NUR 125 – Psychiatric Nursing Comprehensive Study
Guide: Behavioral Health Nursing, Psychiatric Disorders,
Interventions, and Mental Health Assessment Practice
Questions with Answers and Detailed Rationales
Question 1
A patient diagnosed with major depressive disorder tells the nurse, "I don't
see any point in living anymore." Which is the most appropriate initial
response by the nurse?
A. "You have so much to live for, think about your children."
B. "It sounds like you are feeling hopeless. Are you thinking about
harming yourself?"
C. "Everyone feels down sometimes, but things will get better."
D. "Let's talk about what is making you feel this way."
Answer: B
Rationale: The nurse must directly assess for suicide risk when a patient
expresses hopelessness or suicidal ideation. Asking directly about suicidal
thoughts is the most appropriate and therapeutic response. It demonstrates
concern, provides an opportunity for the patient to express feelings, and
allows for immediate safety assessment. Minimizing the patient's feelings or
changing the subject is not therapeutic.
Question 2
The nurse is caring for a patient who is angry and shouting. Which therapeutic
communication technique should the nurse use first?
A. Tell the patient to calm down and lower their voice
B. Approach the patient calmly and speak in a low, quiet voice
C. Leave the room until the patient calms down
D. Use a firm, authoritative tone to gain control
Answer: B
,Rationale: Approaching an angry patient calmly and speaking in a low, quiet
voice helps de-escalate the situation. This modeling of calm behavior can
reduce the patient's anxiety and agitation. Confrontation, leaving the room, or
using an authoritative tone can escalate the situation and increase the
patient's anger.
Question 3
The nurse is using silence during a therapeutic interaction with a patient.
Which statement best describes the purpose of this technique?
A. Silence is used when the nurse is unsure of what to say
B. Silence allows the patient time to reflect and organize thoughts
C. Silence is a sign of disinterest in the patient
D. Silence should be avoided in therapeutic communication
Answer: B
Rationale: Silence is a therapeutic communication technique that allows the
patient time to reflect, organize thoughts, and process feelings. It gives the
patient permission to think and respond without feeling pressured. Silence is
not a sign of disinterest; it is a purposeful technique used to facilitate patient
expression.
Question 4
A patient tells the nurse, "I'm a failure at everything I try." Which response by
the nurse demonstrates the therapeutic technique of clarification?
A. "Why do you think you are a failure?"
B. "You shouldn't feel that way because you are not a failure."
C. "Tell me more about what makes you feel you are a failure."
D. "I understand how you feel. I've been there too."
Answer: C
Rationale: Clarification helps the nurse understand the patient's perspective.
Asking the patient to elaborate on their feelings provides more information
and shows genuine interest. "Why" questions can feel accusatory. Giving
advice or using "I" statements are not therapeutic communication techniques.
,Question 5
A patient with schizophrenia tells the nurse, "The FBI is monitoring me
through my television." Which is the most therapeutic response?
A. "That's not true. The FBI doesn't monitor people that way."
B. "You believe the FBI is watching you. How does that make you feel?"
C. "Let's change the channel and watch something else."
D. "I don't see anyone watching you."
Answer: B
Rationale: This response validates the patient's feelings without reinforcing
the delusion. It acknowledges the patient's belief and focuses on the emotional
response. Arguing with the delusion or dismissing it is not therapeutic.
Changing the subject does not address the patient's concern.
Question 6
A patient is crying and expresses sadness about a recent divorce. The nurse's
best response is:
A. "Cheer up, things will get better."
B. "I can see that you are very sad. It's okay to cry."
C. "You need to move on with your life."
D. "You should focus on the positive aspects of your life."
Answer: B
Rationale: Validating the patient's feelings is therapeutic and demonstrates
empathy. It allows the patient to express emotions without judgment. Telling
the patient to cheer up, move on, or focus on the positive minimizes their
feelings and is not therapeutic.
Question 7
The nurse is assessing a patient's mental status. Which question is most
appropriate to assess short-term memory?
, A. "What is your mother's maiden name?"
B. "What did you eat for breakfast today?"
C. "Who is the current president of the United States?"
D. "What is your date of birth?"
Answer: B
Rationale: Short-term memory is assessed by asking the patient to recall
recent events, such as what they ate for breakfast or current day of the week.
Immediate memory is assessed by asking the patient to repeat a series of
words or numbers. Long-term memory is assessed by asking about childhood
or historical facts.
Question 8
A patient repeatedly states, "I'm fine, I'm fine, I'm fine," while pacing and
wringing their hands. The nurse should identify this as:
A. Denial
B. Incongruence between verbal and nonverbal communication
C. Repression
D. Projection
Answer: B
Rationale: There is incongruence between the patient's verbal statement
("I'm fine") and nonverbal cues (pacing, wringing hands). This discrepancy is
important to address. The nurse should gently point out the inconsistency and
explore the patient's feelings. Denial, repression, and projection are defense
mechanisms but do not specifically describe this incongruence.
Question 9
The nurse is teaching a patient about their antipsychotic medication. Which
statement indicates the patient understands the teaching?
