RN VATI Mental Health Assessment REDO
2026/2027: Complete Practice Questions
with Detailed Rationales
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-CLIENT
RELATIONSHIP (15-20%)
Q1: A nurse is performing an admission assessment for a client who appears withdrawn
and fearful. Which of the following actions should the nurse take first?
A. Ask the client why they are fearful
B. Inform the client that this admission is confidential
C. Reassure the client that everything will be okay
D. Proceed with the admission questions quickly
Correct Answer: B
Rationale:
● Why correct: According to evidence-based practice, the nurse should first inform
the client about confidentiality during the orientation phase of the nurse-client
relationship. This action establishes trust between the client and the nurse, which
in turn decreases the client's anxiety level.
● Distractor analysis:
○ A is incorrect because: Asking "why" is a non-therapeutic communication
technique that can make the client feel defensive
, ○ C is incorrect because: False reassurance is non-therapeutic and
dismisses the client's feelings
○ D is incorrect because: Rushing through questions increases anxiety and
does not establish rapport
● Nursing pearl: The orientation phase focuses on establishing trust, clarifying
roles, and discussing confidentiality before proceeding with assessment.
● Reference: Domain 1: Therapeutic Communication
Q2: A nurse is caring for an adolescent client who has anorexia nervosa. The client
states, "Have I done any permanent damage to my body?" Which of the following
responses should the nurse make?
A. "You shouldn't worry about that right now."
B. "Let's focus on getting you better instead."
C. "You're afraid you have caused physical injury to yourself?"
D. "I'll ask the provider to explain the long-term effects."
Correct Answer: C
Rationale:
● Why correct: This response uses therapeutic communication by repeating the
main idea of what the client has said (restatement), which allows for clarification
of any misunderstanding on the part of the client or the nurse. It validates the
client's concern and encourages further expression.
● Distractor analysis:
○ A is incorrect because: Dismissing the client's concern is non-therapeutic
○ B is incorrect because: Changing the subject avoids addressing the client's
fear
○ D is incorrect because: While referral is appropriate, the nurse should first
address the client's immediate concern
● Nursing pearl: Restatement and reflection are therapeutic techniques that
validate client concerns and encourage further communication.
, ● Reference: Domain 1: Therapeutic Communication
Q3: A client with borderline personality disorder tells the nurse, "You're the only nurse
who understands me. The other nurses are terrible." Which of the following responses is
most therapeutic?
A. "I'm glad you feel comfortable with me."
B. "You seem to be splitting the staff into good and bad."
C. "Tell me more about what makes the other nurses terrible."
D. "I will share your concerns with the other nurses."
Correct Answer: B
Rationale:
● Why correct: Clients with borderline personality disorder often use splitting
(viewing people as all good or all bad). The therapeutic response is to gently
point out this pattern without judgment, helping the client develop more
integrated thinking.
● Distractor analysis:
○ A is incorrect because: This reinforces the splitting behavior
○ C is incorrect because: This encourages the client to elaborate on splitting,
reinforcing the pattern
○ D is incorrect because: This may create conflict and does not address the
underlying issue
● Nursing pearl: Splitting is a defense mechanism common in borderline
personality disorder. Consistent limit setting, clear communication, and team
meetings to ensure consistent approaches are essential.
● Reference: Domain 1: Therapeutic Communication; Domain 8: Personality
Disorders
, Q4: A nurse is caring for a client who states, "I don't think I can handle this anymore."
Which of the following therapeutic communication techniques should the nurse use?
A. "I know exactly how you feel."
B. "You can't handle what anymore?"
C. "Things will get better soon."
D. "Have you talked to your family about this?"
Correct Answer: B
Rationale:
● Why correct: This response uses the therapeutic technique of clarification, which
helps the nurse understand the client's specific concern without making
assumptions. It encourages the client to elaborate on their feelings.
● Distractor analysis:
○ A is incorrect because: The nurse cannot know exactly how the client
feels; this is false empathy
○ C is incorrect because: False reassurance dismisses the client's current
distress
○ D is incorrect because: Changing the subject to family avoids exploring the
client's immediate concern
● Nursing pearl: Clarification ("What do you mean by...?" or "You can't handle
what?") helps ensure accurate understanding of the client's message.
● Reference: Domain 1: Therapeutic Communication
Q5: During the termination phase of the nurse-client relationship, a client states, "I don't
know how I'll manage without our weekly sessions." Which response demonstrates the
best therapeutic approach?
