Question 1: A patient is prescribed 25mg of sertraline orally once daily. The available tablets are 50mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 1.5 tablets
D) 2 tablets

Question 2: A patient requires 100mg of clozapine. The medication is available as a liquid formulation with a concentration of 25mg per 5ml. What volume of liquid should the nurse administer?
A) 10ml
B) 15ml
C) 20ml
D) 25ml

Question 3: A patient is prescribed 0.5mg of lorazepam orally three times a day. The available tablets are 250 micrograms. How many tablets should the nurse administer per dose?
A) 1 tablet
B) 2 tablets
C) 3 tablets
D) 4 tablets

Question 4: A patient is to receive 75mg of venlafaxine. The available capsules are 37.5mg. How many capsules should the nurse administer?
A) 1 capsule
B) 2 capsules
C) 2.5 capsules
D) 3 capsules

Question 5: A patient is prescribed 40mg of fluoxetine daily. The available tablets are 2 x 20mg scored tablets in a blister pack. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 4 tablets

Question 6: A patient requires 300mg of lithium carbonate. The available tablets are 200mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 1.5 tablets
D) 2 tablets

Question 7: A patient is prescribed 5mg of haloperidol orally twice a day. The available liquid formulation is 2mg per 1ml. What volume should the nurse administer per dose?
A) 1.5ml
B) 2ml
C) 2.5ml
D) 3ml

Question 8: A patient needs 150mg of trazodone. The available tablets are 50mg. How many tablets should the nurse administer?
A) 1 tablet
B) 2 tablets
C) 3 tablets
D) 4 tablets

Question 9: A patient is prescribed 2mg of risperidone orally once daily. The available tablets are 1mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 3 tablets

Question 10: A patient requires 75 micrograms of flupentixol. The available tablets are 0.5mg. How many tablets should the nurse administer?
A) 0.15 tablet
B) 0.5 tablet
C) 1 tablet
D) 1.5 tablets

Question 11: A patient is prescribed 10mg of diazepam orally. The available tablets are 5mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 3 tablets

Question 12: A patient needs 60mg of propranolol. The available tablets are 40mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 1.5 tablets
D) 2 tablets

Question 13: A patient is prescribed 30mg of mirtazapine at night. The available tablets are 15mg. How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
C) 2 tablets
D) 3 tablets

Question 14: A patient requires 1.5mg of benztropine. The available tablets are 500 micrograms. How many tablets should the nurse administer?
A) 1 tablet
B) 2 tablets
C) 3 tablets
D) 4 tablets

Question 15: A patient is prescribed 12.5mg of quetiapine twice daily. The available tablets are 25mg. How many tablets should the nurse administer per dose?
A) 0.25 tablet
B) 0.5 tablet
C) 1 tablet
D) 2 tablets

PART B

Question 1:
A mental health nurse is caring for a service user who has recently been admitted to an acute inpatient unit under the Mental Health Act. The service user is agitated and refuses to take their prescribed medication. Which of the following actions should the nurse prioritise?
A) Forcibly administering the medication as per the doctor’s orders.
B) Secluding the service user immediately to prevent harm to themselves and others.
C) Attempting to de-escalate the situation through verbal communication and understanding the reasons for refusal.
D) Documenting the refusal and informing the medical team without further engagement.

Question 2:
Which of the following is a core principle of person-centered care in mental health nursing?
A) Standardised treatment protocols for all service users with the same diagnosis.
B) Focusing primarily on the service user’s deficits and limitations.
C) Ensuring the service user’s active involvement in decision-making about their care.
D) Maintaining professional distance to avoid emotional involvement.

Question 3:
Under the Mental Health Act (in England and Wales), which of the following criteria is necessary for a service user to be detained for treatment?
A) The service user has a mental disorder.
B) The service user lacks capacity to consent to treatment.
C) The service user’s mental disorder is of a nature or degree which warrants detention in hospital for treatment, and it is necessary in the interests of their own health or safety or for the protection of other persons.
D) The service user has expressed suicidal ideation.

Question 4:
A service user with a history of bipolar disorder is currently experiencing a manic episode. Which of the following symptoms is MOST likely to be present?
A) Persistent low mood and loss of interest in activities.
B) Increased energy, racing thoughts, and impulsivity.
C) Social withdrawal and flat affect.
D) Delusions of persecution and auditory hallucinations.

Question 5:
When communicating with a service user who is experiencing paranoia, which of the following approaches is generally MOST helpful?
A) Directly challenging their beliefs and trying to convince them of reality.
B) Being honest and consistent, and avoiding ambiguous statements.
C) Agreeing with their beliefs to build rapport.
D) Avoiding any discussion about their paranoid thoughts.

Question 6:
Which of the following is a key aspect of promoting recovery in mental health?
A) Focusing solely on medication management to control symptoms.
B) Encouraging dependence on services for long-term support.
C) Empowering service users to take control of their lives and pursue their goals.
D) Setting fixed timelines for recovery based on clinical expectations.

