucinations can lead to unsafe behavior; preventing injury is the top priority.
44. A client with anorexia nervosa has bradycardia and low blood pressure. The nurse should:
A. Continue regular meals.
B. Notify the healthcare provider immediately.
C. Provide fluids and wait for improvement.
D. Encourage group participation.
✅ Correct Answer: B
💡 Rationale: Vital sign abnormalities in anorexia indicate medical instability, requiring prompt medical attention.
45. Which communication technique is most useful for a client with depression?
A. Offering false reassurance
B. Using silence and active listening
C. Minimizing the client’s feelings
D. Giving advice
✅ Correct Answer: B
💡 Rationale: Silence and active listening convey empathy and allow the client to express feelings safely.
46. The nurse should prioritize which behavior in a client with mania?
A. Sleeping only 2 hours a night
B. Eating large meals quickly
C. Giving away personal items
D. Talking excessively
✅ Correct Answer: C
💡 Rationale: Giving away possessions may indicate impulsivity and suicidal intent, requiring immediate attention.
47. A client taking antipsychotic medication develops muscle stiffness and tremors. The nurse should suspect:
A. Tardive dyskinesia
B. Extrapyramidal side effects (EPS)
C. Serotonin syndrome
D. Dystonia
✅ Correct Answer: B
💡 Rationale: EPS symptoms include rigidity, tremors, and bradykinesia — often treated with anticholinergic drugs.
48. Which intervention is best for a client with mild depression?
A. Encourage exercise and daily routine.
B. Provide total bed rest.
C. Limit social contact.
D. Increase medication dose.
✅ Correct Answer: A
💡 Rationale: Physical activity boosts mood by releasing endorphins and reducing depressive symptoms.
49. A patient with schizophrenia is taking risperidone. The nurse should monitor for:
A. Increased appetite
B. Weight gain and diabetes
C. Elevated calcium
D. Insomnia
✅ Correct Answer: B
💡 Rationale: Atypical antipsychotics like risperidone may cause metabolic syndrome — monitor weight and glucose.
50. The nurse is caring for a client in alcohol withdrawal. Which medication is commonly used?
A. Diazepam (Valium)
B. Haloperidol (Haldol)
C. Lithium carbonate
D. Fluoxetine (Prozac)
✅ Correct Answer: A
💡 Rationale: Benzodiazepines (like diazepam) prevent seizures and reduce withdrawal symptoms safely.
🧠 NCLEX Mental Health Practice Questions (51–75)
51. A client with schizophrenia says, “The voices tell me to hurt myself.” What should the nurse do first?
A. Ask, “Do you plan to act on what the voices say?”
B. Distract the client with activities.
C. Tell the client that voices are not real.
D. Leave the client alone to calm down.
✅ Correct Answer: A
💡 Rationale: The nurse must first assess suicidal intent or command hallucinations to ensure client safety.
52. A nurse is teaching a client about lithium therapy. Which statement indicates understanding?
A. “I should restrict my salt intake.”
B. “I’ll drink 6–8 glasses of water daily.”
C. “I can skip doses if I feel fine.”
D. “I should double my dose if I miss one.”
✅ Correct Answer: B
💡 Rationale: Adequate hydration and consistent sodium intake are essential to prevent lithium toxicity.
53. Which symptom would suggest serotonin syndrome in a client taking antidepressants?
A. Slow heart rate and confusion
B. Muscle rigidity, fever, and agitation
C. Dry mouth and constipation
D. Tremor and bradykinesia
✅ Correct Answer: B
💡 Rationale: Serotonin syndrome presents with hyperthermia, agitation, muscle rigidity, and tachycardia. It’s a medical emergency.
54. A nurse observes a client rocking back and forth and mumbling to himself. The most appropriate response is:
A. “Stop doing that.”
B. “You seem anxious. Can you tell me what’s happening?”
C. “Ignore the behavior.”
D. “You should go to your room.”
✅ Correct Answer: B
💡 Rationale: Observing and reflecting feelings promotes therapeutic communication and helps identify triggers.
