PSYCHIATRIC MENTAL HEALTH NURSING EXAM – RN-LEVEL
PRACTICE QUESTIONS & CLINICAL REVIEW (NCLEX/ATI/HESI)
All Answers are in RED
Major Study Keywords: Psychiatric mental health nursing exam, RN psych nursing questions, NCLEX psychiatric nursing review, therapeutic communication
techniques, nursing care for bipolar disorder, schizophrenia nursing interventions, ATI psych nursing study guide, HESI psychiatric exam prep, mental health
nursing test bank, crisis intervention and mental status exam.
1. A patient with a diagnosis of major depression who has attenpted suicide says to the nurse, "I should
have died. I've always been a failure. Nothing ever goes right for me." Which response demonstrates
therapeutic communication?
a. "You have everything to live for"
b. "Why do you see yourself as a failiure?"
c. "Feeling like this is all part of being depressed."
d. "You've been feeling like a failure for a while?"
(D) "You've been feeling like a failure for a while?"
RATIONALE: Responding to the feelings expressed by a patient is an effective therapeutic communication
technique. The correct option is an example of the use of restating. The remaining options block communication
because they minimize the patient's experience and do not facilitate exploration of the patient's expressed
feelings. In additions, use of the word "why" is nontherapeutic.
2. When the community health nurse visits a patient at home, the patitent states, "I haven't slept at all the
last cople of nights. Which response by the nurse illustrates a therapeutic communication response to this
patient."
a. "I see."
b. "Really?"
c. "You're having difficulty sleeping?"
d. "Sometimes, I have trouble sleeping too."
(C) "You're having difficulty sleeping?"
RATIONALE: The correct option uses the therapeutic communication technique of restatement. Although
restatement is a technique that has a prompting component to it, it repeats the patients major theme, which
assists the nurse to obtain a more specific perception of the problem from the patient. The remaining options are
not therapeutic responses since none encourage the patient to expand on the problem. Offering personal
experiences moves the focus away from the patient and onto the nurse.
3. A patient experiencing disturbed thought processes believes that his food is being poisoned. Which
communication technique should the use to encourage the patient to eat?
a. Using open-ended questions and silence
b. Sharing personal prefernce regarding food choices
c. Documenting reasons why the patient does not wat to eat
d. Offering opinions about the necessity of adequate nutrition
,(A) Using open-ended questions and silence
RATIONALE: Open-ended questions and silence are strategies use to encourage patients to discuss their
problems. Sharing personal food preferences is not a patient-centered intervention. The remaining options are
not helpful to the patient because they do not encourage the patient to express feelings. The nurse should not
offer opinions and should encourage the patient to identify the reasons for the behavior.
4. A patient admitted to a nental health unit for treatment of psychotic behavior spends hours at teh
locked exit door shouting. "Let me out. Ther's nothing wrong with me. I don't belong here." What
defense mechanism is the patient implementing?
a. Denial
b. Projection
c Regression
d. Rationalization
(A) Denial
RATIONALE: Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In
projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other
persons, objects, or situations. Regression allows the patient to return to an ealier, more comforting, although
less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings
by developing acceptable explanations that satisfy the teller and the listener.
5. A patient diagnosed with terminal cancer says to the nurse "I'm going ot die, and I wish my family
would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's
dying." Which response by the nurse is therapeutic?
a. "Have you shared your feelings with your family?"
b. "I think we should talk more about your anger with your family."
c. "You're feeling angry that your family continues to hope for you to be cured?"
d. "You are probably very depressed, which is understanble with such a diagnosis"
(C) "You're feeling angry that your family continues to hope for you to be cured?"
RATIONALE: Restating is a therapeutic communication technique in which the nurse repeats what the patient
says to show understanding and to review what was said. While it is appropriate for the nurse to attempt to
assess the patient's ability to discuss feelings openly with family members, it does not help the patient discuss
the feelings causing the anger. The nurse's attempt to focus on the central issue of anger is premature. The nurse
would never make a judgment regarding the reason for the patient's feeing, this is non-therapeutic in the one-to-
one relationship.
6. On review of the patients record, the nurse notes the admission was voluntary. Based on this
information, the nurse anticipates which patient behavior?
a. Fearfulness regarding treatment measures.
b. Anger and agressiveness directed toward others.
c. An understanding of the pathology and syptoms of the diagnosis
d. A willingness to participte in the planning of the care and treatment plan
(D) A willingness to participate in the planning of the care and treatment plan
RATIONALE: In general, patients seek voluntary admission. If a patient seeks voluntary admission, the most
likely expectations is the patient will participate in the treatment program since they are actively seeking help.
The remaining options are not characteristics of this type of admission. Fearfulness, anger, and aggressiveness
, are more characteristic of an involuntary admission. Voluntary admission does not guarantee a patients
understanding of their illness, only of their desire for help.
