2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 1 PSYCHIATRIC/MENTAL HEALTH NURSING, MENTAL
HEALTH NURSING CHAPTER 1-10, (RATIONALES) CHAPS 1-5 8 10,
13, 23, PSYCHIATRIC NURSING - PRELIMS, MIDTERM EXAM
The patient says, "My marriage is just great. My spouse and I always agree." The
nurse observes the patient's foot moving continuously as the patient twirls a shirt
button. The conclusion the nurse can draw is that the patient's communication is:
a. clear.
b. mixed.
c. precise.
d. inadequate. - Correct Answer-ANS: B
Mixed messages involve the transmission of conflicting or incongruent messages
by the speaker. The patient's verbal message that all was well in the relationship
was modified by the nonverbal behaviors denoting anxiety. Data are not present
to support the choice of the verbal message being clear, explicit, or inadequate.
A nurse interacts with a newly hospitalized patient. Select the nurse's comment
that applies the communication technique of "offering self."
a. "I've also had traumatic life experiences. Maybe it would help if I told you about
them."
b. "Why do you think you had so much difficulty adjusting to this change in your
life?"
c. "I hope you will feel better after getting accustomed to how this unit operates."
d. "I'd like to sit with you for a while to help you get comfortable talking to me." -
Correct Answer-ANS: D
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, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
"Offering self" is a technique that should be used in the orientation phase of the
nurse-patient relationship. Sitting with the patient, an example of "offering self,"
helps to build trust and convey that the nurse cares about the patient. Two
incorrect responses are ineffective and non-therapeutic. The other incorrect
response is therapeutic but is an example of "offering hope."
Which technique will best communicate to a patient that the nurse is interested in
listening?
a. Restating a feeling or thought the patient has expressed.
b. Asking a direct question, such as "Did you feel angry?"
c. Making a judgment about the patient's problem.
d. Saying, "I understand what you're saying." - Correct Answer-ANS: A
Restating allows the patient to validate the nurse's understanding of what has
been communicated. Restating is an active listening technique. Judgments
should be suspended in a nurse-patient relationship. Close-ended questions
such as "Did you feel angry?" ask for specific information rather than showing
understanding. When the nurse simply states that he or she understands the
patient's words, the patient has no way of measuring the understanding.
A patient discloses several concerns and associated feelings. If the nurse wants to
seek clarification, which comment would be appropriate?
a. "What are the common elements here?"
b. "Tell me again about your experiences."
c. "Am I correct in understanding that . . ."
d. "Tell me everything from the beginning." - Correct Answer-ANS: C
Asking, "Am I correct in understanding that..." permits clarification to ensure
that both the nurse and patient share mutual understanding of the
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, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
communication. Asking about common elements encourages comparison rather
than clarification. The remaining responses are implied questions that suggest
the nurse was not listening.
A patient tells the nurse, "I don't think I'll ever get out of here." Select the nurse's
most therapeutic response.
a. "Don't talk that way. Of course you will leave here!"
b. "Keep up the good work, and you certainly will."
c. "You don't think you're making progress?"
d. "Everyone feels that way sometimes." - Correct Answer-ANS: C
By asking if the patient does not believe that progress has been made, the nurse
is reflecting by putting into words what the patient is hinting. By making
communication more explicit, issues are easier to identify and resolve. The
remaining options are non-therapeutic techniques. Telling the patient not to
"talk that way" is disapproving. Saying that everyone feels that way at times
minimizes feelings. Telling the patient that good work will always result in
success is falsely reassuring.
Documentation in a patient's chart shows, "Throughout a 5-minute interaction,
patient fidgeted and tapped left foot, periodically covered face with hands, and
looked under chair while stating, 'I enjoy spending time with you.'" Which analysis
is most accurate?
a. The patient is giving positive feedback about the nurse's communication
techniques.
b. The nurse is viewing the patient's behavior through a cultural filter.
c. The patient's verbal and nonverbal messages are incongruent.
d. The patient is demonstrating psychotic behaviors. - Correct Answer-ANS: C
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, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
When a verbal message is not reinforced with nonverbal behavior, the message
is confusing and incongruent. Some clinicians call it a "mixed message." It is
inaccurate to say that the patient is giving positive feedback about the nurse's
communication techniques. The concept of a cultural filter is not relevant to the
situation because a cultural filter determines what we will pay attention to and
what we will ignore. Data are insufficient to draw the conclusion that the patient
is demonstrating psychotic behaviors.
While talking with a patient diagnosed with major depression, a nurse notices the
patient is unable to maintain eye contact. The patient's chin lowers to the chest,
while the patient looks at the floor. Which aspect of communication has the nurse
assessed?
a. Nonverbal communication
b. A message filter
c. A cultural barrier
d. Social skills - Correct Answer-ANS: A
Eye contact and body movements are considered nonverbal communication.
There are insufficient data to determine the level of the patient's social skills or
whether a cultural barrier exists.
During the first interview with a parent whose child died in a car accident, the
nurse feels empathic and reaches out to take the patient's hand. Select the correct
analysis of the nurse's behavior.
a. It shows empathy and compassion. It will encourage the patient to continue to
express feelings.
b. The gesture is premature. The patient's cultural and individual interpretation of
touch is unknown.
