Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
CHAMBERLAIN UNIVERSITY COLLEGE OF NURSING
NR 326 - Mental Health Nursing
Comprehensive Examination | 2026/2027
75 Exam-Style Questions with Verified Detailed Answers
ATI Mental Health Review Module-Aligned | Evidence-Based Psychiatric Nursing Practice | NGN-Aligned
Core Domains: Therapeutic Communication, Mental Status Examination, Psychopharmacology,
Anxiety/Trauma/Mood/Psychotic/Personality/Substance Use Disorders, Crisis Intervention,
Legal/Ethical Considerations, Therapeutic Modalities, Vulnerable Populations
75 Questions | 90-120 Minutes | Passing Score: 75-80%
NCSBN CJMM and Next Generation NCLEX (NGN) Standards
Page 1
, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
SECTION I: Therapeutic Communication & Nurse-Client Relationship
1. A client diagnosed with major depressive disorder sits silently during a group therapy
session. The nurse remains quietly seated nearby, maintaining an open posture. Which
therapeutic communication technique is the nurse demonstrating?
[Single Best Answer]
A. Offering self
B. Active listening
C. Silence
D. Restating
Correct Answer: C
Rationale: The nurse is using silence, which is a powerful therapeutic communication technique in
psychiatric nursing. Silence allows the client time to process thoughts and feelings without the pressure of
immediate verbal response. It communicates acceptance, patience, and willingness to listen. In mental
health settings, nurses should not rush to fill silence, as clients may need extended time to articulate difficult
emotions. Offering self involves making oneself available (e.g., “I’ll stay here with you”). Active listening
involves giving full attention through verbal and nonverbal cues. Restating involves repeating the client’s
message in similar words to validate understanding.
2. A client with schizophrenia states, “The FBI is tracking me through my dental fillings.”
Which response by the nurse is most therapeutic?
[Single Best Answer]
A. That’s impossible. Dental fillings cannot transmit signals.
B. I understand you believe the FBI is tracking you. That must be frightening.
C. Let’s talk about something more pleasant.
D. You should tell your doctor about these thoughts immediately.
Correct Answer: B
Rationale: This client is expressing a paranoid delusion, a common positive symptom of schizophrenia.
The most therapeutic response acknowledges the client’s experience and the emotions associated with it
without reinforcing or arguing with the delusional content. The nurse uses the technique of reflection of
feeling by validating that the belief is frightening, thereby building trust. Arguing with or confronting the
delusion (“That’s impossible”) is nontherapeutic because it can increase the client’s defensiveness and
damage the therapeutic relationship. Changing the subject dismisses the client’s expressed concern. While
notifying the treatment team is appropriate, directing the client to tell the doctor immediately is abrupt and
does not address the client’s emotional state in the moment.
3. A nurse is establishing a therapeutic relationship with a client who has borderline
personality disorder. Which behavior by the nurse is most important to maintain boundaries?
[Single Best Answer]
A. Sharing personal phone number for after-hours support
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, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
B. Consistent enforcement of unit rules and treatment plan limits
C. Avoiding all conversation about the client’s feelings of abandonment
D. Agreeing to keep secrets the client shares during sessions
Correct Answer: B
Rationale: Clients with borderline personality disorder often test boundaries, exhibit intense fear of
abandonment, and engage in splitting behaviors. The nurse must maintain consistent, firm, and
compassionate boundaries. Consistent enforcement of unit rules and treatment plan limits provides the
structured, predictable environment these clients need to feel safe. Sharing personal contact information
crosses professional boundaries and can foster dependency. Avoiding discussion of abandonment fears does
not address a core therapeutic issue. Agreeing to keep secrets is unethical and undermines treatment goals;
clients should be informed that certain disclosures may need to be shared with the treatment team for safety
purposes.
4. A client says to the nurse, “Nobody cares about me. I’m completely alone.” Which
therapeutic response uses the technique of clarification?