Question 7:
A mental health nurse suspects that a vulnerable adult is being financially exploited by a family member. What is the nurse’s immediate priority?
A) Directly confronting the family member about the suspected exploitation.
B) Gathering more evidence before taking any action.
C) Following the local safeguarding policy and reporting the concerns to the appropriate authorities.
D) Advising the vulnerable adult to manage their finances more carefully.

Question 8:
A service user with a diagnosis of borderline personality disorder is experiencing intense emotional distress and expresses suicidal ideation. Which of the following nursing interventions is MOST appropriate?
A) Minimising their feelings by telling them that things will get better.
B) Leaving the service user alone to give them space to calm down.
C) Providing a safe environment, exploring their feelings, and developing a safety plan.
D) Immediately calling security to restrain the service user.

Question 9:
Which of the following is a primary goal of Cognitive Behavioral Therapy (CBT) in mental health?
A) To explore unconscious conflicts from early childhood.
B) To change maladaptive thought patterns and behaviors.
C) To provide a supportive and non-directive listening environment.
D) To understand the social and systemic factors contributing to mental illness.

Question 10:
A mental health nurse is working with a service user who has a history of substance misuse. Which of the following approaches is MOST likely to promote engagement in treatment?
A) Using a confrontational approach to highlight the negative consequences of their substance use.
B) Building a therapeutic relationship based on empathy and non-judgmental acceptance.
C) Setting strict rules and expectations for abstinence.
D) Focusing solely on the physical aspects of withdrawal management.

Question 11:
Which of the following is a key principle of the Mental Capacity Act 2005?
A) Assuming that a person has capacity unless it is established that they lack capacity.
B) Making decisions on behalf of individuals based on what is deemed to be in their best interests, regardless of their wishes.
C) Treating individuals with a mental disorder as automatically lacking capacity.
D) Allowing healthcare professionals to make all decisions for individuals who lack capacity.

Question 12:
A service user in a psychiatric intensive care unit (PICU) becomes increasingly aggressive and poses an immediate risk of harm to staff and other service users. Which of the following should be the LAST resort intervention?
A) Verbal de-escalation techniques.
B) Rapid tranquilisation.
C) Physical restraint.
D) Offering a time-out in a quiet room.

Question 13:
Which of the following is a common side effect of first-generation (typical) antipsychotic medications?
A) Weight gain and metabolic syndrome.
B) Extrapyramidal side effects (e.g., dystonia, akathisia, parkinsonism).
C) Sedation and dry mouth.
D) Increased risk of cardiovascular disease.

Question 14:
A mental health nurse is assessing a service user who reports feeling anxious and overwhelmed. Which of the following questions would be MOST helpful in understanding the nature of their anxiety?
A) “Why are you feeling so anxious?”
B) “Have you tried relaxing more?”
C) “Can you tell me more about what triggers your anxiety and how it affects you?”
D) “Don’t worry, everyone feels anxious sometimes.”

Question 15:
Which of the following is a key element of effective multidisciplinary team (MDT) working in mental health?
A) Independent decision-making by each professional based on their area of expertise.
B) Clear communication, shared goals, and mutual respect among team members.
C) Hierarchical structures where the psychiatrist’s opinion always takes precedence.
D) Avoiding open discussion of disagreements to maintain team harmony.

Question 16:
A service user with a diagnosis of anorexia nervosa is refusing to eat. Which of the following nursing interventions is MOST appropriate initially?
A) Insisting that the service user eats a full meal.
B) Explaining the serious health consequences of not eating.
C) Building a trusting relationship and exploring the reasons for their refusal.
D) Arranging for nasogastric feeding without the service user’s consent.

Question 17:
Which of the following is a key aspect of safeguarding children in mental health services?
A) Maintaining absolute confidentiality with the child, even if there are concerns about their safety.
B) Sharing information with relevant agencies when there are concerns about abuse or neglect.
C) Assuming that parents always act in their child’s best interests.
D) Delaying any action until there is concrete proof of harm.

Question 18:
A service user with a long-term history of schizophrenia is experiencing negative symptoms such as apathy and social withdrawal. Which of the following nursing interventions would be MOST helpful in addressing these symptoms?
A) Encouraging the service user to spend more time alone to avoid feeling overwhelmed.
B) Focusing primarily on reducing positive symptoms like hallucinations and delusions.
C) Providing opportunities for social interaction and structured activities in a supportive environment.
D) Avoiding any attempts to engage the service user as they may find it distressing.

Question 19:
Which of the following is a key principle of trauma-informed care in mental health?
A) Focusing on the details of past traumatic experiences.
B) Avoiding any discussion about trauma to prevent re-traumatisation.
C) Recognising the impact of trauma and creating a safe and supportive environment.
D) Assuming that all service users have a history of trauma.

