MH 701: Psychiatric-Mental Health Nursing
Foundations | Exam 2 Review | 2026/2027
50 Practice Questions with Correct Answers and Rationales
This Exam 2 Review document is designed for graduate nursing students enrolled in MH 701:
Psychiatric-Mental Health Nursing Foundations. The 50 multiple-choice practice questions cover the
major content domains tested on the mid-semester assessment, including therapeutic communication
and the nurse-patient relationship, psychiatric assessment and the mental status examination,
psychopathology foundations, introductory psychopharmacology and nursing implications,
legal/ethical foundations with safety planning and milieu therapy, and special populations with
evidence-based interventions. Each question is accompanied by the correct answer (highlighted in cyan)
and a concise rationale to support exam preparation and clinical reasoning development.
Therapeutic Communication & Nurse-Patient Relationship (Q1–Q12)
1. A patient diagnosed with major depressive disorder tells the nurse, "I just feel like everything is
hopeless. Nothing will ever get better." Which response by the nurse is most therapeutic?
A. "I understand how you feel. I went through a tough time myself last year."
B. "You shouldn't feel that way. Many people have it much worse than you do."
C. "It sounds like you're feeling a deep sense of hopelessness right now. Can you tell me
more about what has been happening?"
D. "Don't worry — everything will work out fine in the end."
Rationale: Reflection and open-ended questioning invite the patient to elaborate on their feelings,
which is the essence of therapeutic communication. Option A uses cross-cultural self-disclosure that
redirects focus to the nurse. Option B minimizes and invalidates the patient's experience. Option D
provides false reassurance and closes the door to further exploration.
2. Which statement by the nurse best demonstrates active listening during a psychiatric interview?
A. "I hear that you've been having difficulty sleeping. Tell me what your nights have been
like."
B. "I need to ask you several questions from this assessment form before our time is up."
C. "That must be really hard for you. I'm sure things will improve soon."
D. "You really should try to get more exercise — it would help with your mood."
Rationale: Active listening involves attending to the patient's verbal and nonverbal cues, then
reflecting the content back to encourage deeper exploration. Option A restates what was heard and
invites elaboration. Option B is task-focused rather than patient-centered. Option C offers false
reassurance, and option D gives unsolicited advice — both are nontherapeutic.
1
,3. A patient with a history of childhood abuse becomes tearful during a therapy session and then
abruptly says, "I don't want to talk about this anymore." Which nursing response best demonstrates
the therapeutic use of silence?
A. "That's okay. We don't have to talk about it if you're not ready."
B. Remain present, maintain eye contact, and allow a pause before gently asking, "Would
you like to take a moment, or would you prefer to shift to something else for now?"
C. "I think it's important that we push through this so you can heal."
D. "Why do you always shut down when things get emotional?"
Rationale: Therapeutic silence conveys presence and respect for the patient's pace. The nurse
remains engaged and offers the patient control over the direction of the conversation. Prematurely
closing the topic (A), forcing the patient to continue (C), or challenging their coping (D) all violate
therapeutic communication principles.
4. A nurse on an inpatient psychiatric unit receives a Facebook friend request from a former patient
who was discharged 3 months ago. Which action is most appropriate?
A. Accept the request because the patient has been discharged and the therapeutic relationship has
ended
B. Decline the request and explain to the patient that maintaining professional boundaries
on social media is important for their care and recovery
C. Accept the request but restrict the patient from seeing personal posts
D. Ignore the request and do not respond
Rationale: Professional boundaries extend beyond discharge. Social media contact with former
patients can create dual relationships, compromise objectivity, and blur professional roles. The nurse
should decline and provide a brief, respectful explanation. Ignoring the request does not model
healthy communication or provide closure.
5. A patient diagnosed with borderline personality disorder tells the nurse, "You're the only one who
truly understands me. I saved your phone number so I can text you whenever I need you." Which
nursing response best maintains professional boundaries?
A. "I appreciate that you trust me, but our relationship is professional. If you need support
after hours, please call the crisis line or 988."
B. "That's fine — you can text me whenever you need to talk."
C. "I'll give you my personal email address instead."
D. "You shouldn't rely on anyone. You need to learn to handle things on your own."
Rationale: Patients with borderline personality disorder may test boundaries through idealization
and attempts at personal contact. The nurse must clearly maintain professional limits while offering
appropriate alternatives for support. Giving personal contact information (B, C) creates a dual
relationship. Telling the patient to handle things alone (D) is dismissive and unhelpful.
