Galen NUR 253 Exam 2 – Mental Health (2026)
Actual Questions and Answers (PDF), Exams of
Nursing
Section 1: Therapeutic Communication (Questions 1-75)
1. A nurse is sitting with a patient who is crying after receiving bad news. The
patient states, "I don't know how I'm going to get through this." Which
nursing response demonstrates the therapeutic communication technique of
reflection?
a) "You feel like you won't be able to get through this."
b) "Everything will be okay. You are strong."
c) "Why do you feel that way?"
d) "Let me tell you about resources that can help."
Answer: a) "You feel like you won't be able to get through this."
Rationale: Reflection involves repeating or paraphrasing the patient's
statement to show understanding and encourage further exploration. Option
A reflects the patient's expressed feeling. Option B is false reassurance;
option C is a "why" question that can be perceived as confrontational; option
D is giving advice.
2. Which therapeutic communication technique is being used when the
nurse says, "Tell me more about what happened after you lost your job?"
a) Focusing
b) Exploring
c) Clarifying
d) Summarizing
Answer: b) Exploring
Rationale: Exploring is used to gather more information about a topic the
patient has introduced. It encourages the patient to elaborate on a specific
area of concern. Focusing narrows the conversation; clarifying verifies
understanding; summarizing reviews key points.
,3. A patient with schizophrenia tells the nurse, "The voices are telling me to
hurt myself." Which response by the nurse is most therapeutic?
a) "I don't hear any voices. You are safe here."
b) "That must be very frightening. I am here with you."
c) "Ignore the voices. They aren't real."
d) "What are the voices telling you to do?"
Answer: b) "That must be very frightening. I am here with you."
Rationale: This response validates the patient's emotional experience (fear)
and offers presence. It does not challenge the hallucination directly (which
can increase anxiety) nor does it focus on the content in a way that might
reinforce it.
4. A patient states, "I think I'm going to die. No one can help me." Which
response by the nurse demonstrates empathy?
a) "I know exactly how you feel. I've been there."
b) "You feel like no one can help you, and that must be terrifying."
c) "You shouldn't think that way. There are people who can help."
d) "Why do you think no one can help you?"
Answer: b) "You feel like no one can help you, and that must be terrifying."
Rationale: Empathy involves understanding and reflecting the patient's
feelings without losing objectivity. Option B demonstrates empathy by
articulating the patient's perceived feeling. Option A is sympathy (over-
identification); option C is false reassurance; option D is a "why" question.
5. Which nursing statement is an example of offering self?
a) "I will sit with you for 15 minutes if you would like to talk."
b) "You should go to the day room to socialize."
c) "Tell me about your family."
d) "I noticed you were quiet at group today."
Answer: a) "I will sit with you for 15 minutes if you would like to talk."
Rationale: Offering self involves making oneself available to the patient,
showing willingness to spend time and listen. It conveys caring and
availability without imposing.
,6. A patient tells the nurse, "My husband is so controlling. He won't let me
have any friends." Which response by the nurse is an example of validation?
a) "That sounds like a difficult situation. Tell me more."
b) "Have you tried talking to him about how you feel?"
c) "You are angry because he doesn't allow you to have friends."
d) "Maybe he is just trying to protect you."
Answer: c) "You are angry because he doesn't allow you to have friends."
Rationale: Validation acknowledges and accepts the patient's feelings. By
stating the emotion (anger) and linking it to the patient's statement, the
nurse validates the patient's experience.
7. A nurse is communicating with a patient who is withdrawn and sitting
alone. Which statement is most likely to encourage interaction?
a) "Why are you sitting alone?"
b) "You seem quiet today. Would you like some company?"
c) "You should come to group therapy with the others."
d) "Is something wrong with you?"
Answer: b) "You seem quiet today. Would you like some company?"
Rationale: This response makes an observation (quiet) and offers a choice
(company). It respects the patient's autonomy while showing availability.
