NSG 526 Exam 3 Therapeutic Approaches
Practice Test 2026/2027 | Most
Frequently Tested Questions | Graded A+
1. A client with major depressive disorder tells the nurse, "I'm worthless. Nothing I do matters."
Which response is most therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really hopeless right now."
C) "Let's make a list of your accomplishments."
D) "Why do you feel worthless?"
Answer B: "It sounds like you're feeling really hopeless right now."
Rationale: Reflection validates the client's feeling without arguing or false reassurance. Avoid "why"
questions.
2. Which therapeutic approach is most effective for borderline personality disorder?
A) Psychoanalysis
B) Dialectical behavior therapy (DBT)
C) Electroconvulsive therapy
D) Hypnosis
Answer B: Dialectical behavior therapy (DBT)
Rationale: DBT is the gold standard for BPD, focusing on emotion regulation, distress tolerance, and
interpersonal effectiveness.
3. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is
the priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
,C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate safety interventions (constant
observation, environment safety).
4. Which medication is first-line for obsessive-compulsive disorder (OCD)?
A) Diazepam
B) Sertraline (SSRI)
C) Haloperidol
D) Lithium
Answer B: Sertraline (SSRI)
Rationale: SSRIs (often at higher doses) are first-line pharmacotherapy for OCD, alone or with CBT/ERP.
5. A client in the precontemplation stage of change says, "I don't have a drinking problem." Which
therapeutic approach is most appropriate?
A) Confront the client about the problem
B) Use motivational interviewing to explore ambivalence
C) Provide education about the dangers of alcohol
D) Refer to an inpatient detox program
Answer B: Use motivational interviewing to explore ambivalence
Rationale: Motivational interviewing meets the client where they are and builds motivation without
confrontation.
6. Which therapy is most effective for post-traumatic stress disorder (PTSD)?
A) Psychoanalysis
B) Cognitive processing therapy (CPT) or prolonged exposure
C) Supportive therapy only
,D) Hypnosis
Answer B: Cognitive processing therapy (CPT) or prolonged exposure
Rationale: Trauma-focused CBTs (CPT, PE) are first-line psychotherapies for PTSD.
7. A client with bipolar disorder is taking lithium. Which finding indicates possible toxicity?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) Polyuria
D) Weight gain
Answer B: Coarse tremor, vomiting, and confusion
Rationale: Coarse tremor, GI upset, and confusion indicate toxicity (level >1.5 mEq/L).
8. Which therapeutic communication technique involves restating the client's message in the
nurse's own words?
A) Clarification
B) Paraphrasing
C) Reflection
D) Summarization
Answer B: Paraphrasing
Rationale: Paraphrasing confirms understanding by restating the client's message.
9. A client with generalized anxiety disorder is prescribed buspirone. Which statement is correct?
A) It has immediate anxiolytic effects
B) It takes 2-4 weeks to work and has no abuse potential
C) It is a controlled substance
D) It should be taken PRN for panic attacks
Answer B: It takes 2-4 weeks to work and has no abuse potential
Rationale: Buspirone is a non-benzodiazepine anxiolytic with delayed onset and no dependence.
, 10. Which family therapy approach focuses on changing dysfunctional communication patterns
and boundaries?
A) Psychoeducational therapy
B) Structural family therapy
C) Strategic family therapy
D) Multisystemic therapy
Answer B: Structural family therapy
Rationale: Structural family therapy (Minuchin) addresses boundaries, hierarchy, and subsystem
functioning.
11. A client with schizophrenia is taking clozapine. Which laboratory test must be monitored
regularly?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Thyroid function tests
D) Blood glucose
Answer B: Absolute neutrophil count (ANC)
Rationale: Clozapine causes agranulocytosis; ANC is monitored weekly for 6 months, then every 2 weeks.
12. Which crisis intervention model includes seven stages, from assessing lethality to follow-up?
A) ABC model
B) Roberts' seven-stage crisis intervention model
C) SAFER model
D) Triage model
Answer B: Roberts' seven-stage crisis intervention model
Rationale: Roberts' model provides a structured framework for crisis assessment and intervention.
Practice Test 2026/2027 | Most
Frequently Tested Questions | Graded A+
1. A client with major depressive disorder tells the nurse, "I'm worthless. Nothing I do matters."
Which response is most therapeutic?
