Psychiatric Mental Health Nursing Examination 2026/2027
Psychiatric Mental Health Nursing Practice & Therapeutic
Interventions Examination
2026/2027 Academic Year | 75 Questions with Correct Answers and Rationales | Already Graded A+ | 100%
Verified
Therapeutic Communication & Nurse-Patient Relationship Building
1. A nurse is interviewing a client diagnosed with generalized anxiety disorder (GAD). The client
says, “I can’t stop worrying about everything. My chest gets tight and I feel like I’m going to pass
out.” Which response by the nurse uses the therapeutic technique of restatement?
A. You are experiencing chest tightness and fear of fainting due to your constant worry.
B. I understand exactly what you are going through because anxiety is very common.
C. You should try deep breathing exercises when you feel that way.
D. Why do you think your anxiety has gotten worse recently?
Rationale: Restatement repeats the main idea of the client’s message in slightly different words,
demonstrating attentiveness and encouraging further exploration. Per the ANA Scope and Standards of
Psychiatric-Mental Health Nursing, restatement validates the client’s expressed concerns without
adding interpretation. Option B offers false reassurance, option C gives non-therapeutic advice, and
option D uses probing which may feel intrusive before rapport is established.
2. During a community mental health visit, a client with schizophrenia says, “The government has
implanted a chip in my brain to control my thoughts.” Which nursing response demonstrates the
therapeutic technique of focusing on the underlying emotion?
A. That is impossible. Microchips cannot be implanted in the brain that way.
B. It sounds like you are feeling frightened and powerless right now.
C. Can you tell me more details about how the chip was implanted?
D. Let’s focus on your medication compliance instead of these thoughts.
Rationale: This response redirects the conversation toward the client’s emotional experience (fear and
powerlessness) rather than the content of the delusion. The NCSBN NCLEX-RN Test Plan identifies
acknowledging feelings behind delusions as a therapeutic communication competency. Arguing with the
delusion (option A) increases mistrust, exploring content (option C) may reinforce it, and changing the
subject (option D) dismisses the client’s experience.
3. A nurse is facilitating a therapeutic group for clients with eating disorders. One client says,
“None of you understand how hard it is to recover. You’ve never been through this.” Which
response by the nurse best uses the technique of summarization?
A. We have all experienced pain in different ways. Please try to participate.
1
, Psychiatric Mental Health Nursing Examination 2026/2027
B. It seems like you feel isolated and believe others in the group cannot relate to the challenges
of recovery.
C. You are being resistant to treatment again, which is counterproductive.
D. Tell me specifically who you feel does not understand your situation.
Rationale: Summarization organizes and condenses the main points of what the client has expressed,
demonstrating active listening and helping the client see the pattern in their communication. This
technique is endorsed by the APA/ANA Psychiatric-Mental Health Nursing Standards. Option A
minimizes the client’s feelings, option C is judgmental and confrontational, and option D demands
specific information in an interrogating manner.
4. A nurse on the psychiatric unit is in the working phase of the therapeutic relationship with a
client who has major depressive disorder. The client suddenly becomes tearful after mentioning
their deceased spouse. Which therapeutic technique is most appropriate at this moment?
A. Using therapeutic silence to allow the client to process emotions
B. Immediately asking the client what specifically triggered the tears
C. Changing the subject to reduce emotional distress
D. Reassuring the client that everything will get better over time
Rationale: Therapeutic silence communicates acceptance, provides the client time to organize thoughts
and process emotions, and demonstrates the nurse’s presence and support. Hildegard Peplau’s
Interpersonal Theory identifies silence as a powerful therapeutic tool during emotionally charged
moments. The ANA standards emphasize that silence should not be confused with abandonment—the
nurse remains attentive and present. Asking probing questions, changing the subject, or providing false
reassurance would interrupt the client’s emotional processing.
5. A client with histrionic personality disorder frequently hugs the nurse and brings small gifts. The
nurse begins looking forward to the client’s visits and starts spending extra time with this client
while shortening visits with others. Which phenomenon is occurring?
A. Transference
B. Countertransference
C. Therapeutic boundary violation
D. Genuine therapeutic rapport
Rationale: Countertransference involves the nurse’s unconscious emotional reactions toward the client
that may affect professional judgment. The nurse’s preferential treatment and anticipation of visits
indicate personal feelings are influencing clinical care. The ANA Standards of Psychiatric-Mental
Health Nursing require clinical supervision when countertransference is identified. While transference
involves the client’s projected feelings, this scenario describes the nurse’s reaction. The behavior
described also constitutes a boundary violation.
