MENTAL HEALTH NURSING PNG 2254 –
LETHBRIDGE COLLEGE COMPREHENSIVE
EXAMINATION 1, 175 MULTIPLE-CHOICE
QUESTIONS, INTERMEDIATE TO ADVANCED LEVEL
SECTION A: FOUNDATIONAL CONCEPTS IN MENTAL HEALTH NURSING
(Questions 1-35)
1. The primary nursing goal when establishing a therapeutic relationship with a client
is to:
A. Collect comprehensive assessment data
B. Promote client growth and adaptive functioning
C. Implement physician-prescribed treatments
D. Maintain professional boundaries at all times
Answer: B. Promote client growth and adaptive functioning
Rationale: The primary goal of establishing a therapeutic relationship is to promote client
growth toward more adaptive functioning. While assessment, treatment implementation,
and boundaries are important components of the nurse-client relationship, they serve the
overarching purpose of facilitating the client's personal growth and recovery.
, 2. Which of the following best defines the therapeutic use of self?
A. Using standardized therapeutic techniques and protocols
B. Maintaining emotional distance from clients to ensure objectivity
C. Consciously and deliberately using one's personality to establish relatedness and
structure nursing interventions
D. Implementing evidence-based practice guidelines consistently
Answer: C. Consciously and deliberately using one's personality to establish
relatedness and structure nursing interventions
Rationale: The therapeutic use of self involves the nurse's conscious, deliberate
application of their personality, experiences, and interpersonal skills to develop a
therapeutic relationship and structure nursing interventions. This concept, central to
psychiatric nursing, requires self-awareness and intentionality.
3. Which conditions are essential for the development of a therapeutic nurse-client
relationship?
A. Empathy, sympathy, and unconditional positive regard
B. Rapport, trust, respect, genuineness, and empathy
C. Transference, countertransference, and boundary setting
D. Assessment, diagnosis, planning, and evaluation
Answer: B. Rapport, trust, respect, genuineness, and empathy
Rationale: These five conditions—rapport, trust, respect, genuineness, and empathy—
form the foundation of a therapeutic relationship. Sympathy is not therapeutic as it implies
emotional involvement that can impair objectivity. Transference and countertransference
are phenomena that may occur within the relationship but are not prerequisites.
4. A nurse is working with a client who consistently arrives late to sessions. The nurse
should FIRST:
A. Terminate the therapeutic relationship
B. Explore the meaning of the lateness with the client
C. Implement a strict time management policy
D. Ignore the behavior to avoid confrontation
Answer: B. Explore the meaning of the lateness with the client
,Rationale: Exploring the meaning of client behaviors, including lateness, is essential in the
therapeutic relationship. This approach demonstrates respect, promotes insight, and
addresses potential resistance or other underlying issues. Ignoring the behavior,
terminating the relationship, or implementing rigid policies without exploration are not
therapeutic responses.
5. According to Maslow's hierarchy of needs, which need must be met FIRST for a
client experiencing acute psychosis?
A. Self-esteem needs
B. Love and belonging needs
C. Physiological needs and safety
D. Self-actualization needs
Answer: C. Physiological needs and safety
Rationale: Maslow's hierarchy identifies physiological needs (air, food, water, shelter,
sleep) and safety needs (security, stability) as the most fundamental. In acute psychosis,
ensuring physiological stability and physical safety must precede addressing higher-level
needs like self-esteem, belonging, or self-actualization.
6. Selye's General Adaptation Syndrome consists of which stages in correct order?
A. Stage of resistance, alarm reaction, stage of exhaustion
B. Alarm reaction, stage of resistance, stage of exhaustion
C. Stage of exhaustion, alarm reaction, stage of resistance
D. Alarm reaction, stage of exhaustion, stage of resistance
Answer: B. Alarm reaction, stage of resistance, stage of exhaustion
Rationale: Selye's General Adaptation Syndrome describes the body's response to stress in
three sequential stages: the alarm reaction (fight-or-flight response), followed by the stage
of resistance (adaptation and coping), and finally the stage of exhaustion (depletion of
resources if stress continues).
7. A client who is experiencing a panic attack would be classified at which level of
anxiety?
A. Mild
B. Moderate
, C. Severe
D. Panic
Answer: D. Panic
Rationale: Panic-level anxiety is characterized by overwhelming fear, loss of rational
thought, potential harm to self or others, and inability to process environmental stimuli.
The term "panic attack" specifically identifies this highest level of anxiety in the four-level
classification system.
8. The four levels of anxiety in ascending order of severity are:
A. Mild, moderate, severe, panic
B. Moderate, mild, severe, panic
C. Mild, severe, moderate, panic
D. Moderate, severe, panic, mild
Answer: A. Mild, moderate, severe, panic
Rationale: The four levels of anxiety are classified as mild (slight tension, heightened
awareness), moderate (narrowed perceptual field, selective inattention), severe (greatly
reduced perceptual field, difficulty focusing), and panic (extreme terror, loss of rational
thought, possible harm).
9. Which of the following defense mechanisms involves the involuntary exclusion of
painful or threatening memories from conscious awareness?
A. Suppression
B. Denial
C. Repression
D. Dissociation
Answer: C. Repression
Rationale: Repression is an involuntary defense mechanism that excludes painful,
threatening, or unacceptable memories, thoughts, or impulses from conscious awareness.
Suppression, in contrast, is a conscious, voluntary process. Denial involves refusing to
acknowledge reality, while dissociation involves disruption in consciousness or identity.
