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NUR 253 Mental Health Exam 4 Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Section 1: Therapeutic Communication & Therapeutic Relationship (Questions 1-15)
Q1: A patient says, "I'm so nervous, I don't think I can handle this group therapy session." Which
response by the nurse is an example of the therapeutic communication technique of "offering
self"?
A. "You should try deep breathing exercises before you go in."
B. "Many patients feel nervous at first; you will get used to it."
C. "I will stay with you during the session to help you feel more comfortable."
D. "Why are you feeling so nervous today?"
Correct Answer: C
Rationale: Offering self involves making oneself available to the patient on an emotional or
physical level to show support and commitment. Option C demonstrates this by offering
presence. Option A gives advice, Option B gives false reassurance, and Option D asks a "why"
question which can be defensive.
Q2: During an assessment, a patient asks the nurse, "Do you believe in God?" The nurse
responds, "I believe faith can be a source of strength for many people." This is an example of:
A. Focusing
B. Validating
C. Clarifying
D. Restating
Correct Answer: B
,2
Rationale: Validating confirms the worth or significance of a patient's feelings or thoughts. The
nurse acknowledges the patient's question and validates the concept of faith without imposing
personal religious beliefs on the patient.
Q3: A patient diagnosed with schizophrenia becomes angry and shouts, "You're just like my
mother! You always try to control me!" This behavior is an example of:
A. Countertransference
B. Transference
C. Splitting
D. Resistance
Correct Answer: B
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person from their past onto the nurse. Here, the patient is projecting feelings about
their mother onto the nurse.
Q4: Which nursing statement exemplifies the non-therapeutic technique of "probing"?
A. "Tell me more about what happened when you lost your job."
B. "Why did you feel the need to hit your wife?"
C. "It sounds like you are feeling very frustrated right now."
D. "Let's focus on your coping skills for today."
Correct Answer: B
Rationale: Probing involves persistent questioning, often using "why," which can make the
patient feel interrogated or defensive. It pushes for information the patient may not be ready to
share. "Why" questions are generally non-therapeutic.
Q5: According to Peplau's Interpersonal Relations Theory, when the nurse acts as a "surrogate,"
the nurse:
A. Teaches the patient about their illness and treatment.
,3
B. Helps the patient clarify feelings and solve problems.
C. Substitutes for another person who is significant to the patient.
D. Provides care and performs technical tasks.
Correct Answer: C
Rationale: In the surrogate role, the nurse substitutes for a figure such as a parent, sibling, or
teacher, allowing the patient to work through interpersonal conflicts. Teaching is the "teacher"
role, and solving problems is the "counselor" role.
Q6: A nurse invites a patient to go for a walk and states, "I enjoy getting fresh air too." This
action describes the therapeutic use of self primarily through:
A. Self-awareness
B. Therapeutic use of personality
C. Empathy
D. Genuineness
Correct Answer: D
Rationale: While all options are components of the therapeutic use of self, stating "I enjoy... too"
reflects genuineness (congruence between what the nurse feels and says). It humanizes the
interaction.
Q7: A patient gives the nurse a handmade bracelet as a gift. The nurse accepts it but explains the
unit policy regarding gifts. This is an example of managing:
A. A boundary crossing
B. A boundary violation
C. Countertransference
D. A dual relationship
Correct Answer: A
, 4
Rationale: A boundary crossing is a brief deviation from professional boundaries that may be
benign or even therapeutic (like accepting a small token), provided it is managed and does not
become exploitative. A violation is harmful or exploitative. Explaining policy maintains the
professional boundary.
Q8: In the "orientation phase" of the therapeutic nurse-patient relationship, the nurse's primary
goal is to:
A. Explore the patient's problems in depth.
B. Establish a contract and build trust.
C. Summarize progress and evaluate goals.
D. Terminate the relationship.
Correct Answer: B
Rationale: The orientation phase is the initial stage where the nurse and patient meet, establish
rapport, define parameters (contract), and build trust. Exploring problems happens in the
working phase, and summarizing/termination happens at the end.
Q9: A patient is pacing, clenching their fists, and shouting. Which de-escalation technique is the
priority?
A. Tell the patient firmly to sit down immediately.
B. Maintain a calm demeanor and respect personal space.
C. Call security immediately and physically restrain the patient.
D. Argue with the patient to prove they are wrong.
Correct Answer: B
Rationale: De-escalation requires remaining calm, speaking slowly, and respecting personal
space (about an arm's length) to reduce the patient's anxiety and aggression. Commands, physical
force, or arguing can escalate the situation.
