NSG 3450 / NSG3450 Exam 2: Nursing Practice - Mental Health (2026/2027 Update)
OBJECTIVE ASSESSMENT - EXAM
Nursing Practice -
Mental Health
Exam 2
A+ Verified Edition: 2026/2027 Passing Score: 80%
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Foundations of Psychiatric-Mental Health Nursing & Therapeutic Communication
Section 2: Anxiety, Obsessive-Compulsive & Trauma-Related Disorders
Section 3: Mood Disorders & Suicide Prevention
Section 4: Psychotic Disorders, Schizophrenia Spectrum & Personality Disorders
Section 5: Substance Use, Eating Disorders, Geriatric Psychiatry & Legal/Ethical Issues
This examination assesses undergraduate nursing knowledge in psychiatric-mental health nursing at the
baccalaureate level. Each question presents a realistic clinical scenario followed by four answer choices. Select the
best answer for each question.
Section 1: Foundations of Psychiatric-Mental Health Nursing & Therapeutic Communication
Question 1
Q1. A 34-year-old patient admitted for major depressive disorder tells the nurse, "I don't think anyone
really cares about me." The nurse sits at eye level, maintains open posture, and responds, "It sounds
like you're feeling very alone right now." Which therapeutic communication technique is the nurse
primarily demonstrating?
A. Giving advice by telling the patient what to feel
B. Using clarification to seek understanding
C. Restating the patient's feelings to convey empathy
D. Changing the subject to avoid emotional discomfort
Correct Answer: C
Rationale:
Restating involves repeating the patient's expressed feelings in similar words to convey empathy and encourage further
exploration. This technique validates the patient's emotional state without imposing the nurse's interpretation. Giving advice
and changing the subject are non-therapeutic, while clarification asks for elaboration rather than reflecting feelings.
NSG 3450 / NSG3450 Exam 2: Nursing Practice - Mental Health (2026/2027 Update) | Page 2
, Question 2
Q2. During morning rounds, a psychiatric nurse observes a patient pacing rapidly in the hallway,
clenching fists, and speaking in a loud, threatening tone to another patient. Using the Stages of
Violence Assessment, the nurse recognizes these behaviors as indicators of which phase?
A. The crisis phase where physical aggression has already occurred
B. The trigger phase where environmental stressors accumulate
C. The escalation phase where behavioral cues intensify
D. The recovery phase where de-escalation techniques are effective
Correct Answer: C
Rationale:
The escalation phase is characterized by increasing agitation, pacing, clenched fists, raised voice, and threatening
behavior. These observable cues signal that the patient is progressing toward potential violence and requires immediate
de-escalation intervention. The trigger phase involves preceding stressors, while the crisis phase involves actual physical
aggression.
Question 3
Q3. A nursing student is caring for a patient with borderline personality disorder who says, "You're the
only nurse who understands me. All the others are terrible." Later that day, the student finds the
patient angry and stating, "You don't care about me at all." Which defense mechanism is the patient
most likely exhibiting?
A. Sublimation redirecting impulses into constructive activities
B. Splitting viewing people as all good or all bad
C. Rationalization creating logical excuses for behavior
D. Projection attributing own feelings to others
Correct Answer: B
Rationale:
Splitting is a primitive defense mechanism commonly seen in borderline personality disorder, where individuals view others
as either all good or all bad without integration. The patient idealized the student nurse earlier and then devalued them
later. Sublimation, rationalization, and projection are different defense mechanisms not demonstrated in this scenario.
Question 4
Q4. A nurse on an inpatient psychiatric unit is conducting the initial mental status examination of a
newly admitted 28-year-old patient. When asked about mood, the patient reports feeling "hopeless and
empty." When assessing affect, the nurse observes the patient's facial expression remains flat and
unchanging throughout the interview. Which term best describes this affective presentation?
A. Euphoric affect demonstrating exaggerated happiness
B. Labile affect showing rapid emotional shifts
C. Restricted affect with minimal emotional expression
D. Blunted affect with severe reduction in emotional range
Correct Answer: D
Rationale:
Blunted affect describes a severe reduction in the range and intensity of emotional expression, where the patient's facial
expression remains flat and unchanging despite reported internal feelings. Restricted affect involves mild reduction, while
labile affect involves rapid shifts. Euphoric affect is unrelated to this presentation.
