NUR 124 – Mental Health Nursing Complete
Psychiatric Nursing Study Guide Questions with
Answers and Detailed Rationales
Question 1
A patient with anxiety disorder tells the nurse, "I feel like I'm going crazy. I can't
stop worrying about everything." Which of the following is the most therapeutic
response by the nurse?
A) "Don't worry, everything will be fine."
B) "You need to stop worrying so much."
C) "It sounds like you're feeling very overwhelmed right now."
D) "Why do you think you feel this way?"
Answer: C. "It sounds like you're feeling very overwhelmed right now."
Rationale: This response uses reflection and validation of the patient's feelings,
demonstrating empathy and active listening. "Don't worry" (A) dismisses the
patient's feelings. "Stop worrying" (B) is judgmental. "Why" questions (D) can
make patients feel defensive and are less therapeutic.
Question 2
A patient with depression tells the nurse, "There's no point in living anymore. I just
want to end it all." Which of the following is the priority nursing action?
A) Ask the patient, "Do you have a plan to harm yourself?"
B) Tell the patient, "You have so much to live for."
C) Leave the patient alone to calm down.
D) Ask the patient, "What is making you feel this way?"
Answer: A. Ask the patient, "Do you have a plan to harm yourself?"
Rationale: When a patient expresses suicidal ideation, the priority is to assess for
suicide risk, including plan, means, and intent. This is a direct, non-judgmental
assessment question. Offering platitudes (B) is not therapeutic. Leaving the patient
,alone (C) is unsafe. Exploring feelings (D) is important but secondary to suicide
risk assessment.
Question 3
A patient with schizophrenia tells the nurse, "The FBI is watching me through the
television." Which of the following is the most therapeutic response?
A) "That's impossible. No one is watching you."
B) "I understand. Why do you think the FBI is interested in you?"
C) "That sounds frightening. I don't see anyone watching you, but I
understand you believe that."
D) "The television is just a machine. It cannot watch you."
Answer: C. "That sounds frightening. I don't see anyone watching you, but I
understand you believe that."
Rationale: This response validates the patient's feelings without validating the
delusion. It acknowledges the patient's reality while gently presenting the nurse's
perspective. Arguing (A) or rationalizing (D) with the patient is not therapeutic.
Asking "why" (B) can reinforce the delusion.
Question 4
A patient is silent for an extended period during a therapeutic interaction. Which of
the following nursing interventions is most appropriate?
A) End the session and leave the room.
B) Ask the patient, "Why are you being silent?"
C) Fill the silence with conversation.
D) Sit quietly with the patient and observe non-verbal cues.
Answer: D. Sit quietly with the patient and observe non-verbal cues.
Rationale: Silence can be therapeutic and allows patients time to process thoughts.
Sitting quietly demonstrates presence and acceptance. Ending the session (A) or
asking "why" questions (B) can be counterproductive. Filling the silence (C) may
prevent the patient from expressing themselves.
,Question 5
A patient tells the nurse, "I don't think anyone cares about me." Which of the
following is the most therapeutic response?
A) "I care about you."
B) "What makes you feel that no one cares about you?"
C) "You know that's not true."
D) "I can see you're feeling sad today."
Answer: B. "What makes you feel that no one cares about you?"
Rationale: Exploring the patient's feelings encourages expression and provides
insight into the patient's perception. Saying "I care" (A) shifts the focus to the
nurse. Arguing with the patient (C) dismisses their feelings. Reflecting feelings (D)
is appropriate but exploring the reason (B) is more therapeutic.
Question 6
A patient with borderline personality disorder says, "You're the best nurse ever. No
one has ever cared about me like you do." Which of the following is the most
therapeutic response?
A) "Thank you for the compliment."
B) "I can see you're feeling grateful right now."
C) "I am just doing my job."
D) "You're right. I do care about you."
Answer: B. "I can see you're feeling grateful right now."
Rationale: This response validates the patient's feelings without reinforcing
splitting or idealization. It acknowledges the emotion without personalizing it.
Accepting the compliment (A) may reinforce idealization. "Just doing my job" (C)
dismisses the patient's feelings. Personalizing (D) can lead to relationship issues.
Question 7
A patient with psychosis is hallucinating and is speaking to someone who is not in
the room. Which of the following should the nurse do first?
, A) Tell the patient to stop talking to the voices.
B) Leave the room and return when the patient is calm.
C) Acknowledge the hallucination and redirect to reality.
D) Ask the patient what the voices are saying.
Answer: C. Acknowledge the hallucination and redirect to reality.
Rationale: Acknowledging the hallucination demonstrates respect for the patient's
experience while redirecting to reality helps ground the patient. Telling the patient
to stop (A) is invalidating. Leaving the room (B) is abandoning the patient. Asking
what the voices say (D) may reinforce the hallucination.
Question 8
A patient is angry and yelling, "Everyone here ignores me!" Which of the
following is the most appropriate nursing response?
A) "You need to calm down right now."
B) "If you don't calm down, I will need to call security."
C) "I can see that you're upset. Tell me more about what's happening."
D) "No one is ignoring you. That's not true."
Answer: C. "I can see that you're upset. Tell me more about what's
happening."
Rationale: Validating the patient's feelings and encouraging expression helps de-
escalate anger. Commanding the patient to calm down (A) can escalate anger.
Threatening security (B) may be needed but should not be the first response.
Arguing (D) is not therapeutic.
Question 9
A patient with obsessive-compulsive disorder is performing a ritualistic hand-
washing behavior. Which of the following nursing interventions is most
appropriate?
A) Stop the patient from performing the ritual.
