PSYCHIATRIC-MENTAL HEALTH
NURSING
NCLEX-Style Practice Exam | 2026/2027 | 100
Questions
100 Questions and Correct Answers with Rationales
NCLEX-RN Psychosocial Integrity Domain Focus
Comprehensive Psychiatric Nursing Assessment for NCLEX Preparation
,Table of Contents
Section I: Therapeutic Communication & Nurse-Patient Relationship (Q1–Q16) — 16 Questions
Section II: Psychopathology & Mental Status Assessment (Q17–Q40) — 24 Questions
Section III: Psychopharmacology & Nursing Implications (Q41–Q62) — 22 Questions
Section IV: Crisis Intervention, Legal/Ethical Standards & Milieu Therapy (Q63–Q82) — 20 Questions
Section V: Special Populations, Evidence-Based Interventions & Test Strategies (Q83–Q100) — 18
Questions
Quick Reference Table: Key Psychiatric Parameters
,Section I: Therapeutic Communication & Nurse-Patient
Relationship (Q1–Q16)
Question 1
A patient diagnosed with major depressive disorder says to the nurse, “Nobody cares about me. I am
completely alone.” Which response by the nurse demonstrates the therapeutic communication technique
of reflection?
A. A) “I care about you, and the staff here wants to help you get better.”
B. B) “You are feeling very lonely and like no one understands what you are going
through.”
C. C) “Can you tell me more about who in your life makes you feel alone?”
D. D) “It sounds like you are experiencing hopelessness. Have you had thoughts of harming
yourself?”
Correct Answer: B. B) “You are feeling very lonely and like no one understands what you
are going through.”
Rationale: Reflection directs back to the patient the feelings and meaning implicit in what the patient said.
Option B restates the underlying emotion (feeling alone and uncared for) without adding new content,
validating the patient’s experience and encouraging further expression. Option A provides false reassurance
and focuses on the nurse rather than the patient. Option C uses an open-ended question, which is
therapeutic but is clarification, not reflection. Option D pivots to a safety assessment, which is clinically
important but does not demonstrate reflection.
Question 2
A patient with schizophrenia who is experiencing auditory hallucinations becomes agitated and shouts,
“Stop it! Leave me alone!” Which nursing response best uses the technique of clarification?
A. A) “Please calm down. There is no one here but us.”
B. B) “I notice you are very upset. Are you hearing voices right now?”
C. C) “I can see you are frightened. When you say ‘leave me alone,’ do you mean the voices
you hear?”
D. D) “It must be scary to hear things that others cannot hear. Would you like medication?”
, Correct Answer: C. C) “I can see you are frightened. When you say ‘leave me alone,’ do you
mean the voices you hear?”
Rationale: Clarification involves restating the patient’s message to verify understanding. Option C checks
the nurse’s interpretation of the patient’s behavior and verbalization by linking the observed agitation and
verbal content to a possible cause (auditory hallucinations), then asking for confirmation. Option A uses
reality orientation that may escalate agitation by invalidating the patient’s experience. Option B is more of
an observation combined with a direct question. Option D offers empathy and a solution before fully
understanding the patient’s experience, which does not qualify as clarification.
Question 3
A nurse is caring for a patient who was recently admitted for suicidal ideation. The patient says, “I do not
want to talk about anything today.” Which therapeutic response is most appropriate?
A. A) “That is okay. Sometimes silence can be healing. I will sit here with you.”
B. B) “It is important that we talk so we can develop your safety plan.”
C. C) “Why do you not want to talk? Sharing your feelings is part of recovery.”
D. D) “I understand you are upset, but avoidance will not help you get better.”
Correct Answer: A. A) “That is okay. Sometimes silence can be healing. I will sit here with
you.”
Rationale: Therapeutic use of silence is a recognized communication technique in psychiatric nursing.
Respecting the patient’s wish while remaining available communicates acceptance, patience, and
unconditional positive regard. Forcing conversation (Option B) fails to respect patient autonomy and may
increase resistance. Asking “why” (Option C) can feel interrogative and judgmental. Option D uses a
confrontational, non-therapeutic approach that implies blame. The NCLEX-RN test plan emphasizes the
psychosocial integrity domain’s focus on therapeutic communication that respects patient readiness.
Question 4
During an admission interview, a patient diagnosed with borderline personality disorder says to the nurse,
“You are the only one who truly understands me. The other nurses are cold and uncaring.” Which nursing
response is most therapeutic?
