NCLEX-RN Mental Health Nursing 2026
1. A client says, “I am a terrible parent. My children would be better without
me.” Which response is most therapeutic?
A. “You should not talk about yourself that way.”
B. “What makes you think your children would be better without you?”
C. “It sounds like you are feeling worthless right now.”
D. “Your children probably love you very much.”
Answer: C
Rationale: Reflection and acknowledgment of the client's feelings promote therapeutic
communication without giving false reassurance or judging the client.
2. A client is crying silently. Which action should the nurse take first?
A. Ask the client why they are crying
B. Sit quietly with the client
C. Leave the room to provide privacy
D. Tell the client that everything will be okay
Answer: B
Rationale: Therapeutic presence and silence allow the client time and space to express feelings.
3. Which statement demonstrates therapeutic communication?
A. “Why did you do that?”
B. “You should try to think positively.”
C. “Tell me more about what happened.”
D. “Everything will work out.”
Answer: C
Rationale: An open-ended invitation encourages the client to explore thoughts and feelings.
,4. A client states, “The voices are telling me to hurt myself.” What is the nurse's
priority response?
A. “You know the voices are not real.”
B. “What are the voices telling you to do?”
C. “Try listening to music instead.”
D. “Ignore the voices.”
Answer: B
Rationale: The nurse must assess command hallucinations and determine whether the client is at
immediate risk of harm.
5. Which response is an example of false reassurance?
A. “Tell me more about your concerns.”
B. “Everything will be fine.”
C. “You seem worried about tomorrow.”
D. “What concerns you most?”
Answer: B
Rationale: False reassurance minimizes the client's feelings and may block communication.
6. A client says, “Nobody understands what I am going through.” Which
response is best?
A. “I understand exactly how you feel.”
B. “You should talk to your family.”
C. “Help me understand what this experience has been like for you.”
D. “Many people have similar problems.”
Answer: C
Rationale: The response focuses on the client's individual experience without assuming the nurse
understands it.
7. A client asks the nurse, “Would you be upset if your spouse left you?” Which
response is most therapeutic?
,A. “Yes, I would be devastated.”
B. “Why are you asking me that?”
C. “What feelings come up when you think about your spouse leaving?”
D. “You should focus on your own problems.”
Answer: C
Rationale: Focusing redirects attention to the client's feelings and encourages self-exploration.
8. A client repeatedly changes the subject when discussing a recent loss. Which
technique should the nurse use?
A. Confrontation
B. Focusing
C. Giving advice
D. Changing the subject
Answer: B
Rationale: Focusing helps the client concentrate on an important issue without being
judgmental.
9. Which statement by the nurse is nontherapeutic?
A. “What are you thinking about?”
B. “You should not feel guilty.”
C. “You appear upset.”
D. “Tell me more about that.”
Answer: B
Rationale: Telling the client how to feel dismisses emotions and is judgmental.
10. A client says, “I am afraid I will lose control.” What is the best nursing
response?
A. “You will not lose control.”
B. “Why do you feel that way?”
C. “Tell me what losing control means to you.”
D. “Try not to worry.”
, Answer: C
Rationale: Clarification helps the nurse understand the client's perception and concerns.
11. Which behavior best demonstrates active listening?
A. Interrupting to ask questions
B. Looking at the electronic health record
C. Maintaining appropriate eye contact and attentive posture
D. Frequently changing the subject
Answer: C
Rationale: Appropriate nonverbal behavior demonstrates attention and interest.
12. A client says, “I have nothing to live for.” Which response is the priority?
A. “You have many reasons to live.”
B. “Are you thinking about killing yourself?”
C. “You should talk with your family.”
D. “Things may improve soon.”
Answer: B
Rationale: Direct suicide assessment is essential when a client expresses hopelessness or a
desire not to live.
13. A client is silent after receiving difficult news. What should the nurse do?
A. Immediately ask several questions
B. Change the subject
C. Allow therapeutic silence
D. Leave the client alone
Answer: C
Rationale: Silence can provide time for the client to process emotions and encourages
communication.
