1
NCLEX-PN Mental Health Nursing Test Bank,
2026–2027 Edition, 150 NGN Questions with
Complete Rationales
A+ Guaranteed Pass
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-PATIENT
RELATIONSHIP
(Questions 1-25)
Q1. A 34-year-old client with major depressive disorder is sitting alone in the day room, staring out
the window. When the PN approaches, the client states, "Nobody cares about me. My family would
be better off without me." Which response by the PN demonstrates therapeutic communication?
A. "Your family loves you very much. You shouldn't think that way."
B. "Tell me more about what makes you feel your family would be better off without you."
[CORRECT]
C. "Have you thought about hurting yourself?"
D. "Many people feel this way when they're depressed. You'll feel better soon."
Correct Answer: B
Rationale: This response uses the therapeutic technique of exploration/facilitation to encourage
the client to express feelings and concerns without judgment. Option A is nontherapeutic because it
offers false reassurance and minimizes feelings. Option C, while assessing suicide risk, interrupts
, 2
the therapeutic flow and shifts focus abruptly; risk assessment should follow exploration. Option D
offers false reassurance and clichés, which block communication. The nurse must first understand
the client's perspective before intervening.
Q2. A 28-year-old client with borderline personality disorder becomes angry during a group
session and shouts, "You're all against me! The nurses hate me too!" Which response by the PN is
most therapeutic?
A. "I don't hate you. Let's discuss this calmly."
B. "You're being inappropriate. Please lower your voice."
C. "You seem very angry right now. Can you tell me what triggered these feelings?" [CORRECT]
D. "Other clients are uncomfortable with your behavior."
Correct Answer: C
Rationale: This response validates the client's emotion while setting boundaries through
redirecting to specific feelings. It demonstrates empathy without accepting the projection. Option A
becomes defensive and argumentative. Option B is authoritarian and may escalate agitation. Option
D uses "putting on notice" (bringing in third party), which increases paranoia and defensiveness in
clients with BPD. Validation + limit setting = therapeutic approach.
Q3. A 67-year-old client with dementia repeatedly asks, "Where is my wife? When is she coming?"
The wife died 3 years ago. Which response by the PN demonstrates the therapeutic principle of
validation therapy?
A. "Your wife passed away 3 years ago. Don't you remember?"
B. "Let's talk about something else. Would you like some tea?"
C. "You miss your wife very much. Tell me about her." [CORRECT]
D. "She'll be here soon. Don't worry."
, 3
Correct Answer: C
Rationale: Validation therapy acknowledges the emotional truth behind the statement without
confronting the cognitive deficit. The emotion (missing wife) is real even if the facts are confused.
Option A confronts reality, causing distress and potential catastrophic reaction. Option B blocks
communication through diversion. Option D provides false reassurance, which destroys trust when
the wife doesn't appear. Validation preserves dignity and reduces agitation.
Q4. A 19-year-old client with anorexia nervosa states, "I'm so fat. I can't eat anything or I'll gain
weight." Which response demonstrates the therapeutic technique of clarification?
A. "You're not fat. You're underweight according to your chart."
B. "You see yourself as fat even though others don't. Help me understand what 'fat' means to you."
[CORRECT]
C. "Let's discuss your meal plan instead."
D. "I understand how you feel. Body image is hard for many people."
Correct Answer: B
Rationale: Clarification seeks to understand the client's frame of reference and checks the
meaning of words. This response explores the cognitive distortion without arguing or agreeing.
Option A argues with the delusional body image perception, creating resistance. Option C blocks
communication by changing the subject. Option D uses false understanding ("I understand") and
cliché, which minimizes the client's unique experience. Body image distortion requires exploration,
not contradiction.
Q5. A 45-year-old client with schizophrenia tells the PN, "The voices are telling me to hurt myself."
Which is the PN's priority nursing action?
, 4
A. Ask the client to describe the voices in detail
B. Assess immediate suicide risk and implement safety measures [CORRECT]
C. Administer PRN antipsychotic medication immediately
D. Document the statement and continue with routine care
Correct Answer: B
Rationale: Safety is the priority when command hallucinations involve self-harm. The PN must
assess: specificity of plan, means availability, intent, and protective factors. Option A gathers data
but delays safety intervention. Option C may be appropriate later but requires assessment first and
MD order. Option D ignores the immediate safety threat. The NGN Clinical Judgment Model
prioritizes recognizing cues (command hallucinations) → analyzing (suicide risk) → prioritizing
(safety action).
Q6. [SATA - Select All That Apply] A PN is caring for a 52-year-old client with major depression who
states, "I have nothing to live for." Which nursing actions demonstrate therapeutic communication?
(Select all that apply.)
A. Sitting with the client in silence for several minutes
B. Asking "Why do you feel that way?"
C. Stating "You feel hopeless right now"
D. Offering advice about coping strategies that helped other clients
E. Encouraging the client to participate in group activities
Correct Answers: A, C
Rationale: A demonstrates nonverbal therapeutic presence—silence can convey acceptance and
allow emotional processing. C uses reflection of feeling, validating the emotional state. B uses
"why" questions which put clients on the defensive and imply judgment. D offers advice
(nontherapeutic) and compares to others (minimizing). E blocks immediate feelings by pushing
activity before addressing the emotional content. Therapeutic communication requires being with
the client before doing for the client.
