NURSING 104 – WEEK 5+6 Mood and Affect,
Mental Health Assessment, and Psychiatric
Nursing Concepts 100 Multiple Choice Questions
with Answers and Rationales
1. A nurse is establishing a therapeutic relationship with a newly admitted
psychiatric patient. Which statement reflects the nurse's understanding of the
therapeutic relationship?
A. "I will share my personal experiences to help the patient feel understood."
B. "The focus of our relationship will be on the patient's needs and goals."
C. "I will maintain a social friendship to build trust."
D. "I will advise the patient on how to solve all their problems."
Answer: B. "The focus of our relationship will be on the patient's needs and
goals."
Rationale: The therapeutic relationship is patient-centered and focuses on meeting
the patient's needs and goals. Self-disclosure should be limited and used only when
therapeutic; social relationships are not appropriate; advising is paternalistic and
not therapeutic.
2. A patient tells the nurse, "I don't think I can go on anymore." Which
response demonstrates therapeutic communication?
A. "You have so much to live for, don't say that."
B. "Tell me more about what you're feeling right now."
C. "Everyone feels down sometimes, you'll get through this."
D. "I understand exactly how you feel."
Answer: B. "Tell me more about what you're feeling right now."
Rationale: This response uses an open-ended question that encourages exploration
of feelings and demonstrates therapeutic communication. Minimizing feelings,
false reassurance, and implying the nurse understands exactly are nontherapeutic
responses.
,3. A patient is silent during a therapy session. The nurse's BEST response is:
A. "You seem quiet today. Would you like to talk about what's on your mind?"
B. "I'll leave you alone to think."
C. "Why aren't you talking to me?"
D. "Silence makes me uncomfortable. Let's talk about something else."
Answer: A. "You seem quiet today. Would you like to talk about what's on
your mind?"
Rationale: This response acknowledges the silence and gently invites the patient
to share without pressure. It respects the patient's need for silence while offering an
opportunity for communication.
4. A patient with schizophrenia states, "The aliens are controlling my
thoughts." The nurse's MOST therapeutic response is:
A. "That's not real. The aliens don't exist."
B. "I don't see any aliens. You're having a hallucination."
C. "It must be frightening to feel that your thoughts are being controlled."
D. "Why do you think the aliens are controlling you?"
Answer: C. "It must be frightening to feel that your thoughts are being
controlled."
Rationale: This response validates the patient's feelings without reinforcing the
delusion. It acknowledges the emotional experience while avoiding arguing with or
challenging the delusion, which would damage trust.
5. A nurse is using active listening skills with a patient. Which behavior
indicates effective active listening?
A. The nurse interrupts frequently to clarify points
B. The nurse maintains eye contact and provides verbal acknowledgments
C. The nurse takes detailed notes throughout the conversation
D. The nurse focuses on what to say next while the patient is speaking
Answer: B. The nurse maintains eye contact and provides verbal
acknowledgments
,Rationale: Active listening involves maintaining eye contact, providing verbal and
non-verbal acknowledgments (e.g., nodding, "I see"), and giving full attention to
the patient. Interrupting, focusing on note-taking, or planning responses
demonstrates poor listening.
6. A patient expresses anger toward the nurse, stating, "You never listen to
me!" The nurse's BEST response is:
A. "I listen to you all the time. You're being unreasonable."
B. "I can see you're upset. Let's talk about what's bothering you."
C. "Calm down. There's no reason to be angry."
D. "If you keep yelling, I'll have to leave."
Answer: B. "I can see you're upset. Let's talk about what's bothering you."
Rationale: This response acknowledges the patient's feelings and redirects to a
productive conversation. It avoids defensiveness, minimizes feelings, or
threatening consequences.
