Free Psychiatric Emergencies MCQs with Answers
40 Psychiatric Emergencies MCQs from Mental Health Nursing, each with the correct answer and a written explanation of why it is correct. Free and unlimited, with no account needed.
Psychiatric emergencies include suicidal behavior, homicide risk, severe agitation, panic, acute psychosis, delirium, overdose, and withdrawal states. Students examine rapid risk assessment, crisis intervention, de-escalation, environmental safety, emergency medication, observation levels, and the immediate priorities that differ from routine psychiatric nursing care.
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40 questions · page 2 of 2
- A. Intravenous sodium bicarbonate
- B. Intravenous calcium gluconate
- C. Oral activated charcoal only
- D. Intramuscular naloxone
Explanation: Sodium bicarbonate helps correct the cardiac sodium-channel blockade and metabolic acidosis associated with serious tricyclic…
Correct answer: Intravenous sodium bicarbonate- A. Give the next antidepressant dose
- B. Withhold serotonergic medicines and notify the prescriber
- C. Encourage the patient to walk to reduce restlessness
- D. Place the patient in a brightly lit activity room
Explanation: The combination of mental status change, autonomic overactivity, tremor, and hyperreflexia suggests serotonin syndrome.
Correct answer: Withhold serotonergic medicines and notify the prescriber- A. Administer the scheduled lithium dose
- B. Withhold lithium and notify the prescriber
- C. Give an extra dose with food
- D. Restrict oral fluids until symptoms settle
Explanation: Coarse tremor, gastrointestinal symptoms, ataxia, and slurred speech are warning signs of lithium toxicity.
Correct answer: Withhold lithium and notify the prescriber- A. Apply firm direct pressure to the wound
- B. Ask the patient to describe the reason for self-harm
- C. Search the patient’s room for sharp objects
- D. Arrange a routine psychiatric interview
Explanation: Spurting bleeding and signs of poor perfusion make circulation the immediate priority.
Correct answer: Apply firm direct pressure to the wound- A. Give thiamine before glucose when possible
- B. Give a large dose of haloperidol first
- C. Restrict fluids until orientation improves
- D. Encourage the person to eat a high-protein meal
Explanation: Confusion, ataxia, and abnormal eye movements suggest possible Wernicke encephalopathy caused by thiamine deficiency.
Correct answer: Give thiamine before glucose when possible- A. Assess the airway and prepare prescribed benztropine
- B. Encourage the patient to lie flat and rest
- C. Give the next dose of haloperidol with food
- D. Ask the patient to perform neck exercises
Explanation: Acute dystonia can involve the laryngeal muscles and threaten the airway, so airway assessment comes first.
Correct answer: Assess the airway and prepare prescribed benztropine- A. Begin active cooling and obtain emergency medical support
- B. Place the patient alone in a dark room without monitoring
- C. Offer coffee to improve alertness and cooperation
- D. Encourage vigorous exercise to release excess energy
Explanation: Severe hyperthermia with stimulant toxicity can cause seizures, rhabdomyolysis, kidney injury, and cardiovascular collapse.
Correct answer: Begin active cooling and obtain emergency medical support- A. Reduce stimulation and set clear, consistent limits
- B. Allow unrestricted activity to use the patient’s energy
- C. Argue about the patient’s unrealistic plans
- D. Keep the patient awake for a longer assessment
Explanation: A low-stimulation environment and clear limits reduce escalation while protecting the patient and others.
Correct answer: Reduce stimulation and set clear, consistent limits- A. Respiratory rate and oxygen saturation
- B. Long-term employment and family history
- C. Meal preferences and usual sleep pattern
- D. Degree of social interaction on the ward
Explanation: Sedative overdose can progress to respiratory depression, so breathing and oxygenation require repeated assessment.
