NUR 253 Mental Health Nursing Exam 1 Actual Exam
2026/2027 | Comprehensive Practice Review with
Detailed Rationales | Pass Guaranteed – A+ Graded
SECTION 1: Foundations of Psychiatric Nursing (Questions 1–8)
Q1: During the orientation phase of the therapeutic relationship, a patient asks the
nurse, "Can I call you at home if I need to talk?" Which response by the nurse is MOST
appropriate?
A. "Of course, here's my number. I want you to feel supported."
B. "Let's discuss appropriate boundaries and how you can reach help when I'm not here."
C. "I only give my number to patients I've known for a long time."
D. "You shouldn't need to call me at home if our sessions are effective."
Correct Answer: B
Rationale: Correct because the orientation phase requires establishing clear boundaries
and clarifying expectations for the professional relationship; explaining appropriate
channels for support maintains therapeutic structure while addressing the patient's
need for connection; giving a personal number (A) blurs professional boundaries; (C) is
judgmental and arbitrary; (D) dismisses the patient's concern.
,Q2: A patient states, "I'm so anxious about my surgery tomorrow." The nurse responds,
"Don't worry, everything will be fine. The doctors here are the best." This response is an
example of which non-therapeutic communication technique?
A. Advising
B. Giving approval
C. Providing false reassurance
D. Changing the subject
Correct Answer: C
Rationale: Correct because reassuring a patient that "everything will be fine" minimizes
their feelings and offers false reassurance, which is non-therapeutic; the statement
dismisses the patient's anxiety rather than exploring it; advising (A) would involve telling
the patient what to do; giving approval (B) would be praising; changing the subject (D)
would shift to a different topic.
Q3: A patient with a history of childhood sexual abuse becomes visibly uncomfortable
when the nurse gently touches their shoulder to offer comfort. Which action should the
nurse take?
A. Explain that touch is a normal part of nursing care
B. Immediately withdraw and avoid all physical contact indefinitely
C. Apologize, withdraw the touch, and assess the meaning of touch for this patient
D. Continue the touch while explaining it is therapeutic
Correct Answer: C
,Rationale: Correct because touch must be used cautiously and its meaning assessed
individually; patients with histories of abuse may experience touch as threatening; the
nurse should acknowledge the discomfort, withdraw, and explore the patient's
perspective; defending touch as "normal" (A) or continuing it (D) disregards the patient's
trauma response; avoiding all contact forever (B) is unnecessarily rigid.
Q4: A nurse finds herself feeling unusually angry and frustrated with a patient who
reminds her of her estranged father. The nurse recognizes this as:
A. Transference
B. Countertransference
C. Projection
D. Displacement
Correct Answer: B
Rationale: Correct because countertransference occurs when the nurse projects
personal feelings from past relationships onto the patient; transference (A) is when the
patient projects onto the nurse; projection (C) is attributing one's own unacceptable
feelings to another; displacement (D) is shifting feelings to a safer target; recognizing
countertransference requires self-awareness and seeking supervision.
Q5: A patient says, "I don't know why I'm here. There's nothing wrong with me. I can
handle my drinking on my own." This statement BEST exemplifies which defense
mechanism?
A. Repression
, B. Rationalization
C. Denial
D. Intellectualization
Correct Answer: C
Rationale: Correct because denial is the refusal to acknowledge reality or the existence
of a problem; the patient refuses to accept that their drinking is problematic despite
being hospitalized; rationalization (B) would involve making excuses; intellectualization
(D) would focus on facts to avoid emotions; repression (A) is unconscious forgetting of
traumatic material.
Q6: During a therapeutic conversation, a patient says, "My wife left me, I lost my job, and
now I'm here." The nurse responds, "You've experienced multiple significant losses
recently." This is an example of:
A. Restating
B. Reflecting
C. Summarizing
D. Validating
Correct Answer: A
Rationale: Correct because restating involves repeating the patient's main message in
similar words to show understanding and encourage elaboration; reflecting (B) would
focus on the emotional content; summarizing (C) occurs at the end of a conversation to
review key points; validating (D) would affirm the legitimacy of the patient's feelings.