7. A patient repeatedly asks the same question. The nurse should:
A. Answer the question once and then ignore subsequent repetitions
B. Answer the question each time, recognizing the patient's anxiety
C. Tell the patient to stop asking the same question
D. Redirect the patient to another topic
Answer: B. Answer the question each time, recognizing the patient's anxiety
Rationale: Repetitive questioning often indicates anxiety. Answering the question
each time provides reassurance and consistency. Ignoring or telling the patient to
stop increases anxiety; redirection may be appropriate but should not replace
answering the question.
8. A nurse is caring for a patient who is withdrawn and speaking very little.
Which intervention is MOST appropriate?
A. Leave the patient alone until they are ready to talk
B. Sit quietly with the patient, allowing them to initiate interaction
, C. Ask the patient a series of direct questions
D. Tell the patient to cheer up and join group activities
Answer: B. Sit quietly with the patient, allowing them to initiate interaction
Rationale: Sitting with a withdrawn patient without demanding conversation
demonstrates acceptance and availability. It respects the patient's pace while
maintaining therapeutic presence. Leaving them alone increases isolation; direct
questions may increase anxiety; telling the patient to cheer up minimizes their
feelings.
9. A patient states, "I'm so stupid. I can't do anything right." The nurse's
MOST therapeutic response is:
A. "You're not stupid. You're a very smart person."
B. "Why do you think you're stupid?"
C. "I notice you're feeling down about yourself right now."
D. "Everyone makes mistakes sometimes."
Answer: C. "I notice you're feeling down about yourself right now."
Rationale: This response uses reflection to acknowledge the patient's feelings
without reinforcing negative self-talk. Directly contradicting the patient's statement
may lead to argument; "why" questions can feel accusatory; minimizing feelings is
not therapeutic.
10. The nurse is terminating a therapeutic relationship with a patient. Which
statement is MOST appropriate?
A. "I'm glad we're done. I hope you never have to come back here."
B. "I won't be your nurse anymore, but someone else will be."
C. "Our time together has ended. What have you found most helpful?"
D. "Don't worry, you'll be fine without me."
Answer: C. "Our time together has ended. What have you found most
helpful?"
Rationale: Termination should include summarizing progress, discussing
accomplishments, and facilitating closure. It validates the therapeutic work and
Mental Health Assessment, and Psychiatric
Nursing Concepts 100 Multiple Choice Questions
with Answers and Rationales
1. A nurse is establishing a therapeutic relationship with a newly admitted
psychiatric patient. Which statement reflects the nurse's understanding of the
therapeutic relationship?
A. "I will share my personal experiences to help the patient feel understood."
B. "The focus of our relationship will be on the patient's needs and goals."
C. "I will maintain a social friendship to build trust."
D. "I will advise the patient on how to solve all their problems."
Answer: B. "The focus of our relationship will be on the patient's needs and
goals."
Rationale: The therapeutic relationship is patient-centered and focuses on meeting
the patient's needs and goals. Self-disclosure should be limited and used only when
therapeutic; social relationships are not appropriate; advising is paternalistic and
not therapeutic.
2. A patient tells the nurse, "I don't think I can go on anymore." Which
response demonstrates therapeutic communication?
A. "You have so much to live for, don't say that."
B. "Tell me more about what you're feeling right now."
C. "Everyone feels down sometimes, you'll get through this."
D. "I understand exactly how you feel."
Answer: B. "Tell me more about what you're feeling right now."
Rationale: This response uses an open-ended question that encourages exploration
of feelings and demonstrates therapeutic communication. Minimizing feelings,
false reassurance, and implying the nurse understands exactly are nontherapeutic
responses.
,3. A patient is silent during a therapy session. The nurse's BEST response is:
A. "You seem quiet today. Would you like to talk about what's on your mind?"
B. "I'll leave you alone to think."
C. "Why aren't you talking to me?"
D. "Silence makes me uncomfortable. Let's talk about something else."
Answer: A. "You seem quiet today. Would you like to talk about what's on
your mind?"
Rationale: This response acknowledges the silence and gently invites the patient
to share without pressure. It respects the patient's need for silence while offering an
opportunity for communication.