A. "I should take this medication at the same time every day."
B. "I can stop taking this medication when I feel better."
C. "This medication will cure my illness."
D. "I only need to take this medication if I have symptoms."
Guide: Behavioral Health Nursing, Psychiatric Disorders,
Interventions, and Mental Health Assessment Practice
Questions with Answers and Detailed Rationales
Question 1
A patient diagnosed with major depressive disorder tells the nurse, "I don't
see any point in living anymore." Which is the most appropriate initial
response by the nurse?
A. "You have so much to live for, think about your children."
B. "It sounds like you are feeling hopeless. Are you thinking about
harming yourself?"
C. "Everyone feels down sometimes, but things will get better."
D. "Let's talk about what is making you feel this way."
Answer: B
Rationale: The nurse must directly assess for suicide risk when a patient
expresses hopelessness or suicidal ideation. Asking directly about suicidal
thoughts is the most appropriate and therapeutic response. It demonstrates
concern, provides an opportunity for the patient to express feelings, and
allows for immediate safety assessment. Minimizing the patient's feelings or
changing the subject is not therapeutic.
Question 2
The nurse is caring for a patient who is angry and shouting. Which therapeutic
communication technique should the nurse use first?
A. Tell the patient to calm down and lower their voice
B. Approach the patient calmly and speak in a low, quiet voice
C. Leave the room until the patient calms down
D. Use a firm, authoritative tone to gain control
Answer: B
,Rationale: Approaching an angry patient calmly and speaking in a low, quiet
voice helps de-escalate the situation. This modeling of calm behavior can
reduce the patient's anxiety and agitation. Confrontation, leaving the room, or
using an authoritative tone can escalate the situation and increase the
patient's anger.
Question 3
The nurse is using silence during a therapeutic interaction with a patient.
Which statement best describes the purpose of this technique?
A. Silence is used when the nurse is unsure of what to say
B. Silence allows the patient time to reflect and organize thoughts
C. Silence is a sign of disinterest in the patient
D. Silence should be avoided in therapeutic communication
Answer: B
Rationale: Silence is a therapeutic communication technique that allows the
patient time to reflect, organize thoughts, and process feelings. It gives the
patient permission to think and respond without feeling pressured. Silence is
not a sign of disinterest; it is a purposeful technique used to facilitate patient
expression.
Question 4
A patient tells the nurse, "I'm a failure at everything I try." Which response by
the nurse demonstrates the therapeutic technique of clarification?
A. "Why do you think you are a failure?"
B. "You shouldn't feel that way because you are not a failure."
C. "Tell me more about what makes you feel you are a failure."
D. "I understand how you feel. I've been there too."
Answer: C
Rationale: Clarification helps the nurse understand the patient's perspective.
Asking the patient to elaborate on their feelings provides more information
and shows genuine interest. "Why" questions can feel accusatory. Giving
advice or using "I" statements are not therapeutic communication techniques.
,Question 5
A patient with schizophrenia tells the nurse, "The FBI is monitoring me
through my television." Which is the most therapeutic response?
A. "That's not true. The FBI doesn't monitor people that way."
B. "You believe the FBI is watching you. How does that make you feel?"
C. "Let's change the channel and watch something else."
D. "I don't see anyone watching you."
Answer: B
Rationale: This response validates the patient's feelings without reinforcing
the delusion. It acknowledges the patient's belief and focuses on the emotional
response. Arguing with the delusion or dismissing it is not therapeutic.
Changing the subject does not address the patient's concern.
Question 6
A patient is crying and expresses sadness about a recent divorce. The nurse's
best response is:
A. "Cheer up, things will get better."
B. "I can see that you are very sad. It's okay to cry."
C. "You need to move on with your life."
D. "You should focus on the positive aspects of your life."
Answer: B
Rationale: Validating the patient's feelings is therapeutic and demonstrates
empathy. It allows the patient to express emotions without judgment. Telling
the patient to cheer up, move on, or focus on the positive minimizes their
feelings and is not therapeutic.
Question 7
The nurse is assessing a patient's mental status. Which question is most
appropriate to assess short-term memory?
, A. "What is your mother's maiden name?"
B. "What did you eat for breakfast today?"
C. "Who is the current president of the United States?"
D. "What is your date of birth?"
Answer: B
Rationale: Short-term memory is assessed by asking the patient to recall
recent events, such as what they ate for breakfast or current day of the week.
Immediate memory is assessed by asking the patient to repeat a series of
words or numbers. Long-term memory is assessed by asking about childhood
or historical facts.
Question 8
A patient repeatedly states, "I'm fine, I'm fine, I'm fine," while pacing and
wringing their hands. The nurse should identify this as:
A. Denial
B. Incongruence between verbal and nonverbal communication
C. Repression
D. Projection
Answer: B
Rationale: There is incongruence between the patient's verbal statement
("I'm fine") and nonverbal cues (pacing, wringing hands). This discrepancy is
important to address. The nurse should gently point out the inconsistency and
explore the patient's feelings. Denial, repression, and projection are defense
mechanisms but do not specifically describe this incongruence.
Question 9
The nurse is teaching a patient about their antipsychotic medication. Which
statement indicates the patient understands the teaching?
A. "I should take this medication at the same time every day."
B. "I can stop taking this medication when I feel better."
C. "This medication will cure my illness."
D. "I only need to take this medication if I have symptoms."
