101. Which term describes the inability to experience pleasure?
A. Avolition
B. Anhedonia
C. Alogia
D. Echolalia
Answer: B. Anhedonia
👉 Explanation: Anhedonia is the loss of pleasure in normally enjoyable activities, common in depression and schizophrenia.
102. The nurse identifies flight of ideas in a manic patient when the patient:
A. Repeats words over and over
B. Rapidly shifts from one topic to another
C. Stops speaking suddenly
D. Uses new made-up words
Answer: B. Rapidly shifts from one topic to another
👉 Explanation: Flight of ideas is a hallmark of mania, with accelerated, disorganized speech.
103. Which defense mechanism is being used when a person unconsciously blocks painful memories?
A. Projection
B. Repression
C. Regression
D. Rationalization
Answer: B. Repression
👉 Explanation: Repression is an unconscious process of keeping distressing thoughts out of awareness.
104. Which drug requires regular WBC monitoring due to risk of agranulocytosis?
A. Olanzapine
B. Clozapine
C. Risperidone
D. Haloperidol
Answer: B. Clozapine
👉 Explanation: Clozapine carries a serious risk of agranulocytosis; weekly to monthly WBC checks are mandatory.
105. Which neurotransmitter is increased in schizophrenia?
A. Dopamine
B. Acetylcholine
C. GABA
D. Serotonin
Answer: A. Dopamine
👉 Explanation: The dopamine hypothesis suggests hyperactivity of dopamine pathways contributes to schizophrenia.
106. Which therapy is most effective for obsessive-compulsive disorder (OCD)?
A. Cognitive-behavioral therapy with exposure and response prevention
B. Psychoanalysis
C. Aversion therapy
D. Group therapy only
Answer: A. Cognitive-behavioral therapy with exposure and response prevention
👉 Explanation: ERP is the gold standard treatment for OCD along with SSRIs.
107. Which lab result is most important to check for a patient on valproic acid?
A. Blood glucose
B. Liver function tests
C. Kidney function tests
D. Electrolytes
Answer: B. Liver function tests
👉 Explanation: Valproic acid can cause hepatotoxicity; liver enzymes must be monitored.
108. Which sign suggests alcohol withdrawal?
A. Slurred speech and drowsiness
B. Tremors, anxiety, sweating
C. Euphoria and grandiosity
D. Pinpoint pupils and slow breathing
Answer: B. Tremors, anxiety, sweating
👉 Explanation: Alcohol withdrawal typically begins with tremors, sweating, agitation, and insomnia.
109. A client says, “I am dead, my organs have stopped working.” This is:
A. Nihilistic delusion
B. Somatic delusion
C. Delusion of grandeur
D. Persecutory delusion
Answer: A. Nihilistic delusion
👉 Explanation: Belief that oneself or the world does not exist is a nihilistic delusion.
110. The nurse should give priority to which symptom in a patient with panic attack?
A. Fear of dying
B. Hyperventilation and chest pain
C. Sweating and trembling
D. Nausea and dizziness
Answer: B. Hyperventilation and chest pain
👉 Explanation: Panic attacks can mimic cardiac emergencies; physical symptoms must be assessed first.
111. Which of the following is a risk factor for suicide?
A. Living with family support
B. Past suicide attempt
C. Female gender
D. Middle age
Answer: B. Past suicide attempt
👉 Explanation: A history of previous attempts is the strongest predictor of future suicide risk.
112. A patient says, “The government is watching me through my phone.” This is:
A. Thought insertion
B. Delusion of reference
C. Persecutory delusion
D. Magical thinking
Answer: C. Persecutory delusion
👉 Explanation: Persecutory delusions involve beliefs of being targeted, spied on, or harmed.
113. Which drug class is first-line for generalized anxiety disorder (GAD)?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. MAOIs
Answer: B. SSRIs
👉 Explanation: SSRIs and SNRIs are preferred long-term treatment for GAD; benzodiazepines are used short-term.
114. Which finding indicates neuroleptic malignant syndrome (NMS)?
A. High fever, muscle rigidity, autonomic instability
B. Hallucinations, tachycardia, sweating
C. Confusion, ataxia, nystagmus
D. Tremors, hyperreflexia, shivering
Answer: A. High fever, muscle rigidity, autonomic instability
👉 Explanation: NMS is a rare but fatal reaction to antipsychotics, requiring immediate medical attention.
115. A patient with depression refuses to eat. What should the nurse do?
A. Insist the patient eat everything on the tray
B. Offer frequent, small, high-calorie meals
C. Allow patient to skip meals until hungry
D. Encourage fasting for self-control
Answer: B. Offer frequent, small, high-calorie meals
👉 Explanation: Depressed patients have low appetite; small, frequent meals are more acceptable.
116. Which personality disorder shows lack of empathy and exploitation of others?
A. Borderline
B. Antisocial
C. Avoidant
D. Narcissistic
Answer: B. Antisocial
👉 Explanation: Antisocial personality disorder is marked by disregard for others, impulsivity, and deceit.