55. A client taking clozapine reports sore throat and fever. What should the nurse do?
A. Encourage fluids and rest.
B. Notify the healthcare provider immediately.
C. Administer antipyretics.
D. Reassure the client that it’s a minor side effect.
✅ Correct Answer: B
💡 Rationale: Agranulocytosis, a dangerous drop in WBCs, is a serious adverse effect of clozapine. Immediate evaluation is required.
56. A nurse is caring for a client with obsessive-compulsive disorder (OCD). Which intervention is best?
A. Interrupt ritualistic behavior immediately.
B. Allow time for rituals, then gradually limit them.
C. Encourage the client to ignore obsessions.
D. Force participation in group activities.
✅ Correct Answer: B
💡 Rationale: Allowing rituals initially reduces anxiety; later, the nurse can help develop healthy coping mechanisms.
57. A client with PTSD suddenly becomes anxious after hearing a loud noise. What should the nurse do?
A. Leave the client alone.
B. Reassure safety and use grounding techniques.
C. Ask the client to describe the trauma.
D. Call the psychiatrist.
✅ Correct Answer: B
💡 Rationale: Grounding techniques (deep breathing, touching surroundings) help bring the client back to the present and restore calm.
58. Which statement shows understanding of electroconvulsive therapy (ECT)?
A. “I’ll be awake during the procedure.”
B. “I may have temporary memory loss afterward.”
C. “It’s a painful treatment.”
D. “It’s done only once.”
✅ Correct Answer: B
💡 Rationale: Short-term memory loss is common after ECT, but it’s temporary. The treatment is safe and done under anesthesia.
59. The nurse should suspect alcohol withdrawal when the client shows:
A. Drowsiness and confusion
B. Tremors, sweating, and agitation
C. Slow speech and bradycardia
D. Dilated pupils and euphoria
✅ Correct Answer: B
💡 Rationale: Classic signs of alcohol withdrawal include tremors, sweating, anxiety, and increased pulse within 6–24 hours after the last drink.
60. Which nursing intervention is appropriate for a client with severe anxiety?
A. Encourage detailed problem solving.
B. Use calm, simple communication.
C. Give complex explanations.
D. Leave the client to self-regulate.
✅ Correct Answer: B
💡 Rationale: During severe anxiety, short, calm, and direct communication helps reduce distress and restore focus.
61. A nurse notes that a depressed client’s energy suddenly improves. What should the nurse do first?
A. Encourage socialization.
B. Increase activity levels.
C. Assess for suicidal intent.
D. Praise the progress.
✅ Correct Answer: C
💡 Rationale: Improved energy may indicate the client now has the means to act on suicidal thoughts — immediate assessment is vital.
62. Which is a therapeutic response to a client saying, “I feel like life isn’t worth living”?
A. “That’s not true.”
B. “Let’s talk more about how you feel.”
C. “You shouldn’t think that way.”
D. “Think positively.”
✅ Correct Answer: B
💡 Rationale: Encouraging expression of feelings facilitates open discussion of suicidal thoughts and builds trust.
63. What is the primary goal of milieu therapy?
A. To promote dependence on staff
B. To provide a structured, supportive environment
C. To focus on individual therapy
D. To discourage interaction among patients
✅ Correct Answer: B
💡 Rationale: Milieu therapy creates a therapeutic community that promotes safety, structure, and healthy social interaction.
64. The nurse recognizes that a client with generalized anxiety disorder benefits most from:
A. Deep breathing and relaxation training
B. Confrontation therapy
C. Electroconvulsive therapy
D. Prolonged isolation
✅ Correct Answer: A
💡 Rationale: Relaxation and breathing techniques help manage physiological symptoms of anxiety effectively.
65. Which lab result should be monitored for a client taking valproic acid (Depakote)?
A. Blood glucose
B. Liver function tests
C. Sodium level
D. Creatinine clearance
✅ Correct Answer: B
💡 Rationale: Hepatotoxicity is a potential adverse effect of valproic acid; monitor liver enzymes regularly.
