2026 Psychiatric Nursing Therapeutic
Communication Study Guide Practice Questions
Answer Explanations Active Listening Empathy
Boundaries Patient Relationships Clinical
Scenarios
Section 1: Foundations of Therapeutic Communication — Questions 1–25
1. A nurse is communicating with a client who is experiencing anxiety. Which
statement by the nurse demonstrates therapeutic communication?
A. "You shouldn't feel anxious about this."
B. "Tell me what is making you feel anxious right now."
C. "Everything will be fine, don't worry."
D. "Let's talk about something else to distract you."
Rationale: Asking the client to identify what is making them anxious encourages
expression of feelings and promotes therapeutic communication. Telling the client
not to feel anxious dismisses their feelings. False reassurance and distraction are
non-therapeutic techniques.
2. A nurse is caring for a client who is crying. Which response by the nurse is
most therapeutic?
A. "Don't cry, it will be okay."
B. "I can see you're upset. Would you like to talk about what's bothering
you?"
C. "Crying won't solve anything."
D. "Let me get you something to calm you down."
Rationale: Acknowledging the client's distress and offering to talk is therapeutic.
Telling the client not to cry or that crying won't help dismisses their feelings.
Offering medication to calm down may be premature.
3. A nurse is communicating with a client who is angry. Which statement is
therapeutic?
A. "You need to calm down right now."
,B. "I can see that you're upset. Let's talk about what's bothering you."
C. "You're overreacting to this situation."
D. "If you don't calm down, I'll have to leave."
Rationale: Acknowledging the client's anger and offering to talk is therapeutic.
Telling the client to calm down or that they are overreacting can escalate the
situation. Threatening to leave is non-therapeutic.
4. A nurse is communicating with a client who is experiencing hallucinations.
Which statement is therapeutic?
A. "I don't hear any voices."
B. "What are the voices saying to you?"
C. "You need to ignore the voices."
D. "The voices aren't real, you know that."
Rationale: Asking what the voices are saying helps the nurse assess the content
and command nature of the hallucinations. Telling the client the voices are not real
dismisses their experience and can damage trust.
5. A nurse is communicating with a client who is experiencing delusions.
Which statement is therapeutic?
A. "That's not true and you know it."
B. "I understand that you believe that, but I don't share that belief."
C. "You're wrong about that."
D. "Let's not talk about that right now."
Rationale: Acknowledging the client's belief without agreeing with the delusion is
therapeutic. Telling the client they are wrong or that the delusion is not true can
increase anxiety and defensiveness.
6. A nurse is communicating with a client who is experiencing mania. Which
intervention is appropriate?
A. Engage in lengthy, detailed conversations
B. Use short, simple sentences and redirect as needed
C. Encourage the client to express all their thoughts
D. Allow the client to make all decisions
Rationale: Using short, simple sentences and redirecting as needed helps reduce
stimulation and promote focus in a client experiencing mania. Lengthy
conversations can increase agitation.
,7. A nurse is communicating with a client who is experiencing depression.
Which statement is therapeutic?
A. "You have so much to be thankful for."
B. "I am here to listen if you want to talk."
C. "You should just try to be happy."
D. "Other people have it worse than you."
Rationale: Offering to listen without judgment is therapeutic. Telling the client to
be happy or that others have it worse dismisses their feelings and can increase
feelings of guilt.
8. A nurse is communicating with a client who is experiencing suicidal
ideation. Which statement is therapeutic?
A. "You don't really want to kill yourself."
B. "Are you thinking about killing yourself?"
C. "Let's talk about something else."
D. "You have so much to live for."
Rationale: Directly asking about suicidal ideation is therapeutic and essential for
assessing risk. Telling the client they don't really want to die or that they have
much to live for dismisses their feelings.
9. A nurse is communicating with a client who is experiencing grief. Which
statement is therapeutic?