"Why" questions can feel accusatory; telling the patient what to do may
increase resistance.
8. A patient with bipolar disorder in the manic phase is talking rapidly and
jumping from topic to topic. Which nursing intervention is most
therapeutic?
a) Ask the patient to speak more slowly.
b) Use simple, concrete statements and set limits.
c) Engage in the rapid conversation to build rapport.
d) Walk away when the patient becomes too loud.
Answer: b) Use simple, concrete statements and set limits.
Rationale: During mania, patients have difficulty processing complex
information. Using simple, clear language and setting limits helps maintain
safety and communication without escalating agitation.
, 9. A patient tells the nurse, "I don't think I can go on anymore." Which
response demonstrates the therapeutic technique of clarifying?
a) "Are you thinking about suicide?"
b) "You feel like you can't go on. Can you tell me more about what that
means to you?"
c) "Don't say that. You have so much to live for."
d) "Let's focus on something positive."
Answer: b) "You feel like you can't go on. Can you tell me more about what
that means to you?"
Rationale: Clarifying seeks to understand the meaning behind the patient's
statement. The nurse reflects the statement and asks for elaboration to
ensure accurate understanding, which is essential before assessing suicide
risk directly.
10. Which communication technique is the nurse using when stating, "In the
past hour, we have discussed your fears about discharge and your plans for
follow-up care"?
a) Focusing
b) Restating
c) Summarizing
d) Reflecting
Answer: c) Summarizing
Rationale: Summarizing reviews the key points of a conversation, helping to
bring closure and ensure mutual understanding. It is often used at the end of
an interaction.
11. A patient states, "I am nothing. I have no purpose." Which response by the
nurse is most therapeutic?
a) "That's not true. You are a valuable person."
b) "Everyone has a purpose. You just need to find yours."
c) "You are feeling worthless right now. Tell me more about that."
d) "Why would you say something like that about yourself?"
Answer: c) "You are feeling worthless right now. Tell me more about that."
Rationale: This response validates the patient's feeling (worthlessness) and
Actual Questions and Answers (PDF), Exams of
Nursing
Section 1: Therapeutic Communication (Questions 1-75)
1. A nurse is sitting with a patient who is crying after receiving bad news. The
patient states, "I don't know how I'm going to get through this." Which
nursing response demonstrates the therapeutic communication technique of
reflection?
a) "You feel like you won't be able to get through this."
b) "Everything will be okay. You are strong."
c) "Why do you feel that way?"
d) "Let me tell you about resources that can help."
Answer: a) "You feel like you won't be able to get through this."
Rationale: Reflection involves repeating or paraphrasing the patient's
statement to show understanding and encourage further exploration. Option
A reflects the patient's expressed feeling. Option B is false reassurance;
option C is a "why" question that can be perceived as confrontational; option
D is giving advice.
2. Which therapeutic communication technique is being used when the
nurse says, "Tell me more about what happened after you lost your job?"
a) Focusing
b) Exploring
c) Clarifying
d) Summarizing
Answer: b) Exploring
Rationale: Exploring is used to gather more information about a topic the
patient has introduced. It encourages the patient to elaborate on a specific
area of concern. Focusing narrows the conversation; clarifying verifies
understanding; summarizing reviews key points.
,3. A patient with schizophrenia tells the nurse, "The voices are telling me to
hurt myself." Which response by the nurse is most therapeutic?
a) "I don't hear any voices. You are safe here."
b) "That must be very frightening. I am here with you."
c) "Ignore the voices. They aren't real."
d) "What are the voices telling you to do?"
Answer: b) "That must be very frightening. I am here with you."
Rationale: This response validates the patient's emotional experience (fear)
and offers presence. It does not challenge the hallucination directly (which
can increase anxiety) nor does it focus on the content in a way that might
reinforce it.