2
, Psychiatric Mental Health Nursing Examination 2026/2027
6. Which nursing statement is an example of the non-therapeutic communication technique of
stereotyping?
A. It sounds like you are feeling overwhelmed by the treatment plan.
B. All teenagers go through mood swings. This is just a phase you will outgrow.
C. Can you describe what your anxiety feels like physically?
D. How have you been coping with your symptoms since the last session?
Rationale: Stereotyping assigns generalized characteristics to an individual based on group
membership, which invalidates the client’s unique experience. According to the NCSBN NCLEX-RN
Detailed Test Plan, stereotyping is a non-therapeutic communication technique that undermines the
therapeutic relationship. Options A, C, and D are all therapeutic: option A uses reflection, option C asks
for clarification, and option D encourages exploration of coping mechanisms.
7. A nurse is using the therapeutic technique of broad openings to begin a session with a client
diagnosed with social anxiety disorder. Which statement best demonstrates this technique?
A. Are you feeling anxious about anything specific today?
B. What would you like to talk about during our time together?
C. I noticed you were late again. What happened this time?
D. Your doctor wants me to ask you about your medication side effects.
Rationale: Broad openings allow the client to choose the topic of discussion, promoting autonomy and
self-direction in the therapeutic relationship. The APA/ANA Psychiatric-Mental Health Nursing
Standards identify broad openings as a technique that encourages the client to take initiative. Option A
is a closed-ended question, option C is confrontational, and option D focuses on institutional priorities
rather than the client’s needs.
8. A psychiatric-mental health nurse practitioner discloses personal information about their own
divorce to a client going through a similar experience. Which ethical principle has been
compromised?
A. Beneficence
B. Nonmaleficence
C. Professional boundary maintenance
D. Informed consent
Rationale: Self-disclosure of personal information shifts the focus from the client’s needs to the nurse’s
personal experience, blurring professional boundaries. The ANA Code of Ethics for Nurses states that
self-disclosure should be used sparingly and only when it directly benefits the client’s therapeutic goals.
Excessive self-disclosure can create role confusion, dependency, or reverse the therapeutic direction.
Beneficence (doing good) and nonmaleficence (doing no harm) are broader principles; informed consent
relates to treatment authorization.
Mental Status Examination & DSM-5-TR Diagnostic Criteria
3
Psychiatric Mental Health Nursing Practice & Therapeutic
Interventions Examination
2026/2027 Academic Year | 75 Questions with Correct Answers and Rationales | Already Graded A+ | 100%
Verified
Therapeutic Communication & Nurse-Patient Relationship Building
1. A nurse is interviewing a client diagnosed with generalized anxiety disorder (GAD). The client
says, “I can’t stop worrying about everything. My chest gets tight and I feel like I’m going to pass
out.” Which response by the nurse uses the therapeutic technique of restatement?
A. You are experiencing chest tightness and fear of fainting due to your constant worry.
B. I understand exactly what you are going through because anxiety is very common.
C. You should try deep breathing exercises when you feel that way.
D. Why do you think your anxiety has gotten worse recently?
Rationale: Restatement repeats the main idea of the client’s message in slightly different words,
demonstrating attentiveness and encouraging further exploration. Per the ANA Scope and Standards of
Psychiatric-Mental Health Nursing, restatement validates the client’s expressed concerns without
adding interpretation. Option B offers false reassurance, option C gives non-therapeutic advice, and
option D uses probing which may feel intrusive before rapport is established.
2. During a community mental health visit, a client with schizophrenia says, “The government has
implanted a chip in my brain to control my thoughts.” Which nursing response demonstrates the
therapeutic technique of focusing on the underlying emotion?
A. That is impossible. Microchips cannot be implanted in the brain that way.
B. It sounds like you are feeling frightened and powerless right now.
C. Can you tell me more details about how the chip was implanted?
D. Let’s focus on your medication compliance instead of these thoughts.
Rationale: This response redirects the conversation toward the client’s emotional experience (fear and
powerlessness) rather than the content of the delusion. The NCSBN NCLEX-RN Test Plan identifies
acknowledging feelings behind delusions as a therapeutic communication competency. Arguing with the
delusion (option A) increases mistrust, exploring content (option C) may reinforce it, and changing the
subject (option D) dismisses the client’s experience.
3. A nurse is facilitating a therapeutic group for clients with eating disorders. One client says,
“None of you understand how hard it is to recover. You’ve never been through this.” Which
response by the nurse best uses the technique of summarization?