A. "You should be over this by now."
B. "It's okay to feel sad. I'm here for you."
C. "Everything happens for a reason."
D. "You need to move on with your life."
Rationale: Acknowledging the client's grief and offering support is therapeutic.
Telling the client to move on or that everything happens for a reason dismisses
their feelings.
10. A nurse is communicating with a client who is experiencing paranoia.
Which statement is therapeutic?
A. "No one is following you."
B. "I can see that you are feeling scared. Let's walk together."
C. "You are being paranoid."
D. "Let's talk about something else."
, Rationale: Acknowledging the client's fear and offering to walk with them is
therapeutic. Telling the client they are paranoid or that no one is following them
dismisses their experience.
11. A nurse is communicating with a client who is experiencing a panic attack.
Which statement is therapeutic?
A. "You need to calm down."
B. "I am here with you. Let's take some deep breaths together."
C. "You are overreacting."
D. "There is nothing to be afraid of."
Rationale: Staying with the client and guiding deep breathing is therapeutic during
a panic attack. Telling the client to calm down or that there is nothing to fear
dismisses their experience.
12. A nurse is communicating with a client who is experiencing somatic
symptoms. Which statement is therapeutic?
A. "Your symptoms are all in your head."
B. "I understand that you are experiencing pain. Let's talk about how you are
feeling."
C. "There is nothing wrong with you."
D. "You need to stop focusing on your symptoms."
Rationale: Acknowledging the client's symptoms and offering to talk about their
feelings is therapeutic. Telling the client their symptoms are in their head dismisses
their experience.
13. A nurse is communicating with a client who is experiencing catatonia.
Which intervention is appropriate?
A. Allow the client time to respond to questions
B. Rush the client to respond quickly
C. Complete tasks for the client
D. Avoid all communication
Rationale: Allowing the client time to respond to questions is important in
catatonia, as the client may have slowed responses. Rushing the client can increase
anxiety.
14. A nurse is communicating with a client who is experiencing mutism.
Which intervention is appropriate?
A. Sit with the client in silence and offer presence
B. Force the client to speak
Communication Study Guide Practice Questions
Answer Explanations Active Listening Empathy
Boundaries Patient Relationships Clinical
Scenarios
Section 1: Foundations of Therapeutic Communication — Questions 1–25
1. A nurse is communicating with a client who is experiencing anxiety. Which
statement by the nurse demonstrates therapeutic communication?
A. "You shouldn't feel anxious about this."
B. "Tell me what is making you feel anxious right now."
C. "Everything will be fine, don't worry."
D. "Let's talk about something else to distract you."
Rationale: Asking the client to identify what is making them anxious encourages
expression of feelings and promotes therapeutic communication. Telling the client
not to feel anxious dismisses their feelings. False reassurance and distraction are
non-therapeutic techniques.
2. A nurse is caring for a client who is crying. Which response by the nurse is
most therapeutic?
A. "Don't cry, it will be okay."
B. "I can see you're upset. Would you like to talk about what's bothering
you?"
C. "Crying won't solve anything."
D. "Let me get you something to calm you down."
Rationale: Acknowledging the client's distress and offering to talk is therapeutic.
Telling the client not to cry or that crying won't help dismisses their feelings.
Offering medication to calm down may be premature.
3. A nurse is communicating with a client who is angry. Which statement is
therapeutic?
A. "You need to calm down right now."
,B. "I can see that you're upset. Let's talk about what's bothering you."
C. "You're overreacting to this situation."
D. "If you don't calm down, I'll have to leave."
Rationale: Acknowledging the client's anger and offering to talk is therapeutic.
Telling the client to calm down or that they are overreacting can escalate the
situation. Threatening to leave is non-therapeutic.
4. A nurse is communicating with a client who is experiencing hallucinations.
Which statement is therapeutic?
A. "I don't hear any voices."
B. "What are the voices saying to you?"
C. "You need to ignore the voices."
D. "The voices aren't real, you know that."
Rationale: Asking what the voices are saying helps the nurse assess the content
and command nature of the hallucinations. Telling the client the voices are not real
dismisses their experience and can damage trust.