Question 20:
A mental health nurse is preparing to administer an intramuscular (IM) injection of a long-acting antipsychotic medication. Which of the following is an essential step to ensure safe administration?
A) Asking the service user if they are ready for the injection without explaining the medication.
B) Checking the medication name, dose, route, and the service user’s identification against the prescription.
C) Administering the injection quickly to minimise discomfort.
D) Disposing of the needle and syringe in a regular waste bin.

Question 21:
Which of the following is a key characteristic of a therapeutic relationship in mental health nursing?
A) Maintaining a purely social and informal interaction with the service user.
B) Focusing solely on the nurse’s personal experiences and perspectives.
C) Being empathetic, genuine, and respectful of the service user’s autonomy.
D) Avoiding self-disclosure to maintain professional boundaries.

Question 22:
A service user with a diagnosis of obsessive-compulsive disorder (OCD) reports spending several hours each day performing rituals to reduce anxiety. Which of the following interventions would be MOST appropriate as part of their care plan?
A) Encouraging the service user to completely stop their rituals immediately.
B) Helping the service user to gradually reduce the frequency and intensity of their rituals through exposure and response prevention techniques.
C) Reassuring the service user that their fears are irrational.
D) Avoiding any discussion about their rituals to prevent increasing their anxiety.

Question 23:
Under the Mental Health Act, a service user who is subject to a Community Treatment Order (CTO) can be recalled to hospital if which of the following conditions is met?
A) They have missed one appointment with their community mental health team.
B) Their mental health has deteriorated, and there is a risk to their health or safety or the safety of others.
C) They have expressed dissatisfaction with their medication.
D) They have moved to a different address without informing the mental health team.

Question 24:
Which of the following is a common symptom of post-traumatic stress disorder (PTSD)?
A) Grandiosity and inflated self-esteem.
B) Intrusive memories, flashbacks, and avoidance of trauma-related stimuli.
C) Excessive happiness and euphoria.
D) Social engagement and seeking out reminders of the traumatic event.

Question 25:
When communicating with a service user who is experiencing delusions of grandeur, which of the following approaches is generally MOST appropriate?
A) Directly challenging the delusion and presenting evidence to the contrary.
B) Acknowledging the service user’s feelings without validating the delusional content.
C) Agreeing with the delusion to build rapport.
D) Ignoring the delusion and focusing on other topics of conversation.

Question 26:
Which of the following is a key principle of promoting social inclusion for individuals with mental health problems?
A) Encouraging segregation from the general community to avoid stigma.
B) Focusing solely on individual therapy to address personal issues.
C) Providing opportunities for meaningful social participation and reducing barriers to inclusion.
D) Assuming that individuals with mental health problems are unable to engage in social activities.

Question 27:
A mental health nurse is concerned that a colleague may be working under the influence of alcohol. What is the nurse’s professional responsibility?
A) Ignoring the concern unless it directly affects patient care.
B) Confronting the colleague directly and asking them about their alcohol use.
C) Reporting the concern to a senior member of staff or following the organisation’s policy on fitness to practice.
D) Discussing the concern with other colleagues to gather more information.

Question 28:
A service user with a diagnosis of schizoaffective disorder is experiencing a combination of mood symptoms and psychotic symptoms. Which of the following is characteristic of this condition?
A) Primarily experiencing psychotic symptoms with brief periods of mood disturbance.
B) Experiencing mood symptoms and psychotic symptoms that occur independently of each other.
C) Experiencing a continuous period of illness during which there is a major mood episode (depressive or manic) concurrent with the active phase of schizophrenia.
D) Primarily experiencing mood symptoms with occasional psychotic features during periods of high stress.

Question 29:
Which of the following is a core skill in Motivational Interviewing (MI)?
A) Providing direct advice and solutions to the service user’s problems.
B) Confronting the service user’s resistance to change.
C) Expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy.
D) Using persuasive arguments to convince the service user to change their behavior.

Question 30:
A mental health nurse is working with a service user who has a gambling addiction. Which of the following interventions would be MOST appropriate as part of their care plan?
A) Lending the service user money to cover their debts.
B) Encouraging the service user to keep their gambling activities secret from their family.
C) Providing psychoeducation about gambling addiction and exploring coping strategies and support resources.
D) Minimising the impact of their gambling by focusing on other areas of their life.

Question 31:
Which of the following is a legal requirement for obtaining valid consent for treatment under the Mental Health Act?
A) The service user must fully understand the nature, purpose, and likely effects of the treatment, and be able to make a free choice.
B) Consent can be implied if the service user does not actively refuse treatment.
C) Consent from the nearest relative is sufficient if the service user lacks capacity.
D) Treatment can proceed without consent if it is deemed to be in the service user’s best interests by the healthcare team.