7. A patient admitted voluntarily for treatment of an anxiety disorder demands to be released from the
hospital. Which action shoul dthe nurse take INITIALLY?
a. Contact the patients health care provider (HCP)
b. Call the patients family to arrange for transportations.
c. Attempt to persuade the pationt to stay "for only a few more days"
d. Tell the patient tha tleaving would likely result in an involuntary commitment
(A) Contact the patients health care provider (HCP)
RATIONALE: In general, patients seek, voluntary admission. Voluntary patients have the right to demand and
obtain release. The nurse needs ot be familiar with the state and facility policies and procedures. The best
nursing action is to contact the HCP, who has the authority to discuss discharge with the patient. While
arranging for safe transportation is appropriate it is premature in this situation and should be done only with the
patients' permission. While it is appropriate to discuss why the patient feels the need to leave and the possible
outcomes of leaving against medical advice, attempting to get the patient to agree to staying "a few more days"
has little value and will not likely be successful. Many states require that the patient submit a written release
notice to the facility staff members, who reevaluate the patient's condition for possible conversion to
involuntary status if necessary, according to criteria established by law. While this is a possibility, it should not
be used as a threat to the patient.
8. When reviewing the admission assessment, the nurse notes that a patient was admitted to the mental
health unity involuntarily. Based on this type of admission, the nurse should provide which intervention
for this patient?
a. Monitor closely for harm to self or others
b. Assist in completing an applicaiont for admission
c. Supply the patient with written information about their mental illness
d. Provide an opprotunity fo the family to discuss why they felt the admission was needed
(A) Monitor closely for harm to self or others
RATIONALE: Involuntary admission is necessary when a person is a danger to self or others or is in need of
psychiatric treatment regardless of the patient's willingness to consent to the hospitalization. A written request is
a component of a voluntary admission. Providing written information regarding the illness is likely premature
initially. The family may have had no role to play in the patients' admission.
9. The nurse is preparing a patient for the termination phase of the nurse-patient relationship. The nurse
prepares to implement which nursing task that is MOST APPROPRIATE for this phase?
a. Planning short-term goals
b. Making appropriate referrals
c. Developing realistic solutions
d. Identifying expected outcomes
(B) Making appropriate referrals
RATIONALE: Tasks of the termination phase include evaluating patient performance, evaluating achievement
of expected out-comes, evaluating future needs, making appropriate referrals and dealing with the common
behaviors associated with termination. The remaining options identify tasks appropriate for the working phase
of the relationship.
PRACTICE QUESTIONS & CLINICAL REVIEW (NCLEX/ATI/HESI)
All Answers are in RED
Major Study Keywords: Psychiatric mental health nursing exam, RN psych nursing questions, NCLEX psychiatric nursing review, therapeutic communication
techniques, nursing care for bipolar disorder, schizophrenia nursing interventions, ATI psych nursing study guide, HESI psychiatric exam prep, mental health
nursing test bank, crisis intervention and mental status exam.
1. A patient with a diagnosis of major depression who has attenpted suicide says to the nurse, "I should
have died. I've always been a failure. Nothing ever goes right for me." Which response demonstrates
therapeutic communication?
a. "You have everything to live for"
b. "Why do you see yourself as a failiure?"
c. "Feeling like this is all part of being depressed."
d. "You've been feeling like a failure for a while?"
(D) "You've been feeling like a failure for a while?"
RATIONALE: Responding to the feelings expressed by a patient is an effective therapeutic communication
technique. The correct option is an example of the use of restating. The remaining options block communication
because they minimize the patient's experience and do not facilitate exploration of the patient's expressed
feelings. In additions, use of the word "why" is nontherapeutic.
2. When the community health nurse visits a patient at home, the patitent states, "I haven't slept at all the
last cople of nights. Which response by the nurse illustrates a therapeutic communication response to this
patient."
a. "I see."
b. "Really?"
c. "You're having difficulty sleeping?"
d. "Sometimes, I have trouble sleeping too."
(C) "You're having difficulty sleeping?"
RATIONALE: The correct option uses the therapeutic communication technique of restatement. Although
restatement is a technique that has a prompting component to it, it repeats the patients major theme, which
assists the nurse to obtain a more specific perception of the problem from the patient. The remaining options are
not therapeutic responses since none encourage the patient to expand on the problem. Offering personal
experiences moves the focus away from the patient and onto the nurse.
3. A patient experiencing disturbed thought processes believes that his food is being poisoned. Which
communication technique should the use to encourage the patient to eat?
a. Using open-ended questions and silence
b. Sharing personal prefernce regarding food choices
c. Documenting reasons why the patient does not wat to eat
d. Offering opinions about the necessity of adequate nutrition
,(A) Using open-ended questions and silence
RATIONALE: Open-ended questions and silence are strategies use to encourage patients to discuss their
problems. Sharing personal food preferences is not a patient-centered intervention. The remaining options are
not helpful to the patient because they do not encourage the patient to express feelings. The nurse should not
offer opinions and should encourage the patient to identify the reasons for the behavior.