66. The nurse should include which teaching for a client taking benzodiazepines?
A. “You can stop taking it whenever you want.”
B. “Avoid alcohol while on this medication.”
C. “You may drive right after taking it.”
D. “Increase dosage if anxious.”
✅ Correct Answer: B
💡 Rationale: Combining benzodiazepines and alcohol can cause dangerous CNS depression and respiratory failure.
67. A client with depression says, “I’m useless.” Which response is therapeutic?
A. “You’re not useless.”
B. “Tell me what makes you feel that way.”
C. “Don’t say that again.”
D. “Think about your family.”
✅ Correct Answer: B
💡 Rationale: Exploring the statement helps identify underlying thoughts and emotions rather than offering false reassurance.
68. Which finding requires immediate attention in a client taking antipsychotic medication?
A. Dry mouth
B. Constipation
C. Fever and muscle rigidity
D. Weight gain
✅ Correct Answer: C
💡 Rationale: Fever and rigidity indicate neuroleptic malignant syndrome (NMS) — a life-threatening emergency.
69. What is the nurse’s priority when a client begins to panic?
A. Encourage insight and reflection
B. Stay with the client and speak calmly
C. Give written instructions
D. Leave the room
✅ Correct Answer: B
💡 Rationale: Remaining with the client provides emotional safety and helps reduce panic symptoms.
70. A client is prescribed fluoxetine (Prozac). Which statement shows correct understanding?
A. “It may take a few weeks to work.”
B. “I’ll stop if I feel better.”
C. “It’s okay to drink alcohol with it.”
D. “It will help me sleep right away.”
✅ Correct Answer: A
💡 Rationale: SSRIs like fluoxetine may take 2–4 weeks to show improvement; stopping early risks relapse.
71. Which intervention is most effective for a client with borderline personality disorder?
A. Encourage emotional dependency
B. Establish clear boundaries and consistency
C. Allow impulsive behaviors
D. Focus only on medication compliance
✅ Correct Answer: B
💡 Rationale: Borderline clients require firm boundaries and consistent limits to reduce manipulation and maintain safety.
72. The nurse notices a client with schizophrenia laughing without reason. The nurse should:
A. Ask, “Are you hearing something right now?”
B. Laugh with the client.
C. Ignore the behavior.
D. Tell the client to stop.
✅ Correct Answer: A
💡 Rationale: Assessing for auditory hallucinations helps the nurse understand the client’s experience and respond appropriately.
73. The nurse’s priority goal for a client with anorexia nervosa is to:
A. Increase social interaction
B. Achieve normal weight safely
C. Explore family dynamics
D. Improve self-esteem
✅ Correct Answer: B
💡 Rationale: The first priority in anorexia is physical stabilization and safe weight restoration before psychological goals.
74. Which nursing intervention supports recovery in a client with substance use disorder?
A. Confront denial harshly
B. Encourage participation in group therapy
C. Discourage discussing relapse
D. Avoid talking about triggers
✅ Correct Answer: B
💡 Rationale: Group therapy fosters peer support and accountability, essential for long-term recovery.
75. A client taking haloperidol reports muscle stiffness and difficulty swallowing. The nurse should:
A. Encourage deep breathing
B. Administer prescribed benztropine
C. Apply a warm compress
D. Continue to observe
✅ Correct Answer: B
💡 Rationale: These are extrapyramidal symptoms (EPS) — anticholinergic medications like benztropine relieve them quickly.
🧠 NCLEX Mental Health Practice Questions (76–100)
76. A client with bipolar disorder is in the manic phase. Which activity is most appropriate?
A. Group discussion therapy
B. Playing chess
C. Walking with staff in a quiet area
D. Watching an emotional movie
✅ Correct Answer: C
💡 Rationale: During mania, activities should be noncompetitive and calming, helping release energy without overstimulation.