A. We have all experienced pain in different ways. Please try to participate.
1
, Psychiatric Mental Health Nursing Examination 2026/2027
B. It seems like you feel isolated and believe others in the group cannot relate to the challenges
of recovery.
C. You are being resistant to treatment again, which is counterproductive.
D. Tell me specifically who you feel does not understand your situation.
Rationale: Summarization organizes and condenses the main points of what the client has expressed,
demonstrating active listening and helping the client see the pattern in their communication. This
technique is endorsed by the APA/ANA Psychiatric-Mental Health Nursing Standards. Option A
minimizes the client’s feelings, option C is judgmental and confrontational, and option D demands
specific information in an interrogating manner.
4. A nurse on the psychiatric unit is in the working phase of the therapeutic relationship with a
client who has major depressive disorder. The client suddenly becomes tearful after mentioning
their deceased spouse. Which therapeutic technique is most appropriate at this moment?
A. Using therapeutic silence to allow the client to process emotions
B. Immediately asking the client what specifically triggered the tears
C. Changing the subject to reduce emotional distress
D. Reassuring the client that everything will get better over time
Rationale: Therapeutic silence communicates acceptance, provides the client time to organize thoughts
and process emotions, and demonstrates the nurse’s presence and support. Hildegard Peplau’s
Interpersonal Theory identifies silence as a powerful therapeutic tool during emotionally charged
moments. The ANA standards emphasize that silence should not be confused with abandonment—the
nurse remains attentive and present. Asking probing questions, changing the subject, or providing false
reassurance would interrupt the client’s emotional processing.
5. A client with histrionic personality disorder frequently hugs the nurse and brings small gifts. The
nurse begins looking forward to the client’s visits and starts spending extra time with this client
while shortening visits with others. Which phenomenon is occurring?
A. Transference
B. Countertransference
C. Therapeutic boundary violation
D. Genuine therapeutic rapport
Rationale: Countertransference involves the nurse’s unconscious emotional reactions toward the client
that may affect professional judgment. The nurse’s preferential treatment and anticipation of visits
indicate personal feelings are influencing clinical care. The ANA Standards of Psychiatric-Mental
Health Nursing require clinical supervision when countertransference is identified. While transference
involves the client’s projected feelings, this scenario describes the nurse’s reaction. The behavior
described also constitutes a boundary violation.
2
, Psychiatric Mental Health Nursing Examination 2026/2027
6. Which nursing statement is an example of the non-therapeutic communication technique of
stereotyping?
A. It sounds like you are feeling overwhelmed by the treatment plan.
B. All teenagers go through mood swings. This is just a phase you will outgrow.
C. Can you describe what your anxiety feels like physically?
D. How have you been coping with your symptoms since the last session?
Rationale: Stereotyping assigns generalized characteristics to an individual based on group
membership, which invalidates the client’s unique experience. According to the NCSBN NCLEX-RN
Detailed Test Plan, stereotyping is a non-therapeutic communication technique that undermines the
therapeutic relationship. Options A, C, and D are all therapeutic: option A uses reflection, option C asks
for clarification, and option D encourages exploration of coping mechanisms.
7. A nurse is using the therapeutic technique of broad openings to begin a session with a client
diagnosed with social anxiety disorder. Which statement best demonstrates this technique?
A. Are you feeling anxious about anything specific today?
B. What would you like to talk about during our time together?
C. I noticed you were late again. What happened this time?
D. Your doctor wants me to ask you about your medication side effects.
Rationale: Broad openings allow the client to choose the topic of discussion, promoting autonomy and
self-direction in the therapeutic relationship. The APA/ANA Psychiatric-Mental Health Nursing
Standards identify broad openings as a technique that encourages the client to take initiative. Option A
is a closed-ended question, option C is confrontational, and option D focuses on institutional priorities
rather than the client’s needs.
8. A psychiatric-mental health nurse practitioner discloses personal information about their own
divorce to a client going through a similar experience. Which ethical principle has been
compromised?
A. Beneficence
B. Nonmaleficence
C. Professional boundary maintenance
D. Informed consent
Rationale: Self-disclosure of personal information shifts the focus from the client’s needs to the nurse’s
personal experience, blurring professional boundaries. The ANA Code of Ethics for Nurses states that
self-disclosure should be used sparingly and only when it directly benefits the client’s therapeutic goals.
Excessive self-disclosure can create role confusion, dependency, or reverse the therapeutic direction.
Beneficence (doing good) and nonmaleficence (doing no harm) are broader principles; informed consent
relates to treatment authorization.
Mental Status Examination & DSM-5-TR Diagnostic Criteria
3
