NSG 3280 Exam 1 Comprehensive Test Bank – Newest Complete
Questions & Answers with High-Yield Clinical Rationales –
Psychiatric-Mental Health Nursing Master Study Guide (Latest
2026/2027 Edition) PDF
Section 1: Therapeutic Communication & The Nurse-Client Relationship
1. A client newly admitted to an inpatient psychiatric unit approaches the nurse and
states, "I don't belong here. The police brought me because my family is lying about
me." Which of the following responses should the nurse make?
A) "Your family loves you and wouldn't lie about something this serious."
B) "Why do you think your family would want to put you in a hospital?"
C) "It must be distressing to feel that you don't belong here. Let’s talk about what led
to your admission."
D) "You are here because the doctor determined you need help staying safe."
Rationale: Therapeutic communication requires acknowledging the client's feelings and
validating their emotional experience without arguing with their perception of reality or taking
sides.
2. During the orientation phase of the therapeutic nurse-client relationship, which of
the following actions is a nursing priority?
A) Encourage the client to implement specific behavioral coping strategies.
B) Establish trust, formulate a contract, and clarify boundaries and expectations.
C) Work through the client's resistance to discussing deeply buried trauma.
D) Evaluate the client’s progress toward achieving long-term personal goals.
Rationale: The orientation phase is dedicated to building rapport, establishing trust,
,defining parameters of the relationship (such as confidentiality and meeting times), and
setting boundaries. Working through problems occurs in the working phase.
3. A nurse is caring for a client who sits silently in the dayroom weeping. The nurse
sits down next to the client. Which of the following statements by the nurse utilizes
the therapeutic technique of "offering self"?
A) "Everything happens for a reason, so please try not to cry."
B) "Why are you crying today? Did something specific happen?"
C) "I see you are crying. I am going to sit here with you for a while if that is okay."
D) "If you keep crying, you will miss the morning group therapy session."
Rationale: "Offering self" provides the nurse's presence and time unconditionally,
conveying acceptance and value to a distressed or withdrawn client without placing a verbal
burden on them.
4. A client states, "I am a complete failure at everything. I can't even hold down a
simple job." The nurse responds by stating, "You feel like you have failed because
you lost your job?" Which therapeutic technique did the nurse use?
A) Reassuring
B) Restating
C) Focusing
D) Confronting
Rationale: Restating involves repeating the main idea or core of what the client has
expressed back to them using similar words. This validates that the nurse is listening and
clarifies the client's message.
5. A nurse notice that a client with borderline personality disorder alternates between
praising the nurse as "the best nurse on the unit" and criticizing them as "terrible
,and uncaring" when a request is denied. The nurse should recognize this as which
defense mechanism?
A) Projection
B) Rationalization
C) Splitting
D) Sublimation
Rationale: Splitting is a defense mechanism common in borderline personality disorder
where an individual is unable to integrate positive and negative qualities of self or others,
viewing people as completely good or completely bad.
6. Which of the following communication techniques is a block to therapeutic
communication and should be avoided by the nurse?
A) Offering general leads
B) Reflecting
C) Giving advice
D) Exploring
Rationale: Giving advice implies that the nurse knows what is best for the client and
discourages independent decision-making and problem-solving, creating dependency.
7. A nurse is terminating a relationship with a client who is being discharged. The
client says, "I don't think I can handle things out there without you." Which phase of
the nurse-client relationship is being completed?
A) Pre-interaction phase
B) Orientation phase
C) Working phase
D) Termination phase
, Rationale: The termination phase focuses on reviewing therapeutic goals achieved,
discussing coping strategies for the future, and exploring feelings related to ending the
relationship.
8. A nurse is caring for a client who is angry about their involuntary admission and
refuses to speak. Which of the following actions should the nurse perform?
A) Threaten to place the client in restraints if they don't answer intake questions.
B) Offer brief, regular contacts throughout the shift to show presence and support
without demands.
C) Leave the client completely alone until they decide to seek out staff.
D) Force the client to sit in the middle of a high-stimulus group therapy session.
Rationale: For an uncommunicative or angry client, offering brief, frequent, low-demand
contact conveys availability and respect, helping to gradually build trust.
9. What term describes the unconscious process where a client redirects feelings,
expectations, or attitudes they hold toward a significant person in their past onto the
nurse?
A) Countertransference
B) Transference
C) Introjection
D) Reaction formation
Rationale: Transference occurs when the client projects past emotional relationship
patterns onto the nurse. Countertransference is the reverse process, where the nurse
projects personal feelings onto the client.
