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FOUNDATIONS OF MENTAL HEALTH (Q1–15)
1. A nurse is establishing a therapeutic relationship with a new client. Which action should
the nurse take during the orientation phase?
A. Explore the client's past coping mechanisms
B. Establish trust and clarify the purpose of the relationship
C. Evaluate progress toward goals
D. Summarize achievements and terminate the relationship
Answer: B — The orientation phase focuses on establishing trust, rapport, and the contract.
2. Which statement by the nurse demonstrates therapeutic communication?
A. "Why did you stop taking your medication?"
B. "You shouldn't feel that way."
C. "Tell me more about what you're feeling."
D. "Everything will be fine."
Answer: C — Open-ended, nonjudgmental exploration is therapeutic.
3. A client says, "I don't want to talk right now." What is the nurse's best response?
A. "You need to talk to get better."
B. "That's fine. I'll sit with you for a while."
C. "Why are you being difficult?"
D. "I'll come back when you're ready to cooperate."
Answer: B — Respecting the client's wishes while offering presence builds trust.
4. Which is an example of a nontherapeutic communication technique?
A. Restating
B. Reflecting
C. Giving false reassurance
D. Clarifying
Answer: C — False reassurance minimizes client concerns and blocks communication.
5. A nurse is working with a client who has a history of aggression. Which is the priority
nursing action?
A. Set firm limits on behavior
B. Ensure safety of client and others
C. Encourage verbal expression of feelings
D. Administer PRN medication
Answer: B — Safety is always the priority.
6. During the working phase of the nurse-client relationship, the nurse should:
A. Establish the contract
B. Promote client independence and problem-solving
C. Summarize progress
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D. Terminate the relationship
Answer: B — The working phase focuses on goal achievement and growth.
7. A client tells the nurse, "I feel like I'm a burden to my family." Which response is most
therapeutic?
A. "You're not a burden."
B. "Why do you feel that way?"
C. "It sounds like you're feeling worthless and guilty."
D. "Your family loves you."
Answer: C — Reflecting feeling validates the client's experience.
8. Which action by the nurse violates client confidentiality?
A. Discussing the client in a private team meeting
B. Sharing client information with the client's employer without consent
C. Documenting in the client's chart
D. Reporting suspected abuse to authorities
Answer: B — Disclosure without consent (except legally mandated reporting) is a breach.
9. A nurse is caring for a client who is involuntarily committed. The client asks, "Can I leave
whenever I want?" What is the best response?
A. "Yes, you can leave anytime."
B. "You cannot leave until the court says so."
C. "You may be able to leave if your provider determines you are no longer a danger to
yourself or others."
D. "You gave up your rights when you were committed."
Answer: C — Clients retain rights; release depends on clinical/legal criteria.
10. Which is a sign of countertransference?
A. The nurse feels angry at a client who reminds them of a family member
B. The client transfers feelings about a parent to the nurse
C. The nurse maintains professional boundaries
D. The client refuses to engage in therapy
Answer: A — Countertransference is the nurse's emotional reaction to the client.
11. A nurse is teaching a client about the Health Insurance Portability and Accountability
Act (HIPAA). Which statement by the client indicates understanding?
A. "My family can access my records anytime."
B. "My information can be shared without my permission for treatment purposes."
C. "I can't see my own records."
D. "My employer can request my records freely."
Answer: B — HIPAA permits sharing for treatment, payment, and operations.
12. Which is the best example of active listening?
A. Taking notes while the client speaks
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B. Nodding and maintaining eye contact
C. Interrupting to ask questions
D. Changing the subject when the client pauses
Answer: B — Active listening involves nonverbal attending.
13. A nurse is assessing a client's judgment. Which question is most appropriate?
A. "What day is it?"
B. "What would you do if you found a wallet on the street?"
C. "Who is the president?"
D. "Can you count backward from 20?"
Answer: B — Judgment is assessed by hypothetical problem-solving.
14. A client with a mental illness is being discharged. Which is the most important factor in
preventing relapse?
A. Medication compliance
B. Family income
C. Living alone
D. Avoiding all stress
Answer: A — Medication adherence is a key protective factor.
15. Which ethical principle supports a client's right to refuse medication?
A. Beneficence
B. Autonomy
C. Justice
D. Fidelity
Answer: B — Autonomy respects the client's right to self-determination.
ANXIETY, CRISIS, AND DEFENSE MECHANISMS (Q16–30)
16. A client is pacing, sweating, and reports feeling "out of control." This indicates which
anxiety level?
A. Mild
B. Moderate
C. Severe
D. Panic
Answer: C — Severe anxiety includes physical symptoms and decreased ability to focus.
17. Which intervention is most appropriate for a client in a panic attack?
A. Encourage the client to describe their feelings in detail
B. Stay with the client and use short, simple sentences
C. Leave the client alone to calm down
FOUNDATIONS OF MENTAL HEALTH (Q1–15)
1. A nurse is establishing a therapeutic relationship with a new client. Which action should
the nurse take during the orientation phase?
