190 Psychiatry questions written for the NCLEX-RN, each with a rationale explaining why the correct answer is correct and why the others are not. Free, no account required. 10 examples are shown below.
Practice all 190 questions →Answers are shown so you can read these as worked examples. To answer them yourself and track what you get wrong, start a practice set.
The answer: B — Risk for suicide related to recent life stressors and social isolation Think of it this way: In nursing priority-setting, there is a difference between a DIAGNOSIS and a PROBLEM requiring immediate intervention. The patient has MDD, but that is background. The immediate threat — the thing requiring urgent nursing action right now — is the patient's risk of suicide. That is what must be addressed first. Why B is right: While Major Depressive Disorder (option A) is the underlying psychiatric diagnosis, the immediate nursing priority is the direct threat to the patient's life. 'Risk for suicide' as a nursing diagnosis captures the highest-acuity problem, warranting immediate intervention: continuous observation, environmental safety, provider notification, and psychiatric consultation. Why the others are wrong: - A: MDD is the patient's diagnosis and contributes to suicidal ideation, but identifying the diagnosis is less actionable than identifying the immediate safety risk. The priority problem is the suicide risk itself. - C: Ineffective coping related to unemployment and divorce describes contributing factors (stressors) — not the immediate clinical problem. Addressing coping is part of treatment, but safety comes first. - D: Medication non-compliance is a behavior, not an impulse control disorder, and is a contributing factor — not the primary problem requiring immediate intervention. Remember: When safety is at stake, it is ALWAYS the priority. Life-threatening risks come before diagnoses and contributing factors. Technical note: In the nursing process, problems are prioritized using frameworks like Maslow (physiological → safety → psychological). Safety threats (like suicide risk) sit at the top — above comfort, coping, or diagnostic labeling.
Clozapine requires regular monitoring of white blood cell (WBC) count due to the risk of agranulocytosis, a potentially fatal condition where the bone marrow fails to produce enough white blood cells. WBC counts must be monitored weekly for the first 6 months, then every 2 weeks for the next 6 months, and monthly thereafter.
Haloperidol is a typical antipsychotic that causes alpha-adrenergic blockade, leading to orthostatic hypotension, especially during initial therapy or dose increases. This poses an immediate safety risk for falls. While agranulocytosis is associated with clozapine (not haloperidol), dry mouth and weight gain are possible but less urgent safety concerns than falls from orthostatic hypotension.
According to DSM-5 criteria, GAD requires excessive anxiety and worry for at least 6 months. The anxiety and worry must be present more days than not. Option B describes phobias. Option C describes panic disorder. Option D is incorrect.
Passive-aggressive behavior (also called passive-aggressive personality disorder features) is commonly seen in dependent personality disorder. This manifests as procrastination, intentional incompetence, or resistance to demands, often to avoid taking responsibility while maintaining dependence on others.
The correct answer is option A: 'I will call my therapist if I feel depressed.' This statement indicates a need for continued intensive suicide prevention planning because it is vague and lacks specificity. A safe discharge plan should include concrete steps, multiple support contacts, and means restriction. Option A only identifies one action (calling a therapist) and one trigger (depression), with no backup plan. In contrast, options B, C, and D demonstrate more concrete safety measures: family supervision (B), removal of medications (C), and 24/7 support (D). Therefore, option A is the most concerning and indicates the client needs further planning.
Offering a tissue and sitting with the patient in silence demonstrates therapeutic presence and nonverbal support. This allows the patient to express emotions freely while feeling supported, without rushing them or dismissing their feelings.
The core symptoms of major depressive disorder according to DSM-5 include depressed mood and anhedonia (loss of interest or pleasure). Other symptoms include: significant weight loss/gain, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, feelings of worthlessness/guilt, diminished concentration, recurrent thoughts of death. Decreased appetite (not increased) is typically associated with depression, though atypical depression may present with increased appetite.
According to DSM-5, a personality disorder is an enduring pattern of inner experience and behavior that deviates significantly from cultural expectations, is pervasive and inflexible, has onset in adolescence or early adulthood, leads to distress or impairment, and is stable over time.
Alcohol intoxication typically presents with central nervous system depression including nystagmus (involuntary eye movements), slurred speech, impaired coordination, and slowed cognitive processing. The other options describe symptoms more consistent with other conditions.
