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MENTAL HEALTH: EXAM 1: LATEST UPDATE 2025 NCLEX
REVIEW QUESTIONS AND CORRECT ANSWERS
Ms. Wong, aged 52 years, comes to the emergency room with severe anxiety. She
was raised in China but immigrated to the United States at age 40 years. She was
recently fired from her job because of a major error in the accounting department
that she managed. Ms. Wong's aged parents live with her. Ms. Wong states, "I am a
failure." Which of the following statements may accurately assess the basis for Ms.
Wong's anxiety and feelings of failure?
A) Ms. Wong may feel that she has let herself down since she did not achieve her
personal goals in the workplace.
B) Ms. Wong may feel that she has shamed the family by being fired and may no
longer be able to provide for them.
C) Ms. Wong may feel personally inadequate since she failed in her quest for
independence and self-reliance.
D) Ms. Wong may be feeling anxiety because in her family's traditions her failure
may result in a changed fate. - Answer: B) Ms. Wong may feel that she has
shamed the family by being fired and may no longer be able to provide for them.
Eastern tradition, such as in China, where Ms. Wong is from, sees the family as the
basis for one's identity, and family interdependence as the norm. The views
expressed in options a and c demonstrate Western tradition where self-reliance,
individuality, and autonomy are highly valued. In the Eastern view one is born into
an unchangeable fate.
Which of the following best explains the concept of cultural competence?
A) Nurses have enough knowledge about different cultures to be assured they are
delivering culturally sensitive care.
B) Nurses are able to educate their patients from other cultures appropriately about
the cultural norms of the United States.
C) Nurses adjust their own practices to meet their patients' cultural preferences,
beliefs, and practices.
D) Nurses must take continuing education classes on culture in the process of
becoming culturally competent. - Answer: C) Nurses adjust their own practices to
meet their patients' cultural preferences, beliefs, and practices.
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Cultural competence means that nurses adjust and conform to their patients'
cultural needs, beliefs, practices, and preferences rather than their own. This option
does not describe cultural competence. Although nurses are continually learning
regarding culture, it is a career-long process. The goal is not to educate patients
about our own culture but rather to adjust to their cultural preferences. Although
nurses may take continuing education regarding culture, this does not describe the
term cultural competence. The other options do not describe cultural competence.
Josefina Juarez, aged 36 years, comes to the mental health clinic where you work
after being referred by her primary care provider. Josefina came to live in the
United States from Brazil 5 years ago. She is now a single mother to 6 children,
ages 2 to 15, following the death of her husband last year. During the initial intake
assessment, Josefina tells you her problem is that she has headaches and backaches
"almost every day" and "can't sleep at night." She shakes her head no and looks
away when asked about anxiety or depression and states she does not know why
she was referred to the mental health clinic. You recognize that Josefina may be
exhibiting:
A) regression.
B) somatization.
C) enculturation.
D) assimilation. - Answer: B) somatization.
Somatization is described as experiencing and expressing emotional or
psychological distress as physical symptoms. Regression is a defense mechanism
meaning to begin to function at a lower or previous level of functioning.
Enculturation refers to how cultural beliefs, practices, and norms are
communicated to its members. Assimilation refers to a situation in which
immigrants adapt to and absorb the practices and beliefs of a new culture until
these customs are more natural than the ones they learned in their homeland.
You are working on the psychiatric unit and assisting with the care for Mr. Tran, a
refugee from Darfur, who came to the United States 1 year ago. Although Mr. Tran
understands and speaks some very limited English, he is much more comfortable
conversing in his native language. Mike, the nurse working directly with Mr. Tran,
says to you, "I am so frustrated trying to communicate with Mr. Tran! He insists on
speaking his language instead of English. I think if people want to live here, they
ought to have to speak our language and act like we do!" Which of the following
responses you could make promotes culturally competent care? (select all that
apply):
, 3|Page
A) "You are right that Mr. Tran needs to speak English, but all patients do have a
right to an interpreter, so you need to comply."
B) "I agree that it is frustrating trying to communicate with Mr. Tran. Maybe we
could see if his family members can help convince him to - Answer: D) "What you
are saying is actually considered cultural imposition, which is imposing our own
culture onto someone from a different culture."
E) "Mr. Tran's ability to speak and understand English is very limited. He needs to
have an interpreter to make sure he can make his needs and feelings known."
Cultural imposition is imposing our own cultural norms onto those from another
cultural group. By obtaining an interpreter for Mr. Tran, the nurse is promoting
culturally competent care, ensuring the patient can communicate his feelings and
needs thoroughly to the staff. Patients do have a right to an interpreter, but stating
that Mike is right is not promoting culturally competent care and is instead
confirming his opinion. Asking family members to convince the patient to speak
English is not promoting culturally competent care and also undermines the trust
between nurse and patient. Instead of encouraging the patient to speak English an
interpreter should be obtained for the patient.
You are working on an inpatient psychiatric unit and caring for Elizabeth, who is
becoming agitated. You speak with Elizabeth one to one in a private setting, find
out the reason for the agitation, and then assist Elizabeth with ways to calm down,
possibly including prn medication to prevent further escalation of Elizabeth's
agitation, which could lead to seclusion and/or restraints. You are making care
decisions based on:
A) writ of habeas corpus.
B) least restrictive alternative doctrine.
C) veracity.
D) bioethics. - Answer: B) least restrictive alternative doctrine.
Least restrictive alternative doctrine is described as using the least drastic means of
achieving a specific goal. By doing the actions described you are possibly
preventing the more restrictive setting of seclusion and/or restraints. Writ of habeas
corpus is a legal term meaning a written order "to free the person." Veracity is one
of the five ethical principles or guidelines. Bioethics refers to ethics in a health care
setting.