[Single Best Answer]
A. I care about you and you’re not alone.
B. Are you saying that you feel as though no one in your life understands what you’re
going through?
C. Everyone feels alone sometimes.
D. Tell me more about your childhood.
Correct Answer: B
Rationale: Clarification is a therapeutic communication technique used when the nurse needs more
information or wants to ensure accurate understanding of the client’s statement. The nurse asks the client to
elaborate or rephrase, which promotes deeper exploration of the client’s feelings. “Are you saying that you
feel as though no one in your life understands what you’re going through?” invites the client to clarify the
specific meaning behind their statement, which may relate to perceived social isolation, emotional neglect,
or lack of support. Offering reassurance (“I care about you”) may dismiss the client’s feelings. Minimizing
(“Everyone feels alone sometimes”) is nontherapeutic. Abruptly changing the topic to childhood is not
clarification.
5. A client with generalized anxiety disorder tells the nurse, “I just can’t stop worrying. My
mind won’t shut off.” Which response best demonstrates the therapeutic technique of
restating?
[Single Best Answer]
A. Many people with anxiety experience racing thoughts.
B. You’re saying that you can’t stop worrying and that your thoughts feel continuous.
C. Try counting backwards from 100 to distract yourself.
D. You should discuss medication options with your psychiatrist.
Correct Answer: B
Rationale: Restating involves repeating the main idea of what the client said using slightly different
words. This technique validates that the nurse is listening and gives the client the opportunity to confirm,
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, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
correct, or expand on what was communicated. “You’re saying that you can’t stop worrying and that your
thoughts feel continuous” accurately restates the client’s message and opens further dialogue. Offering a
generalization (“Many people experience this”) may feel dismissive. Suggesting a distraction technique,
while potentially helpful, is premature before further exploration. Advising medication discussion is
appropriate but not restating.
6. A nurse is caring for a client who uses manipulative behaviors to obtain additional
medications. Which nursing response best demonstrates limit-setting?
[Single Best Answer]
A. I understand you’re in pain, so I’ll ask the provider for more medication.
B. The prescribed medication schedule is every 6 hours. Your next dose is due at 2:00
PM.
C. You need to stop asking for extra medication because it’s against the rules.
D. I’ll give you the medication early this once, but don’t tell anyone.
Correct Answer: B
Rationale: Limit-setting is a therapeutic technique that clearly communicates the boundaries of
acceptable behavior while maintaining a supportive and nonjudgmental tone. Effective limit-setting
identifies the specific behavior, states the expected limit, and provides the rationale or consequence. In this
scenario, the nurse states the medication schedule factually and provides the next due time, maintaining the
treatment plan without being punitive or giving in to manipulation. Giving in (“I’ll ask for more” or “I’ll give
it early this once”) reinforces manipulative behavior. Using accusatory language (“You need to stop
asking”) is confrontational and increases defensiveness.
7. A client who was sexually assaulted is being interviewed by the nurse. Which statement by
the nurse best conveys empathic understanding?
[Single Best Answer]
A. I know exactly how you feel because my friend went through something similar.
B. It sounds like this experience has been deeply painful for you.
C. You should try to focus on the positive aspects of your life.
D. Can you tell me why you think this happened to you?
Correct Answer: B
Rationale: Empathic understanding involves recognizing and acknowledging the client’s feelings and
perspective without imposing one’s own experiences or judgments. “It sounds like this experience has been
deeply painful for you” communicates empathy by validating the client’s emotional experience without
claiming to know exactly what the client feels (which would be presumptuous) or blaming the client.
Claiming to know exactly how the client feels minimizes the uniqueness of their experience. Focusing on
positives invalidates the client’s current emotional reality. Asking why the assault happened implies victim-
blaming and is a nontherapeutic closed-ended question.
8. A nurse is providing discharge education to a client with depression. The client appears
distracted and is looking at the floor. Which action by the nurse is most appropriate?