A. Explore the client's past coping mechanisms
B. Establish trust and clarify the purpose of the relationship
C. Evaluate progress toward goals
D. Summarize achievements and terminate the relationship
Answer: B — The orientation phase focuses on establishing trust, rapport, and the contract.
2. Which statement by the nurse demonstrates therapeutic communication?
A. "Why did you stop taking your medication?"
B. "You shouldn't feel that way."
C. "Tell me more about what you're feeling."
D. "Everything will be fine."
Answer: C — Open-ended, nonjudgmental exploration is therapeutic.
3. A client says, "I don't want to talk right now." What is the nurse's best response?
A. "You need to talk to get better."
B. "That's fine. I'll sit with you for a while."
C. "Why are you being difficult?"
D. "I'll come back when you're ready to cooperate."
Answer: B — Respecting the client's wishes while offering presence builds trust.
4. Which is an example of a nontherapeutic communication technique?
A. Restating
B. Reflecting
C. Giving false reassurance
D. Clarifying
Answer: C — False reassurance minimizes client concerns and blocks communication.
5. A nurse is working with a client who has a history of aggression. Which is the priority
nursing action?
A. Set firm limits on behavior
B. Ensure safety of client and others
C. Encourage verbal expression of feelings
D. Administer PRN medication
Answer: B — Safety is always the priority.
6. During the working phase of the nurse-client relationship, the nurse should:
A. Establish the contract
B. Promote client independence and problem-solving
C. Summarize progress
, 2
D. Terminate the relationship
Answer: B — The working phase focuses on goal achievement and growth.
7. A client tells the nurse, "I feel like I'm a burden to my family." Which response is most
therapeutic?
A. "You're not a burden."
B. "Why do you feel that way?"
C. "It sounds like you're feeling worthless and guilty."
D. "Your family loves you."
Answer: C — Reflecting feeling validates the client's experience.
8. Which action by the nurse violates client confidentiality?
A. Discussing the client in a private team meeting
B. Sharing client information with the client's employer without consent
C. Documenting in the client's chart
D. Reporting suspected abuse to authorities
Answer: B — Disclosure without consent (except legally mandated reporting) is a breach.
9. A nurse is caring for a client who is involuntarily committed. The client asks, "Can I leave
whenever I want?" What is the best response?
A. "Yes, you can leave anytime."
B. "You cannot leave until the court says so."
C. "You may be able to leave if your provider determines you are no longer a danger to
yourself or others."
D. "You gave up your rights when you were committed."
Answer: C — Clients retain rights; release depends on clinical/legal criteria.
10. Which is a sign of countertransference?
A. The nurse feels angry at a client who reminds them of a family member
B. The client transfers feelings about a parent to the nurse
C. The nurse maintains professional boundaries
D. The client refuses to engage in therapy
Answer: A — Countertransference is the nurse's emotional reaction to the client.
11. A nurse is teaching a client about the Health Insurance Portability and Accountability
Act (HIPAA). Which statement by the client indicates understanding?
A. "My family can access my records anytime."
B. "My information can be shared without my permission for treatment purposes."
C. "I can't see my own records."
D. "My employer can request my records freely."
Answer: B — HIPAA permits sharing for treatment, payment, and operations.
12. Which is the best example of active listening?
A. Taking notes while the client speaks
, 3
B. Nodding and maintaining eye contact
C. Interrupting to ask questions
D. Changing the subject when the client pauses
Answer: B — Active listening involves nonverbal attending.
13. A nurse is assessing a client's judgment. Which question is most appropriate?
A. "What day is it?"
B. "What would you do if you found a wallet on the street?"
C. "Who is the president?"
D. "Can you count backward from 20?"
Answer: B — Judgment is assessed by hypothetical problem-solving.
14. A client with a mental illness is being discharged. Which is the most important factor in
preventing relapse?
A. Medication compliance
B. Family income
C. Living alone
D. Avoiding all stress
Answer: A — Medication adherence is a key protective factor.
15. Which ethical principle supports a client's right to refuse medication?
A. Beneficence
B. Autonomy
C. Justice
D. Fidelity
Answer: B — Autonomy respects the client's right to self-determination.
ANXIETY, CRISIS, AND DEFENSE MECHANISMS (Q16–30)
16. A client is pacing, sweating, and reports feeling "out of control." This indicates which
anxiety level?
A. Mild
B. Moderate
C. Severe
D. Panic
Answer: C — Severe anxiety includes physical symptoms and decreased ability to focus.
17. Which intervention is most appropriate for a client in a panic attack?
A. Encourage the client to describe their feelings in detail
B. Stay with the client and use short, simple sentences
C. Leave the client alone to calm down