Questions & Answers with High-Yield Clinical Rationales –
Psychiatric-Mental Health Nursing Master Study Guide (Latest
2026/2027 Edition) PDF
Section 1: Therapeutic Communication & The Nurse-Client Relationship
1. A client newly admitted to an inpatient psychiatric unit approaches the nurse and
states, "I don't belong here. The police brought me because my family is lying about
me." Which of the following responses should the nurse make?
A) "Your family loves you and wouldn't lie about something this serious."
B) "Why do you think your family would want to put you in a hospital?"
C) "It must be distressing to feel that you don't belong here. Let’s talk about what led
to your admission."
D) "You are here because the doctor determined you need help staying safe."
Rationale: Therapeutic communication requires acknowledging the client's feelings and
validating their emotional experience without arguing with their perception of reality or taking
sides.
2. During the orientation phase of the therapeutic nurse-client relationship, which of
the following actions is a nursing priority?
A) Encourage the client to implement specific behavioral coping strategies.
B) Establish trust, formulate a contract, and clarify boundaries and expectations.
C) Work through the client's resistance to discussing deeply buried trauma.
D) Evaluate the client’s progress toward achieving long-term personal goals.
Rationale: The orientation phase is dedicated to building rapport, establishing trust,
,defining parameters of the relationship (such as confidentiality and meeting times), and
setting boundaries. Working through problems occurs in the working phase.
3. A nurse is caring for a client who sits silently in the dayroom weeping. The nurse
sits down next to the client. Which of the following statements by the nurse utilizes
the therapeutic technique of "offering self"?
A) "Everything happens for a reason, so please try not to cry."
B) "Why are you crying today? Did something specific happen?"
C) "I see you are crying. I am going to sit here with you for a while if that is okay."
D) "If you keep crying, you will miss the morning group therapy session."
Rationale: "Offering self" provides the nurse's presence and time unconditionally,
conveying acceptance and value to a distressed or withdrawn client without placing a verbal
burden on them.
4. A client states, "I am a complete failure at everything. I can't even hold down a
simple job." The nurse responds by stating, "You feel like you have failed because
you lost your job?" Which therapeutic technique did the nurse use?
A) Reassuring
B) Restating
C) Focusing
D) Confronting
Rationale: Restating involves repeating the main idea or core of what the client has
expressed back to them using similar words. This validates that the nurse is listening and
clarifies the client's message.
5. A nurse notice that a client with borderline personality disorder alternates between
praising the nurse as "the best nurse on the unit" and criticizing them as "terrible
,and uncaring" when a request is denied. The nurse should recognize this as which
defense mechanism?
A) Projection
B) Rationalization
C) Splitting
D) Sublimation
Rationale: Splitting is a defense mechanism common in borderline personality disorder
where an individual is unable to integrate positive and negative qualities of self or others,
viewing people as completely good or completely bad.
6. Which of the following communication techniques is a block to therapeutic
communication and should be avoided by the nurse?
A) Offering general leads
B) Reflecting
C) Giving advice
D) Exploring
Rationale: Giving advice implies that the nurse knows what is best for the client and
discourages independent decision-making and problem-solving, creating dependency.
7. A nurse is terminating a relationship with a client who is being discharged. The
client says, "I don't think I can handle things out there without you." Which phase of
the nurse-client relationship is being completed?
A) Pre-interaction phase
B) Orientation phase
C) Working phase
D) Termination phase
, Rationale: The termination phase focuses on reviewing therapeutic goals achieved,
discussing coping strategies for the future, and exploring feelings related to ending the
relationship.
8. A nurse is caring for a client who is angry about their involuntary admission and
refuses to speak. Which of the following actions should the nurse perform?
A) Threaten to place the client in restraints if they don't answer intake questions.
B) Offer brief, regular contacts throughout the shift to show presence and support
without demands.
C) Leave the client completely alone until they decide to seek out staff.
D) Force the client to sit in the middle of a high-stimulus group therapy session.
Rationale: For an uncommunicative or angry client, offering brief, frequent, low-demand
contact conveys availability and respect, helping to gradually build trust.
9. What term describes the unconscious process where a client redirects feelings,
expectations, or attitudes they hold toward a significant person in their past onto the
nurse?
A) Countertransference
B) Transference
C) Introjection
D) Reaction formation
Rationale: Transference occurs when the client projects past emotional relationship
patterns onto the nurse. Countertransference is the reverse process, where the nurse
projects personal feelings onto the client.
