100 NCLEX-Style Questions and Answers with
Rationales: Varcarolis’ Foundations of Psychiatric-
Mental Health Nursing
Section 1: Foundations and Therapeutic Communication (1–
15)
1. Which statement best describes the primary goal of psychiatric-mental health nursing?
A. To eliminate all emotional distress B. To promote mental health, recovery, and adaptive
functioning C. To ensure patients depend on nurses for support D. To prevent patients from
making independent decisions
Answer: B. To promote mental health, recovery, and adaptive functioning.
Rationale: Psychiatric nursing promotes mental wellness, coping, recovery, autonomy, and
improved quality of life.
2. A patient says, “Nobody cares about me.” Which response is most therapeutic?
A. “That is not true; your family cares.” B. “You should try to be more positive.” C. “You feel as
though nobody cares about you.” D. “Why do you think that way?”
Answer: C. “You feel as though nobody cares about you.”
Rationale: Reflecting feelings communicates understanding and encourages the patient to
explore emotions without judgment.
3. Which action demonstrates active listening?
A. Interrupting to provide advice B. Maintaining attentive, appropriate eye contact and reflecting
the patient's message C. Changing the subject when the patient cries D. Completing
documentation while the patient speaks
Answer: B. Maintaining attentive, appropriate eye contact and reflecting the patient's message.
Rationale: Active listening involves attention to verbal and nonverbal communication,
clarification, and reflection. Eye contact should be culturally appropriate.
4. A patient says, “I am frightened about my surgery.” What is the best response?
A. “There is nothing to fear.” B. “Everyone feels that way.” C. “Tell me more about what
frightens you.” D. “You should not worry.”
,Answer: C. “Tell me more about what frightens you.”
Rationale: An open-ended question encourages expression and helps the nurse identify the
patient's specific concerns.
5. Which response is an example of false reassurance?
A. “You seem worried.” B. “I will stay with you while we discuss this.” C. “Everything will be
fine.” D. “What concerns you most?”
Answer: C. “Everything will be fine.”
Rationale: False reassurance makes promises the nurse cannot guarantee and may discourage the
patient from discussing genuine fears.
6. A patient remains silent during an interview. What should the nurse do first?
A. End the interview immediately B. Use therapeutic silence and allow time for a response C.
Ask several questions rapidly D. Tell the patient that cooperation is required
Answer: B. Use therapeutic silence and allow time for a response.
Rationale: Silence can provide time for reflection, emotional processing, or the development of
trust.
7. Which statement is an example of clarification?
A. “You should forget about the incident.” B. “Everything happens for a reason.” C. “When you
say you feel empty, what does that mean to you?” D. “I know exactly how you feel.”
Answer: C. “When you say you feel empty, what does that mean to you?”
Rationale: Clarification helps the nurse understand the patient's meaning instead of making
assumptions.
8. A patient says, “I feel useless because I lost my job.” Which response uses reflection?
A. “You need to find another job.” B. “Losing your job has affected how you see yourself.” C.
“Why didn't you work harder?” D. “At least you still have your health.”
Answer: B. “Losing your job has affected how you see yourself.”
Rationale: Reflection returns the patient's expressed concern in a way that encourages further
exploration.
9. Which behavior is a nontherapeutic communication technique?
, A. Offering self B. Exploring feelings C. Giving unsolicited advice D. Restating important
information
Answer: C. Giving unsolicited advice.
Rationale: Unsolicited advice can undermine autonomy. The nurse should help the patient
explore options and make informed decisions.
10. A patient asks, “Do you think I should divorce my spouse?” What is the best nursing
response?
A. “Yes, you should leave.” B. “No, you should stay married.” C. “What factors are you
considering as you make this decision?” D. “I would divorce that person.”
Answer: C. “What factors are you considering as you make this decision?”
Rationale: The nurse supports decision-making without imposing personal values.
11. What is the primary purpose of a therapeutic nurse-patient relationship?
A. To meet the nurse's emotional needs B. To promote the patient's health and recovery C. To
establish a personal friendship D. To eliminate all disagreement
Answer: B. To promote the patient's health and recovery.
Rationale: A therapeutic relationship is purposeful, professional, patient-centered, and directed
toward agreed-upon health goals.
12. Which action demonstrates empathy?
A. Feeling exactly the same emotions as the patient B. Understanding and acknowledging the
patient's emotional experience C. Telling the patient to stop crying D. Comparing the patient's
problem with the nurse's own life
Answer: B. Understanding and acknowledging the patient's emotional experience.
Rationale: Empathy involves understanding another person's perspective and communicating that
understanding while maintaining professional boundaries.
13. Which behavior best demonstrates professional boundaries?
A. Giving the patient the nurse's personal phone number for unlimited contact B. Accepting
expensive gifts to strengthen the relationship C. Maintaining a therapeutic focus and following
professional policies D. Sharing private details to become the patient's closest friend
Answer: C. Maintaining a therapeutic focus and following professional policies.