Question 32:
A service user in an inpatient unit is expressing concerns about the confidentiality of their medical records. How should the nurse respond?
A) Reassure the service user that their records are completely private and no one else can access them.
B) Explain the service user’s rights regarding confidentiality and how their information is shared within the multidisciplinary team for the purpose of their care.
C) Avoid discussing confidentiality to prevent increasing the service user’s anxiety.
D) Tell the service user that confidentiality cannot be guaranteed in a hospital setting.

Question 33:
Which of the following is a common early sign of dementia?
A) Sudden onset of severe confusion and disorientation.
B) Progressive decline in memory, particularly recent events.
C) Fluctuating levels of consciousness.
D) Rapid improvement in cognitive function over time.

Question 34:
A mental health nurse is assessing a service user who reports low mood, fatigue, and loss of interest in activities for the past six months. Which of the following diagnostic criteria from DSM-5 is MOST likely to be considered?
A) Presence of manic or hypomanic episodes.
B) Symptoms causing clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C) Presence of psychotic symptoms such as hallucinations or delusions.
D) Symptoms being attributable to the physiological effects of a substance or another medical condition.

Question 35:
Which of the following is a key element of effective risk assessment in mental health?
A) Focusing solely on predicting future dangerousness.
B) Using standardised risk assessment tools without considering individual circumstances.
C) Regularly reviewing and updating the risk assessment based on changes in the service user’s condition and circumstances.
D) Assuming that past behaviour is the only reliable indicator of future risk.

Question 36:
A service user with a learning disability is admitted to an acute mental health unit experiencing a psychotic episode. Which of the following adaptations to communication would be MOST appropriate?
A) Using complex medical terminology to ensure accurate information transfer.
B) Speaking quickly and using abstract concepts to engage their attention.
C) Using simple language, visual aids, and repeating information as needed.
D) Assuming that the service user will not be able to understand the information provided.

Question 37:
Which of the following is a key principle of the Care Programme Approach (CPA) in the UK?
A) Providing a standardised package of care for all service users with mental health problems.
B) Ensuring that service users have a single point of contact and a coordinated care plan that meets their individual needs.
C) Focusing primarily on crisis intervention rather than long-term support.
D) Limiting the involvement of family members and carers in the care planning process.

Question 38:
A mental health nurse is facilitating a psychoeducational group for service users with anxiety disorders. Which of the following topics would be MOST relevant to include?
A) Exploring past traumatic experiences in detail.
B) Teaching relaxation techniques and coping strategies for managing anxiety symptoms.
C) Encouraging participants to avoid situations that trigger their anxiety.
D) Providing individual therapy within the group setting.

Question 39:
Which of the following is a potential indicator of self-neglect in an older adult?
A) Maintaining a clean and well-maintained home environment.
B) Actively engaging in social activities and hobbies.
C) Poor personal hygiene and an unkempt appearance.
D) Regularly attending medical appointments and following treatment recommendations.

Question 40:
A mental health nurse is asked by a service user’s family member for information about the service user’s treatment. How should the nurse respond?
A) Provide detailed information about the service user’s diagnosis and treatment plan without their consent.
B) Explain the principles of confidentiality and that information cannot be shared without the service user’s explicit consent, unless there are safeguarding concerns.
C) Tell the family member to speak directly to the service user.
D) Offer general information about mental health conditions but avoid discussing the specific service user.

Question 41:
Which of the following is a key ethical principle in mental health nursing practice?
A) Paternalism, acting in the best interest of the service user without their input.
B) Autonomy, respecting the service user’s right to make their own decisions.
C) Beneficence, always prioritising the needs of the healthcare team.
D) Non-maleficence, intentionally causing harm to the service user for their own good.

Question 42:
A service user with a diagnosis of bulimia nervosa has been engaging in secretive binge-eating and purging behaviors. Which of the following nursing interventions is MOST important in the initial stages of treatment?
A) Implementing strict monitoring of food intake and bathroom use.
B) Encouraging the service user to immediately stop all binge-eating and purging.
C) Establishing a trusting therapeutic relationship and exploring the underlying emotional issues.
D) Focusing solely on the physical health consequences of bulimia.

Question 43:
Under the Mental Health Act, which of the following professionals is NOT typically authorised to make recommendations for a service user’s detention?
A) An Approved Mental Health Professional (AMHP).
B) A Section 12 approved doctor.
C) A registered mental health nurse.
D) A general practitioner (GP).

Question 44:
Which of the following is a common symptom of attention-deficit/hyperactivity disorder (ADHD) in adults?
A) Excessive sleeping and fatigue.
B) Difficulty with focus and organisation, impulsivity, and restlessness.
C) Intense fear of social situations.
D) Preoccupation with orderliness and perfectionism.

Question 45:
When communicating with a service user who is experiencing a panic attack, which of the following interventions would be MOST helpful?
A) Telling the service user to calm down and breathe slowly.
B) Leaving the service user alone to allow them to regain control.
C) Staying with the service user, providing reassurance, and guiding them with slow, deep breathing exercises.
D) Minimising their distress by saying that it is just anxiety and will pass quickly.