[Single Best Answer]
Page 4
CHAMBERLAIN UNIVERSITY COLLEGE OF NURSING
NR 326 - Mental Health Nursing
Comprehensive Examination | 2026/2027
75 Exam-Style Questions with Verified Detailed Answers
ATI Mental Health Review Module-Aligned | Evidence-Based Psychiatric Nursing Practice | NGN-Aligned
Core Domains: Therapeutic Communication, Mental Status Examination, Psychopharmacology,
Anxiety/Trauma/Mood/Psychotic/Personality/Substance Use Disorders, Crisis Intervention,
Legal/Ethical Considerations, Therapeutic Modalities, Vulnerable Populations
75 Questions | 90-120 Minutes | Passing Score: 75-80%
NCSBN CJMM and Next Generation NCLEX (NGN) Standards
Page 1
, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
SECTION I: Therapeutic Communication & Nurse-Client Relationship
1. A client diagnosed with major depressive disorder sits silently during a group therapy
session. The nurse remains quietly seated nearby, maintaining an open posture. Which
therapeutic communication technique is the nurse demonstrating?
[Single Best Answer]
A. Offering self
B. Active listening
C. Silence
D. Restating
Correct Answer: C
Rationale: The nurse is using silence, which is a powerful therapeutic communication technique in
psychiatric nursing. Silence allows the client time to process thoughts and feelings without the pressure of
immediate verbal response. It communicates acceptance, patience, and willingness to listen. In mental
health settings, nurses should not rush to fill silence, as clients may need extended time to articulate difficult
emotions. Offering self involves making oneself available (e.g., “I’ll stay here with you”). Active listening
involves giving full attention through verbal and nonverbal cues. Restating involves repeating the client’s
message in similar words to validate understanding.
2. A client with schizophrenia states, “The FBI is tracking me through my dental fillings.”
Which response by the nurse is most therapeutic?
[Single Best Answer]
A. That’s impossible. Dental fillings cannot transmit signals.
B. I understand you believe the FBI is tracking you. That must be frightening.
C. Let’s talk about something more pleasant.
D. You should tell your doctor about these thoughts immediately.
Correct Answer: B
Rationale: This client is expressing a paranoid delusion, a common positive symptom of schizophrenia.
The most therapeutic response acknowledges the client’s experience and the emotions associated with it
without reinforcing or arguing with the delusional content. The nurse uses the technique of reflection of
feeling by validating that the belief is frightening, thereby building trust. Arguing with or confronting the
delusion (“That’s impossible”) is nontherapeutic because it can increase the client’s defensiveness and
damage the therapeutic relationship. Changing the subject dismisses the client’s expressed concern. While
notifying the treatment team is appropriate, directing the client to tell the doctor immediately is abrupt and
does not address the client’s emotional state in the moment.
3. A nurse is establishing a therapeutic relationship with a client who has borderline
personality disorder. Which behavior by the nurse is most important to maintain boundaries?
[Single Best Answer]
A. Sharing personal phone number for after-hours support
Page 2
, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
B. Consistent enforcement of unit rules and treatment plan limits
C. Avoiding all conversation about the client’s feelings of abandonment
D. Agreeing to keep secrets the client shares during sessions
Correct Answer: B
Rationale: Clients with borderline personality disorder often test boundaries, exhibit intense fear of
abandonment, and engage in splitting behaviors. The nurse must maintain consistent, firm, and
compassionate boundaries. Consistent enforcement of unit rules and treatment plan limits provides the
structured, predictable environment these clients need to feel safe. Sharing personal contact information
crosses professional boundaries and can foster dependency. Avoiding discussion of abandonment fears does
not address a core therapeutic issue. Agreeing to keep secrets is unethical and undermines treatment goals;
clients should be informed that certain disclosures may need to be shared with the treatment team for safety
purposes.
4. A client says to the nurse, “Nobody cares about me. I’m completely alone.” Which
therapeutic response uses the technique of clarification?
[Single Best Answer]
A. I care about you and you’re not alone.
B. Are you saying that you feel as though no one in your life understands what you’re
going through?
