1
NURS 318 FOCUS ON MENTAL HEALTH EXAM QUESTIONS
AND ANSWERS WITH RATIONALES LATEST UPDATE 2025-26
SPECIFIC TO ACTUAL EXAM
1. A client says, “I have so much trouble caring for my husband’s
child from his first marriage. I resent the money we have to pay for
child support because we have to deprive my own child of things. How
can I stop feeling this way?” Which response by the nurse is
therapeutic?
A. “Your child benefits from having a sibling.”
B. “Have you shared your feelings with your husband?” Correct
C. “You need to take a second job to give your child what you
think she deserves.”
D. “I wonder why you married him, knowing that he wouldn’t
desert his biological child.”
Rationale: Remarried individuals often encounter problems as a result of the stressors they
bring into a marriage without prior discussion with the new partner.
Bonding sometimes does
not always occur when a child is not one’s biological offspring. The
correct answer is focused
on the client’s feelings. “Your child benefits from having a sibling” is not
facilitative. “I wonder
why you married him, knowing that he wouldn’t desert his biological
child” is incorrect
because it prejudges the client. “You need to take a second job to give
your child what you
think she deserves” is not open ended, does not facilitate feelings, and
,2
gives advice.
Test-Taking Strategy: Use your knowledge of therapeutic
communication techniques and
remember to focus on the client’s feelings. This will direct you to the
correct option.
Review: therapeutic communication techniques if you had difficulty
with this question.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Family Dynamics
Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., p. 27). St.
HESI Concepts: Communication, Developmental
Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
2.
A client who is hallucinating fearfully says to the nurse, “Please tell
that demon to get out.” How should the nurse respond to the
client?
A. “If you tell the demon to go away, it will.”
B. “I’ll stay here with you until the demon leaves your room.”
C. “If you return to bed, you will find that the demon will leave.”
D. “I know you must be very upset by this, but I don’t see a
,3
demon.” Correct Rationale: If the client hallucinates, it is best to
provide reality-based perceptions and not negate the client’s
experience, because this may lead to a regressive struggle with the
client. Giving advice or false reassurance is incorrect because such
techniques indicate that demons actually are present, which feeds
into the client’s hallucination and reinforces the client’s behavior.
Test-Taking Strategy: Use your knowledge of therapeutic
communication techniques, noting
, 4
that the client is hallucinating. Remember that it is most important to
maintain reality with the client. This will direct you to the correct
option.
Review: communication techniques for the client who is hallucinating
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Psychosis
HESI Concepts: Cognition, Communication
References: Stuart, G. (2013). Principles & practice of psychiatric
nursing (10th ed., pp. 25-29). St. Louis: Mosby.
Varcarolis, E. (2013). Essentials of Psychiatric Mental Health
Nursing: A communication approach to evidence-based care.
(revised reprint)) (2nd ed. p. 320). St. Louis: Saunders. Awarded
99.0 points out of 99.0 possible points.
3.
The mother of a 3-year-old says, “My child hit his teddy bear after
being scolded for picking the neighbors’ flowers.” The nurse should
explain the child is using which defense mechanism?
A. Projection
B. Sublimation
C. Displacement Correct
D. Identification
Rationale: The defense mechanism of displacement involves the
discharge of intense feelings
NURS 318 FOCUS ON MENTAL HEALTH EXAM QUESTIONS
AND ANSWERS WITH RATIONALES LATEST UPDATE 2025-26
SPECIFIC TO ACTUAL EXAM
1. A client says, “I have so much trouble caring for my husband’s
child from his first marriage. I resent the money we have to pay for
child support because we have to deprive my own child of things. How
can I stop feeling this way?” Which response by the nurse is
therapeutic?
A. “Your child benefits from having a sibling.”
B. “Have you shared your feelings with your husband?” Correct
C. “You need to take a second job to give your child what you
think she deserves.”
D. “I wonder why you married him, knowing that he wouldn’t
desert his biological child.”
Rationale: Remarried individuals often encounter problems as a result of the stressors they
bring into a marriage without prior discussion with the new partner.
Bonding sometimes does
not always occur when a child is not one’s biological offspring. The
correct answer is focused
on the client’s feelings. “Your child benefits from having a sibling” is not
facilitative. “I wonder
why you married him, knowing that he wouldn’t desert his biological
child” is incorrect
because it prejudges the client. “You need to take a second job to give
your child what you
think she deserves” is not open ended, does not facilitate feelings, and
,2
gives advice.
Test-Taking Strategy: Use your knowledge of therapeutic
communication techniques and
remember to focus on the client’s feelings. This will direct you to the
correct option.
Review: therapeutic communication techniques if you had difficulty
with this question.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Family Dynamics
Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., p. 27). St.
HESI Concepts: Communication, Developmental
Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
2.
A client who is hallucinating fearfully says to the nurse, “Please tell
that demon to get out.” How should the nurse respond to the
client?
A. “If you tell the demon to go away, it will.”
B. “I’ll stay here with you until the demon leaves your room.”
C. “If you return to bed, you will find that the demon will leave.”
D. “I know you must be very upset by this, but I don’t see a
,3
demon.” Correct Rationale: If the client hallucinates, it is best to
provide reality-based perceptions and not negate the client’s
experience, because this may lead to a regressive struggle with the
client. Giving advice or false reassurance is incorrect because such
techniques indicate that demons actually are present, which feeds
into the client’s hallucination and reinforces the client’s behavior.
Test-Taking Strategy: Use your knowledge of therapeutic
communication techniques, noting
, 4
that the client is hallucinating. Remember that it is most important to
maintain reality with the client. This will direct you to the correct
option.
Review: communication techniques for the client who is hallucinating
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Psychosis
HESI Concepts: Cognition, Communication
References: Stuart, G. (2013). Principles & practice of psychiatric
nursing (10th ed., pp. 25-29). St. Louis: Mosby.
Varcarolis, E. (2013). Essentials of Psychiatric Mental Health
Nursing: A communication approach to evidence-based care.
(revised reprint)) (2nd ed. p. 320). St. Louis: Saunders. Awarded
99.0 points out of 99.0 possible points.
3.
The mother of a 3-year-old says, “My child hit his teddy bear after
being scolded for picking the neighbors’ flowers.” The nurse should
explain the child is using which defense mechanism?
A. Projection
B. Sublimation
C. Displacement Correct
D. Identification
Rationale: The defense mechanism of displacement involves the
discharge of intense feelings