77. Which intervention is most effective for a client experiencing hallucinations?
A. Challenge the hallucination directly
B. Tell the client you hear the same thing
C. Acknowledge the experience and redirect attention
D. Leave the client alone
✅ Correct Answer: C
💡 Rationale: The nurse should acknowledge the client’s experience without validating the hallucination and gently redirect focus to reality-based activities.
78. What is the priority nursing action for a client with command hallucinations?
A. Distract the client with music
B. Determine what the voices are saying
C. Encourage quiet rest
D. Notify family
✅ Correct Answer: B
💡 Rationale: The nurse must assess for safety by determining if the voices instruct self-harm or harm to others.
79. A client says, “I feel hopeless and tired all the time.” What is the best nursing response?
A. “You’ll feel better soon.”
B. “Have you thought about hurting yourself?”
C. “Try going out for a walk.”
D. “That’s normal when you’re depressed.”
✅ Correct Answer: B
💡 Rationale: Directly assessing suicidal ideation is essential for safety and is a therapeutic response.
80. Which of the following is a priority in caring for a client with schizophrenia who is pacing and muttering?
A. Offer medication immediately
B. Maintain a safe distance and calm approach
C. Ask detailed questions
D. Restrain the client
✅ Correct Answer: B
💡 Rationale: Safety and nonthreatening communication are key when a client shows agitation.
81. A nurse plans care for a client with anxiety disorder. Which nursing intervention is most effective long term?
A. Encourage use of defense mechanisms
B. Teach relaxation and coping techniques
C. Provide frequent reassurance
D. Give sedative medications daily
✅ Correct Answer: B
💡 Rationale: Coping and relaxation techniques build independence and reduce anxiety recurrence.
82. What is the best approach for a client with Alzheimer’s disease who becomes agitated during care?
A. Argue and correct the client’s confusion
B. Reorient gently and use distraction
C. Leave the client unattended
D. Increase stimulation in the environment
✅ Correct Answer: B
💡 Rationale: Gentle reorientation and distraction reduce anxiety and prevent escalation.
83. The nurse should avoid which food when a client is taking MAOI antidepressants?
A. Apple
B. Banana
C. Aged cheese
D. Rice
✅ Correct Answer: C
💡 Rationale: Tyramine-rich foods like aged cheese can cause a hypertensive crisis when combined with MAOIs.
84. A client states, “I feel like the staff doesn’t like me.” What is the most therapeutic response?
A. “That’s not true.”
B. “Tell me more about why you feel that way.”
C. “You’re being paranoid.”
D. “You shouldn’t think like that.”
✅ Correct Answer: B
💡 Rationale: Encouraging expression of feelings helps explore underlying emotions and builds trust.
85. A nurse observes tardive dyskinesia in a client taking antipsychotics. What should be done first?
A. Document the behavior
B. Notify the provider immediately
C. Continue medication
D. Reassure the client
✅ Correct Answer: B
💡 Rationale: Tardive dyskinesia is an irreversible movement disorder; early provider notification can prevent worsening.
86. A client with alcohol use disorder is prescribed disulfiram (Antabuse). Which statement shows correct understanding?
A. “I can drink small amounts safely.”
B. “I must avoid all alcohol-containing products.”
C. “It reduces my craving for alcohol.”
D. “I’ll take it only when I drink.”
✅ Correct Answer: B
💡 Rationale: Disulfiram causes severe reactions if alcohol is consumed — even in cough syrups or aftershaves.
87. A client with depression refuses meals. What should the nurse do first?
A. Leave the tray for later
B. Offer small, frequent snacks
C. Force the client to eat
D. Remove the tray immediately
✅ Correct Answer: B
💡 Rationale: Offering small, appealing, high-calorie meals supports nutrition without overwhelming the client.
88. A client says, “I don’t want to attend group therapy today.” The best response is:
A. “You have to go.”
B. “Tell me what’s making you feel that way.”
C. “You’re just being lazy.”
D. “You can skip it.”
✅ Correct Answer: B
💡 Rationale: Exploring reasons promotes insight and cooperation in treatment.