Question 46:
Which of the following is a key aspect of promoting physical health in service users with mental health problems?
A) Assuming that physical health is a secondary concern compared to mental health.
B) Ignoring physical health symptoms as they are likely to be psychologically based.
C) Regularly monitoring physical health indicators, promoting healthy lifestyles, and addressing physical health needs.
D) Discouraging service users from engaging in physical activity as it may exacerbate their mental health symptoms.

Question 47:
A mental health nurse witnesses a colleague behaving in a way that is discriminatory towards a service user based on their ethnicity. What is the nurse’s professional responsibility?
A) Ignoring the behavior as it is not their direct responsibility.
B) Directly confronting the colleague in front of the service user.
C) Reporting the incident to a senior member of staff or following the organisation’s policy on equality and diversity.
D) Discussing the incident with other colleagues to seek their opinions.

Question 48:
A service user with a diagnosis of cyclothymic disorder experiences which of the following?
A) Severe episodes of mania and depression that meet the criteria for bipolar2 I disorder.
B) Less severe fluctuations in mood, with periods of hypomanic symptoms and mild depressive symptoms that do not meet the criteria for major depressive or manic episodes.
C) Prolonged periods of severe depression with occasional psychotic features.
D) Rapid cycling between intense highs and lows within a short period.

Question 49:
Which of the following is a key principle of Dialectical Behavior Therapy (DBT)?
A) Primarily focusing on past traumatic experiences.
B) Emphasising radical acceptance and change-oriented strategies.
C) Encouraging emotional suppression to manage distress.
D) Avoiding the discussion of suicidal ideation or self-harming behaviors.

Question 50:
A mental health nurse is working with a service user who is experiencing social anxiety. Which of the following interventions would be MOST helpful in addressing their anxiety?
A) Encouraging the service user to avoid all social situations.
B) Gradually exposing the service user to feared social situations in a safe and controlled manner.
C) Telling the service user that their fears are irrational and they should just relax.
D) Focusing solely on medication management to reduce their anxiety.

Question 51:
Which of the following is a key consideration when assessing capacity to consent to treatment under the Mental Capacity Act?
A) The service user’s diagnosis of a mental disorder automatically indicates a lack of capacity.
B) Capacity should be assessed at a specific point in time and in relation to the specific decision that needs to be made.
C) If a service user makes an unwise decision, it automatically means they lack capacity.
D) Capacity assessments should only be carried out by psychiatrists.

Question 52:
A service user in an inpatient unit is found to have a concealed weapon. What is the nurse’s immediate priority?
A) Documenting the finding in the service user’s notes.
B) Confronting the service user and asking why they have the weapon.
C) Ensuring the safety of the service user, other service users, and staff by safely removing and securing the weapon, and following local policies.
D) Ignoring the finding if the service user appears calm and cooperative.

Question 53:
Which of the following is a potential long-term risk associated with the use of second-generation (atypical) antipsychotic medications?
A) Tardive dyskinesia.
B) Neuroleptic Malignant Syndrome.
C) Weight gain, metabolic syndrome, and increased risk of cardiovascular disease.
D) Acute dystonic reactions.

Question 54:
A mental health nurse is assessing a service user who reports experiencing command hallucinations. Which of the following questions is MOST important to ask?
A) “What do the voices sound like?”
B) “How often do you hear the voices?”
C) “What are the voices telling you to do?”
D) “Do you believe the voices are real?”

Question 55:
Which of the following is a key principle of effective communication with families and carers of service users with mental health problems?
A) Sharing all details of the service user’s treatment without their consent to ensure the family is fully informed.
B) Establishing clear boundaries regarding confidentiality and information sharing, while involving families and carers appropriately in the care process with the service user’s consent.
C) Avoiding communication with families and carers to maintain the service user’s privacy.
D) Providing vague and general information to families and carers to avoid overwhelming them.

Question 56:
A service user with a diagnosis of avoidant personality disorder is likely to present with which of the following characteristics?
A) A pervasive pattern of disregard for and violation of the rights of others.
B) A pattern of excessive emotionality and attention-seeking.
C) Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
D) Grandiosity, a need for admiration, and a lack of empathy.

Question 57:
Which of the following is a key aspect of promoting equality and diversity in mental health services?
A) Treating all service users the same, regardless of their individual needs and backgrounds.
B) Recognising and addressing the diverse needs of service users from different cultural, ethnic, and social backgrounds.
C) Ignoring cultural differences to provide standardised care.
D) Making assumptions about service users based on stereotypes.

Question 58:
A mental health nurse is caring for a service user who has recently experienced a bereavement and is exhibiting symptoms of grief. Which of the following interventions would be MOST appropriate?
A) Encouraging the service user to suppress their feelings and move on quickly.
B) Providing a supportive and empathetic environment, and allowing the service user to express their grief in their own way.
C) Telling the service user that they need to be strong and not dwell on their loss.
D) Avoiding any discussion about the bereavement to prevent upsetting the service user.