Correct answer: Respiratory rate and oxygen saturation- A. Intramuscular injection
- B. Delayed-release oral tablet
- C. Topical skin preparation
- D. Rectal medication without assessment
Explanation: When oral medication cannot be taken safely, a prescribed intramuscular medicine can provide relatively rapid treatment during a…
Correct answer: Intramuscular injection- A. Oral lithium therapy
- B. Prescribed lorazepam therapy
- C. Routine antidepressant therapy
- D. Fluid restriction therapy
Explanation: Lorazepam is commonly used as the initial treatment for catatonia and may produce a rapid improvement.
Correct answer: Prescribed lorazepam therapy- A. Institute seizure precautions and notify the prescriber
- B. Encourage vigorous exercise to reduce anxiety
- C. Place the patient alone in a dark room
- D. Administer the next dose only after symptoms settle
Explanation: Abrupt benzodiazepine withdrawal can cause seizures, delirium, and severe autonomic symptoms.
Correct answer: Institute seizure precautions and notify the prescriber- A. Insert a padded tongue blade between the teeth
- B. Restrain the arms and legs to stop movement
- C. Protect the patient and maintain the airway after the seizure
- D. Offer oral fluids immediately during the seizure
Explanation: The nurse protects the patient from injury, maintains airway safety, and turns the patient laterally when possible.
Correct answer: Protect the patient and maintain the airway after the seizure- A. Acute dystonia
- B. Akathisia
- C. Tardive dyskinesia
- D. Neuroleptic malignant syndrome
Explanation: Akathisia causes intense inner restlessness and an inability to remain still, often soon after starting or increasing an antipsychotic.
Correct answer: Akathisia- A. Leave the patient unobserved to reduce stimulation
- B. Maintain continuous observation and reassess safety needs
- C. Keep the door locked until the next scheduled review
- D. Withhold fluids until the patient becomes cooperative
Explanation: Seclusion requires continuous observation, regular assessment, and release as soon as the patient is safe.
Correct answer: Maintain continuous observation and reassess safety needs- A. Assess cardiac rhythm with an ECG and monitor vital signs
- B. Give an antipsychotic to control the confusion
- C. Induce vomiting to remove the remaining tablets
- D. Restrict oral fluids to prevent urinary retention
Explanation: These findings suggest an anticholinergic toxidrome, which can cause dangerous tachyarrhythmias and hyperthermia.
Correct answer: Assess cardiac rhythm with an ECG and monitor vital signs- A. Place the patient supine and offer water
- B. Maintain the airway and position the patient laterally
- C. Induce further vomiting with warm salt water
- D. Give activated charcoal without checking consciousness
Explanation: Airway protection is the immediate priority because drowsiness and vomiting increase aspiration risk.
Correct answer: Maintain the airway and position the patient laterally- A. Continue seclusion and reassess after the patient calms
- B. Assess airway, breathing, circulation, and obtain urgent help
- C. Offer reassurance that anxiety commonly causes chest pain
- D. Administer the next psychiatric medication as prescribed
Explanation: Chest pain with sweating and breathlessness may indicate a life-threatening medical emergency, so ABC assessment and urgent assistance…
Correct answer: Assess airway, breathing, circulation, and obtain urgent help- A. Place the patient in a stimulating group activity
- B. Recognize possible medical instability and obtain urgent review
- C. Ask the patient to walk until the agitation improves
- D. Delay physical assessment until psychiatric symptoms settle
Explanation: Fever, tachycardia, and hypotension indicate possible medical deterioration, intoxication, infection, or a serious medication reaction.
Correct answer: Recognize possible medical instability and obtain urgent review- A. Leave the patient alone to encourage independent coping
- B. Assess suicide risk directly and increase safety supervision
- C. Promise that the information will never be shared
- D. Encourage the patient to make important decisions immediately
Explanation: Hopelessness, refusal of intake, and suicidal language require direct suicide-risk assessment and immediate safety measures.
Correct answer: Assess suicide risk directly and increase safety supervision