4. A patient states, "I think I'm going to die. No one can help me." Which
response by the nurse demonstrates empathy?
a) "I know exactly how you feel. I've been there."
b) "You feel like no one can help you, and that must be terrifying."
c) "You shouldn't think that way. There are people who can help."
d) "Why do you think no one can help you?"
Answer: b) "You feel like no one can help you, and that must be terrifying."
Rationale: Empathy involves understanding and reflecting the patient's
feelings without losing objectivity. Option B demonstrates empathy by
articulating the patient's perceived feeling. Option A is sympathy (over-
identification); option C is false reassurance; option D is a "why" question.
5. Which nursing statement is an example of offering self?
a) "I will sit with you for 15 minutes if you would like to talk."
b) "You should go to the day room to socialize."
c) "Tell me about your family."
d) "I noticed you were quiet at group today."
Answer: a) "I will sit with you for 15 minutes if you would like to talk."
Rationale: Offering self involves making oneself available to the patient,
showing willingness to spend time and listen. It conveys caring and
availability without imposing.
,6. A patient tells the nurse, "My husband is so controlling. He won't let me
have any friends." Which response by the nurse is an example of validation?
a) "That sounds like a difficult situation. Tell me more."
b) "Have you tried talking to him about how you feel?"
c) "You are angry because he doesn't allow you to have friends."
d) "Maybe he is just trying to protect you."
Answer: c) "You are angry because he doesn't allow you to have friends."
Rationale: Validation acknowledges and accepts the patient's feelings. By
stating the emotion (anger) and linking it to the patient's statement, the
nurse validates the patient's experience.
7. A nurse is communicating with a patient who is withdrawn and sitting
alone. Which statement is most likely to encourage interaction?
a) "Why are you sitting alone?"
b) "You seem quiet today. Would you like some company?"
c) "You should come to group therapy with the others."
d) "Is something wrong with you?"
Answer: b) "You seem quiet today. Would you like some company?"
Rationale: This response makes an observation (quiet) and offers a choice
(company). It respects the patient's autonomy while showing availability.
"Why" questions can feel accusatory; telling the patient what to do may
increase resistance.
8. A patient with bipolar disorder in the manic phase is talking rapidly and
jumping from topic to topic. Which nursing intervention is most
therapeutic?
a) Ask the patient to speak more slowly.
b) Use simple, concrete statements and set limits.
c) Engage in the rapid conversation to build rapport.
d) Walk away when the patient becomes too loud.
Answer: b) Use simple, concrete statements and set limits.
Rationale: During mania, patients have difficulty processing complex
information. Using simple, clear language and setting limits helps maintain
safety and communication without escalating agitation.
, 9. A patient tells the nurse, "I don't think I can go on anymore." Which
response demonstrates the therapeutic technique of clarifying?
a) "Are you thinking about suicide?"
b) "You feel like you can't go on. Can you tell me more about what that
means to you?"
c) "Don't say that. You have so much to live for."
d) "Let's focus on something positive."
Answer: b) "You feel like you can't go on. Can you tell me more about what
that means to you?"
Rationale: Clarifying seeks to understand the meaning behind the patient's
statement. The nurse reflects the statement and asks for elaboration to
ensure accurate understanding, which is essential before assessing suicide
risk directly.
10. Which communication technique is the nurse using when stating, "In the
past hour, we have discussed your fears about discharge and your plans for
follow-up care"?
a) Focusing
b) Restating
c) Summarizing
d) Reflecting
Answer: c) Summarizing
Rationale: Summarizing reviews the key points of a conversation, helping to
bring closure and ensure mutual understanding. It is often used at the end of
an interaction.
11. A patient states, "I am nothing. I have no purpose." Which response by the
nurse is most therapeutic?
a) "That's not true. You are a valuable person."
b) "Everyone has a purpose. You just need to find yours."
c) "You are feeling worthless right now. Tell me more about that."
d) "Why would you say something like that about yourself?"
Answer: c) "You are feeling worthless right now. Tell me more about that."
Rationale: This response validates the patient's feeling (worthlessness) and
