NUR 253 Exams 1-4 mENtal HEaltH GalEN CollEGE of NURsiNG
aCtUal Exam 2026/2027 – ComplEtE Exam-stylE QUEstioNs witH
DEtailED RatioNalEs | pass GUaRaNtEED – a+ GRaDED
NUR 253 Exam 1: Foundations of Mental Health Nursing & Therapeutic Communication
(Questions 1-35)
1. A nurse is performing a mental status examination (MSE) on a client who is suspected
of having a cognitive disorder. Which of the following findings indicates the client is
experiencing clouded sensorium?
A. The client states, "I am the President of the United States."
B. The client is oriented to person, place, and time.
C. The client is drowsy and difficult to arouse.
D. The client exhibits rapid, pressured speech.
Answer: C
Rationale: Clouded sensorium refers to a state of reduced awareness or alertness,
where the client appears drowsy or obtunded and has difficulty maintaining focus.
Delusions (A) and pressured speech (D) relate to thought processes rather than level of
consciousness. Being fully oriented (B) indicates clear sensorium, whereas clouded
sensorium represents a deficit in the arousal component of consciousness.
---
2. A nurse is communicating with a client who has been admitted to the psychiatric unit.
Which of the following statements by the nurse is an example of a therapeutic
communication technique?
,A. "I think you should focus on getting better so you can go home."
B. "Why did you do that? It doesn't make sense."
C. "Can you tell me more about what happened when you arrived?"
D. "Don't worry, everyone here feels anxious sometimes."
Answer: C
Rationale: "Can you tell me more" is an open-ended question that encourages the client
to express feelings and thoughts. Option A gives advice (non-therapeutic). Option B
asks "why," which can sound accusatory. Option D offers false reassurance.
---
3. A client with major depressive disorder states, "I'm worthless. I can't do anything
right." Which response by the nurse is most therapeutic?
A. "You're not worthless; you have many positive qualities."
B. "Why do you feel worthless?"
C. "You feel that you cannot do anything right."
D. "Don't think that way; focus on your strengths."
Answer: C
Rationale: This response uses reflection, paraphrasing the client's feeling back to them.
It validates the emotion without agreeing or disagreeing. Option A offers false
reassurance; B asks "why"; D gives advice.
---
4. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself."
Which response is most appropriate?
, A. "I don't hear any voices. You must be hallucinating."
B. "That must be frightening. Do you have a plan to hurt yourself?"
C. "Try to ignore the voices. They are not real."
D. "Why do you think the voices are telling you that?"
Answer: B
Rationale: This response validates the client's feeling (frightening) and assesses safety
directly. Option A dismisses the experience; C gives advice that may not be feasible; D
asks "why," which is non-therapeutic.
---
5. A nurse is caring for a client who is experiencing a panic attack. Which intervention
should the nurse implement first?
A. Teach the client deep breathing exercises
B. Stay with the client and provide a quiet, low-stimulation environment
C. Administer a PRN benzodiazepine
D. Ask the client to describe the trigger for the panic attack
Answer: B
Rationale: During a panic attack, the priority is to ensure safety and reduce stimuli.
Staying with the client and providing a quiet environment helps de-escalate. Teaching
(A) is not effective during panic; medication (C) may be needed but is not first; exploring
triggers (D) is for after the attack.
---
6. A client states, "I don't want to take my medication anymore." The nurse replies, "You
don't want to take your medication?" This is an example of which therapeutic
technique?
aCtUal Exam 2026/2027 – ComplEtE Exam-stylE QUEstioNs witH
DEtailED RatioNalEs | pass GUaRaNtEED – a+ GRaDED
NUR 253 Exam 1: Foundations of Mental Health Nursing & Therapeutic Communication
(Questions 1-35)
1. A nurse is performing a mental status examination (MSE) on a client who is suspected
of having a cognitive disorder. Which of the following findings indicates the client is
experiencing clouded sensorium?
A. The client states, "I am the President of the United States."
B. The client is oriented to person, place, and time.
C. The client is drowsy and difficult to arouse.
D. The client exhibits rapid, pressured speech.
Answer: C
Rationale: Clouded sensorium refers to a state of reduced awareness or alertness,
where the client appears drowsy or obtunded and has difficulty maintaining focus.
Delusions (A) and pressured speech (D) relate to thought processes rather than level of
consciousness. Being fully oriented (B) indicates clear sensorium, whereas clouded
sensorium represents a deficit in the arousal component of consciousness.
---
2. A nurse is communicating with a client who has been admitted to the psychiatric unit.
Which of the following statements by the nurse is an example of a therapeutic
communication technique?
,A. "I think you should focus on getting better so you can go home."
B. "Why did you do that? It doesn't make sense."
C. "Can you tell me more about what happened when you arrived?"
D. "Don't worry, everyone here feels anxious sometimes."
Answer: C
Rationale: "Can you tell me more" is an open-ended question that encourages the client
to express feelings and thoughts. Option A gives advice (non-therapeutic). Option B
asks "why," which can sound accusatory. Option D offers false reassurance.
---
3. A client with major depressive disorder states, "I'm worthless. I can't do anything
right." Which response by the nurse is most therapeutic?
A. "You're not worthless; you have many positive qualities."
B. "Why do you feel worthless?"
C. "You feel that you cannot do anything right."
D. "Don't think that way; focus on your strengths."
Answer: C
Rationale: This response uses reflection, paraphrasing the client's feeling back to them.
It validates the emotion without agreeing or disagreeing. Option A offers false
reassurance; B asks "why"; D gives advice.
---
4. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself."
Which response is most appropriate?
, A. "I don't hear any voices. You must be hallucinating."
B. "That must be frightening. Do you have a plan to hurt yourself?"
C. "Try to ignore the voices. They are not real."
D. "Why do you think the voices are telling you that?"
Answer: B
Rationale: This response validates the client's feeling (frightening) and assesses safety
directly. Option A dismisses the experience; C gives advice that may not be feasible; D
asks "why," which is non-therapeutic.
---
5. A nurse is caring for a client who is experiencing a panic attack. Which intervention
should the nurse implement first?
A. Teach the client deep breathing exercises
B. Stay with the client and provide a quiet, low-stimulation environment
C. Administer a PRN benzodiazepine
D. Ask the client to describe the trigger for the panic attack
Answer: B
Rationale: During a panic attack, the priority is to ensure safety and reduce stimuli.
Staying with the client and providing a quiet environment helps de-escalate. Teaching
(A) is not effective during panic; medication (C) may be needed but is not first; exploring
triggers (D) is for after the attack.
---
6. A client states, "I don't want to take my medication anymore." The nurse replies, "You
don't want to take your medication?" This is an example of which therapeutic
technique?
