Original DHA nursing questions on mental health & neurology, with explanations.
Short answer: 10 original multiple-choice practice questions on mental health & neurology for nurses preparing for the DHA licensing exam, each with the correct answer and a full explanation. This is a Meddex topic, not a DHA heading. They are original and are not real exam items.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
What mental health covers
Psychiatric emergencies, therapeutic communication and neuro conditions.
Keep the patient safe, stay calm and use open, non-judgemental communication. The preferred answer rarely argues with, tricks or restrains a patient unless there is immediate risk.
Where it fits in the exam
DHA lists four coverage headings for Registered Nurse and publishes no weights. Mental Health & Neurology is one of ten Meddex domains, so it is a Meddex grouping and not a DHA heading. Its questions can appear under more than one DHA heading.
DHA does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Mental Health & NeurologyMedium
Which combination of features is required to diagnose delirium using the Confusion Assessment Method (CAM)?
AOption A: Acute onset with a fluctuating course and inattention, plus either disorganised thinking or an altered level of consciousness
BOption B: Low mood and loss of interest lasting more than two weeks
COption C: Hallucinations and delusions with a clear level of consciousness
DOption D: Memory loss over several months, with word-finding difficulty, poor judgement and a clear level of consciousness
Show answer for question 1
Correct answer: A. Acute onset with a fluctuating course and inattention, plus either disorganised thinking or an altered level of consciousness
The CAM requires acute onset with a fluctuating course and inattention, plus either disorganised thinking or an altered level of consciousness. It is a quick bedside tool for nurses, and a positive result needs prompt medical review for causes. A slowly progressive memory decline suggests dementia, psychotic symptoms alone suggest a primary psychosis, and persistent low mood suggests depression.
Why B is wrong. Persistent low mood describes depression.
Why C is wrong. Psychotic symptoms with clear consciousness do not meet the criteria for delirium.
Why D is wrong. Gradual memory decline over months describes dementia.
Topic: Confusion Assessment Method criteria. Reference: Inouye and colleagues: Confusion Assessment Method; NICE guideline CG103: Delirium: prevention, diagnosis and management
Question 2
Mental Health & NeurologyMedium
On day 6 after delivery a woman is sleepless, elated, confused and says the baby is special and she can hear voices giving her instructions. What is the MOST appropriate nursing action?
AOption A: Treat it as a psychiatric emergency: do not leave her alone with the baby and arrange urgent assessment
BOption B: Explain that this is the baby blues and will settle within a few days with rest and support from the family
COption C: Encourage her to take the baby home today to settle her mood
DOption D: Offer a herbal sleep remedy and review in a week
Show answer for question 2
Correct answer: A. Treat it as a psychiatric emergency: do not leave her alone with the baby and arrange urgent assessment
Rapid onset of elated or confused mood, insomnia and hallucinations in the first two weeks after birth suggests postpartum psychosis, a psychiatric emergency with a risk of harm to mother and infant. She needs urgent specialist assessment, close supervision and a safe plan for the baby. Baby blues are mild, short-lived tearfulness without psychotic symptoms.
Why B is wrong. Baby blues do not cause hallucinations or confusion, so this reassurance misses an emergency.
Why C is wrong. Discharging a psychotic mother with her infant is unsafe.
Why D is wrong. A herbal remedy and a week of waiting is a dangerous delay.
Topic: Postpartum psychosis. Reference: NICE CG192 Antenatal and postnatal mental health; RCPsych Perinatal mental health guidance
Question 3
Mental Health & NeurologyMedium
A man who last injected heroin 12 hours ago has yawning, a runny nose, dilated pupils, goose bumps, abdominal cramps and diarrhoea. He is alert and oriented. What is the MOST appropriate nursing response?
AOption A: Give naloxone to reverse the symptoms of opioid withdrawal and repeat the dose every 2 to 3 minutes until they settle
BOption B: Recognise opioid withdrawal, which is distressing but seldom life-threatening, assess severity with a scale and request prescriber review
COption C: Observe for seizures as the main risk and restrain him if they begin
DOption D: Discharge him to manage at home because the symptoms are not dangerous
Show answer for question 3
Correct answer: B. Recognise opioid withdrawal, which is distressing but seldom life-threatening, assess severity with a scale and request prescriber review
These are classic signs of opioid withdrawal. It is very uncomfortable but, unlike alcohol or benzodiazepine withdrawal, rarely causes seizures or death unless complications such as dehydration develop. Care includes a structured assessment (for example the Clinical Opiate Withdrawal Scale), fluids, symptom relief and prescriber review for opioid substitution. Naloxone would precipitate severe withdrawal.
Why A is wrong. Naloxone antagonises opioids and would worsen withdrawal sharply.
Why C is wrong. Seizures are not the typical risk in opioid withdrawal and restraint is never first-line.
Why D is wrong. Sending him home untreated risks relapse and dehydration, and he needs assessment and support.