NUR 253 Mental Health Exam 4 Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Section 1: Therapeutic Communication & Therapeutic Relationship (Questions 1-15)
Q1: A patient says, "I'm so nervous, I don't think I can handle this group therapy session." Which
response by the nurse is an example of the therapeutic communication technique of "offering
self"?
A. "You should try deep breathing exercises before you go in."
B. "Many patients feel nervous at first; you will get used to it."
C. "I will stay with you during the session to help you feel more comfortable."
D. "Why are you feeling so nervous today?"
Correct Answer: C
Rationale: Offering self involves making oneself available to the patient on an emotional or
physical level to show support and commitment. Option C demonstrates this by offering
presence. Option A gives advice, Option B gives false reassurance, and Option D asks a "why"
question which can be defensive.
Q2: During an assessment, a patient asks the nurse, "Do you believe in God?" The nurse
responds, "I believe faith can be a source of strength for many people." This is an example of:
A. Focusing
B. Validating
C. Clarifying
D. Restating
Correct Answer: B
,2
Rationale: Validating confirms the worth or significance of a patient's feelings or thoughts. The
nurse acknowledges the patient's question and validates the concept of faith without imposing
personal religious beliefs on the patient.
Q3: A patient diagnosed with schizophrenia becomes angry and shouts, "You're just like my
mother! You always try to control me!" This behavior is an example of:
A. Countertransference
B. Transference
C. Splitting
D. Resistance
Correct Answer: B
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person from their past onto the nurse. Here, the patient is projecting feelings about
their mother onto the nurse.
Q4: Which nursing statement exemplifies the non-therapeutic technique of "probing"?
A. "Tell me more about what happened when you lost your job."
B. "Why did you feel the need to hit your wife?"
C. "It sounds like you are feeling very frustrated right now."
D. "Let's focus on your coping skills for today."
Correct Answer: B
Rationale: Probing involves persistent questioning, often using "why," which can make the
patient feel interrogated or defensive. It pushes for information the patient may not be ready to
share. "Why" questions are generally non-therapeutic.
Q5: According to Peplau's Interpersonal Relations Theory, when the nurse acts as a "surrogate,"
the nurse:
A. Teaches the patient about their illness and treatment.
,3
B. Helps the patient clarify feelings and solve problems.
C. Substitutes for another person who is significant to the patient.
D. Provides care and performs technical tasks.
Correct Answer: C
Rationale: In the surrogate role, the nurse substitutes for a figure such as a parent, sibling, or
teacher, allowing the patient to work through interpersonal conflicts. Teaching is the "teacher"
role, and solving problems is the "counselor" role.
Q6: A nurse invites a patient to go for a walk and states, "I enjoy getting fresh air too." This
action describes the therapeutic use of self primarily through:
A. Self-awareness
B. Therapeutic use of personality
C. Empathy
D. Genuineness
Correct Answer: D
Rationale: While all options are components of the therapeutic use of self, stating "I enjoy... too"
reflects genuineness (congruence between what the nurse feels and says). It humanizes the
interaction.
Q7: A patient gives the nurse a handmade bracelet as a gift. The nurse accepts it but explains the
unit policy regarding gifts. This is an example of managing:
A. A boundary crossing
B. A boundary violation
C. Countertransference
D. A dual relationship
Correct Answer: A
, 4
Rationale: A boundary crossing is a brief deviation from professional boundaries that may be
benign or even therapeutic (like accepting a small token), provided it is managed and does not
become exploitative. A violation is harmful or exploitative. Explaining policy maintains the
professional boundary.
Q8: In the "orientation phase" of the therapeutic nurse-patient relationship, the nurse's primary
goal is to:
A. Explore the patient's problems in depth.
B. Establish a contract and build trust.
C. Summarize progress and evaluate goals.
D. Terminate the relationship.
Correct Answer: B
Rationale: The orientation phase is the initial stage where the nurse and patient meet, establish
rapport, define parameters (contract), and build trust. Exploring problems happens in the
working phase, and summarizing/termination happens at the end.
Q9: A patient is pacing, clenching their fists, and shouting. Which de-escalation technique is the
priority?
A. Tell the patient firmly to sit down immediately.
B. Maintain a calm demeanor and respect personal space.
C. Call security immediately and physically restrain the patient.
D. Argue with the patient to prove they are wrong.
Correct Answer: B
Rationale: De-escalation requires remaining calm, speaking slowly, and respecting personal
space (about an arm's length) to reduce the patient's anxiety and aggression. Commands, physical
force, or arguing can escalate the situation.