117. Which therapy is most effective for phobias?
A. Systematic desensitization
B. Cognitive restructuring
C. Aversion therapy
D. ECT
Answer: A. Systematic desensitization
👉 Explanation: Gradual exposure with relaxation techniques is the best method for phobias.
118. Which of the following is a somatic symptom disorder?
A. A patient has seizures with no neurologic basis
B. A patient fakes illness for money
C. A patient forgets their identity after trauma
D. A patient has delusions about being poisoned
Answer: A. A patient has seizures with no neurologic basis
👉 Explanation: Somatic symptom disorder presents with physical symptoms not fully explained medically.
119. Which patient statement suggests hallucination?
A. “I feel worthless and hopeless.”
B. “I hear voices telling me to run away.”
C. “My neighbor is controlling my mind.”
D. “I am the president of the world.”
Answer: B. “I hear voices telling me to run away.”
👉 Explanation: Hallucinations are false sensory perceptions, such as hearing voices.
120. A patient with schizophrenia is taking risperidone. Which side effect should the nurse monitor?
A. Dry cough
B. Gynecomastia
C. Hair loss
D. Hypoglycemia
Answer: B. Gynecomastia
👉 Explanation: Risperidone can cause endocrine effects such as gynecomastia and galactorrhea due to prolactin elevation.
121. Which of the following is a negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Social withdrawal
D. Disorganized speech
Answer: C. Social withdrawal
👉 Explanation: Negative symptoms include apathy, flat affect, and withdrawal; positive symptoms are hallucinations and delusions.
122. Which antidepressant carries a risk of hypertensive crisis with tyramine-rich foods?
A. SSRI
B. MAOI
C. SNRI
D. TCA
Answer: B. MAOI
👉 Explanation: MAOIs (e.g., phenelzine) can cause hypertensive crisis when combined with tyramine-rich foods like cheese and wine.
123. A manic patient suddenly stops talking and becomes immobile. This may indicate:
A. Catatonia
B. Panic attack
C. Dissociation
D. Withdrawal
Answer: A. Catatonia
👉 Explanation: Catatonia is a psychomotor disturbance seen in schizophrenia or mania, with immobility or purposeless activity.
124. The most important nursing intervention for a patient with suicidal ideation is:
A. Encouraging group therapy
B. Providing a safe environment
C. Teaching relaxation techniques
D. Administering antidepressants
Answer: B. Providing a safe environment
👉 Explanation: Suicide prevention starts with safety measures, such as removing harmful objects and close monitoring.
125. Which of the following drugs is used for acute mania?
A. Lithium
B. Buspirone
C. Haloperidol
D. Both A and C
Answer: D. Both A and C
👉 Explanation: Lithium is the gold standard for bipolar disorder; antipsychotics like haloperidol are used for acute control.
126. A patient repeats everything the nurse says. This is:
A. Echolalia
B. Echopraxia
C. Neologism
D. Clang association
Answer: A. Echolalia
👉 Explanation: Echolalia is the repetition of words spoken by another person, often seen in schizophrenia.
127. Which neurotransmitter is decreased in depression?
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Answer: B. Serotonin
👉 Explanation: Depression is linked with low serotonin and norepinephrine levels.
128. A client with borderline personality disorder shows self-harm behavior. The nurse should:
A. Punish the client for cutting
B. Provide immediate medical care and set limits
C. Ignore the behavior
D. Allow peers to confront the client
Answer: B. Provide immediate medical care and set limits
👉 Explanation: Self-harm must be treated with empathy and firm boundary-setting without reinforcing the behavior.
129. Which of the following is an extrapyramidal side effect (EPS) of antipsychotics?
A. Tremors and rigidity
B. Blurred vision
C. Constipation
D. Sedation
Answer: A. Tremors and rigidity
👉 Explanation: EPS includes tremors, rigidity, akathisia, and dystonia due to dopamine blockade.
130. Which condition is treated with disulfiram (Antabuse)?
A. Depression
B. Alcohol dependence
C. Nicotine addiction
D. Schizophrenia
Answer: B. Alcohol dependence
👉 Explanation: Disulfiram produces unpleasant effects with alcohol intake, deterring drinking behavior.
131. Which sleep disorder involves sudden attacks of muscle weakness triggered by emotions?
A. Insomnia
B. Narcolepsy with cataplexy
C. Sleep apnea
D. Night terrors
Answer: B. Narcolepsy with cataplexy
👉 Explanation: Cataplexy is sudden muscle weakness often triggered by laughter or anger in narcolepsy.
132. The nurse suspects serotonin syndrome when the patient develops:
A. Fever, agitation, hyperreflexia
B. Muscle rigidity, bradycardia
C. Hypotension, sedation
D. Drowsiness, constipation
Answer: A. Fever, agitation, hyperreflexia
👉 Explanation: Serotonin syndrome is caused by excess serotonin, leading to fever, hyperreflexia, and agitation.
133. Which therapy is most effective for post-traumatic stress disorder (PTSD)?
A. Systematic desensitization
B. Cognitive processing therapy and EMDR
C. Psychoanalysis
D. Electroconvulsive therapy
Answer: B. Cognitive processing therapy and EMDR
👉 Explanation: Evidence-based PTSD treatments include trauma-focused CBT and EMDR.