C. Everyone feels alone sometimes.
D. Tell me more about your childhood.
Correct Answer: B
Rationale: Clarification is a therapeutic communication technique used when the nurse needs more
information or wants to ensure accurate understanding of the client’s statement. The nurse asks the client to
elaborate or rephrase, which promotes deeper exploration of the client’s feelings. “Are you saying that you
feel as though no one in your life understands what you’re going through?” invites the client to clarify the
specific meaning behind their statement, which may relate to perceived social isolation, emotional neglect,
or lack of support. Offering reassurance (“I care about you”) may dismiss the client’s feelings. Minimizing
(“Everyone feels alone sometimes”) is nontherapeutic. Abruptly changing the topic to childhood is not
clarification.
5. A client with generalized anxiety disorder tells the nurse, “I just can’t stop worrying. My
mind won’t shut off.” Which response best demonstrates the therapeutic technique of
restating?
[Single Best Answer]
A. Many people with anxiety experience racing thoughts.
B. You’re saying that you can’t stop worrying and that your thoughts feel continuous.
C. Try counting backwards from 100 to distract yourself.
D. You should discuss medication options with your psychiatrist.
Correct Answer: B
Rationale: Restating involves repeating the main idea of what the client said using slightly different
words. This technique validates that the nurse is listening and gives the client the opportunity to confirm,
Page 3
, Chamberlain NR 326 | Mental Health Nursing Exam | 2026/2027
correct, or expand on what was communicated. “You’re saying that you can’t stop worrying and that your
thoughts feel continuous” accurately restates the client’s message and opens further dialogue. Offering a
generalization (“Many people experience this”) may feel dismissive. Suggesting a distraction technique,
while potentially helpful, is premature before further exploration. Advising medication discussion is
appropriate but not restating.
6. A nurse is caring for a client who uses manipulative behaviors to obtain additional
medications. Which nursing response best demonstrates limit-setting?
[Single Best Answer]
A. I understand you’re in pain, so I’ll ask the provider for more medication.
B. The prescribed medication schedule is every 6 hours. Your next dose is due at 2:00
PM.
C. You need to stop asking for extra medication because it’s against the rules.
D. I’ll give you the medication early this once, but don’t tell anyone.
Correct Answer: B
Rationale: Limit-setting is a therapeutic technique that clearly communicates the boundaries of
acceptable behavior while maintaining a supportive and nonjudgmental tone. Effective limit-setting
identifies the specific behavior, states the expected limit, and provides the rationale or consequence. In this
scenario, the nurse states the medication schedule factually and provides the next due time, maintaining the
treatment plan without being punitive or giving in to manipulation. Giving in (“I’ll ask for more” or “I’ll give
it early this once”) reinforces manipulative behavior. Using accusatory language (“You need to stop
asking”) is confrontational and increases defensiveness.
7. A client who was sexually assaulted is being interviewed by the nurse. Which statement by
the nurse best conveys empathic understanding?
[Single Best Answer]
A. I know exactly how you feel because my friend went through something similar.
B. It sounds like this experience has been deeply painful for you.
C. You should try to focus on the positive aspects of your life.
D. Can you tell me why you think this happened to you?
Correct Answer: B
Rationale: Empathic understanding involves recognizing and acknowledging the client’s feelings and
perspective without imposing one’s own experiences or judgments. “It sounds like this experience has been
deeply painful for you” communicates empathy by validating the client’s emotional experience without
claiming to know exactly what the client feels (which would be presumptuous) or blaming the client.
Claiming to know exactly how the client feels minimizes the uniqueness of their experience. Focusing on
positives invalidates the client’s current emotional reality. Asking why the assault happened implies victim-
blaming and is a nontherapeutic closed-ended question.
8. A nurse is providing discharge education to a client with depression. The client appears
distracted and is looking at the floor. Which action by the nurse is most appropriate?
[Single Best Answer]
Page 4
