NUR 354 FINAL EXAM STUDY GUIDE | NURSING PRACTICE QUESTIONS &
ANSWERS WITH RATIONALES 2026/2027
Becky tells you, "I have something secret to tell you, but you can't tell anyone else." The nurse
agrees. What is the likely consequence of the nurse's action?
a. healthy feelings of sympathy by the nurse towards the client
b. blurred boundaries in the nurse-client relationship
c. improved rapport between the nurse and client
d. enhanced trust between the nurse and client - ANS ✔✔b. Blurred boundaries in the nurse-
client relationship.
As you begin working with her, you notice that your patient has an uncanny resemblance to
your younger sister. As a child, this sister lied and criticized you constantly, then screamed and
cried to others if you challenged her. You realize that you are responding negatively to this
patient. What's going on here?
a. counter-transference
b. self-actualization
c. transference
d. bias - ANS ✔✔a. counter-transference
A nurse seeks to establish a relationship with a patient readmitted to the hospital. The patient
has bipolar disorder, depressed type, and was hospitalized the preceding month. Which
statement by the nurse would contribute to establishing trust?
a. weren't you compliant with your medication?
b. it must be discouraging to have been readmitted to the hospital so soon
c. everyone with bipolar disorder ends up in the hospital periodically
d. you must take your medications religiously or you will be re-hospitalized - ANS ✔✔b. it must
be discouraging to have been readmitted to the hospital so soon
,As a nurse assesses a new client, the nurse makes sure the door remains open. Which type of
communication factor is this action?
a. environmental
b. personal
c. non-verbal
d. relationship - ANS ✔✔a. environmental
When the community health nurse visits a client at home, the client states, "I haven't slept at all
the last couple of nights." Which response by the nurse illustrates a therapeutic communication
response to this client? (select all that apply)
a. "really?"
b. "you're having difficulty sleeping?"
c. "I see."
d. "sometimes I have trouble sleeping too" - ANS ✔✔b. "you're having difficulty sleeping?"
The nurse in the mental health unit recognizes which as being therapeutic communication
techniques? Select all that apply.
1. Restating
2. Listening
3. Asking the client, "Why?"
4. Maintaining neutral responses
5. Providing acknowledgment and feedback
6. Giving advice and approval or disapproval - ANS ✔✔1, 2, 4, 5
In which part of the nursing care plan would the nurse expect to find this statement: "Patient
voluntarily attends group activities but does not participate actively."
a. Evaluation
b. Assessment
, c. Diagnosis
d. Planning - ANS ✔✔a. evaluation
A nurse spends extra time with a client who has personality features similar to the nurse's
estranged spouse. Which aspect of countertransference is most likely to result?
a. Over-involvement
b. Misuse of honesty
c. Indifference
d. Rescue - ANS ✔✔a. over-involvement
A client experiencing disturbed thought processes believes that his food is being poisoned.
Which communication technique should the nurse use to encourage the client to eat?
A. Sharing personal preference regarding food choices
B. Offering opinions about the necessity of adequate nutrition.
C. Using open-ended questions and silence
D. Documenting reasons why client doesn't want to eat - ANS ✔✔c. using open-ended
questions and silence
Which communication technique would be most challenging for a new nurse to use
therapeutically?
a. Acknowledging feelings
b. Sharing observations
c. Giving information
d.Interpretation
e.Motivational interviewing - ANS ✔✔e. motivational interviewing
ANSWERS WITH RATIONALES 2026/2027
Becky tells you, "I have something secret to tell you, but you can't tell anyone else." The nurse
agrees. What is the likely consequence of the nurse's action?
a. healthy feelings of sympathy by the nurse towards the client
b. blurred boundaries in the nurse-client relationship
c. improved rapport between the nurse and client
d. enhanced trust between the nurse and client - ANS ✔✔b. Blurred boundaries in the nurse-
client relationship.
As you begin working with her, you notice that your patient has an uncanny resemblance to
your younger sister. As a child, this sister lied and criticized you constantly, then screamed and
cried to others if you challenged her. You realize that you are responding negatively to this
patient. What's going on here?
a. counter-transference
b. self-actualization
c. transference
d. bias - ANS ✔✔a. counter-transference
A nurse seeks to establish a relationship with a patient readmitted to the hospital. The patient
has bipolar disorder, depressed type, and was hospitalized the preceding month. Which
statement by the nurse would contribute to establishing trust?
a. weren't you compliant with your medication?
b. it must be discouraging to have been readmitted to the hospital so soon
c. everyone with bipolar disorder ends up in the hospital periodically
d. you must take your medications religiously or you will be re-hospitalized - ANS ✔✔b. it must
be discouraging to have been readmitted to the hospital so soon
,As a nurse assesses a new client, the nurse makes sure the door remains open. Which type of
communication factor is this action?
a. environmental
b. personal
c. non-verbal
d. relationship - ANS ✔✔a. environmental
When the community health nurse visits a client at home, the client states, "I haven't slept at all
the last couple of nights." Which response by the nurse illustrates a therapeutic communication
response to this client? (select all that apply)
a. "really?"
b. "you're having difficulty sleeping?"
c. "I see."
d. "sometimes I have trouble sleeping too" - ANS ✔✔b. "you're having difficulty sleeping?"
The nurse in the mental health unit recognizes which as being therapeutic communication
techniques? Select all that apply.
1. Restating
2. Listening
3. Asking the client, "Why?"
4. Maintaining neutral responses
5. Providing acknowledgment and feedback
6. Giving advice and approval or disapproval - ANS ✔✔1, 2, 4, 5
In which part of the nursing care plan would the nurse expect to find this statement: "Patient
voluntarily attends group activities but does not participate actively."
a. Evaluation
b. Assessment
, c. Diagnosis
d. Planning - ANS ✔✔a. evaluation
A nurse spends extra time with a client who has personality features similar to the nurse's
estranged spouse. Which aspect of countertransference is most likely to result?
a. Over-involvement
b. Misuse of honesty
c. Indifference
d. Rescue - ANS ✔✔a. over-involvement
A client experiencing disturbed thought processes believes that his food is being poisoned.
Which communication technique should the nurse use to encourage the client to eat?
A. Sharing personal preference regarding food choices
B. Offering opinions about the necessity of adequate nutrition.
C. Using open-ended questions and silence
D. Documenting reasons why client doesn't want to eat - ANS ✔✔c. using open-ended
questions and silence
Which communication technique would be most challenging for a new nurse to use
therapeutically?
a. Acknowledging feelings
b. Sharing observations
c. Giving information
d.Interpretation
e.Motivational interviewing - ANS ✔✔e. motivational interviewing
