,Galen NSG 3450 Exam 2 | Nursing Practice: Mental Health
(2026) Actual Q&A PDF
1. A nurse is conducting an admission interview with an adolescent who states, "Why should
I tell you anything? You'll just tell my parents everything." Which response by the nurse is
most appropriate?
A) "Your parents have a legal right to know everything you tell me."
B) "What you say about your feelings is private, but some things, like suicidal thoughts, must
be reported to the treatment team."
C) "I promise I won't tell your parents anything you say."
D) "You're right to be concerned, but I have to tell your parents everything."
Correct Answer: "What you say about your feelings is private, but some things, like suicidal
thoughts, must be reported to the treatment team."
Rationale: This response is honest about the limits of confidentiality while respecting the
adolescent's need for privacy. It establishes trust by clarifying what information will be
shared and under what circumstances, which is essential for building a therapeutic alliance.
The other options either misrepresent confidentiality or make false promises.
2. A patient tells the nurse, "My marriage is perfect," while repeatedly tapping their foot and
avoiding eye contact. The nurse recognizes this as an example of:
A) Congruent communication
B) Incongruous communication
C) Defensive communication
D) Passive communication
Correct Answer: Incongruous communication
,Rationale: Incongruous communication occurs when there is a mismatch between verbal and
nonverbal messages. The patient's words describe a "perfect" marriage, but nonverbal cues
suggest anxiety or discomfort, indicating the verbal message may not be genuine. The nurse
should gently explore this discrepancy.
3. Which of the following is a nontherapeutic communication technique?
A) Active listening
B) Clarification
C) Asking "why" questions
D) Reflection
Correct Answer: Asking "why" questions
Rationale: Asking "why" questions is a nontherapeutic communication technique because it
can make patients feel defensive or judged. Therapeutic techniques include active listening,
clarification, reflection, validation, and summarization. "Why" questions often imply
criticism and should be avoided.
4. A nurse is working with a patient who is highly anxious. The nurse maintains a calm
demeanor and speaks in a low, soothing tone. This is an example of which therapeutic
communication technique?
A) Active listening
B) Nonverbal communication
C) Clarification
D) Confrontation
Correct Answer: Nonverbal communication
Rationale: Nonverbal communication includes facial expressions, tone of voice, posture, and
gestures. Maintaining a calm demeanor and using a soothing tone conveys safety and
, reassurance to an anxious patient. Nonverbal cues often communicate more than words and
must be congruent with verbal messages.
5. During the working phase of the therapeutic relationship, the nurse's primary focus should
be on:
A) Establishing trust and setting goals
B) Implementing interventions and facilitating behavioral change
C) Reviewing progress and planning for termination
D) Gathering initial assessment data
Correct Answer: Implementing interventions and facilitating behavioral change
Rationale: The therapeutic relationship has four phases: pre-interaction, orientation (trust-
building, goal-setting), working (implementing interventions, problem-solving, facilitating
change), and termination (reviewing progress, discharge planning). The working phase is
where active therapeutic work occurs.
6. A patient repeatedly asks the nurse for personal information and attempts to extend the
relationship beyond the professional setting. The nurse recognizes this as:
A) Transference
B) Countertransference
C) Boundary blurring
D) Therapeutic alliance
Correct Answer: Boundary blurring
Rationale: Boundary blurring occurs when the limits of the professional relationship are
crossed or unclear. The patient attempting to extend the relationship beyond professional
boundaries is an example of this. Transference refers to the patient projecting feelings onto
the nurse, while countertransference refers to the nurse's emotional reaction to the patient.
(2026) Actual Q&A PDF
1. A nurse is conducting an admission interview with an adolescent who states, "Why should
I tell you anything? You'll just tell my parents everything." Which response by the nurse is
most appropriate?
A) "Your parents have a legal right to know everything you tell me."
B) "What you say about your feelings is private, but some things, like suicidal thoughts, must
be reported to the treatment team."
C) "I promise I won't tell your parents anything you say."
D) "You're right to be concerned, but I have to tell your parents everything."
Correct Answer: "What you say about your feelings is private, but some things, like suicidal
thoughts, must be reported to the treatment team."
Rationale: This response is honest about the limits of confidentiality while respecting the
adolescent's need for privacy. It establishes trust by clarifying what information will be
shared and under what circumstances, which is essential for building a therapeutic alliance.
The other options either misrepresent confidentiality or make false promises.
2. A patient tells the nurse, "My marriage is perfect," while repeatedly tapping their foot and
avoiding eye contact. The nurse recognizes this as an example of:
A) Congruent communication
B) Incongruous communication
C) Defensive communication
D) Passive communication
Correct Answer: Incongruous communication
,Rationale: Incongruous communication occurs when there is a mismatch between verbal and
nonverbal messages. The patient's words describe a "perfect" marriage, but nonverbal cues
suggest anxiety or discomfort, indicating the verbal message may not be genuine. The nurse
should gently explore this discrepancy.
3. Which of the following is a nontherapeutic communication technique?
A) Active listening
B) Clarification
C) Asking "why" questions
D) Reflection
Correct Answer: Asking "why" questions
Rationale: Asking "why" questions is a nontherapeutic communication technique because it
can make patients feel defensive or judged. Therapeutic techniques include active listening,
clarification, reflection, validation, and summarization. "Why" questions often imply
criticism and should be avoided.
4. A nurse is working with a patient who is highly anxious. The nurse maintains a calm
demeanor and speaks in a low, soothing tone. This is an example of which therapeutic
communication technique?
A) Active listening
B) Nonverbal communication
C) Clarification
D) Confrontation
Correct Answer: Nonverbal communication
Rationale: Nonverbal communication includes facial expressions, tone of voice, posture, and
gestures. Maintaining a calm demeanor and using a soothing tone conveys safety and
, reassurance to an anxious patient. Nonverbal cues often communicate more than words and
must be congruent with verbal messages.
5. During the working phase of the therapeutic relationship, the nurse's primary focus should
be on:
A) Establishing trust and setting goals
B) Implementing interventions and facilitating behavioral change
C) Reviewing progress and planning for termination
D) Gathering initial assessment data
Correct Answer: Implementing interventions and facilitating behavioral change
Rationale: The therapeutic relationship has four phases: pre-interaction, orientation (trust-
building, goal-setting), working (implementing interventions, problem-solving, facilitating
change), and termination (reviewing progress, discharge planning). The working phase is
where active therapeutic work occurs.
6. A patient repeatedly asks the nurse for personal information and attempts to extend the
relationship beyond the professional setting. The nurse recognizes this as:
A) Transference
B) Countertransference
C) Boundary blurring
D) Therapeutic alliance
Correct Answer: Boundary blurring
Rationale: Boundary blurring occurs when the limits of the professional relationship are
crossed or unclear. The patient attempting to extend the relationship beyond professional
boundaries is an example of this. Transference refers to the patient projecting feelings onto
the nurse, while countertransference refers to the nurse's emotional reaction to the patient.
