NSG 3450 Mental Health Actual Exam
2 – Nursing Program – 2026/2027
Academic Year – Verified Questions
and Answers for Mental Health
Nursing Students
Foundations of Mental Health Nursing & Communication
1. A nurse is assessing a client who is experiencing occasional sadness due to the
recent death of a beloved pet. The client's appetite remains good, sleep is
uninterrupted, and they are able to go to work and socialize. How should the
nurse document this finding?
A. The client is experiencing clinical depression.
B. The client may be at risk for a mental disorder.
C. This is a normal response to loss, not a mental illness.
D. The client should be referred to a psychiatrist.
Answer: C
Rationale: The client is demonstrating a normal grief response to a significant loss.
Mental health is not simply the absence of sadness; it is the ability to function in daily
life despite emotional pain. This client's daily functioning is intact, which indicates
resilience, not pathology. Clinical depression would involve persistent symptoms
affecting multiple areas of functioning for at least two weeks .
,2. At what point should the nurse determine that a client is at risk for developing a
mental disorder?
A. When the client experiences feelings of sadness.
B. When the client's behavior becomes culturally deviant.
C. When the client experiences difficulty at work AND in relationships.
D. When a family member has a diagnosed mental illness.
Answer: C
Rationale: The DSM-5 diagnostic criteria for most mental disorders require that
symptoms cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning. Distress in multiple domains is more indicative of a
possible disorder. Sadness alone or cultural differences alone do not indicate a mental
disorder .
3. Which ethical principle is violated when a nurse threatens to put a patient in
"the quiet room" if they don't eat?
A. Justice
B. Nonmaleficence
C. Autonomy
D. Fidelity
Answer: B
Rationale: Nonmaleficence means "do no harm." Threatening to use seclusion or
restraints as a punishment or to coerce behavior is harmful and violates this principle.
Seclusion and restraints are only for immediate safety, never as a threat or punishment.
Justice refers to fairness, autonomy refers to self-determination, and fidelity refers to
keeping promises .
,4. Which nursing statement is an example of reflection?
A. "I think this feeling will pass."
B. "So you are saying that life has no meaning."
C. "I'm not sure I understand what you mean."
D. "You look sad."
Answer: D
Rationale: Reflection involves verbalizing what the nurse observes in the patient,
particularly their feelings or behaviors. "You look sad" reflects the patient's observed
affect. Option B is a restatement or paraphrasing, option C is a request for clarification,
and option A gives advice, which is nontherapeutic .
5. When should a nurse be most alert to the possibility of communication errors
resulting in harm to the patient?
A. Change of shift report
B. During admission assessment
C. When documenting in the electronic health record
D. During patient education sessions
Answer: A
Rationale: Handoff communication during shift change is a high-risk time for errors due
to missed information or misinterpretation. Standardized tools like SBAR (Situation,
Background, Assessment, Recommendation) are used to reduce communication failures
during transitions of care .
, 6. What principle about nurse-patient communication should guide a nurse's fear
about "saying the wrong thing" to a patient?
A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance,
respect, and concern.
B. Patients are more interested in talking than listening, so they are not likely to be
offended.
C. Considering the patient's history, there is little chance the comment will do harm.
D. The nurse should always avoid sharing any personal feelings.
Answer: A
Rationale: The therapeutic relationship is built on genuineness, respect, and
unconditional positive regard (Carl Rogers). Patients can sense authenticity and tolerate
minor missteps when the nurse's intent is clearly caring. Fear of saying the wrong thing
should not prevent the nurse from engaging therapeutically .
7. A new staff nurse completes an orientation to the psychiatric unit. This nurse
will expect to ask an advanced practice nurse to perform which action for
patients?
A. Perform mental health assessment interviews.
B. Prescribe psychotropic medication.
C. Establish therapeutic relationships.
D. Individualize nursing care plans.
Answer: B
2 – Nursing Program – 2026/2027
Academic Year – Verified Questions
and Answers for Mental Health
Nursing Students
Foundations of Mental Health Nursing & Communication
1. A nurse is assessing a client who is experiencing occasional sadness due to the
recent death of a beloved pet. The client's appetite remains good, sleep is
uninterrupted, and they are able to go to work and socialize. How should the
nurse document this finding?
A. The client is experiencing clinical depression.
B. The client may be at risk for a mental disorder.
C. This is a normal response to loss, not a mental illness.
D. The client should be referred to a psychiatrist.
Answer: C
Rationale: The client is demonstrating a normal grief response to a significant loss.
Mental health is not simply the absence of sadness; it is the ability to function in daily
life despite emotional pain. This client's daily functioning is intact, which indicates
resilience, not pathology. Clinical depression would involve persistent symptoms
affecting multiple areas of functioning for at least two weeks .
,2. At what point should the nurse determine that a client is at risk for developing a
mental disorder?
A. When the client experiences feelings of sadness.
B. When the client's behavior becomes culturally deviant.
C. When the client experiences difficulty at work AND in relationships.
D. When a family member has a diagnosed mental illness.
Answer: C
Rationale: The DSM-5 diagnostic criteria for most mental disorders require that
symptoms cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning. Distress in multiple domains is more indicative of a
possible disorder. Sadness alone or cultural differences alone do not indicate a mental
disorder .
3. Which ethical principle is violated when a nurse threatens to put a patient in
"the quiet room" if they don't eat?
A. Justice
B. Nonmaleficence
C. Autonomy
D. Fidelity
Answer: B
Rationale: Nonmaleficence means "do no harm." Threatening to use seclusion or
restraints as a punishment or to coerce behavior is harmful and violates this principle.
Seclusion and restraints are only for immediate safety, never as a threat or punishment.
Justice refers to fairness, autonomy refers to self-determination, and fidelity refers to
keeping promises .
,4. Which nursing statement is an example of reflection?
A. "I think this feeling will pass."
B. "So you are saying that life has no meaning."
C. "I'm not sure I understand what you mean."
D. "You look sad."
Answer: D
Rationale: Reflection involves verbalizing what the nurse observes in the patient,
particularly their feelings or behaviors. "You look sad" reflects the patient's observed
affect. Option B is a restatement or paraphrasing, option C is a request for clarification,
and option A gives advice, which is nontherapeutic .
5. When should a nurse be most alert to the possibility of communication errors
resulting in harm to the patient?
A. Change of shift report
B. During admission assessment
C. When documenting in the electronic health record
D. During patient education sessions
Answer: A
Rationale: Handoff communication during shift change is a high-risk time for errors due
to missed information or misinterpretation. Standardized tools like SBAR (Situation,
Background, Assessment, Recommendation) are used to reduce communication failures
during transitions of care .
, 6. What principle about nurse-patient communication should guide a nurse's fear
about "saying the wrong thing" to a patient?
A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance,
respect, and concern.
B. Patients are more interested in talking than listening, so they are not likely to be
offended.
C. Considering the patient's history, there is little chance the comment will do harm.
D. The nurse should always avoid sharing any personal feelings.
Answer: A
Rationale: The therapeutic relationship is built on genuineness, respect, and
unconditional positive regard (Carl Rogers). Patients can sense authenticity and tolerate
minor missteps when the nurse's intent is clearly caring. Fear of saying the wrong thing
should not prevent the nurse from engaging therapeutically .
7. A new staff nurse completes an orientation to the psychiatric unit. This nurse
will expect to ask an advanced practice nurse to perform which action for
patients?
A. Perform mental health assessment interviews.
B. Prescribe psychotropic medication.
C. Establish therapeutic relationships.
D. Individualize nursing care plans.
Answer: B