134. A patient shows alternating euphoria and severe depression. This suggests:
A. Bipolar disorder
B. Schizophrenia
C. Cyclothymia
D. Dysthymia
Answer: A. Bipolar disorder
👉 Explanation: Bipolar disorder features manic episodes alternating with depressive episodes.
135. The nurse gives haloperidol IM for agitation. The patient develops a stiff neck and difficulty swallowing. This is:
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Parkinsonism
Answer: B. Acute dystonia
👉 Explanation: Acute dystonia is a painful EPS reaction with muscle spasms, requiring anticholinergic treatment.
136. Which term describes a fixed false belief not based in reality?
A. Illusion
B. Hallucination
C. Delusion
D. Phobia
Answer: C. Delusion
👉 Explanation: Delusions are false beliefs held despite clear evidence to the contrary.
137. Which of the following is considered a mood stabilizer?
A. Lithium
B. Valproic acid
C. Carbamazepine
D. All of the above
Answer: D. All of the above
👉 Explanation: All listed drugs are commonly used as mood stabilizers in bipolar disorder.
138. Which medication is safest for treating anxiety in a patient with substance abuse history?
A. Diazepam
B. Lorazepam
C. Buspirone
D. Alprazolam
Answer: C. Buspirone
👉 Explanation: Buspirone is non-addictive and suitable for long-term anxiety management.
139. A patient has repetitive handwashing rituals. The nurse should:
A. Forbid the patient from washing hands
B. Allow rituals at first, then gradually limit them
C. Encourage group therapy only
D. Distract the patient without addressing anxiety
Answer: B. Allow rituals at first, then gradually limit them
👉 Explanation: Compulsions reduce anxiety temporarily; exposure and gradual prevention is most therapeutic.
140. Which disorder involves at least 2 distinct personality states?
A. Dissociative identity disorder
B. Somatic symptom disorder
C. Delusional disorder
D. Depersonalization disorder
Answer: A. Dissociative identity disorder
👉 Explanation: DID involves presence of two or more distinct identities controlling behavior.
141. A patient with anorexia nervosa is admitted with severe electrolyte imbalance. First priority is:
A. Psychotherapy
B. Restoring medical stability
C. Family therapy
D. Antidepressants
Answer: B. Restoring medical stability
👉 Explanation: Life-threatening complications like electrolyte imbalance must be corrected before psychotherapy.
142. Which drug is first-line for ADHD?
A. Risperidone
B. Methylphenidate
C. Imipramine
D. Valproic acid
Answer: B. Methylphenidate
👉 Explanation: Stimulants like methylphenidate and amphetamines are first-line ADHD treatments.
143. Which defense mechanism is shown when a student channels anger into sports?
A. Sublimation
B. Projection
C. Regression
D. Denial
Answer: A. Sublimation
👉 Explanation: Sublimation is channeling unacceptable impulses into constructive activities.
144. Which lab test is critical before starting lithium therapy?
A. Liver function test
B. Renal function test
C. Blood sugar
D. WBC count
Answer: B. Renal function test
👉 Explanation: Lithium is excreted by kidneys; baseline renal function must be assessed.
145. Which therapy is best for borderline personality disorder?
A. Dialectical behavior therapy (DBT)
B. Psychoanalysis
C. Aversion therapy
D. Family therapy only
Answer: A. Dialectical behavior therapy (DBT)
👉 Explanation: DBT is evidence-based and effective for borderline personality disorder.
146. Which of the following is a hallmark of PTSD?
A. Recurrent nightmares and flashbacks
B. Catatonia
C. Hypersexuality
D. Amnesia for daily events only
Answer: A. Recurrent nightmares and flashbacks
👉 Explanation: PTSD patients re-experience trauma through nightmares, flashbacks, and intrusive memories.
147. A patient is overly suspicious and interprets others’ motives as hostile. This is:
A. Schizoid personality disorder
B. Paranoid personality disorder
C. Avoidant personality disorder
D. Dependent personality disorder
Answer: B. Paranoid personality disorder
👉 Explanation: Paranoid PD involves pervasive distrust and suspicion of others.
148. Which antidepressant has the lowest risk of sexual side effects?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Paroxetine
Answer: B. Bupropion
👉 Explanation: Bupropion is unique among antidepressants with minimal sexual dysfunction.
149. A nurse suspects tardive dyskinesia when the patient shows:
A. Tongue protrusion and lip smacking
B. Rigidity and bradykinesia
C. Sudden neck spasms
D. Agitation and pacing
Answer: A. Tongue protrusion and lip smacking
👉 Explanation: Tardive dyskinesia is a late side effect of antipsychotics causing involuntary movements.
150. Which nursing diagnosis is most appropriate for schizophrenia with auditory hallucinations?
A. Risk for injury related to command hallucinations
B. Disturbed body image
C. Impaired skin integrity
D. Ineffective breathing pattern
Answer: A. Risk for injury related to command hallucinations
👉 Explanation: Command hallucinations may direct the patient to harm self or others, requiring immediate safety measures.
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