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NCLEX-RN psychiatric/mental HEALTH NURSING PRACTICE
EXAM QUESTIONS WITH LOGICAL RATIONALES
Nursing / Psychiatric
Exam coverage:
I. Section 1: Q1-20 – Therapeutic Communication & Nurse-
Client Relationship
II. Section 2: Q21-35 – Schizophrenia Spectrum & Psychotic
Disorders
III. Section 3: Q36-55 – Depressive & Bipolar Disorders
IV. Section 4: Q56-65 – Anxiety, Trauma & Stressor-Related
Disorders
V. Section 5: Q66-80 – Personality, Eating & Substance Use
Disorders
VI. Section 6: Q81-90 – Crisis Intervention, Legal & Ethical
Issues
VII. Section 7: Q91-100 – Psychopharmacology
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-
CLIENT RELATIONSHIP (Questions 1–20)
Question 1
A client diagnosed with major depressive disorder states to the
nurse, "I'm a burden to everyone. My family would be better off
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without me." Which response by the nurse demonstrates the
most therapeutic communication technique?
A) "You're not a burden; your family loves you very much."
B) "Why would you say something like that? You have so much
to live for."
C) "You shouldn't feel that way. Things will get better soon."
D) ✓ "It sounds like you are feeling like a burden to your
family. Tell me more about those feelings."
CORRECT: D
RATIONALE: This response uses the therapeutic
communication techniques of reflection and open-ended
questioning. It validates the client's feelings without judgment
and encourages further exploration. Option A provides false
reassurance, which dismisses the client's feelings. Option B
uses a "why" question, which can feel judgmental and
defensive. Option C offers false reassurance and minimizes the
client's expressed emotions.
Question 2
A client with schizophrenia tells the nurse, "The voices are
telling me that the government is tracking my thoughts through
the television." Which response by the nurse is most
therapeutic?
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A) "That's not true. The government is not tracking your
thoughts."
B) "I understand. The television can be very frightening
sometimes."
C) "Let's turn off the television so you don't have to hear those
voices."
D) ✓ "I do not hear the voices you are describing, but I
understand they are very real and frightening to you."
CORRECT: D
RATIONALE: This response acknowledges the client's
experience without reinforcing the hallucination. By stating that
the nurse does not hear the voices, the nurse presents reality
gently while validating the client's distress. Option A confronts
the delusion directly and may damage therapeutic rapport.
Option B inadvertently validates the hallucination. Option C
reinforces the client's belief that the television is the source of
the voices.
Question 3
A client who is recently admitted to the psychiatric unit states, "I
don't want to talk to anyone. Just leave me alone." Which
response by the nurse is most therapeutic?
A) "You need to participate in group therapy. It's part of your
treatment plan."
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B) "I'll leave you alone, but you need to let me know if you need
anything."
C) ✓ "I can see that you want to be alone right now. I'll check
back with you in 30 minutes if that's okay."
D) "Why don't you want to talk? You can tell me what's bothering
you."
CORRECT: C
RATIONALE: This response respects the client's need for
solitude while maintaining therapeutic presence and setting a
time for follow-up. Option A is authoritarian and dismisses the
client's expressed need. Option B may be interpreted as
abandonment. Option D uses a "why" question that can feel
intrusive and judgmental.
Question 4
A client tells the nurse, "I've been feeling so anxious lately. I
can't sleep, and I can't concentrate on anything." Which
response by the nurse demonstrates the therapeutic technique
of exploring?
A) "That sounds really difficult. Have you tried any relaxation
techniques?"
B) ✓ "Tell me more about what happens when you try to sleep
or concentrate."
NCLEX-RN psychiatric/mental HEALTH NURSING PRACTICE
EXAM QUESTIONS WITH LOGICAL RATIONALES
Nursing / Psychiatric
Exam coverage:
I. Section 1: Q1-20 – Therapeutic Communication & Nurse-
Client Relationship
II. Section 2: Q21-35 – Schizophrenia Spectrum & Psychotic
Disorders
III. Section 3: Q36-55 – Depressive & Bipolar Disorders
IV. Section 4: Q56-65 – Anxiety, Trauma & Stressor-Related
Disorders
V. Section 5: Q66-80 – Personality, Eating & Substance Use
Disorders
VI. Section 6: Q81-90 – Crisis Intervention, Legal & Ethical
Issues
VII. Section 7: Q91-100 – Psychopharmacology
SECTION 1: THERAPEUTIC COMMUNICATION & NURSE-
CLIENT RELATIONSHIP (Questions 1–20)
Question 1
A client diagnosed with major depressive disorder states to the
nurse, "I'm a burden to everyone. My family would be better off
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without me." Which response by the nurse demonstrates the
most therapeutic communication technique?
A) "You're not a burden; your family loves you very much."
B) "Why would you say something like that? You have so much
to live for."
C) "You shouldn't feel that way. Things will get better soon."
D) ✓ "It sounds like you are feeling like a burden to your
family. Tell me more about those feelings."
CORRECT: D
RATIONALE: This response uses the therapeutic
communication techniques of reflection and open-ended
questioning. It validates the client's feelings without judgment
and encourages further exploration. Option A provides false
reassurance, which dismisses the client's feelings. Option B
uses a "why" question, which can feel judgmental and
defensive. Option C offers false reassurance and minimizes the
client's expressed emotions.
Question 2
A client with schizophrenia tells the nurse, "The voices are
telling me that the government is tracking my thoughts through
the television." Which response by the nurse is most
therapeutic?
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A) "That's not true. The government is not tracking your
thoughts."
B) "I understand. The television can be very frightening
sometimes."
C) "Let's turn off the television so you don't have to hear those
voices."
D) ✓ "I do not hear the voices you are describing, but I
understand they are very real and frightening to you."
CORRECT: D
RATIONALE: This response acknowledges the client's
experience without reinforcing the hallucination. By stating that
the nurse does not hear the voices, the nurse presents reality
gently while validating the client's distress. Option A confronts
the delusion directly and may damage therapeutic rapport.
Option B inadvertently validates the hallucination. Option C
reinforces the client's belief that the television is the source of
the voices.
Question 3
A client who is recently admitted to the psychiatric unit states, "I
don't want to talk to anyone. Just leave me alone." Which
response by the nurse is most therapeutic?
A) "You need to participate in group therapy. It's part of your
treatment plan."
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B) "I'll leave you alone, but you need to let me know if you need
anything."
C) ✓ "I can see that you want to be alone right now. I'll check
back with you in 30 minutes if that's okay."
D) "Why don't you want to talk? You can tell me what's bothering
you."
CORRECT: C
RATIONALE: This response respects the client's need for
solitude while maintaining therapeutic presence and setting a
time for follow-up. Option A is authoritarian and dismisses the
client's expressed need. Option B may be interpreted as
abandonment. Option D uses a "why" question that can feel
intrusive and judgmental.
Question 4
A client tells the nurse, "I've been feeling so anxious lately. I
can't sleep, and I can't concentrate on anything." Which
response by the nurse demonstrates the therapeutic technique
of exploring?
A) "That sounds really difficult. Have you tried any relaxation
techniques?"
B) ✓ "Tell me more about what happens when you try to sleep
or concentrate."