4. A patient with schizophrenia states, "The aliens are controlling my
thoughts." The nurse's MOST therapeutic response is:
A. "That's not real. The aliens don't exist."
B. "I don't see any aliens. You're having a hallucination."
C. "It must be frightening to feel that your thoughts are being controlled."
D. "Why do you think the aliens are controlling you?"
Answer: C. "It must be frightening to feel that your thoughts are being
controlled."
Rationale: This response validates the patient's feelings without reinforcing the
delusion. It acknowledges the emotional experience while avoiding arguing with or
challenging the delusion, which would damage trust.
5. A nurse is using active listening skills with a patient. Which behavior
indicates effective active listening?
A. The nurse interrupts frequently to clarify points
B. The nurse maintains eye contact and provides verbal acknowledgments
C. The nurse takes detailed notes throughout the conversation
D. The nurse focuses on what to say next while the patient is speaking
Answer: B. The nurse maintains eye contact and provides verbal
acknowledgments
,Rationale: Active listening involves maintaining eye contact, providing verbal and
non-verbal acknowledgments (e.g., nodding, "I see"), and giving full attention to
the patient. Interrupting, focusing on note-taking, or planning responses
demonstrates poor listening.
6. A patient expresses anger toward the nurse, stating, "You never listen to
me!" The nurse's BEST response is:
A. "I listen to you all the time. You're being unreasonable."
B. "I can see you're upset. Let's talk about what's bothering you."
C. "Calm down. There's no reason to be angry."
D. "If you keep yelling, I'll have to leave."
Answer: B. "I can see you're upset. Let's talk about what's bothering you."
Rationale: This response acknowledges the patient's feelings and redirects to a
productive conversation. It avoids defensiveness, minimizes feelings, or
threatening consequences.
7. A patient repeatedly asks the same question. The nurse should:
A. Answer the question once and then ignore subsequent repetitions
B. Answer the question each time, recognizing the patient's anxiety
C. Tell the patient to stop asking the same question
D. Redirect the patient to another topic
Answer: B. Answer the question each time, recognizing the patient's anxiety
Rationale: Repetitive questioning often indicates anxiety. Answering the question
each time provides reassurance and consistency. Ignoring or telling the patient to
stop increases anxiety; redirection may be appropriate but should not replace
answering the question.
8. A nurse is caring for a patient who is withdrawn and speaking very little.
Which intervention is MOST appropriate?
A. Leave the patient alone until they are ready to talk
B. Sit quietly with the patient, allowing them to initiate interaction
, C. Ask the patient a series of direct questions
D. Tell the patient to cheer up and join group activities
Answer: B. Sit quietly with the patient, allowing them to initiate interaction
Rationale: Sitting with a withdrawn patient without demanding conversation
demonstrates acceptance and availability. It respects the patient's pace while
maintaining therapeutic presence. Leaving them alone increases isolation; direct
questions may increase anxiety; telling the patient to cheer up minimizes their
feelings.
9. A patient states, "I'm so stupid. I can't do anything right." The nurse's
MOST therapeutic response is:
A. "You're not stupid. You're a very smart person."
B. "Why do you think you're stupid?"
C. "I notice you're feeling down about yourself right now."
D. "Everyone makes mistakes sometimes."
Answer: C. "I notice you're feeling down about yourself right now."
Rationale: This response uses reflection to acknowledge the patient's feelings
without reinforcing negative self-talk. Directly contradicting the patient's statement
may lead to argument; "why" questions can feel accusatory; minimizing feelings is
not therapeutic.
10. The nurse is terminating a therapeutic relationship with a patient. Which
statement is MOST appropriate?
A. "I'm glad we're done. I hope you never have to come back here."
B. "I won't be your nurse anymore, but someone else will be."
C. "Our time together has ended. What have you found most helpful?"
D. "Don't worry, you'll be fine without me."
Answer: C. "Our time together has ended. What have you found most
helpful?"
Rationale: Termination should include summarizing progress, discussing
accomplishments, and facilitating closure. It validates the therapeutic work and