2
, 6. During a therapy session, a patient becomes angry and shouts, "You're just like my mother —
always telling me what to do!" The nurse recognizes this as which phenomenon?
A. Countertransference
B. Transference
C. Resistance
D. Dissociation
Rationale: Transference occurs when a patient unconsciously redirects feelings about a significant
person from their past onto the therapist or nurse. The patient is projecting feelings about their
mother onto the nurse. Countertransference involves the nurse's unconscious emotional reaction to
the patient based on the nurse's own past experiences.
7. A nurse working with a patient who was abandoned by her father finds herself unusually protective
of the patient, staying past her shift and bringing the patient extra items. The nurse recognizes this as
which phenomenon?
A. Transference
B. Countertransference
C. Empathy
D. Advocacy
Rationale: Countertransference occurs when the nurse's own unresolved feelings, experiences, or
needs influence the therapeutic relationship. The nurse's overinvolvement and protective behaviors
suggest unconscious feelings triggered by the patient's history, which may relate to the nurse's own
experiences. Recognizing and seeking supervision for countertransference is essential for maintaining
therapeutic boundaries.
8. A patient states, "I've been having these thoughts that won't go away. They're intrusive and they
scare me." Which response by the nurse best uses clarification?
A. "Everyone has scary thoughts sometimes. Don't worry about it."
B. "Can you describe what you mean by 'intrusive thoughts'? I want to make sure I
understand what you're experiencing."
C. "You probably just need to distract yourself with something positive."
D. "How long have you been seeing a therapist for this issue?"
Rationale: Clarification is a therapeutic technique in which the nurse asks the patient to explain or
elaborate on ambiguous statements to ensure accurate understanding. Option B uses clarification
effectively while conveying genuine interest. Option A minimizes, option C gives advice, and option D
changes the subject — all are nontherapeutic.
9. A patient says to the nurse, "I don't know why I'm even here. Nobody cares about what happens to
me." Which response by the nurse avoids the nontherapeutic technique of giving false reassurance?
3
Foundations | Exam 2 Review | 2026/2027
50 Practice Questions with Correct Answers and Rationales
This Exam 2 Review document is designed for graduate nursing students enrolled in MH 701:
Psychiatric-Mental Health Nursing Foundations. The 50 multiple-choice practice questions cover the
major content domains tested on the mid-semester assessment, including therapeutic communication
and the nurse-patient relationship, psychiatric assessment and the mental status examination,
psychopathology foundations, introductory psychopharmacology and nursing implications,
legal/ethical foundations with safety planning and milieu therapy, and special populations with
evidence-based interventions. Each question is accompanied by the correct answer (highlighted in cyan)
and a concise rationale to support exam preparation and clinical reasoning development.
Therapeutic Communication & Nurse-Patient Relationship (Q1–Q12)
1. A patient diagnosed with major depressive disorder tells the nurse, "I just feel like everything is
hopeless. Nothing will ever get better." Which response by the nurse is most therapeutic?
A. "I understand how you feel. I went through a tough time myself last year."
B. "You shouldn't feel that way. Many people have it much worse than you do."
C. "It sounds like you're feeling a deep sense of hopelessness right now. Can you tell me
more about what has been happening?"
D. "Don't worry — everything will work out fine in the end."
Rationale: Reflection and open-ended questioning invite the patient to elaborate on their feelings,
which is the essence of therapeutic communication. Option A uses cross-cultural self-disclosure that
redirects focus to the nurse. Option B minimizes and invalidates the patient's experience. Option D
provides false reassurance and closes the door to further exploration.
2. Which statement by the nurse best demonstrates active listening during a psychiatric interview?
A. "I hear that you've been having difficulty sleeping. Tell me what your nights have been
like."
B. "I need to ask you several questions from this assessment form before our time is up."
C. "That must be really hard for you. I'm sure things will improve soon."
D. "You really should try to get more exercise — it would help with your mood."
Rationale: Active listening involves attending to the patient's verbal and nonverbal cues, then
reflecting the content back to encourage deeper exploration. Option A restates what was heard and
invites elaboration. Option B is task-focused rather than patient-centered. Option C offers false
reassurance, and option D gives unsolicited advice — both are nontherapeutic.