LETHBRIDGE COLLEGE COMPREHENSIVE
EXAMINATION 1, 175 MULTIPLE-CHOICE
QUESTIONS, INTERMEDIATE TO ADVANCED LEVEL
SECTION A: FOUNDATIONAL CONCEPTS IN MENTAL HEALTH NURSING
(Questions 1-35)
1. The primary nursing goal when establishing a therapeutic relationship with a client
is to:
A. Collect comprehensive assessment data
B. Promote client growth and adaptive functioning
C. Implement physician-prescribed treatments
D. Maintain professional boundaries at all times
Answer: B. Promote client growth and adaptive functioning
Rationale: The primary goal of establishing a therapeutic relationship is to promote client
growth toward more adaptive functioning. While assessment, treatment implementation,
and boundaries are important components of the nurse-client relationship, they serve the
overarching purpose of facilitating the client's personal growth and recovery.
, 2. Which of the following best defines the therapeutic use of self?
A. Using standardized therapeutic techniques and protocols
B. Maintaining emotional distance from clients to ensure objectivity
C. Consciously and deliberately using one's personality to establish relatedness and
structure nursing interventions
D. Implementing evidence-based practice guidelines consistently
Answer: C. Consciously and deliberately using one's personality to establish
relatedness and structure nursing interventions
Rationale: The therapeutic use of self involves the nurse's conscious, deliberate
application of their personality, experiences, and interpersonal skills to develop a
therapeutic relationship and structure nursing interventions. This concept, central to
psychiatric nursing, requires self-awareness and intentionality.
3. Which conditions are essential for the development of a therapeutic nurse-client
relationship?
A. Empathy, sympathy, and unconditional positive regard
B. Rapport, trust, respect, genuineness, and empathy
C. Transference, countertransference, and boundary setting
D. Assessment, diagnosis, planning, and evaluation
Answer: B. Rapport, trust, respect, genuineness, and empathy
Rationale: These five conditions—rapport, trust, respect, genuineness, and empathy—
form the foundation of a therapeutic relationship. Sympathy is not therapeutic as it implies
emotional involvement that can impair objectivity. Transference and countertransference
are phenomena that may occur within the relationship but are not prerequisites.
4. A nurse is working with a client who consistently arrives late to sessions. The nurse
should FIRST:
A. Terminate the therapeutic relationship
B. Explore the meaning of the lateness with the client
C. Implement a strict time management policy
D. Ignore the behavior to avoid confrontation
Answer: B. Explore the meaning of the lateness with the client
,Rationale: Exploring the meaning of client behaviors, including lateness, is essential in the
therapeutic relationship. This approach demonstrates respect, promotes insight, and
addresses potential resistance or other underlying issues. Ignoring the behavior,
terminating the relationship, or implementing rigid policies without exploration are not
therapeutic responses.
5. According to Maslow's hierarchy of needs, which need must be met FIRST for a
client experiencing acute psychosis?
A. Self-esteem needs
B. Love and belonging needs
C. Physiological needs and safety
D. Self-actualization needs
Answer: C. Physiological needs and safety
Rationale: Maslow's hierarchy identifies physiological needs (air, food, water, shelter,
sleep) and safety needs (security, stability) as the most fundamental. In acute psychosis,
ensuring physiological stability and physical safety must precede addressing higher-level
needs like self-esteem, belonging, or self-actualization.
6. Selye's General Adaptation Syndrome consists of which stages in correct order?
A. Stage of resistance, alarm reaction, stage of exhaustion
B. Alarm reaction, stage of resistance, stage of exhaustion
C. Stage of exhaustion, alarm reaction, stage of resistance
D. Alarm reaction, stage of exhaustion, stage of resistance
Answer: B. Alarm reaction, stage of resistance, stage of exhaustion
Rationale: Selye's General Adaptation Syndrome describes the body's response to stress in
three sequential stages: the alarm reaction (fight-or-flight response), followed by the stage
of resistance (adaptation and coping), and finally the stage of exhaustion (depletion of
resources if stress continues).
7. A client who is experiencing a panic attack would be classified at which level of
anxiety?
A. Mild
B. Moderate
, C. Severe
D. Panic
Answer: D. Panic
Rationale: Panic-level anxiety is characterized by overwhelming fear, loss of rational
thought, potential harm to self or others, and inability to process environmental stimuli.
The term "panic attack" specifically identifies this highest level of anxiety in the four-level
classification system.
8. The four levels of anxiety in ascending order of severity are:
A. Mild, moderate, severe, panic
B. Moderate, mild, severe, panic
C. Mild, severe, moderate, panic
D. Moderate, severe, panic, mild
Answer: A. Mild, moderate, severe, panic
Rationale: The four levels of anxiety are classified as mild (slight tension, heightened
awareness), moderate (narrowed perceptual field, selective inattention), severe (greatly
reduced perceptual field, difficulty focusing), and panic (extreme terror, loss of rational
thought, possible harm).
9. Which of the following defense mechanisms involves the involuntary exclusion of
painful or threatening memories from conscious awareness?
A. Suppression
B. Denial
C. Repression
D. Dissociation
Answer: C. Repression
Rationale: Repression is an involuntary defense mechanism that excludes painful,
threatening, or unacceptable memories, thoughts, or impulses from conscious awareness.
Suppression, in contrast, is a conscious, voluntary process. Denial involves refusing to
acknowledge reality, while dissociation involves disruption in consciousness or identity.