89. Which of the following indicates effective treatment for schizophrenia?
A. Persistent hallucinations
B. Improved social interaction
C. Flat affect
D. Isolated behavior
✅ Correct Answer: B
💡 Rationale: Improved communication and socialization show progress and effective therapy.
90. Which is a common side effect of SSRIs?
A. Weight gain and sexual dysfunction
B. Dry mouth and blurred vision
C. Tremors and rigidity
D. Hypotension
✅ Correct Answer: A
💡 Rationale: SSRIs often cause weight gain and decreased libido but are otherwise well tolerated.
91. A client with panic disorder experiences hyperventilation. What should the nurse do?
A. Encourage slow, deep breathing
B. Leave the client alone
C. Provide stimulants
D. Give detailed education
✅ Correct Answer: A
💡 Rationale: Controlled breathing techniques help reduce CO₂ loss and prevent fainting.
92. A nurse caring for a suicidal client should ensure:
A. Constant observation and safety measures
B. Open access to sharp objects
C. Group therapy first
D. Discussion about religion
✅ Correct Answer: A
💡 Rationale: Safety is always the top priority — ensure a safe environment and close monitoring.
93. Which finding requires urgent action in a client taking lithium?
A. Mild thirst
B. Tremors and confusion
C. Increased appetite
D. Insomnia
✅ Correct Answer: B
💡 Rationale: Lithium toxicity presents with tremors, confusion, and ataxia — requires immediate intervention.
94. A client with depression says, “Nothing ever goes right for me.” The nurse should respond:
A. “You’re just being negative.”
B. “Let’s talk about one thing that went well recently.”
C. “You shouldn’t think like that.”
D. “That’s your opinion.”
✅ Correct Answer: B
💡 Rationale: Redirecting toward positive thinking helps challenge cognitive distortions.
95. The nurse prepares to give haloperidol. What assessment is essential?
A. Heart rate
B. Temperature and muscle tone
C. Vision
D. Reflexes
✅ Correct Answer: B
💡 Rationale: Fever and rigidity indicate NMS, a serious side effect of haloperidol requiring urgent care.
96. Which client statement indicates understanding of cognitive behavioral therapy (CBT)?
A. “It helps me change negative thoughts.”
B. “It’s just talking about my childhood.”
C. “It focuses only on medication.”
D. “It avoids dealing with emotions.”
✅ Correct Answer: A
💡 Rationale: CBT helps identify and modify negative thought patterns to improve behavior and mood.
97. A client with schizophrenia believes staff members are plotting against him. What is the best approach?
A. Argue that the belief is false.
B. Explore the client’s feelings of fear.
C. Support the delusion to build trust.
D. Laugh it off.
✅ Correct Answer: B
💡 Rationale: Addressing feelings rather than delusional content promotes trust and reduces anxiety.
98. What should the nurse teach about discontinuing antidepressants?
A. Stop immediately once feeling better.
B. Taper off gradually under supervision.
C. Skip doses occasionally.
D. Stop after two weeks.
✅ Correct Answer: B
💡 Rationale: Gradual tapering prevents withdrawal symptoms and relapse.
99. The nurse’s most important role during a psychiatric emergency is to:
A. Give detailed instructions
B. Maintain safety for all clients
C. Collect background history
D. Call the family
✅ Correct Answer: B
💡 Rationale: In any psychiatric crisis, ensuring safety is the first nursing responsibility.
100. Which approach is best for a client with depression who refuses to participate in activities?
A. Allow the client to stay isolated
B. Gently invite participation without pressure
C. Scold for nonparticipation
D. Ignore the client
✅ Correct Answer: B
💡 Rationale: Encouragement and gentle participation help reduce isolation and build motivation without overwhelming the client.
🧩 Conclusion
Preparing for the NCLEX Mental Health section requires not just memorization but understanding how to apply therapeutic principles in real scenarios. These 100 NCLEX Mental Health Questions with answers and rationales cover psych disorders, medications, safety, and communication skills — the exact areas where most candidates struggle.
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