1
,3. A patient with a history of childhood abuse becomes tearful during a therapy session and then
abruptly says, "I don't want to talk about this anymore." Which nursing response best demonstrates
the therapeutic use of silence?
A. "That's okay. We don't have to talk about it if you're not ready."
B. Remain present, maintain eye contact, and allow a pause before gently asking, "Would
you like to take a moment, or would you prefer to shift to something else for now?"
C. "I think it's important that we push through this so you can heal."
D. "Why do you always shut down when things get emotional?"
Rationale: Therapeutic silence conveys presence and respect for the patient's pace. The nurse
remains engaged and offers the patient control over the direction of the conversation. Prematurely
closing the topic (A), forcing the patient to continue (C), or challenging their coping (D) all violate
therapeutic communication principles.
4. A nurse on an inpatient psychiatric unit receives a Facebook friend request from a former patient
who was discharged 3 months ago. Which action is most appropriate?
A. Accept the request because the patient has been discharged and the therapeutic relationship has
ended
B. Decline the request and explain to the patient that maintaining professional boundaries
on social media is important for their care and recovery
C. Accept the request but restrict the patient from seeing personal posts
D. Ignore the request and do not respond
Rationale: Professional boundaries extend beyond discharge. Social media contact with former
patients can create dual relationships, compromise objectivity, and blur professional roles. The nurse
should decline and provide a brief, respectful explanation. Ignoring the request does not model
healthy communication or provide closure.
5. A patient diagnosed with borderline personality disorder tells the nurse, "You're the only one who
truly understands me. I saved your phone number so I can text you whenever I need you." Which
nursing response best maintains professional boundaries?
A. "I appreciate that you trust me, but our relationship is professional. If you need support
after hours, please call the crisis line or 988."
B. "That's fine — you can text me whenever you need to talk."
C. "I'll give you my personal email address instead."
D. "You shouldn't rely on anyone. You need to learn to handle things on your own."
Rationale: Patients with borderline personality disorder may test boundaries through idealization
and attempts at personal contact. The nurse must clearly maintain professional limits while offering
appropriate alternatives for support. Giving personal contact information (B, C) creates a dual
relationship. Telling the patient to handle things alone (D) is dismissive and unhelpful.
2
, 6. During a therapy session, a patient becomes angry and shouts, "You're just like my mother —
always telling me what to do!" The nurse recognizes this as which phenomenon?
A. Countertransference
B. Transference
C. Resistance
D. Dissociation
Rationale: Transference occurs when a patient unconsciously redirects feelings about a significant
person from their past onto the therapist or nurse. The patient is projecting feelings about their
mother onto the nurse. Countertransference involves the nurse's unconscious emotional reaction to
the patient based on the nurse's own past experiences.
7. A nurse working with a patient who was abandoned by her father finds herself unusually protective
of the patient, staying past her shift and bringing the patient extra items. The nurse recognizes this as
which phenomenon?
A. Transference
B. Countertransference
C. Empathy
D. Advocacy
Rationale: Countertransference occurs when the nurse's own unresolved feelings, experiences, or
needs influence the therapeutic relationship. The nurse's overinvolvement and protective behaviors
suggest unconscious feelings triggered by the patient's history, which may relate to the nurse's own
experiences. Recognizing and seeking supervision for countertransference is essential for maintaining
therapeutic boundaries.
8. A patient states, "I've been having these thoughts that won't go away. They're intrusive and they
scare me." Which response by the nurse best uses clarification?
A. "Everyone has scary thoughts sometimes. Don't worry about it."
B. "Can you describe what you mean by 'intrusive thoughts'? I want to make sure I
understand what you're experiencing."
C. "You probably just need to distract yourself with something positive."
D. "How long have you been seeing a therapist for this issue?"
Rationale: Clarification is a therapeutic technique in which the nurse asks the patient to explain or
elaborate on ambiguous statements to ensure accurate understanding. Option B uses clarification
effectively while conveying genuine interest. Option A minimizes, option C gives advice, and option D
changes the subject — all are nontherapeutic.
9. A patient says to the nurse, "I don't know why I'm even here. Nobody cares about what happens to
me." Which response by the nurse avoids the nontherapeutic technique of giving false reassurance?
3