A. "You can always call me if you need to talk."
B. "We've accomplished a lot together, haven't we?"
2026/2027: Complete Practice Questions
with Detailed Rationales
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-CLIENT
RELATIONSHIP (15-20%)
Q1: A nurse is performing an admission assessment for a client who appears withdrawn
and fearful. Which of the following actions should the nurse take first?
A. Ask the client why they are fearful
B. Inform the client that this admission is confidential
C. Reassure the client that everything will be okay
D. Proceed with the admission questions quickly
Correct Answer: B
Rationale:
● Why correct: According to evidence-based practice, the nurse should first inform
the client about confidentiality during the orientation phase of the nurse-client
relationship. This action establishes trust between the client and the nurse, which
in turn decreases the client's anxiety level.
● Distractor analysis:
○ A is incorrect because: Asking "why" is a non-therapeutic communication
technique that can make the client feel defensive
, ○ C is incorrect because: False reassurance is non-therapeutic and
dismisses the client's feelings
○ D is incorrect because: Rushing through questions increases anxiety and
does not establish rapport
● Nursing pearl: The orientation phase focuses on establishing trust, clarifying
roles, and discussing confidentiality before proceeding with assessment.
● Reference: Domain 1: Therapeutic Communication
Q2: A nurse is caring for an adolescent client who has anorexia nervosa. The client
states, "Have I done any permanent damage to my body?" Which of the following
responses should the nurse make?
A. "You shouldn't worry about that right now."
B. "Let's focus on getting you better instead."
C. "You're afraid you have caused physical injury to yourself?"
D. "I'll ask the provider to explain the long-term effects."
Correct Answer: C
Rationale:
● Why correct: This response uses therapeutic communication by repeating the
main idea of what the client has said (restatement), which allows for clarification
of any misunderstanding on the part of the client or the nurse. It validates the
client's concern and encourages further expression.
● Distractor analysis:
○ A is incorrect because: Dismissing the client's concern is non-therapeutic
○ B is incorrect because: Changing the subject avoids addressing the client's
fear
○ D is incorrect because: While referral is appropriate, the nurse should first
address the client's immediate concern
● Nursing pearl: Restatement and reflection are therapeutic techniques that
validate client concerns and encourage further communication.
, ● Reference: Domain 1: Therapeutic Communication
Q3: A client with borderline personality disorder tells the nurse, "You're the only nurse
who understands me. The other nurses are terrible." Which of the following responses is
most therapeutic?
A. "I'm glad you feel comfortable with me."
B. "You seem to be splitting the staff into good and bad."
C. "Tell me more about what makes the other nurses terrible."
D. "I will share your concerns with the other nurses."
Correct Answer: B
Rationale:
● Why correct: Clients with borderline personality disorder often use splitting
(viewing people as all good or all bad). The therapeutic response is to gently
point out this pattern without judgment, helping the client develop more
integrated thinking.
● Distractor analysis:
○ A is incorrect because: This reinforces the splitting behavior
○ C is incorrect because: This encourages the client to elaborate on splitting,
reinforcing the pattern
○ D is incorrect because: This may create conflict and does not address the
underlying issue
● Nursing pearl: Splitting is a defense mechanism common in borderline
personality disorder. Consistent limit setting, clear communication, and team
meetings to ensure consistent approaches are essential.
● Reference: Domain 1: Therapeutic Communication; Domain 8: Personality
Disorders
, Q4: A nurse is caring for a client who states, "I don't think I can handle this anymore."
Which of the following therapeutic communication techniques should the nurse use?
A. "I know exactly how you feel."
B. "You can't handle what anymore?"
C. "Things will get better soon."
D. "Have you talked to your family about this?"
Correct Answer: B
Rationale:
● Why correct: This response uses the therapeutic technique of clarification, which
helps the nurse understand the client's specific concern without making
assumptions. It encourages the client to elaborate on their feelings.
● Distractor analysis:
○ A is incorrect because: The nurse cannot know exactly how the client
feels; this is false empathy
○ C is incorrect because: False reassurance dismisses the client's current
distress
○ D is incorrect because: Changing the subject to family avoids exploring the
client's immediate concern
● Nursing pearl: Clarification ("What do you mean by...?" or "You can't handle
what?") helps ensure accurate understanding of the client's message.
● Reference: Domain 1: Therapeutic Communication
Q5: During the termination phase of the nurse-client relationship, a client states, "I don't
know how I'll manage without our weekly sessions." Which response demonstrates the
best therapeutic approach?
A. "You can always call me if you need to talk."
B. "We've accomplished a lot together, haven't we?"