Question 59:
Which of the following is a key principle of recovery-oriented practice in mental health?
A) Focusing on managing symptoms and maintaining stability.
B) Emphasising hope, empowerment, and self-determination.
C) Assuming that recovery is not possible for individuals with severe mental illness.
D) Setting professional goals for the service user’s recovery journey.

Question 60:
A mental health nurse is preparing to administer medication to a service user who has expressed concerns about potential side effects. Which of the following actions should the nurse take?
A) Administer the medication without addressing the service user’s concerns to ensure compliance.
B) Dismiss the service user’s concerns as being due to their mental illness.
C) Provide clear and accurate information about the medication, including potential side effects, and address the service user’s questions and concerns.
D) Tell the service user that side effects are rare and they should not worry about them.

Question 61:
Which of the following is a key aspect of professional accountability for a registered mental health nurse?
A) Following instructions from senior colleagues without question.
B) Taking responsibility for their own actions and omissions, and adhering to the NMC Code of Conduct.
C) Blaming others when errors occur.
D) Avoiding documentation to minimise scrutiny of their practice.

Question 62:
A service user with a diagnosis of histrionic personality disorder is MOST likely to exhibit which of the following behaviors?
A) Social withdrawal and a lack of desire for close relationships.
B) Grandiosity, arrogance, and a sense of entitlement.
C) Excessive emotionality, attention-seeking behavior, and a need to be the center of attention.
D) Preoccupation with orderliness, perfectionism, and control.

Question 63:
Under the Mental Health Act, a service user who is detained under Section 2 has the right to appeal their detention to which of the following bodies?
A) The local authority.
B) The hospital management.
C) The Mental Health Tribunal.
D) The police.

Question 64:
Which of the following is a common risk factor for developing depression in later life?
A) Increased social engagement and activity.
B) Good physical health and functional independence.
C) Social isolation, bereavement, and chronic physical illness.
D) Financial security and a strong support network.

Question 65:
When communicating with a service user who is expressing suicidal ideation, which of the following questions is MOST important to ask?
A) “Are you just saying this to get attention?”
B) “Have you thought about how you would do it?”
C) “You wouldn’t really do that, would you?”
D) “Have you considered how your family would feel?”

Question 66:
Which of the following is a key aspect of promoting independence and self-management for service users with long-term mental health conditions?
A) Doing everything for the service user to reduce their burden.
B) Encouraging reliance on professional support for all aspects of their life.
C) Supporting the service user to develop skills and strategies to manage their condition and live as independently as possible.
D) Setting unrealistic expectations for the service user’s level of functioning.

Question 67:
A mental health nurse suspects that a child is being neglected by their parents. What is the nurse’s immediate priority?
A) Directly confronting the parents about the suspected neglect.
B) Waiting for more conclusive evidence before taking any action.
C) Following the local safeguarding policy and reporting the concerns to the appropriate authorities.
D) Offering the parents advice on how to improve their parenting skills.

Question 68:
A service user with a diagnosis of schizotypal personality disorder is likely to present with which of the following characteristics?
A) A pattern of unstable interpersonal relationships, self-image, and affects, and marked impulsivity.
B) Social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior.
C) A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.
D) A pattern of grandiosity, need for admiration, and lack of empathy.

Question 69:
Which of the following is a core principle of solution-focused brief therapy (SFBT)?
A) Focusing on the service user’s problems and their origins.
B) Identifying and amplifying the service user’s strengths and resources to achieve their goals.
C) Providing interpretations of the service user’s unconscious conflicts.
D) Exploring the service user’s past experiences in detail.

Question 70:
A mental health nurse is working with a service user who has a dual diagnosis of a mental health problem and a learning disability. Which of the following considerations is MOST important when planning their care?
A) Assuming that their mental health needs are secondary to their learning disability.
B) Using complex and abstract language to explain their treatment plan.
C) Adapting communication and interventions to match the service user’s cognitive abilities and understanding.
D) Excluding the service user from decision-making due to their learning disability.

Question 71:
Which of the following is a key legal requirement regarding the use of restrictive practices in mental health care?
A) Restrictive practices can be used whenever staff deem them necessary for the safety of the unit.
B) Restrictive practices should only be used as a last resort, when all other less restrictive options have been tried and failed, and must be proportionate to the risk.
C) The use of restrictive practices does not need to be documented if it is for a short duration.
D) Verbal consent from the service user is not required before using restrictive practices.

Question 72:
A service user in an inpatient unit reports feeling increasingly agitated and restless. Which of the following nursing assessments should be prioritised?
A) Assessing the service user’s appetite and fluid intake.
B) Assessing the service user’s sleep patterns over the past few days.
C) Assessing the service user’s current mental state, including any changes in mood, thoughts, or behavior, and exploring potential triggers for their agitation.
D) Assessing the service user’s physical health, including vital signs.