5. A nurse is communicating with a client who is experiencing delusions.
Which statement is therapeutic?
A. "That's not true and you know it."
B. "I understand that you believe that, but I don't share that belief."
C. "You're wrong about that."
D. "Let's not talk about that right now."
Rationale: Acknowledging the client's belief without agreeing with the delusion is
therapeutic. Telling the client they are wrong or that the delusion is not true can
increase anxiety and defensiveness.
6. A nurse is communicating with a client who is experiencing mania. Which
intervention is appropriate?
A. Engage in lengthy, detailed conversations
B. Use short, simple sentences and redirect as needed
C. Encourage the client to express all their thoughts
D. Allow the client to make all decisions
Rationale: Using short, simple sentences and redirecting as needed helps reduce
stimulation and promote focus in a client experiencing mania. Lengthy
conversations can increase agitation.
,7. A nurse is communicating with a client who is experiencing depression.
Which statement is therapeutic?
A. "You have so much to be thankful for."
B. "I am here to listen if you want to talk."
C. "You should just try to be happy."
D. "Other people have it worse than you."
Rationale: Offering to listen without judgment is therapeutic. Telling the client to
be happy or that others have it worse dismisses their feelings and can increase
feelings of guilt.
8. A nurse is communicating with a client who is experiencing suicidal
ideation. Which statement is therapeutic?
A. "You don't really want to kill yourself."
B. "Are you thinking about killing yourself?"
C. "Let's talk about something else."
D. "You have so much to live for."
Rationale: Directly asking about suicidal ideation is therapeutic and essential for
assessing risk. Telling the client they don't really want to die or that they have
much to live for dismisses their feelings.
9. A nurse is communicating with a client who is experiencing grief. Which
statement is therapeutic?
A. "You should be over this by now."
B. "It's okay to feel sad. I'm here for you."
C. "Everything happens for a reason."
D. "You need to move on with your life."
Rationale: Acknowledging the client's grief and offering support is therapeutic.
Telling the client to move on or that everything happens for a reason dismisses
their feelings.
10. A nurse is communicating with a client who is experiencing paranoia.
Which statement is therapeutic?
A. "No one is following you."
B. "I can see that you are feeling scared. Let's walk together."
C. "You are being paranoid."
D. "Let's talk about something else."
, Rationale: Acknowledging the client's fear and offering to walk with them is
therapeutic. Telling the client they are paranoid or that no one is following them
dismisses their experience.
11. A nurse is communicating with a client who is experiencing a panic attack.
Which statement is therapeutic?
A. "You need to calm down."
B. "I am here with you. Let's take some deep breaths together."
C. "You are overreacting."
D. "There is nothing to be afraid of."
Rationale: Staying with the client and guiding deep breathing is therapeutic during
a panic attack. Telling the client to calm down or that there is nothing to fear
dismisses their experience.
12. A nurse is communicating with a client who is experiencing somatic
symptoms. Which statement is therapeutic?
A. "Your symptoms are all in your head."
B. "I understand that you are experiencing pain. Let's talk about how you are
feeling."
C. "There is nothing wrong with you."
D. "You need to stop focusing on your symptoms."
Rationale: Acknowledging the client's symptoms and offering to talk about their
feelings is therapeutic. Telling the client their symptoms are in their head dismisses
their experience.
13. A nurse is communicating with a client who is experiencing catatonia.
Which intervention is appropriate?
A. Allow the client time to respond to questions
B. Rush the client to respond quickly
C. Complete tasks for the client
D. Avoid all communication
Rationale: Allowing the client time to respond to questions is important in
catatonia, as the client may have slowed responses. Rushing the client can increase
anxiety.
14. A nurse is communicating with a client who is experiencing mutism.
Which intervention is appropriate?
A. Sit with the client in silence and offer presence
B. Force the client to speak