4. A patient admitted to a nental health unit for treatment of psychotic behavior spends hours at teh
locked exit door shouting. "Let me out. Ther's nothing wrong with me. I don't belong here." What
defense mechanism is the patient implementing?
a. Denial
b. Projection
c Regression
d. Rationalization
(A) Denial
RATIONALE: Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In
projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other
persons, objects, or situations. Regression allows the patient to return to an ealier, more comforting, although
less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings
by developing acceptable explanations that satisfy the teller and the listener.
5. A patient diagnosed with terminal cancer says to the nurse "I'm going ot die, and I wish my family
would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's
dying." Which response by the nurse is therapeutic?
a. "Have you shared your feelings with your family?"
b. "I think we should talk more about your anger with your family."
c. "You're feeling angry that your family continues to hope for you to be cured?"
d. "You are probably very depressed, which is understanble with such a diagnosis"
(C) "You're feeling angry that your family continues to hope for you to be cured?"
RATIONALE: Restating is a therapeutic communication technique in which the nurse repeats what the patient
says to show understanding and to review what was said. While it is appropriate for the nurse to attempt to
assess the patient's ability to discuss feelings openly with family members, it does not help the patient discuss
the feelings causing the anger. The nurse's attempt to focus on the central issue of anger is premature. The nurse
would never make a judgment regarding the reason for the patient's feeing, this is non-therapeutic in the one-to-
one relationship.
6. On review of the patients record, the nurse notes the admission was voluntary. Based on this
information, the nurse anticipates which patient behavior?
a. Fearfulness regarding treatment measures.
b. Anger and agressiveness directed toward others.
c. An understanding of the pathology and syptoms of the diagnosis
d. A willingness to participte in the planning of the care and treatment plan
(D) A willingness to participate in the planning of the care and treatment plan
RATIONALE: In general, patients seek voluntary admission. If a patient seeks voluntary admission, the most
likely expectations is the patient will participate in the treatment program since they are actively seeking help.
The remaining options are not characteristics of this type of admission. Fearfulness, anger, and aggressiveness
, are more characteristic of an involuntary admission. Voluntary admission does not guarantee a patients
understanding of their illness, only of their desire for help.
7. A patient admitted voluntarily for treatment of an anxiety disorder demands to be released from the
hospital. Which action shoul dthe nurse take INITIALLY?
a. Contact the patients health care provider (HCP)
b. Call the patients family to arrange for transportations.
c. Attempt to persuade the pationt to stay "for only a few more days"
d. Tell the patient tha tleaving would likely result in an involuntary commitment
(A) Contact the patients health care provider (HCP)
RATIONALE: In general, patients seek, voluntary admission. Voluntary patients have the right to demand and
obtain release. The nurse needs ot be familiar with the state and facility policies and procedures. The best
nursing action is to contact the HCP, who has the authority to discuss discharge with the patient. While
arranging for safe transportation is appropriate it is premature in this situation and should be done only with the
patients' permission. While it is appropriate to discuss why the patient feels the need to leave and the possible
outcomes of leaving against medical advice, attempting to get the patient to agree to staying "a few more days"
has little value and will not likely be successful. Many states require that the patient submit a written release
notice to the facility staff members, who reevaluate the patient's condition for possible conversion to
involuntary status if necessary, according to criteria established by law. While this is a possibility, it should not
be used as a threat to the patient.
8. When reviewing the admission assessment, the nurse notes that a patient was admitted to the mental
health unity involuntarily. Based on this type of admission, the nurse should provide which intervention
for this patient?
a. Monitor closely for harm to self or others
b. Assist in completing an applicaiont for admission
c. Supply the patient with written information about their mental illness
d. Provide an opprotunity fo the family to discuss why they felt the admission was needed
(A) Monitor closely for harm to self or others
RATIONALE: Involuntary admission is necessary when a person is a danger to self or others or is in need of
psychiatric treatment regardless of the patient's willingness to consent to the hospitalization. A written request is
a component of a voluntary admission. Providing written information regarding the illness is likely premature
initially. The family may have had no role to play in the patients' admission.
9. The nurse is preparing a patient for the termination phase of the nurse-patient relationship. The nurse
prepares to implement which nursing task that is MOST APPROPRIATE for this phase?
a. Planning short-term goals
b. Making appropriate referrals
c. Developing realistic solutions
d. Identifying expected outcomes
(B) Making appropriate referrals
RATIONALE: Tasks of the termination phase include evaluating patient performance, evaluating achievement
of expected out-comes, evaluating future needs, making appropriate referrals and dealing with the common
behaviors associated with termination. The remaining options identify tasks appropriate for the working phase
of the relationship.
