1|Page
NCLEX Mental Health Exam:
Comprehensive Study Guide with Complete
Questions and Correct Detailed Answers for
Psychiatric Nursing, Covering Therapeutic
Communication, Substance Use Disorders,
and Mental Health Interventions.
A client with a diagnosis of major depression who has attempted 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?
1.) "You have everything to live for"
2.) "Why do you see yourself as a failure?"
3.) "Feeling like this is all part of being depressed"
4.) "You've been feeling like a failure for a while?"
Answer: 4.) "youve been been feeling like a failure for a while?"
Use of restating is an effective therapeutic communication technique for
responding to the feelings of the patient.
When the community health nurse visits a client at home, the client states, "I
haven't slept at all the last couple of nights." Which response by the nurse
illustrates a therapeutic communication response to this client?
1.) "I see"
2.) "Really?"
3.) "You're having difficulty sleeping?"
4.) "Sometimes, I have trouble sleeping too"
,2|Page
Answer: 3.) "You're having difficulty sleeping?"
Restating
A client experiencing disturbed thought processes believes that his food is being
poisoned. Which communication technique should the nurse use to encourage the
client to eat?
1.) using open-ended questions and silence
2.) sharing personal preference regarding food choices
3.) documenting reasons why the client does not want to eat
4.) offering opinions about the necessity of adequate nutrition
Answer: 1.) using open-ended questions and silence
A client admitted to a mental health unit for treatment of psychotic behavior
spends hours at the locked exit door shouting, " Let me out. There's nothing wrong
with me. I don't belong here." What defense mechanism is the client
implementing?
1.) Denial
2.) Projection
3.) Regression
4.) Rationalization
Answer: 1.) Denial
A client diagnosed with terminal cancer says to the nurse, " I'm going to die and I
wish my family would stop hoping for a cure! I get so angry when they carry on
,3|Page
like this. After all, I'm the one who's dying." Which response by the nurse is
therapeutic?
1.) " Have you shared your feelings with your family."
2.) "I think we should talk more about your anger with your family"
3.) "You're feeling angry that your family continues to hope for you to be cured?"
4.) "You are probably very depressed, which is understandable with such a
diagnosis."
Answer: 3.) "You're feeling angry that your family continues to hope for you to be
cured?"
Restating
On review of the client's record, the nurse notes that the admission was voluntary.
Based on this information, the nurse anticipates which client behavior?
1.) fearfulness regarding treatment measures
2.) anger and aggressiveness directed toward others
3.) an understanding of the pathology and symptoms of the diagnosis
4.) a willingness to participate in the planning of the care and treatment plan
Answer: 4.) a willingness to participate in the planning of the care and treatment
plan
A client admitted voluntarily for treatment of an anxiety disorder demands to be
released from the hospital. Which action should the nurse take initially?
1.) Contact the client's HCP
2.) Call the client's family to arrange for transportation
, 4|Page
3.) Attempt to persuade the client to stay "for only a few more days"
4.) Tell the client that leaving would likely result in an voluntary commitment
Answer: 1.) Contact the client's HCP
The FIRAT INITIAL action would be to call the HCP because they are the only
one who can initiate/sign off on a discharge
The client with a major depressive disorder taking the selective serotonin reuptake
inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling
confused and restless and having an elevated temperature. Which action should the
psychiatric nurse take?
1. Determine if the client has flulike symptoms
2. Instruct the client to stop taking the SSRI
3. Recommend the client take the medication at night.
4. Explain that these are expected side effects
Answer: 2. Instruct the client to stop taking the SSRI
Serotonin syndrome is a serious complication of SSRIs that produces mental
changes (confusion, anxiety, and restlessness), hypertension, tremors, sweating,
hyperpyrexia (elevated temperature), and ataxia. Conservation treatment includes
stopping the SSRI and supportive treatment. If untreated, ESE can lead to death
The client diagnosed with a major depressive disorder asks the nurse, "Why did my
psychiatrist prescribe an SSRI medication rather than one of the other types of anti-
depressants?" Which statement by the nurse would be most appropriate?