NSG 3450 / NSG3450 Exam 2: Nursing Practice - Mental Health (2026/2027 Update) | Page 3
OBJECTIVE ASSESSMENT - EXAM
Nursing Practice -
Mental Health
Exam 2
A+ Verified Edition: 2026/2027 Passing Score: 80%
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Foundations of Psychiatric-Mental Health Nursing & Therapeutic Communication
Section 2: Anxiety, Obsessive-Compulsive & Trauma-Related Disorders
Section 3: Mood Disorders & Suicide Prevention
Section 4: Psychotic Disorders, Schizophrenia Spectrum & Personality Disorders
Section 5: Substance Use, Eating Disorders, Geriatric Psychiatry & Legal/Ethical Issues
This examination assesses undergraduate nursing knowledge in psychiatric-mental health nursing at the
baccalaureate level. Each question presents a realistic clinical scenario followed by four answer choices. Select the
best answer for each question.
Section 1: Foundations of Psychiatric-Mental Health Nursing & Therapeutic Communication
Question 1
Q1. A 34-year-old patient admitted for major depressive disorder tells the nurse, "I don't think anyone
really cares about me." The nurse sits at eye level, maintains open posture, and responds, "It sounds
like you're feeling very alone right now." Which therapeutic communication technique is the nurse
primarily demonstrating?
A. Giving advice by telling the patient what to feel
B. Using clarification to seek understanding
C. Restating the patient's feelings to convey empathy
D. Changing the subject to avoid emotional discomfort
Correct Answer: C
Rationale:
Restating involves repeating the patient's expressed feelings in similar words to convey empathy and encourage further
exploration. This technique validates the patient's emotional state without imposing the nurse's interpretation. Giving advice
and changing the subject are non-therapeutic, while clarification asks for elaboration rather than reflecting feelings.
NSG 3450 / NSG3450 Exam 2: Nursing Practice - Mental Health (2026/2027 Update) | Page 2
, Question 2
Q2. During morning rounds, a psychiatric nurse observes a patient pacing rapidly in the hallway,
clenching fists, and speaking in a loud, threatening tone to another patient. Using the Stages of
Violence Assessment, the nurse recognizes these behaviors as indicators of which phase?
A. The crisis phase where physical aggression has already occurred
B. The trigger phase where environmental stressors accumulate
C. The escalation phase where behavioral cues intensify
D. The recovery phase where de-escalation techniques are effective
Correct Answer: C
Rationale:
The escalation phase is characterized by increasing agitation, pacing, clenched fists, raised voice, and threatening
behavior. These observable cues signal that the patient is progressing toward potential violence and requires immediate
de-escalation intervention. The trigger phase involves preceding stressors, while the crisis phase involves actual physical
aggression.
Question 3
Q3. A nursing student is caring for a patient with borderline personality disorder who says, "You're the
only nurse who understands me. All the others are terrible." Later that day, the student finds the
patient angry and stating, "You don't care about me at all." Which defense mechanism is the patient
most likely exhibiting?
A. Sublimation redirecting impulses into constructive activities
B. Splitting viewing people as all good or all bad
C. Rationalization creating logical excuses for behavior
D. Projection attributing own feelings to others
Correct Answer: B
Rationale:
Splitting is a primitive defense mechanism commonly seen in borderline personality disorder, where individuals view others
as either all good or all bad without integration. The patient idealized the student nurse earlier and then devalued them
later. Sublimation, rationalization, and projection are different defense mechanisms not demonstrated in this scenario.
Question 4
Q4. A nurse on an inpatient psychiatric unit is conducting the initial mental status examination of a
newly admitted 28-year-old patient. When asked about mood, the patient reports feeling "hopeless and
empty." When assessing affect, the nurse observes the patient's facial expression remains flat and
unchanging throughout the interview. Which term best describes this affective presentation?
A. Euphoric affect demonstrating exaggerated happiness
B. Labile affect showing rapid emotional shifts
C. Restricted affect with minimal emotional expression
D. Blunted affect with severe reduction in emotional range
Correct Answer: D
Rationale:
Blunted affect describes a severe reduction in the range and intensity of emotional expression, where the patient's facial
expression remains flat and unchanging despite reported internal feelings. Restricted affect involves mild reduction, while
labile affect involves rapid shifts. Euphoric affect is unrelated to this presentation.
NSG 3450 / NSG3450 Exam 2: Nursing Practice - Mental Health (2026/2027 Update) | Page 3