NCLEX-PN Mental Health Nursing Test Bank,
2026–2027 Edition, 150 NGN Questions with
Complete Rationales
A+ Guaranteed Pass
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-PATIENT
RELATIONSHIP
(Questions 1-25)
Q1. A 34-year-old client with major depressive disorder is sitting alone in the day room, staring out
the window. When the PN approaches, the client states, "Nobody cares about me. My family would
be better off without me." Which response by the PN demonstrates therapeutic communication?
A. "Your family loves you very much. You shouldn't think that way."
B. "Tell me more about what makes you feel your family would be better off without you."
[CORRECT]
C. "Have you thought about hurting yourself?"
D. "Many people feel this way when they're depressed. You'll feel better soon."
Correct Answer: B
Rationale: This response uses the therapeutic technique of exploration/facilitation to encourage
the client to express feelings and concerns without judgment. Option A is nontherapeutic because it
offers false reassurance and minimizes feelings. Option C, while assessing suicide risk, interrupts
, 2
the therapeutic flow and shifts focus abruptly; risk assessment should follow exploration. Option D
offers false reassurance and clichés, which block communication. The nurse must first understand
the client's perspective before intervening.
Q2. A 28-year-old client with borderline personality disorder becomes angry during a group
session and shouts, "You're all against me! The nurses hate me too!" Which response by the PN is
most therapeutic?
A. "I don't hate you. Let's discuss this calmly."
B. "You're being inappropriate. Please lower your voice."
C. "You seem very angry right now. Can you tell me what triggered these feelings?" [CORRECT]
D. "Other clients are uncomfortable with your behavior."
Correct Answer: C
Rationale: This response validates the client's emotion while setting boundaries through
redirecting to specific feelings. It demonstrates empathy without accepting the projection. Option A
becomes defensive and argumentative. Option B is authoritarian and may escalate agitation. Option
D uses "putting on notice" (bringing in third party), which increases paranoia and defensiveness in
clients with BPD. Validation + limit setting = therapeutic approach.
Q3. A 67-year-old client with dementia repeatedly asks, "Where is my wife? When is she coming?"
The wife died 3 years ago. Which response by the PN demonstrates the therapeutic principle of
validation therapy?
A. "Your wife passed away 3 years ago. Don't you remember?"
B. "Let's talk about something else. Would you like some tea?"
C. "You miss your wife very much. Tell me about her." [CORRECT]
D. "She'll be here soon. Don't worry."
, 3
Correct Answer: C
Rationale: Validation therapy acknowledges the emotional truth behind the statement without
confronting the cognitive deficit. The emotion (missing wife) is real even if the facts are confused.
Option A confronts reality, causing distress and potential catastrophic reaction. Option B blocks
communication through diversion. Option D provides false reassurance, which destroys trust when
the wife doesn't appear. Validation preserves dignity and reduces agitation.
Q4. A 19-year-old client with anorexia nervosa states, "I'm so fat. I can't eat anything or I'll gain
weight." Which response demonstrates the therapeutic technique of clarification?
A. "You're not fat. You're underweight according to your chart."
B. "You see yourself as fat even though others don't. Help me understand what 'fat' means to you."
[CORRECT]
C. "Let's discuss your meal plan instead."
D. "I understand how you feel. Body image is hard for many people."
Correct Answer: B
Rationale: Clarification seeks to understand the client's frame of reference and checks the
meaning of words. This response explores the cognitive distortion without arguing or agreeing.
Option A argues with the delusional body image perception, creating resistance. Option C blocks
communication by changing the subject. Option D uses false understanding ("I understand") and
cliché, which minimizes the client's unique experience. Body image distortion requires exploration,
not contradiction.
Q5. A 45-year-old client with schizophrenia tells the PN, "The voices are telling me to hurt myself."
Which is the PN's priority nursing action?
, 4
A. Ask the client to describe the voices in detail
B. Assess immediate suicide risk and implement safety measures [CORRECT]
C. Administer PRN antipsychotic medication immediately
D. Document the statement and continue with routine care
Correct Answer: B
Rationale: Safety is the priority when command hallucinations involve self-harm. The PN must
assess: specificity of plan, means availability, intent, and protective factors. Option A gathers data
but delays safety intervention. Option C may be appropriate later but requires assessment first and
MD order. Option D ignores the immediate safety threat. The NGN Clinical Judgment Model
prioritizes recognizing cues (command hallucinations) → analyzing (suicide risk) → prioritizing
(safety action).
Q6. [SATA - Select All That Apply] A PN is caring for a 52-year-old client with major depression who
states, "I have nothing to live for." Which nursing actions demonstrate therapeutic communication?
(Select all that apply.)
A. Sitting with the client in silence for several minutes
B. Asking "Why do you feel that way?"
C. Stating "You feel hopeless right now"
D. Offering advice about coping strategies that helped other clients
E. Encouraging the client to participate in group activities
Correct Answers: A, C
Rationale: A demonstrates nonverbal therapeutic presence—silence can convey acceptance and
allow emotional processing. C uses reflection of feeling, validating the emotional state. B uses
"why" questions which put clients on the defensive and imply judgment. D offers advice
(nontherapeutic) and compares to others (minimizing). E blocks immediate feelings by pushing
activity before addressing the emotional content. Therapeutic communication requires being with
the client before doing for the client.