A) "You shouldn't feel that way; you have many strengths."
B) "It sounds like you're feeling really hopeless right now."
C) "Let's make a list of your accomplishments."
D) "Why do you feel worthless?"
Answer B: "It sounds like you're feeling really hopeless right now."
Rationale: Reflection validates the client's feeling without arguing or false reassurance. Avoid "why"
questions.
2. Which therapeutic approach is most effective for borderline personality disorder?
A) Psychoanalysis
B) Dialectical behavior therapy (DBT)
C) Electroconvulsive therapy
D) Hypnosis
Answer B: Dialectical behavior therapy (DBT)
Rationale: DBT is the gold standard for BPD, focusing on emotion regulation, distress tolerance, and
interpersonal effectiveness.
3. A client with schizophrenia tells the nurse, "The voices are telling me to hurt myself." What is
the priority nursing action?
A) Ask the client what the voices are saying in detail
B) Implement suicide precautions and notify the provider
,C) Tell the client to ignore the voices
D) Administer a PRN antipsychotic
Answer B: Implement suicide precautions and notify the provider
Rationale: Command hallucinations to self-harm require immediate safety interventions (constant
observation, environment safety).
4. Which medication is first-line for obsessive-compulsive disorder (OCD)?
A) Diazepam
B) Sertraline (SSRI)
C) Haloperidol
D) Lithium
Answer B: Sertraline (SSRI)
Rationale: SSRIs (often at higher doses) are first-line pharmacotherapy for OCD, alone or with CBT/ERP.
5. A client in the precontemplation stage of change says, "I don't have a drinking problem." Which
therapeutic approach is most appropriate?
A) Confront the client about the problem
B) Use motivational interviewing to explore ambivalence
C) Provide education about the dangers of alcohol
D) Refer to an inpatient detox program
Answer B: Use motivational interviewing to explore ambivalence
Rationale: Motivational interviewing meets the client where they are and builds motivation without
confrontation.
6. Which therapy is most effective for post-traumatic stress disorder (PTSD)?
A) Psychoanalysis
B) Cognitive processing therapy (CPT) or prolonged exposure
C) Supportive therapy only
,D) Hypnosis
Answer B: Cognitive processing therapy (CPT) or prolonged exposure
Rationale: Trauma-focused CBTs (CPT, PE) are first-line psychotherapies for PTSD.
7. A client with bipolar disorder is taking lithium. Which finding indicates possible toxicity?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) Polyuria
D) Weight gain
Answer B: Coarse tremor, vomiting, and confusion
Rationale: Coarse tremor, GI upset, and confusion indicate toxicity (level >1.5 mEq/L).
8. Which therapeutic communication technique involves restating the client's message in the
nurse's own words?
A) Clarification
B) Paraphrasing
C) Reflection
D) Summarization
Answer B: Paraphrasing
Rationale: Paraphrasing confirms understanding by restating the client's message.
9. A client with generalized anxiety disorder is prescribed buspirone. Which statement is correct?
A) It has immediate anxiolytic effects
B) It takes 2-4 weeks to work and has no abuse potential
C) It is a controlled substance
D) It should be taken PRN for panic attacks
Answer B: It takes 2-4 weeks to work and has no abuse potential
Rationale: Buspirone is a non-benzodiazepine anxiolytic with delayed onset and no dependence.
, 10. Which family therapy approach focuses on changing dysfunctional communication patterns
and boundaries?
A) Psychoeducational therapy
B) Structural family therapy
C) Strategic family therapy
D) Multisystemic therapy
Answer B: Structural family therapy
Rationale: Structural family therapy (Minuchin) addresses boundaries, hierarchy, and subsystem
functioning.
11. A client with schizophrenia is taking clozapine. Which laboratory test must be monitored
regularly?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Thyroid function tests
D) Blood glucose
Answer B: Absolute neutrophil count (ANC)
Rationale: Clozapine causes agranulocytosis; ANC is monitored weekly for 6 months, then every 2 weeks.
12. Which crisis intervention model includes seven stages, from assessing lethality to follow-up?
A) ABC model
B) Roberts' seven-stage crisis intervention model
C) SAFER model
D) Triage model
Answer B: Roberts' seven-stage crisis intervention model
Rationale: Roberts' model provides a structured framework for crisis assessment and intervention.