Question 73:
Which of the following is a common side effect of lithium?
A) Hypoglycemia.
B) Hypertension.
C) Fine hand tremor and increased thirst.
D) Bradycardia.

Question 74:
A mental health nurse is assessing a service user who presents with pressured speech, flight of ideas, and distractibility. These symptoms are MOST indicative of which of the following?
A) Major depressive episode.
B) Manic episode.
C) Panic disorder.
D) Generalised anxiety disorder.

Question 75:
Which of the following is a key element of effective documentation in mental health nursing?
A) Recording personal opinions and subjective interpretations.
B) Using abbreviations and jargon without explanation.
C) Ensuring that documentation is accurate, objective, timely, and reflects the service user’s perspective.
D) Only documenting negative or critical incidents.

Question 76:
A service user with a diagnosis of dependent personality disorder is likely to present with which of the following characteristics?
A) A lack of empathy and a tendency to exploit others.
B) A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation.
C) A pattern of perfectionism and inflexibility about matters of morality, ethics, or values.
D) A persistent avoidance of social contact due to a fear of criticism or rejection.

Question 77:
Which of the following is a key aspect of addressing stigma associated with mental health problems?
A) Using labels and diagnostic terms frequently to raise awareness.
B) Promoting positive attitudes and understanding towards mental illness through education and challenging negative stereotypes.
C) Avoiding any discussion about mental health problems to protect individuals’ privacy.
D) Focusing solely on the biological causes of mental illness.

Question 78:
A mental health nurse is caring for a service user who is experiencing auditory hallucinations that are persecutory in nature. Which of the following nursing interventions would be MOST appropriate?
A) Telling the service user that the voices are not real and they should ignore them.
B) Encouraging the service user to confront the voices and argue with them.
C) Providing a safe and supportive environment, acknowledging the service user’s distress, and helping them to develop coping strategies.
D) Increasing the service user’s antipsychotic medication immediately.

Question 79:
Which of the following is a key principle of working with individuals who have experienced trauma?
A) Pressuring the individual to disclose details of their traumatic experiences.
B) Minimising the impact of trauma to encourage resilience.
C) Creating a sense of safety and trust, and empowering the individual to regain control.
D) Assuming that all individuals who have experienced trauma will develop PTSD.

Question 80:
A mental health nurse is preparing to discharge a service user from an inpatient unit. Which of the following is an essential component of the discharge plan?
A) Ensuring that the service user has a sufficient supply of medication but no follow-up appointments.
B) Providing the service user with information about community resources and support networks, and arranging follow-up appointments with the community mental health team or other relevant services.
C) Assuming that the service user’s family will provide all the necessary support.
D) Focusing solely on the service user’s mental health needs and neglecting any physical health or social care requirements.

Question 81:
Which of the following is a key aspect of maintaining professional boundaries in mental health nursing?
A) Sharing personal contact information3 with service users to build rapport.
B) Accepting gifts or favours from service users.
C) Focusing the therapeutic relationship4 on the service user’s needs and avoiding personal self-disclosure that is not therapeutic.
D) Developing close friendships with service users after discharge.

Question 82:
A service user with a diagnosis of narcissistic personality disorder is MOST likely to exhibit which of the following behaviors?
A) Extreme self-doubt and fear of criticism.
B) A pervasive pattern of social inhibition and feelings of inadequacy.
C) Grandiosity, a need for admiration, and a lack of empathy.
D) A preoccupation with orderliness and perfectionism at the expense of flexibility and efficiency.

Question 83:
Under the Mental Health Act, which of the following is the role of the Nearest Relative?
A) To make all decisions about the service user’s treatment if they lack capacity.
B) To be consulted about the service user’s care and treatment, and to have certain rights such as applying for the service user’s discharge from detention.
C) To provide financial support for the service user’s care.
D) To act as a legal guardian for the service user.

Question 84:
Which of the following is a common symptom of anxiety disorders?
A) Increased appetite and weight gain.
B) Restlessness, worry, and difficulty concentrating.
C) Social withdrawal and flat affect.
D) Grandiose delusions and racing thoughts.

Question 85:
When communicating with a service user who is expressing anger and frustration, which of the following approaches is generally MOST helpful?
A) Becoming defensive and arguing with the service user.
B) Telling the service user to calm down and stop being angry.
C) Remaining calm, listening empathetically, and acknowledging their feelings.
D) Ignoring the service user’s anger and walking away.

Question 86:
Which of the following is a key aspect of promoting hope and optimism in service users with mental health problems?
A) Downplaying the challenges and difficulties they may face.
B) Sharing stories of recovery and highlighting the potential for positive change.
C) Setting unrealistic goals to inspire them.
D) Avoiding any discussion of their future to prevent anxiety.