1. A client says, “I am a terrible parent. My children would be better without
me.” Which response is most therapeutic?
A. “You should not talk about yourself that way.”
B. “What makes you think your children would be better without you?”
C. “It sounds like you are feeling worthless right now.”
D. “Your children probably love you very much.”
Answer: C
Rationale: Reflection and acknowledgment of the client's feelings promote therapeutic
communication without giving false reassurance or judging the client.
2. A client is crying silently. Which action should the nurse take first?
A. Ask the client why they are crying
B. Sit quietly with the client
C. Leave the room to provide privacy
D. Tell the client that everything will be okay
Answer: B
Rationale: Therapeutic presence and silence allow the client time and space to express feelings.
3. Which statement demonstrates therapeutic communication?
A. “Why did you do that?”
B. “You should try to think positively.”
C. “Tell me more about what happened.”
D. “Everything will work out.”
Answer: C
Rationale: An open-ended invitation encourages the client to explore thoughts and feelings.
,4. A client states, “The voices are telling me to hurt myself.” What is the nurse's
priority response?
A. “You know the voices are not real.”
B. “What are the voices telling you to do?”
C. “Try listening to music instead.”
D. “Ignore the voices.”
Answer: B
Rationale: The nurse must assess command hallucinations and determine whether the client is at
immediate risk of harm.
5. Which response is an example of false reassurance?
A. “Tell me more about your concerns.”
B. “Everything will be fine.”
C. “You seem worried about tomorrow.”
D. “What concerns you most?”
Answer: B
Rationale: False reassurance minimizes the client's feelings and may block communication.
6. A client says, “Nobody understands what I am going through.” Which
response is best?
A. “I understand exactly how you feel.”
B. “You should talk to your family.”
C. “Help me understand what this experience has been like for you.”
D. “Many people have similar problems.”
Answer: C
Rationale: The response focuses on the client's individual experience without assuming the nurse
understands it.
7. A client asks the nurse, “Would you be upset if your spouse left you?” Which
response is most therapeutic?
,A. “Yes, I would be devastated.”
B. “Why are you asking me that?”
C. “What feelings come up when you think about your spouse leaving?”
D. “You should focus on your own problems.”
Answer: C
Rationale: Focusing redirects attention to the client's feelings and encourages self-exploration.
8. A client repeatedly changes the subject when discussing a recent loss. Which
technique should the nurse use?
A. Confrontation
B. Focusing
C. Giving advice
D. Changing the subject
Answer: B
Rationale: Focusing helps the client concentrate on an important issue without being
judgmental.
9. Which statement by the nurse is nontherapeutic?
A. “What are you thinking about?”
B. “You should not feel guilty.”
C. “You appear upset.”
D. “Tell me more about that.”
Answer: B
Rationale: Telling the client how to feel dismisses emotions and is judgmental.
10. A client says, “I am afraid I will lose control.” What is the best nursing
response?
A. “You will not lose control.”
B. “Why do you feel that way?”
C. “Tell me what losing control means to you.”
D. “Try not to worry.”
, Answer: C
Rationale: Clarification helps the nurse understand the client's perception and concerns.
11. Which behavior best demonstrates active listening?
A. Interrupting to ask questions
B. Looking at the electronic health record
C. Maintaining appropriate eye contact and attentive posture
D. Frequently changing the subject
Answer: C
Rationale: Appropriate nonverbal behavior demonstrates attention and interest.
12. A client says, “I have nothing to live for.” Which response is the priority?
A. “You have many reasons to live.”
B. “Are you thinking about killing yourself?”
C. “You should talk with your family.”
D. “Things may improve soon.”
Answer: B
Rationale: Direct suicide assessment is essential when a client expresses hopelessness or a
desire not to live.
13. A client is silent after receiving difficult news. What should the nurse do?
A. Immediately ask several questions
B. Change the subject
C. Allow therapeutic silence
D. Leave the client alone
Answer: C
Rationale: Silence can provide time for the client to process emotions and encourages
communication.
