,NUR 253 : MENTAL HEALTH EXAM 1
MULTIPLE CHOICES
1. A nurse is communicating with a client experiencing anxiety. Which therapeutic response is most
appropriate?
A. "You should calm down immediately."
B. "Tell me more about what you are feeling."
C. "There is nothing to worry about."
D. "Other patients feel worse than you."
Answer: B
Rationale: Open-ended therapeutic communication encourages expression of feelings and builds
trust; telling the client to calm down or comparing to others is dismissive.
2. Which defense mechanism involves refusing to acknowledge reality?
A. Projection
B. Denial
C. Displacement
D. Rationalization
Answer: B
Rationale: Denial occurs when a person refuses to accept painful facts or reality; it is an
unconscious defense mechanism protecting the ego from overwhelming anxiety.
3. A client with panic disorder is hyperventilating. What is the nurse's priority action?
A. Leave the client alone.
B. Encourage rapid breathing.
C. Stay with the client and speak calmly.
D. Provide detailed teaching immediately.
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,Answer: C
Rationale: Remaining calm and present helps decrease panic and promotes safety; detailed
teaching is ineffective during acute panic due to impaired concentration.
4. Which finding is commonly associated with generalized anxiety disorder?
A. Hallucinations
B. Excessive uncontrollable worry
C. Grandiosity
D. Flat affect only
Answer: B
Rationale: Generalized anxiety disorder involves persistent excessive anxiety and worry about
multiple events or activities; hallucinations and grandiosity suggest psychotic disorders.
5. A nurse is assessing suicide risk. Which statement requires immediate intervention?
A. "I feel tired lately."
B. "Sometimes I feel hopeless."
C. "I have a plan to kill myself tonight."
D. "I do not enjoy hobbies anymore."
Answer: C
Rationale: A specific suicide plan indicates high suicide risk and requires immediate action
including one-to-one observation and provider notification.
6. Which therapeutic communication technique is being used when the nurse says, "Go on"?
A. Restating
B. Exploring
C. Broad opening
D. Giving recognition
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, Answer: C
Rationale: "Go on" is a broad opening that encourages the client to continue expressing thoughts
without directing the conversation.
7. A client states, "Since my partner died, nothing seems worth doing." Which response best uses
reflection?
A. "You should stay busy so you do not think about it."
B. "You feel that life has lost meaning since your partner died."
C. "Why are you allowing yourself to feel this way?"
D. "Everything will improve if you give it enough time."
Answer: B
Rationale: Reflection restates the person's expressed feeling or meaning and invites further
exploration without judging or giving premature advice.
8. A client says, "I don't know what you mean by coping." Which response best demonstrates
clarification?
A. "Everyone should understand that term."
B. "Let's skip that topic."
C. "You probably use unhealthy coping."
D. "By coping, I mean the ways you handle stress, such as talking with someone. Is that what you
were asking?"
Answer: D
Rationale: Clarification checks mutual understanding by restating or defining an unclear idea;
dismissive or judgmental responses discourage communication.
9. Which response best uses silence therapeutically?
A. Leaving the room without explanation
B. Immediately changing the subject to medications
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