A. A) “Thank you for saying that. I try my best for all my patients.”
NURSING
NCLEX-Style Practice Exam | 2026/2027 | 100
Questions
100 Questions and Correct Answers with Rationales
NCLEX-RN Psychosocial Integrity Domain Focus
Comprehensive Psychiatric Nursing Assessment for NCLEX Preparation
,Table of Contents
Section I: Therapeutic Communication & Nurse-Patient Relationship (Q1–Q16) — 16 Questions
Section II: Psychopathology & Mental Status Assessment (Q17–Q40) — 24 Questions
Section III: Psychopharmacology & Nursing Implications (Q41–Q62) — 22 Questions
Section IV: Crisis Intervention, Legal/Ethical Standards & Milieu Therapy (Q63–Q82) — 20 Questions
Section V: Special Populations, Evidence-Based Interventions & Test Strategies (Q83–Q100) — 18
Questions
Quick Reference Table: Key Psychiatric Parameters
,Section I: Therapeutic Communication & Nurse-Patient
Relationship (Q1–Q16)
Question 1
A patient diagnosed with major depressive disorder says to the nurse, “Nobody cares about me. I am
completely alone.” Which response by the nurse demonstrates the therapeutic communication technique
of reflection?
A. A) “I care about you, and the staff here wants to help you get better.”
B. B) “You are feeling very lonely and like no one understands what you are going
through.”
C. C) “Can you tell me more about who in your life makes you feel alone?”
D. D) “It sounds like you are experiencing hopelessness. Have you had thoughts of harming
yourself?”
Correct Answer: B. B) “You are feeling very lonely and like no one understands what you
are going through.”
Rationale: Reflection directs back to the patient the feelings and meaning implicit in what the patient said.
Option B restates the underlying emotion (feeling alone and uncared for) without adding new content,
validating the patient’s experience and encouraging further expression. Option A provides false reassurance
and focuses on the nurse rather than the patient. Option C uses an open-ended question, which is
therapeutic but is clarification, not reflection. Option D pivots to a safety assessment, which is clinically
important but does not demonstrate reflection.
Question 2
A patient with schizophrenia who is experiencing auditory hallucinations becomes agitated and shouts,
“Stop it! Leave me alone!” Which nursing response best uses the technique of clarification?
A. A) “Please calm down. There is no one here but us.”
B. B) “I notice you are very upset. Are you hearing voices right now?”
C. C) “I can see you are frightened. When you say ‘leave me alone,’ do you mean the voices
you hear?”
D. D) “It must be scary to hear things that others cannot hear. Would you like medication?”
, Correct Answer: C. C) “I can see you are frightened. When you say ‘leave me alone,’ do you
mean the voices you hear?”
Rationale: Clarification involves restating the patient’s message to verify understanding. Option C checks
the nurse’s interpretation of the patient’s behavior and verbalization by linking the observed agitation and
verbal content to a possible cause (auditory hallucinations), then asking for confirmation. Option A uses
reality orientation that may escalate agitation by invalidating the patient’s experience. Option B is more of
an observation combined with a direct question. Option D offers empathy and a solution before fully
understanding the patient’s experience, which does not qualify as clarification.
Question 3
A nurse is caring for a patient who was recently admitted for suicidal ideation. The patient says, “I do not
want to talk about anything today.” Which therapeutic response is most appropriate?
A. A) “That is okay. Sometimes silence can be healing. I will sit here with you.”
B. B) “It is important that we talk so we can develop your safety plan.”
C. C) “Why do you not want to talk? Sharing your feelings is part of recovery.”
D. D) “I understand you are upset, but avoidance will not help you get better.”
Correct Answer: A. A) “That is okay. Sometimes silence can be healing. I will sit here with
you.”
Rationale: Therapeutic use of silence is a recognized communication technique in psychiatric nursing.
Respecting the patient’s wish while remaining available communicates acceptance, patience, and
unconditional positive regard. Forcing conversation (Option B) fails to respect patient autonomy and may
increase resistance. Asking “why” (Option C) can feel interrogative and judgmental. Option D uses a
confrontational, non-therapeutic approach that implies blame. The NCLEX-RN test plan emphasizes the
psychosocial integrity domain’s focus on therapeutic communication that respects patient readiness.
Question 4
During an admission interview, a patient diagnosed with borderline personality disorder says to the nurse,
“You are the only one who truly understands me. The other nurses are cold and uncaring.” Which nursing
response is most therapeutic?
A. A) “Thank you for saying that. I try my best for all my patients.”
