RN Mental Health 2026: Ace the
NCLEX with Next-Gen Questions &
Evidence-Based Rationales//Instant
Download Pdf
Topics Covered:
Therapeutic Communication & Nurse-Client
Relationship
Psychiatric Disorders (Mood, Anxiety, Psychotic,
Personality)
Psychopharmacology
Crisis Intervention & Trauma
Legal & Ethical Issues
Substance Use Disorders
NGN-Style Case Studies
Question 1
A nurse is establishing a therapeutic relationship with a client who
has major depressive disorder. Which of the following statements
by the nurse best demonstrates the use of empathy?
,A. "I understand exactly how you feel. I've been depressed before
too."
B. "It sounds like you're feeling very sad and hopeless right now."
C. "You should try to think more positively about your situation."
D. "Why do you think you're feeling this way?"
Answer: B
Rationale: Empathy involves understanding and reflecting the
client's feelings without imposing the nurse's own experiences or
judgments. Option B demonstrates empathy by validating the
client's feelings. Option A uses sympathy and self-disclosure
inappropriately. Option C is giving advice, which is
nontherapeutic. Option D uses "why" questions, which can feel
accusatory and are generally avoided in therapeutic
communication.
Question 2
A client tells the nurse, "I don't think I can go on living like this
anymore." Which of the following is the nurse's priority response?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about harming yourself or ending your life?"
C. "Let's focus on the positive things in your life right now."
D. "I'll call your doctor to discuss your medication."
Answer: B
Rationale: When a client makes a statement suggesting suicidal
ideation, the nurse must directly assess for suicide risk. Asking
directly about suicidal thoughts is essential and does not increase
,the risk of suicide; it actually allows for appropriate intervention.
Options A and C minimize the client's feelings. Option D delays
the immediate safety assessment.
Question 3
A nurse is caring for a client who is withdrawn and refuses to
speak. Which of the following is the most appropriate nursing
intervention?
A. Sit silently with the client for short periods
B. Leave the client alone until they are ready to talk
C. Ask the client direct questions about why they won't speak
D. Tell the client that talking will help them feel better
Answer: A
Rationale: Sitting silently with a withdrawn client demonstrates
acceptance and presence without demanding interaction. This
provides a safe environment and allows the client to initiate
communication when ready. Option B could be perceived as
rejection. Option C may increase anxiety. Option D is pressuring
the client.
Question 4
A client with schizophrenia tells the nurse, "The FBI is monitoring
my thoughts through my television." Which of the following is the
most therapeutic response?
, A. "That's not true. The FBI doesn't monitor people's thoughts."
B. "I don't see any FBI agents. You're safe here."
C. "It must be frightening to believe that your thoughts are being
monitored. Tell me more about what that's like for you."
D. "Let's change the subject to something more pleasant."
Answer: C
Rationale: This response acknowledges the client's feelings
without validating the delusion. It shows empathy and encourages
the client to express their experience. Option A directly challenges
the delusion, which can damage trust. Option B dismisses the
client's reality. Option D avoids addressing the client's concern.
Question 5
A nurse is caring for a client who is angry and yelling. Which of
the following actions should the nurse take first?
A. Call security to restrain the client
B. Tell the client to calm down immediately
C. Speak to the client in a calm, low voice and maintain a safe
distance
D. Leave the room and close the door
Answer: C
Rationale: The priority is de-escalation. Speaking calmly,
maintaining a safe distance, and using a non-threatening tone can
help reduce the client's agitation. Restraint (Option A) should only
be used as a last resort. Telling the client to calm down (Option B)
NCLEX with Next-Gen Questions &
Evidence-Based Rationales//Instant
Download Pdf
Topics Covered:
Therapeutic Communication & Nurse-Client
Relationship
Psychiatric Disorders (Mood, Anxiety, Psychotic,
Personality)
Psychopharmacology
Crisis Intervention & Trauma
Legal & Ethical Issues
Substance Use Disorders
NGN-Style Case Studies
Question 1
A nurse is establishing a therapeutic relationship with a client who
has major depressive disorder. Which of the following statements
by the nurse best demonstrates the use of empathy?
,A. "I understand exactly how you feel. I've been depressed before
too."
B. "It sounds like you're feeling very sad and hopeless right now."
C. "You should try to think more positively about your situation."
D. "Why do you think you're feeling this way?"
Answer: B
Rationale: Empathy involves understanding and reflecting the
client's feelings without imposing the nurse's own experiences or
judgments. Option B demonstrates empathy by validating the
client's feelings. Option A uses sympathy and self-disclosure
inappropriately. Option C is giving advice, which is
nontherapeutic. Option D uses "why" questions, which can feel
accusatory and are generally avoided in therapeutic
communication.
Question 2
A client tells the nurse, "I don't think I can go on living like this
anymore." Which of the following is the nurse's priority response?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about harming yourself or ending your life?"
C. "Let's focus on the positive things in your life right now."
D. "I'll call your doctor to discuss your medication."
Answer: B
Rationale: When a client makes a statement suggesting suicidal
ideation, the nurse must directly assess for suicide risk. Asking
directly about suicidal thoughts is essential and does not increase
,the risk of suicide; it actually allows for appropriate intervention.
Options A and C minimize the client's feelings. Option D delays
the immediate safety assessment.
Question 3
A nurse is caring for a client who is withdrawn and refuses to
speak. Which of the following is the most appropriate nursing
intervention?
A. Sit silently with the client for short periods
B. Leave the client alone until they are ready to talk
C. Ask the client direct questions about why they won't speak
D. Tell the client that talking will help them feel better
Answer: A
Rationale: Sitting silently with a withdrawn client demonstrates
acceptance and presence without demanding interaction. This
provides a safe environment and allows the client to initiate
communication when ready. Option B could be perceived as
rejection. Option C may increase anxiety. Option D is pressuring
the client.
Question 4
A client with schizophrenia tells the nurse, "The FBI is monitoring
my thoughts through my television." Which of the following is the
most therapeutic response?
, A. "That's not true. The FBI doesn't monitor people's thoughts."
B. "I don't see any FBI agents. You're safe here."
C. "It must be frightening to believe that your thoughts are being
monitored. Tell me more about what that's like for you."
D. "Let's change the subject to something more pleasant."
Answer: C
Rationale: This response acknowledges the client's feelings
without validating the delusion. It shows empathy and encourages
the client to express their experience. Option A directly challenges
the delusion, which can damage trust. Option B dismisses the
client's reality. Option D avoids addressing the client's concern.
Question 5
A nurse is caring for a client who is angry and yelling. Which of
the following actions should the nurse take first?
A. Call security to restrain the client
B. Tell the client to calm down immediately
C. Speak to the client in a calm, low voice and maintain a safe
distance
D. Leave the room and close the door
Answer: C
Rationale: The priority is de-escalation. Speaking calmly,
maintaining a safe distance, and using a non-threatening tone can
help reduce the client's agitation. Restraint (Option A) should only
be used as a last resort. Telling the client to calm down (Option B)