2026/2027 | Comprehensive Practice Review with
Detailed Rationales | Pass Guaranteed – A+ Graded
SECTION 1: Foundations of Psychiatric Nursing (Questions 1–8)
Q1: During the orientation phase of the therapeutic relationship, a patient asks the
nurse, "Can I call you at home if I need to talk?" Which response by the nurse is MOST
appropriate?
A. "Of course, here's my number. I want you to feel supported."
B. "Let's discuss appropriate boundaries and how you can reach help when I'm not here."
C. "I only give my number to patients I've known for a long time."
D. "You shouldn't need to call me at home if our sessions are effective."
Correct Answer: B
Rationale: Correct because the orientation phase requires establishing clear boundaries
and clarifying expectations for the professional relationship; explaining appropriate
channels for support maintains therapeutic structure while addressing the patient's
need for connection; giving a personal number (A) blurs professional boundaries; (C) is
judgmental and arbitrary; (D) dismisses the patient's concern.
,Q2: A patient states, "I'm so anxious about my surgery tomorrow." The nurse responds,
"Don't worry, everything will be fine. The doctors here are the best." This response is an
example of which non-therapeutic communication technique?
A. Advising
B. Giving approval
C. Providing false reassurance
D. Changing the subject
Correct Answer: C
Rationale: Correct because reassuring a patient that "everything will be fine" minimizes
their feelings and offers false reassurance, which is non-therapeutic; the statement
dismisses the patient's anxiety rather than exploring it; advising (A) would involve telling
the patient what to do; giving approval (B) would be praising; changing the subject (D)
would shift to a different topic.
Q3: A patient with a history of childhood sexual abuse becomes visibly uncomfortable
when the nurse gently touches their shoulder to offer comfort. Which action should the
nurse take?
A. Explain that touch is a normal part of nursing care
B. Immediately withdraw and avoid all physical contact indefinitely
C. Apologize, withdraw the touch, and assess the meaning of touch for this patient
D. Continue the touch while explaining it is therapeutic
Correct Answer: C
,Rationale: Correct because touch must be used cautiously and its meaning assessed
individually; patients with histories of abuse may experience touch as threatening; the
nurse should acknowledge the discomfort, withdraw, and explore the patient's
perspective; defending touch as "normal" (A) or continuing it (D) disregards the patient's
trauma response; avoiding all contact forever (B) is unnecessarily rigid.
Q4: A nurse finds herself feeling unusually angry and frustrated with a patient who
reminds her of her estranged father. The nurse recognizes this as:
A. Transference
B. Countertransference
C. Projection
D. Displacement
Correct Answer: B
Rationale: Correct because countertransference occurs when the nurse projects
personal feelings from past relationships onto the patient; transference (A) is when the
patient projects onto the nurse; projection (C) is attributing one's own unacceptable
feelings to another; displacement (D) is shifting feelings to a safer target; recognizing
countertransference requires self-awareness and seeking supervision.
Q5: A patient says, "I don't know why I'm here. There's nothing wrong with me. I can
handle my drinking on my own." This statement BEST exemplifies which defense
mechanism?
A. Repression
, B. Rationalization
C. Denial
D. Intellectualization
Correct Answer: C
Rationale: Correct because denial is the refusal to acknowledge reality or the existence
of a problem; the patient refuses to accept that their drinking is problematic despite
being hospitalized; rationalization (B) would involve making excuses; intellectualization
(D) would focus on facts to avoid emotions; repression (A) is unconscious forgetting of
traumatic material.
Q6: During a therapeutic conversation, a patient says, "My wife left me, I lost my job, and
now I'm here." The nurse responds, "You've experienced multiple significant losses
recently." This is an example of:
A. Restating
B. Reflecting
C. Summarizing
D. Validating
Correct Answer: A
Rationale: Correct because restating involves repeating the patient's main message in
similar words to show understanding and encourage elaboration; reflecting (B) would
focus on the emotional content; summarizing (C) occurs at the end of a conversation to
review key points; validating (D) would affirm the legitimacy of the patient's feelings.
