Mental Health Nursing
Comprehensive Review Guide
Practice Questions and Detailed Answers
Based on Core Mental Health Nursing Concepts
1. Therapeutic Communication and Nurse-Patient Relationships
Question 1:
A patient with depression states, "I'm worthless and nobody cares about me." What is
the most therapeutic response by the nurse?
A) "That's not true. Your family loves you very much."
B) "You sound like you're feeling hopeless right now."
C) "Why do you feel that way?"
D) "You shouldn't think such negative thoughts."
Answer: B) "You sound like you're feeling hopeless right now."
This response uses reflection technique, acknowledging the patient's feelings without
judgment. It validates their emotional experience while opening dialogue for further
exploration. Option A is false reassurance, C uses "why" questions that can feel
interrogating, and D is dismissive.
Question 2:
During the orientation phase of the nurse-patient relationship, the priority nursing
action is:
A) Exploring the patient's past relationships
B) Establishing trust and defining roles
C) Teaching coping strategies
D) Evaluating treatment outcomes
Answer: B) Establishing trust and defining roles
The orientation phase focuses on building rapport, establishing trust, clarifying
expectations, and defining boundaries. This foundation is essential before moving into
working phases where exploration and intervention occur.
KEY CONCEPT: Active listening involves reflecting, clarifying, and
summarizing - avoid "why" questions, false reassurance, and giving advice.
2. Anxiety Disorders
Question 3:
A patient experiencing a panic attack is brought to the emergency department. The
priority nursing intervention is:
A) Encourage the patient to discuss their fears
B) Stay with the patient and speak in calm, short sentences
C) Teach deep breathing exercises
D) Administer prescribed anxiolytic medication
, Answer: B) Stay with the patient and speak in calm, short sentences
During acute panic, patients cannot process complex information. The priority is
ensuring safety and providing a calming presence. Teaching and discussing fears
should wait until the acute phase passes. Medication may be needed but staying with
the patient is the immediate priority.
Question 4:
Which assessment finding would indicate a patient with generalized anxiety disorder
is improving?
A) Reports sleeping 8 hours without interruption
B) Avoids situations that cause anxiety
C) Takes prescribed medication only when anxious
D) Stays home to avoid panic attacks
Answer: A) Reports sleeping 8 hours without interruption
Improved sleep patterns indicate decreased anxiety and better symptom management.
Options B and D indicate avoidance behaviors that worsen anxiety long-term. Option
C shows poor medication compliance as most anti-anxiety medications need
consistent dosing.
PRIORITY: During panic attacks - Stay with patient, maintain calm
environment, use short simple statements, ensure safety.
3. Mood Disorders (Depression and Bipolar)
Question 5:
A patient with major depressive disorder has been taking sertraline (Zoloft) for 2
weeks and reports no improvement. The nurse's best response is:
A) "You should ask your doctor to change medications."
B) "Antidepressants typically take 4-6 weeks to show full effects."
C) "You're probably not taking the medication correctly."
D) "The medication isn't working for you."
Answer: B) "Antidepressants typically take 4-6 weeks to show full effects."
Patient education about realistic timeframes for antidepressant effectiveness is
crucial. Many patients discontinue medication prematurely due to unrealistic
expectations. SSRIs like sertraline need time to build therapeutic levels and create
neurochemical changes.
Question 6:
A patient in the manic phase of bipolar disorder is pacing, speaking rapidly, and hasn't
slept in 3 days. The priority nursing diagnosis is:
A) Disturbed thought processes
B) Risk for injury related to hyperactivity
C) Impaired social interaction
D) Ineffective coping
Answer: B) Risk for injury related to hyperactivity
Comprehensive Review Guide
Practice Questions and Detailed Answers
Based on Core Mental Health Nursing Concepts
1. Therapeutic Communication and Nurse-Patient Relationships
Question 1:
A patient with depression states, "I'm worthless and nobody cares about me." What is
the most therapeutic response by the nurse?
A) "That's not true. Your family loves you very much."
B) "You sound like you're feeling hopeless right now."
C) "Why do you feel that way?"
D) "You shouldn't think such negative thoughts."
Answer: B) "You sound like you're feeling hopeless right now."
This response uses reflection technique, acknowledging the patient's feelings without
judgment. It validates their emotional experience while opening dialogue for further
exploration. Option A is false reassurance, C uses "why" questions that can feel
interrogating, and D is dismissive.
Question 2:
During the orientation phase of the nurse-patient relationship, the priority nursing
action is:
A) Exploring the patient's past relationships
B) Establishing trust and defining roles
C) Teaching coping strategies
D) Evaluating treatment outcomes
Answer: B) Establishing trust and defining roles
The orientation phase focuses on building rapport, establishing trust, clarifying
expectations, and defining boundaries. This foundation is essential before moving into
working phases where exploration and intervention occur.
KEY CONCEPT: Active listening involves reflecting, clarifying, and
summarizing - avoid "why" questions, false reassurance, and giving advice.
2. Anxiety Disorders
Question 3:
A patient experiencing a panic attack is brought to the emergency department. The
priority nursing intervention is:
A) Encourage the patient to discuss their fears
B) Stay with the patient and speak in calm, short sentences
C) Teach deep breathing exercises
D) Administer prescribed anxiolytic medication
, Answer: B) Stay with the patient and speak in calm, short sentences
During acute panic, patients cannot process complex information. The priority is
ensuring safety and providing a calming presence. Teaching and discussing fears
should wait until the acute phase passes. Medication may be needed but staying with
the patient is the immediate priority.
Question 4:
Which assessment finding would indicate a patient with generalized anxiety disorder
is improving?
A) Reports sleeping 8 hours without interruption
B) Avoids situations that cause anxiety
C) Takes prescribed medication only when anxious
D) Stays home to avoid panic attacks
Answer: A) Reports sleeping 8 hours without interruption
Improved sleep patterns indicate decreased anxiety and better symptom management.
Options B and D indicate avoidance behaviors that worsen anxiety long-term. Option
C shows poor medication compliance as most anti-anxiety medications need
consistent dosing.
PRIORITY: During panic attacks - Stay with patient, maintain calm
environment, use short simple statements, ensure safety.
3. Mood Disorders (Depression and Bipolar)
Question 5:
A patient with major depressive disorder has been taking sertraline (Zoloft) for 2
weeks and reports no improvement. The nurse's best response is:
A) "You should ask your doctor to change medications."
B) "Antidepressants typically take 4-6 weeks to show full effects."
C) "You're probably not taking the medication correctly."
D) "The medication isn't working for you."
Answer: B) "Antidepressants typically take 4-6 weeks to show full effects."
Patient education about realistic timeframes for antidepressant effectiveness is
crucial. Many patients discontinue medication prematurely due to unrealistic
expectations. SSRIs like sertraline need time to build therapeutic levels and create
neurochemical changes.
Question 6:
A patient in the manic phase of bipolar disorder is pacing, speaking rapidly, and hasn't
slept in 3 days. The priority nursing diagnosis is:
A) Disturbed thought processes
B) Risk for injury related to hyperactivity
C) Impaired social interaction
D) Ineffective coping
Answer: B) Risk for injury related to hyperactivity