Topic: Opioid withdrawal. Reference: WHO Guidelines for the psychosocially assisted pharmacological treatment of persons dependent on opioids; NICE Drug misuse in over 16s: opioid detoxification
Question 4
Mental Health & NeurologyMedium
On an inpatient unit a patient with borderline personality disorder praises one nurse as the only person who understands her, criticises the others and asks the nurse to keep a secret. What is the BEST team response?
AOption A: Avoid the patient so that conflict is reduced
BOption B: Allow the favoured nurse to take over all of her care because she trusts that nurse and is calmer in her presence on the ward
COption C: Agree to keep the secret to protect the relationship
DOption D: Use a consistent team approach with a shared care plan and clear boundaries, and explain that secrets cannot be kept
Show answer for question 4
Correct answer: D. Use a consistent team approach with a shared care plan and clear boundaries, and explain that secrets cannot be kept
Splitting divides staff into good and bad and can cause conflict in the team. Consistency across staff, regular team discussion, clear and predictable boundaries, and a shared plan reduce splitting. Nurses cannot promise secrecy because safety information must be shared. Exclusive relationships and avoidance both reinforce the pattern.
Why A is wrong. Avoidance is likely to increase distress, abandonment fears and risk behaviours.
Why B is wrong. Exclusive care increases dependence and splitting and exhausts one nurse.
Why C is wrong. Promising secrecy breaches the duty to share safety information and fuels splitting.
Topic: Borderline personality disorder: team approach. Reference: NICE CG78 Borderline personality disorder: recognition and management; Stuart Principles and Practice of Psychiatric Nursing
Question 5
Mental Health & NeurologyMedium
Two days after starting haloperidol, a young man suddenly has painful twisting of the neck and his eyes are fixed upwards. He is frightened and alert. What is the MOST appropriate nursing action?
AOption A: Place him on his side and prepare for a seizure that is about to occur
BOption B: Reassure him, stay with him, and request urgent prescriber review for an anticholinergic such as procyclidine
COption C: Ignore the movements because they are a harmless tic that will settle within a week without any treatment or review
DOption D: Take his temperature and check muscle tone because this is likely neuroleptic malignant syndrome
Show answer for question 5
Correct answer: B. Reassure him, stay with him, and request urgent prescriber review for an anticholinergic such as procyclidine
Sudden painful muscle spasms of the neck, jaw or eyes soon after starting an antipsychotic are acute dystonia, an extrapyramidal side effect that is frightening and can threaten the airway. It responds quickly to an anticholinergic medicine given on prescription. It is not a seizure (he is alert), and neuroleptic malignant syndrome presents with fever, rigidity and altered consciousness.
Why A is wrong. He is alert and the movements are sustained spasms, which does not fit a seizure.
Why C is wrong. Painful dystonia is not harmless and needs prompt treatment; it can also lead to non-adherence.
Why D is wrong. Neuroleptic malignant syndrome features fever, severe rigidity and reduced consciousness, which are not described.
A 19-year-old attends the emergency department with superficial cuts on her forearm. She says quietly, 'You must think I'm stupid.' Which response is most appropriate?
AOption A: Avoid discussing why it happened so that she is not upset, and move on to the discharge letter
BOption B: Explain that self-harm takes staff time from sicker patients, then dress the wounds quickly
COption C: Treat the wounds with equal care, listen without judging and ask about current thoughts of suicide
DOption D: Ask her to promise that she will not hurt herself again before any of the wounds are cleaned or dressed
Show answer for question 6
Correct answer: C. Treat the wounds with equal care, listen without judging and ask about current thoughts of suicide
People who self-harm often expect judgement, and a respectful response keeps them engaged. Wounds and pain are treated with the same care, the nurse listens, asks about suicidal thoughts and current distress, and arranges a psychosocial assessment. Promises, lectures or avoidance do not reduce risk.
Why A is wrong. Avoiding the subject misses the chance to assess risk and arrange psychosocial help.
Why B is wrong. Blaming her for using resources is judgemental and discourages her from seeking help again.
Why D is wrong. Conditional care and promises are not protective and make treatment feel punitive.
Topic: Therapeutic communication - a patient who has self-harmed. Reference: NICE NG225 Self-harm: assessment, management and preventing recurrence; Videbeck: Psychiatric-Mental Health Nursing
Question 7
Mental Health & NeurologyMedium
A 27-year-old man with first-episode psychosis is about to start olanzapine. The nurse is asked to complete the baseline checks before the first dose. Which set is most appropriate?
AOption A: A serum lithium level, thyroid function and a urine pregnancy test
BOption B: Weight and waist, blood pressure and pulse, fasting glucose or HbA1c, a lipid profile and a movement-disorder assessment
COption C: A chest radiograph and spirometry, because antipsychotics mainly affect the lungs
DOption D: A mental state examination alone, because physical monitoring is only needed once side effects appear
Show answer for question 7
Correct answer: B. Weight and waist, blood pressure and pulse, fasting glucose or HbA1c, a lipid profile and a movement-disorder assessment
Antipsychotics cause weight gain, glucose and lipid abnormalities, raised blood pressure and movement disorders, and people with psychosis already have excess cardiovascular risk. NICE advises recording baseline physical investigations before starting treatment and then monitoring regularly. Baseline measures include weight and waist, pulse and blood pressure, glucose or HbA1c, lipids and a check for movement disorders, with an ECG where indicated.