Question 87:
A mental health nurse is concerned about the safety of a service user who has disclosed suicidal ideation and has a history of self-harm. What is the nurse’s immediate priority?
A) Leaving the service user alone to give them space to think.
B) Minimising the service user’s feelings and reassuring them that everything will be alright.
C) Ensuring the service user’s immediate safety by remaining with them, assessing the risk in detail, and implementing appropriate safety measures.
D) Telling the service user that suicide is not the answer.

Question 88:
A service user with a diagnosis of obsessive-compulsive personality disorder is likely to present with which of the following characteristics?
A) A pattern of excessive attention-seeking and dramatic behavior.
B) A pervasive pattern of disregard for and violation of the rights of others.
C) A preoccupation with orderliness, perfectionism, and control at the expense of flexibility and efficiency.
D) Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Question 89:
Which of the following is a key principle of family therapy in mental health?
A) Focusing solely on the individual service user’s problems.
B) Viewing the family as a system and understanding how interactions within the family can contribute to or maintain mental6 health problems.
C) Blaming family members for the service user’s difficulties.
D) Excluding family members from the treatment process.

Question7 90:
A mental health nurse is working with a service user who is experiencing a relapse of a psychotic disorder. Which of the following interventions would be MOST appropriate?
A) Discontinuing their medication immediately.
B) Encouraging them to ignore the symptoms and try to carry on as normal.
C) Assessing their current mental state, reviewing their medication and support plan, and involving the multidisciplinary team.
D) Telling them that it is all in their head and they need to snap out of it.

Question 91:
Which of the following is a key aspect of the Mental Capacity Act’s best interests principle?
A) Decisions should always be made by healthcare professionals based on their clinical judgment.
B) The service user’s past and present wishes and feelings, beliefs and values must be considered when making decisions on their behalf.
C) Decisions should primarily focus on what is most convenient for the healthcare team.
D) The views of family members should always override the service user’s wishes.

Question 92:
A service user in an inpatient unit is refusing to eat and drink. Which of the following nursing actions should be prioritised?
A) Forcibly feeding the service user to ensure adequate nutrition.
B) Documenting the refusal and leaving the service user alone.
C) Assessing the service user’s capacity to make decisions about their care, exploring the reasons for their refusal, and offering support and encouragement.
D) Assuming the service user is attention-seeking and ignoring their behavior.

Question 93:
Which of the following is a potential side effect of clozapine that requires regular monitoring?
A) Hypertension.
B) Agranulocytosis.
C) Hyperglycemia.
D) Bradycardia.

Question 94:
A mental health nurse is assessing a service user who reports feeling detached from their body and surroundings. This symptom is known as which of the following?
A) Hallucination.
B) Delusion.
C) Depersonalisation/derealisation.
D) Thought insertion.

Question 95:
Which of the following is a key element of effective handover between nursing shifts?
A) Providing brief and incomplete information to save time.
B) Sharing all confidential information regardless of its relevance.
C) Ensuring a clear, concise, and accurate exchange of information about the service user’s current condition, care plan, and any changes or concerns.
D) Only focusing on the tasks that need to be completed during the next shift.

Question 96:
A service user with a diagnosis of paranoid personality disorder is likely to present with which of the following characteristics?
A) A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent.
B) A pattern of unstable interpersonal relationships, self-image, and affects, and marked impulsivity.
C) Social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships.
D) A pervasive pattern of excessive emotionality and attention-seeking.

Question 97:
Which of the following is a key aspect of promoting well-being and resilience in mental health?
A) Avoiding any discussion of stressors or difficulties.
B) Encouraging the development of coping skills, social support networks, and healthy lifestyle habits.
C) Assuming that individuals with mental health problems are inherently vulnerable.
D) Focusing solely on treating mental illness rather than promoting overall well-being.

Question 98:
A mental health nurse is caring for a service user who is experiencing a severe depressive episode. Which of the following nursing interventions would be MOST appropriate?
A) Encouraging the service user to engage in vigorous physical activity to boost their mood.
B) Providing a structured routine, offering support and encouragement with activities of daily living, and monitoring for suicidal ideation.
C) Telling the service user to snap out of it and think positive thoughts.
D) Leaving the service user alone in their room to rest and recover.

Question 99:
Which of the following is a key principle of providing culturally competent mental health care?
A) Assuming that all service users from the same cultural background will have the same beliefs and values.
B) Being aware of and sensitive to the service user’s cultural background, beliefs, and practices, and adapting care accordingly.
C) Ignoring cultural differences to provide standardised care.
D) Relying solely on one’s own cultural understanding when interacting with service users from diverse backgrounds.

Question 100:
A mental health nurse is preparing to administer oral medication to a service user. Which of the following is an essential step to ensure safe administration?
A) Leaving the medication at the service user’s bedside for them to take later.
B) Crushing all tablets and mixing them with food without the service user’s knowledge.
C) Checking the service user’s identification, confirming any allergies, and observing the service user taking the medication.
D) Administering the medication quickly without providing any explanation.