B) Allow unlimited time for the ritual.
Psychiatric Nursing Study Guide Questions with
Answers and Detailed Rationales
Question 1
A patient with anxiety disorder tells the nurse, "I feel like I'm going crazy. I can't
stop worrying about everything." Which of the following is the most therapeutic
response by the nurse?
A) "Don't worry, everything will be fine."
B) "You need to stop worrying so much."
C) "It sounds like you're feeling very overwhelmed right now."
D) "Why do you think you feel this way?"
Answer: C. "It sounds like you're feeling very overwhelmed right now."
Rationale: This response uses reflection and validation of the patient's feelings,
demonstrating empathy and active listening. "Don't worry" (A) dismisses the
patient's feelings. "Stop worrying" (B) is judgmental. "Why" questions (D) can
make patients feel defensive and are less therapeutic.
Question 2
A patient with depression tells the nurse, "There's no point in living anymore. I just
want to end it all." Which of the following is the priority nursing action?
A) Ask the patient, "Do you have a plan to harm yourself?"
B) Tell the patient, "You have so much to live for."
C) Leave the patient alone to calm down.
D) Ask the patient, "What is making you feel this way?"
Answer: A. Ask the patient, "Do you have a plan to harm yourself?"
Rationale: When a patient expresses suicidal ideation, the priority is to assess for
suicide risk, including plan, means, and intent. This is a direct, non-judgmental
assessment question. Offering platitudes (B) is not therapeutic. Leaving the patient
,alone (C) is unsafe. Exploring feelings (D) is important but secondary to suicide
risk assessment.
Question 3
A patient with schizophrenia tells the nurse, "The FBI is watching me through the
television." Which of the following is the most therapeutic response?
A) "That's impossible. No one is watching you."
B) "I understand. Why do you think the FBI is interested in you?"
C) "That sounds frightening. I don't see anyone watching you, but I
understand you believe that."
D) "The television is just a machine. It cannot watch you."
Answer: C. "That sounds frightening. I don't see anyone watching you, but I
understand you believe that."
Rationale: This response validates the patient's feelings without validating the
delusion. It acknowledges the patient's reality while gently presenting the nurse's
perspective. Arguing (A) or rationalizing (D) with the patient is not therapeutic.
Asking "why" (B) can reinforce the delusion.
Question 4
A patient is silent for an extended period during a therapeutic interaction. Which of
the following nursing interventions is most appropriate?
A) End the session and leave the room.
B) Ask the patient, "Why are you being silent?"
C) Fill the silence with conversation.
D) Sit quietly with the patient and observe non-verbal cues.
Answer: D. Sit quietly with the patient and observe non-verbal cues.
Rationale: Silence can be therapeutic and allows patients time to process thoughts.
Sitting quietly demonstrates presence and acceptance. Ending the session (A) or
asking "why" questions (B) can be counterproductive. Filling the silence (C) may
prevent the patient from expressing themselves.
,Question 5
A patient tells the nurse, "I don't think anyone cares about me." Which of the
following is the most therapeutic response?
A) "I care about you."
B) "What makes you feel that no one cares about you?"
C) "You know that's not true."
D) "I can see you're feeling sad today."
Answer: B. "What makes you feel that no one cares about you?"
Rationale: Exploring the patient's feelings encourages expression and provides
insight into the patient's perception. Saying "I care" (A) shifts the focus to the
nurse. Arguing with the patient (C) dismisses their feelings. Reflecting feelings (D)
is appropriate but exploring the reason (B) is more therapeutic.
Question 6
A patient with borderline personality disorder says, "You're the best nurse ever. No
one has ever cared about me like you do." Which of the following is the most
therapeutic response?
A) "Thank you for the compliment."
B) "I can see you're feeling grateful right now."
C) "I am just doing my job."
D) "You're right. I do care about you."
Answer: B. "I can see you're feeling grateful right now."
Rationale: This response validates the patient's feelings without reinforcing
splitting or idealization. It acknowledges the emotion without personalizing it.
Accepting the compliment (A) may reinforce idealization. "Just doing my job" (C)
dismisses the patient's feelings. Personalizing (D) can lead to relationship issues.
Question 7
A patient with psychosis is hallucinating and is speaking to someone who is not in
the room. Which of the following should the nurse do first?
, A) Tell the patient to stop talking to the voices.
B) Leave the room and return when the patient is calm.
C) Acknowledge the hallucination and redirect to reality.
D) Ask the patient what the voices are saying.
Answer: C. Acknowledge the hallucination and redirect to reality.
Rationale: Acknowledging the hallucination demonstrates respect for the patient's
experience while redirecting to reality helps ground the patient. Telling the patient
to stop (A) is invalidating. Leaving the room (B) is abandoning the patient. Asking
what the voices say (D) may reinforce the hallucination.
Question 8
A patient is angry and yelling, "Everyone here ignores me!" Which of the
following is the most appropriate nursing response?
A) "You need to calm down right now."
B) "If you don't calm down, I will need to call security."
C) "I can see that you're upset. Tell me more about what's happening."
D) "No one is ignoring you. That's not true."
Answer: C. "I can see that you're upset. Tell me more about what's
happening."
Rationale: Validating the patient's feelings and encouraging expression helps de-
escalate anger. Commanding the patient to calm down (A) can escalate anger.
Threatening security (B) may be needed but should not be the first response.
Arguing (D) is not therapeutic.
Question 9
A patient with obsessive-compulsive disorder is performing a ritualistic hand-
washing behavior. Which of the following nursing interventions is most
appropriate?
A) Stop the patient from performing the ritual.
B) Allow unlimited time for the ritual.