1. "Probably it is the medication that your insurance will pay for"
2. "You should ask your psychiatrist why the SSRI was ordered"
3. "SSRIs have fewer side effects than the other classifications"
NCLEX Mental Health Exam:
Comprehensive Study Guide with Complete
Questions and Correct Detailed Answers for
Psychiatric Nursing, Covering Therapeutic
Communication, Substance Use Disorders,
and Mental Health Interventions.
A client with a diagnosis of major depression who has attempted 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?
1.) "You have everything to live for"
2.) "Why do you see yourself as a failure?"
3.) "Feeling like this is all part of being depressed"
4.) "You've been feeling like a failure for a while?"
Answer: 4.) "youve been been feeling like a failure for a while?"
Use of restating is an effective therapeutic communication technique for
responding to the feelings of the patient.
When the community health nurse visits a client at home, the client states, "I
haven't slept at all the last couple of nights." Which response by the nurse
illustrates a therapeutic communication response to this client?
1.) "I see"
2.) "Really?"
3.) "You're having difficulty sleeping?"
4.) "Sometimes, I have trouble sleeping too"
,2|Page
Answer: 3.) "You're having difficulty sleeping?"
Restating
A client experiencing disturbed thought processes believes that his food is being
poisoned. Which communication technique should the nurse use to encourage the
client to eat?
1.) using open-ended questions and silence
2.) sharing personal preference regarding food choices
3.) documenting reasons why the client does not want to eat
4.) offering opinions about the necessity of adequate nutrition
Answer: 1.) using open-ended questions and silence
A client admitted to a mental health unit for treatment of psychotic behavior
spends hours at the locked exit door shouting, " Let me out. There's nothing wrong
with me. I don't belong here." What defense mechanism is the client
implementing?
1.) Denial
2.) Projection
3.) Regression
4.) Rationalization
Answer: 1.) Denial
A client diagnosed with terminal cancer says to the nurse, " I'm going to die and I
wish my family would stop hoping for a cure! I get so angry when they carry on
,3|Page
like this. After all, I'm the one who's dying." Which response by the nurse is
therapeutic?
1.) " Have you shared your feelings with your family."
2.) "I think we should talk more about your anger with your family"
3.) "You're feeling angry that your family continues to hope for you to be cured?"
4.) "You are probably very depressed, which is understandable with such a
diagnosis."
Answer: 3.) "You're feeling angry that your family continues to hope for you to be
cured?"
Restating
On review of the client's record, the nurse notes that the admission was voluntary.
Based on this information, the nurse anticipates which client behavior?
1.) fearfulness regarding treatment measures
2.) anger and aggressiveness directed toward others
3.) an understanding of the pathology and symptoms of the diagnosis
4.) a willingness to participate in the planning of the care and treatment plan
Answer: 4.) a willingness to participate in the planning of the care and treatment
plan
A client admitted voluntarily for treatment of an anxiety disorder demands to be
released from the hospital. Which action should the nurse take initially?
1.) Contact the client's HCP
2.) Call the client's family to arrange for transportation
, 4|Page
3.) Attempt to persuade the client to stay "for only a few more days"
4.) Tell the client that leaving would likely result in an voluntary commitment
Answer: 1.) Contact the client's HCP
The FIRAT INITIAL action would be to call the HCP because they are the only
one who can initiate/sign off on a discharge
The client with a major depressive disorder taking the selective serotonin reuptake
inhibitor (SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling
confused and restless and having an elevated temperature. Which action should the
psychiatric nurse take?
1. Determine if the client has flulike symptoms
2. Instruct the client to stop taking the SSRI
3. Recommend the client take the medication at night.
4. Explain that these are expected side effects
Answer: 2. Instruct the client to stop taking the SSRI
Serotonin syndrome is a serious complication of SSRIs that produces mental
changes (confusion, anxiety, and restlessness), hypertension, tremors, sweating,
hyperpyrexia (elevated temperature), and ataxia. Conservation treatment includes
stopping the SSRI and supportive treatment. If untreated, ESE can lead to death
The client diagnosed with a major depressive disorder asks the nurse, "Why did my
psychiatrist prescribe an SSRI medication rather than one of the other types of anti-
depressants?" Which statement by the nurse would be most appropriate?
1. "Probably it is the medication that your insurance will pay for"
2. "You should ask your psychiatrist why the SSRI was ordered"
3. "SSRIs have fewer side effects than the other classifications"