Rationales: Varcarolis’ Foundations of Psychiatric-
Mental Health Nursing
Section 1: Foundations and Therapeutic Communication (1–
15)
1. Which statement best describes the primary goal of psychiatric-mental health nursing?
A. To eliminate all emotional distress B. To promote mental health, recovery, and adaptive
functioning C. To ensure patients depend on nurses for support D. To prevent patients from
making independent decisions
Answer: B. To promote mental health, recovery, and adaptive functioning.
Rationale: Psychiatric nursing promotes mental wellness, coping, recovery, autonomy, and
improved quality of life.
2. A patient says, “Nobody cares about me.” Which response is most therapeutic?
A. “That is not true; your family cares.” B. “You should try to be more positive.” C. “You feel as
though nobody cares about you.” D. “Why do you think that way?”
Answer: C. “You feel as though nobody cares about you.”
Rationale: Reflecting feelings communicates understanding and encourages the patient to
explore emotions without judgment.
3. Which action demonstrates active listening?
A. Interrupting to provide advice B. Maintaining attentive, appropriate eye contact and reflecting
the patient's message C. Changing the subject when the patient cries D. Completing
documentation while the patient speaks
Answer: B. Maintaining attentive, appropriate eye contact and reflecting the patient's message.
Rationale: Active listening involves attention to verbal and nonverbal communication,
clarification, and reflection. Eye contact should be culturally appropriate.
4. A patient says, “I am frightened about my surgery.” What is the best response?
A. “There is nothing to fear.” B. “Everyone feels that way.” C. “Tell me more about what
frightens you.” D. “You should not worry.”
,Answer: C. “Tell me more about what frightens you.”
Rationale: An open-ended question encourages expression and helps the nurse identify the
patient's specific concerns.
5. Which response is an example of false reassurance?
A. “You seem worried.” B. “I will stay with you while we discuss this.” C. “Everything will be
fine.” D. “What concerns you most?”
Answer: C. “Everything will be fine.”
Rationale: False reassurance makes promises the nurse cannot guarantee and may discourage the
patient from discussing genuine fears.
6. A patient remains silent during an interview. What should the nurse do first?
A. End the interview immediately B. Use therapeutic silence and allow time for a response C.
Ask several questions rapidly D. Tell the patient that cooperation is required
Answer: B. Use therapeutic silence and allow time for a response.
Rationale: Silence can provide time for reflection, emotional processing, or the development of
trust.
7. Which statement is an example of clarification?
A. “You should forget about the incident.” B. “Everything happens for a reason.” C. “When you
say you feel empty, what does that mean to you?” D. “I know exactly how you feel.”
Answer: C. “When you say you feel empty, what does that mean to you?”
Rationale: Clarification helps the nurse understand the patient's meaning instead of making
assumptions.
8. A patient says, “I feel useless because I lost my job.” Which response uses reflection?
A. “You need to find another job.” B. “Losing your job has affected how you see yourself.” C.
“Why didn't you work harder?” D. “At least you still have your health.”
Answer: B. “Losing your job has affected how you see yourself.”
Rationale: Reflection returns the patient's expressed concern in a way that encourages further
exploration.
9. Which behavior is a nontherapeutic communication technique?
, A. Offering self B. Exploring feelings C. Giving unsolicited advice D. Restating important
information
Answer: C. Giving unsolicited advice.
Rationale: Unsolicited advice can undermine autonomy. The nurse should help the patient
explore options and make informed decisions.
10. A patient asks, “Do you think I should divorce my spouse?” What is the best nursing
response?
A. “Yes, you should leave.” B. “No, you should stay married.” C. “What factors are you
considering as you make this decision?” D. “I would divorce that person.”
Answer: C. “What factors are you considering as you make this decision?”
Rationale: The nurse supports decision-making without imposing personal values.
11. What is the primary purpose of a therapeutic nurse-patient relationship?
A. To meet the nurse's emotional needs B. To promote the patient's health and recovery C. To
establish a personal friendship D. To eliminate all disagreement
Answer: B. To promote the patient's health and recovery.
Rationale: A therapeutic relationship is purposeful, professional, patient-centered, and directed
toward agreed-upon health goals.
12. Which action demonstrates empathy?
A. Feeling exactly the same emotions as the patient B. Understanding and acknowledging the
patient's emotional experience C. Telling the patient to stop crying D. Comparing the patient's
problem with the nurse's own life
Answer: B. Understanding and acknowledging the patient's emotional experience.
Rationale: Empathy involves understanding another person's perspective and communicating that
understanding while maintaining professional boundaries.
13. Which behavior best demonstrates professional boundaries?
A. Giving the patient the nurse's personal phone number for unlimited contact B. Accepting
expensive gifts to strengthen the relationship C. Maintaining a therapeutic focus and following
professional policies D. Sharing private details to become the patient's closest friend
Answer: C. Maintaining a therapeutic focus and following professional policies.