Why A is wrong. These tests relate to lithium and pregnancy, not to the main risks of an antipsychotic.
Why C is wrong. The respiratory system is not the main site of antipsychotic harm, so these tests do not guide monitoring.
Why D is wrong. Waiting for symptoms removes the baseline needed to detect metabolic and cardiovascular change.
Topic: Antipsychotic treatment - baseline physical health checks. Reference: NICE CG178 Psychosis and schizophrenia in adults: prevention and management; Videbeck: Psychiatric-Mental Health Nursing
Question 8
Mental Health & NeurologyEasy
A man with Parkinson disease, due for discharge, stops dead at the ward doorway with his feet 'stuck to the floor' and begins to lean forward. He is not in pain and his medicines are on time. What should the nurse do?
AOption A: Push him gently from behind so that he is carried over the threshold
BOption B: Ask him to try harder and walk faster to overcome the stiffness
COption C: Pull him forward by the arms to restore his momentum
DOption D: Stay beside him and give a rhythmic or visual cue, such as counting aloud or stepping over a line
Show answer for question 8
Correct answer: D. Stay beside him and give a rhythmic or visual cue, such as counting aloud or stepping over a line
Freezing is a sudden failure to start or continue stepping, and it can cause falls, especially at doorways and turns. External cues, such as counting aloud, marching on the spot, stepping over a line or a rhythmic beat, help the person restart. The nurse stays close, stays calm, reduces hurry and clutter, and refers for physiotherapy and occupational therapy input. Pushing or pulling can throw him off balance.
Why A is wrong. Pushing from behind destabilises his posture and can cause a forward fall.
Why B is wrong. Freezing is not a matter of effort, and urging him to hurry usually makes it worse.
Why C is wrong. Pulling him adds a destabilising force and does not treat the movement problem.
Topic: Parkinson disease - freezing of gait: bedside cueing. Reference: NICE NG71 Parkinson's disease in adults; Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems
Question 9
Mental Health & NeurologyMedium
A 17-year-old with anorexia nervosa is admitted for supervised nutritional rehabilitation. Which nursing approach at mealtimes is most appropriate?
AOption A: Stay with her during and after meals, and talk about topics other than food
BOption B: Praise her for each mouthful and tell her how much weight she has gained
COption C: Agree each portion size with her before every meal to build her trust
DOption D: Leave her alone to eat so that she is not embarrassed in front of staff
Show answer for question 9
Correct answer: A. Stay with her during and after meals, and talk about topics other than food
Supervised meals with a calm, consistent nurse present during and for a period after eating reduce hiding food and purging, and conversation away from food, weight and body shape lowers anxiety. Portion sizes are set by the plan, not negotiated, and praise for eating or weight can reinforce the preoccupation.
Why B is wrong. Praise for eating or weight gain keeps the focus on food and weight, which can raise anxiety.
Why C is wrong. Negotiating portions gives the illness room to bargain and undermines the agreed plan.
Why D is wrong. Eating alone allows food to be hidden or discarded and purging afterwards.
Topic: Eating disorders - supporting mealtimes in anorexia nervosa. Reference: NICE NG69 Eating disorders: recognition and treatment; Videbeck Psychiatric-Mental Health Nursing
Question 10
Mental Health & NeurologyEasy
A patient with known panic disorder is trembling and breathing quickly, and says she is going to die. Her observations are normal. Which action is best?
AOption A: Give her a paper bag to breathe into until the symptoms settle
BOption B: Leave her alone in a quiet, dimly lit room until the attack passes by itself
COption C: Ask her to describe in detail what triggered the attack
DOption D: Stay with her and use short calm sentences to coach slow breathing
Show answer for question 10
Correct answer: D. Stay with her and use short calm sentences to coach slow breathing
During a panic attack the nurse stays with the person, keeps a calm voice and short simple sentences, and coaches slow breathing, which reduces hyperventilation. Exploring causes can wait until the person is calm. Being left alone raises fear, and paper-bag rebreathing can lower oxygen and is not advised.
Why A is wrong. Rebreathing into a bag can lower oxygen levels and could hide another cause of breathlessness.
Why B is wrong. Being left alone increases fear and the sense of danger.
Why C is wrong. Detailed questioning during the attack adds to her distress and can wait until she has calmed.
Topic: Panic attack - immediate nursing response. Reference: NICE CG113 Generalised anxiety disorder and panic disorder in adults: management; Videbeck Psychiatric-Mental Health Nursing
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Frequently asked questions
DHA does not publish how many questions come from each topic. It lists four coverage headings for Registered Nurse with no weights. Meddex groups its questions into ten domains of its own.
No. They are original practice questions written by Meddex for exam preparation. DHA does not publish sample questions, and its Assessment Manual says sharing assessment questions is not allowed, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.