MENTAL HEALTH: EXAM 1: LATEST UPDATE 2025 NCLEX
REVIEW QUESTIONS AND CORRECT ANSWERS
Ms. Wong, aged 52 years, comes to the emergency room with severe anxiety. She
was raised in China but immigrated to the United States at age 40 years. She was
recently fired from her job because of a major error in the accounting department
that she managed. Ms. Wong's aged parents live with her. Ms. Wong states, "I am a
failure." Which of the following statements may accurately assess the basis for Ms.
Wong's anxiety and feelings of failure?
A) Ms. Wong may feel that she has let herself down since she did not achieve her
personal goals in the workplace.
B) Ms. Wong may feel that she has shamed the family by being fired and may no
longer be able to provide for them.
C) Ms. Wong may feel personally inadequate since she failed in her quest for
independence and self-reliance.
D) Ms. Wong may be feeling anxiety because in her family's traditions her failure
may result in a changed fate. - Answer: B) Ms. Wong may feel that she has
shamed the family by being fired and may no longer be able to provide for them.
Eastern tradition, such as in China, where Ms. Wong is from, sees the family as the
basis for one's identity, and family interdependence as the norm. The views
expressed in options a and c demonstrate Western tradition where self-reliance,
individuality, and autonomy are highly valued. In the Eastern view one is born into
an unchangeable fate.
Which of the following best explains the concept of cultural competence?
A) Nurses have enough knowledge about different cultures to be assured they are
delivering culturally sensitive care.
B) Nurses are able to educate their patients from other cultures appropriately about
the cultural norms of the United States.
C) Nurses adjust their own practices to meet their patients' cultural preferences,
beliefs, and practices.
D) Nurses must take continuing education classes on culture in the process of
becoming culturally competent. - Answer: C) Nurses adjust their own practices to
meet their patients' cultural preferences, beliefs, and practices.
,2|Page
Cultural competence means that nurses adjust and conform to their patients'
cultural needs, beliefs, practices, and preferences rather than their own. This option
does not describe cultural competence. Although nurses are continually learning
regarding culture, it is a career-long process. The goal is not to educate patients
about our own culture but rather to adjust to their cultural preferences. Although
nurses may take continuing education regarding culture, this does not describe the
term cultural competence. The other options do not describe cultural competence.
Josefina Juarez, aged 36 years, comes to the mental health clinic where you work
after being referred by her primary care provider. Josefina came to live in the
United States from Brazil 5 years ago. She is now a single mother to 6 children,
ages 2 to 15, following the death of her husband last year. During the initial intake
assessment, Josefina tells you her problem is that she has headaches and backaches
"almost every day" and "can't sleep at night." She shakes her head no and looks
away when asked about anxiety or depression and states she does not know why
she was referred to the mental health clinic. You recognize that Josefina may be
exhibiting:
A) regression.
B) somatization.
C) enculturation.
D) assimilation. - Answer: B) somatization.
Somatization is described as experiencing and expressing emotional or
psychological distress as physical symptoms. Regression is a defense mechanism
meaning to begin to function at a lower or previous level of functioning.
Enculturation refers to how cultural beliefs, practices, and norms are
communicated to its members. Assimilation refers to a situation in which
immigrants adapt to and absorb the practices and beliefs of a new culture until
these customs are more natural than the ones they learned in their homeland.
You are working on the psychiatric unit and assisting with the care for Mr. Tran, a
refugee from Darfur, who came to the United States 1 year ago. Although Mr. Tran
understands and speaks some very limited English, he is much more comfortable
conversing in his native language. Mike, the nurse working directly with Mr. Tran,
says to you, "I am so frustrated trying to communicate with Mr. Tran! He insists on
speaking his language instead of English. I think if people want to live here, they
ought to have to speak our language and act like we do!" Which of the following
responses you could make promotes culturally competent care? (select all that
apply):
, 3|Page
A) "You are right that Mr. Tran needs to speak English, but all patients do have a
right to an interpreter, so you need to comply."
B) "I agree that it is frustrating trying to communicate with Mr. Tran. Maybe we
could see if his family members can help convince him to - Answer: D) "What you
are saying is actually considered cultural imposition, which is imposing our own
culture onto someone from a different culture."
E) "Mr. Tran's ability to speak and understand English is very limited. He needs to
have an interpreter to make sure he can make his needs and feelings known."
Cultural imposition is imposing our own cultural norms onto those from another
cultural group. By obtaining an interpreter for Mr. Tran, the nurse is promoting
culturally competent care, ensuring the patient can communicate his feelings and
needs thoroughly to the staff. Patients do have a right to an interpreter, but stating
that Mike is right is not promoting culturally competent care and is instead
confirming his opinion. Asking family members to convince the patient to speak
English is not promoting culturally competent care and also undermines the trust
between nurse and patient. Instead of encouraging the patient to speak English an
interpreter should be obtained for the patient.
You are working on an inpatient psychiatric unit and caring for Elizabeth, who is
becoming agitated. You speak with Elizabeth one to one in a private setting, find
out the reason for the agitation, and then assist Elizabeth with ways to calm down,
possibly including prn medication to prevent further escalation of Elizabeth's
agitation, which could lead to seclusion and/or restraints. You are making care
decisions based on:
A) writ of habeas corpus.
B) least restrictive alternative doctrine.
C) veracity.
D) bioethics. - Answer: B) least restrictive alternative doctrine.
Least restrictive alternative doctrine is described as using the least drastic means of
achieving a specific goal. By doing the actions described you are possibly
preventing the more restrictive setting of seclusion and/or restraints. Writ of habeas
corpus is a legal term meaning a written order "to free the person." Veracity is one
of the five ethical principles or guidelines. Bioethics refers to ethics in a health care
setting.