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2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 1 PSYCHIATRIC/MENTAL HEALTH NURSING, MENTAL
HEALTH NURSING CHAPTER 1-10, (RATIONALES) CHAPS 1-5 8 10,
13, 23, PSYCHIATRIC NURSING - PRELIMS, MIDTERM EXAM
The patient says, "My marriage is just great. My spouse and I always agree." The
nurse observes the patient's foot moving continuously as the patient twirls a shirt
button. The conclusion the nurse can draw is that the patient's communication is:
a. clear.
b. mixed.
c. precise.
d. inadequate. - Correct Answer-ANS: B
Mixed messages involve the transmission of conflicting or incongruent messages
by the speaker. The patient's verbal message that all was well in the relationship
was modified by the nonverbal behaviors denoting anxiety. Data are not present
to support the choice of the verbal message being clear, explicit, or inadequate.
A nurse interacts with a newly hospitalized patient. Select the nurse's comment
that applies the communication technique of "offering self."
a. "I've also had traumatic life experiences. Maybe it would help if I told you about
them."
b. "Why do you think you had so much difficulty adjusting to this change in your
life?"
c. "I hope you will feel better after getting accustomed to how this unit operates."
d. "I'd like to sit with you for a while to help you get comfortable talking to me." -
Correct Answer-ANS: D
1|Page
, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
"Offering self" is a technique that should be used in the orientation phase of the
nurse-patient relationship. Sitting with the patient, an example of "offering self,"
helps to build trust and convey that the nurse cares about the patient. Two
incorrect responses are ineffective and non-therapeutic. The other incorrect
response is therapeutic but is an example of "offering hope."
Which technique will best communicate to a patient that the nurse is interested in
listening?
a. Restating a feeling or thought the patient has expressed.
b. Asking a direct question, such as "Did you feel angry?"
c. Making a judgment about the patient's problem.
d. Saying, "I understand what you're saying." - Correct Answer-ANS: A
Restating allows the patient to validate the nurse's understanding of what has
been communicated. Restating is an active listening technique. Judgments
should be suspended in a nurse-patient relationship. Close-ended questions
such as "Did you feel angry?" ask for specific information rather than showing
understanding. When the nurse simply states that he or she understands the
patient's words, the patient has no way of measuring the understanding.
A patient discloses several concerns and associated feelings. If the nurse wants to
seek clarification, which comment would be appropriate?
a. "What are the common elements here?"
b. "Tell me again about your experiences."
c. "Am I correct in understanding that . . ."
d. "Tell me everything from the beginning." - Correct Answer-ANS: C
Asking, "Am I correct in understanding that..." permits clarification to ensure
that both the nurse and patient share mutual understanding of the
2|Page
, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
communication. Asking about common elements encourages comparison rather
than clarification. The remaining responses are implied questions that suggest
the nurse was not listening.
A patient tells the nurse, "I don't think I'll ever get out of here." Select the nurse's
most therapeutic response.
a. "Don't talk that way. Of course you will leave here!"
b. "Keep up the good work, and you certainly will."
c. "You don't think you're making progress?"
d. "Everyone feels that way sometimes." - Correct Answer-ANS: C
By asking if the patient does not believe that progress has been made, the nurse
is reflecting by putting into words what the patient is hinting. By making
communication more explicit, issues are easier to identify and resolve. The
remaining options are non-therapeutic techniques. Telling the patient not to
"talk that way" is disapproving. Saying that everyone feels that way at times
minimizes feelings. Telling the patient that good work will always result in
success is falsely reassuring.
Documentation in a patient's chart shows, "Throughout a 5-minute interaction,
patient fidgeted and tapped left foot, periodically covered face with hands, and
looked under chair while stating, 'I enjoy spending time with you.'" Which analysis
is most accurate?
a. The patient is giving positive feedback about the nurse's communication
techniques.
b. The nurse is viewing the patient's behavior through a cultural filter.
c. The patient's verbal and nonverbal messages are incongruent.
d. The patient is demonstrating psychotic behaviors. - Correct Answer-ANS: C
3|Page
, 2025 CONTEMPORARY PSYCHIATRIC MENTAL HEALTH NURSING EXAM 1
When a verbal message is not reinforced with nonverbal behavior, the message
is confusing and incongruent. Some clinicians call it a "mixed message." It is
inaccurate to say that the patient is giving positive feedback about the nurse's
communication techniques. The concept of a cultural filter is not relevant to the
situation because a cultural filter determines what we will pay attention to and
what we will ignore. Data are insufficient to draw the conclusion that the patient
is demonstrating psychotic behaviors.
While talking with a patient diagnosed with major depression, a nurse notices the
patient is unable to maintain eye contact. The patient's chin lowers to the chest,
while the patient looks at the floor. Which aspect of communication has the nurse
assessed?
a. Nonverbal communication
b. A message filter
c. A cultural barrier
d. Social skills - Correct Answer-ANS: A
Eye contact and body movements are considered nonverbal communication.
There are insufficient data to determine the level of the patient's social skills or
whether a cultural barrier exists.
During the first interview with a parent whose child died in a car accident, the
nurse feels empathic and reaches out to take the patient's hand. Select the correct
analysis of the nurse's behavior.
a. It shows empathy and compassion. It will encourage the patient to continue to
express feelings.
b. The gesture is premature. The patient's cultural and individual interpretation of
touch is unknown.
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