Therapeutic Communication Techniques
Practice Exam (2026 Edition) | Advanced
NCLEX-RN Psychiatric Nursing & Patient
Interaction Skills Review
Question 1
A client diagnosed with major depressive disorder states,
"Everyone would be better off if I disappeared." Which
response by the nurse demonstrates the most therapeutic
communication?
A. "You shouldn't think that way."
B. "Why do you feel everyone would be better off?"
C. "Tell me more about what makes you feel that way."
D. "Your family loves you and needs you."
Answer: C. "Tell me more about what makes you feel that
way."
This response uses the therapeutic technique of exploration
and encourages the client to elaborate on feelings. It avoids
judgment, minimizes assumptions, and facilitates assessment
of possible suicidal ideation. Option A dismisses feelings, B
begins with "why," which can sound accusatory, and D
provides false reassurance rather than exploring the client's
emotions.
,Question 2
A client says, "The voices tell me that the staff are trying to
poison me." What is the most therapeutic response?
A. "The voices are not real."
B. "I understand that you hear voices, but I do not hear
them."
C. "You should ignore the voices."
D. "The staff would never harm you."
Answer: B. "I understand that you hear voices, but I do not
hear them."
This response presents reality without arguing about the
hallucination. It acknowledges the client's experience while
reinforcing reality orientation. Options A and D challenge the
client's perception directly, which may increase defensiveness.
Option C oversimplifies a complex symptom.
Question 3
A client newly diagnosed with cancer asks, "Am I going to
die?" Which response is most therapeutic?
A. "No, you'll be fine."
B. "Many people survive cancer."
C. "What concerns you most about your diagnosis?"
D. "Try not to think about dying."
,Answer: C. "What concerns you most about your
diagnosis?"
This response encourages expression of fears and concerns
rather than offering premature reassurance. Therapeutic
communication focuses on understanding the client's
perspective. The other responses redirect or minimize the
client's emotions.
Question 4
A client begins crying silently during an interview. Which
nursing action is most therapeutic?
A. Immediately change the subject.
B. Ask numerous assessment questions.
C. Leave the room to provide privacy.
D. Sit quietly with the client and allow time for expression.
Answer: D. Sit quietly with the client and allow time for
expression.
Therapeutic use of silence allows clients to process emotions
and communicate when ready. Silence demonstrates
acceptance and support. Changing the subject or asking
excessive questions may interrupt emotional expression.
Question 5
Which statement by the nurse is an example of reflection?
, A. "Tell me more."
B. "You seem frustrated about your treatment."
C. "Everything will work out."
D. "Why are you frustrated?"
Answer: B. "You seem frustrated about your treatment."
Reflection directs attention back to the client's feelings and
encourages deeper exploration. It helps clients examine
emotions and perceptions. The other responses either offer
reassurance, request information, or ask a potentially
defensive "why" question.
Question 6
A client states, "I know everyone on the unit hates me."
Which response uses the technique of presenting reality?
A. "That's not true."
B. "What evidence makes you think everyone hates you?"
C. "You are being irrational."
D. "Nobody hates you."
Answer: B. "What evidence makes you think everyone hates
you?"
This response gently encourages the client to evaluate
perceptions against objective evidence. It promotes reality
testing without confrontation. The remaining responses are
dismissive and may hinder communication.
Practice Exam (2026 Edition) | Advanced
NCLEX-RN Psychiatric Nursing & Patient
Interaction Skills Review
Question 1
A client diagnosed with major depressive disorder states,
"Everyone would be better off if I disappeared." Which
response by the nurse demonstrates the most therapeutic
communication?
A. "You shouldn't think that way."
B. "Why do you feel everyone would be better off?"
C. "Tell me more about what makes you feel that way."
D. "Your family loves you and needs you."
Answer: C. "Tell me more about what makes you feel that
way."
This response uses the therapeutic technique of exploration
and encourages the client to elaborate on feelings. It avoids
judgment, minimizes assumptions, and facilitates assessment
of possible suicidal ideation. Option A dismisses feelings, B
begins with "why," which can sound accusatory, and D
provides false reassurance rather than exploring the client's
emotions.
,Question 2
A client says, "The voices tell me that the staff are trying to
poison me." What is the most therapeutic response?
A. "The voices are not real."
B. "I understand that you hear voices, but I do not hear
them."
C. "You should ignore the voices."
D. "The staff would never harm you."
Answer: B. "I understand that you hear voices, but I do not
hear them."
This response presents reality without arguing about the
hallucination. It acknowledges the client's experience while
reinforcing reality orientation. Options A and D challenge the
client's perception directly, which may increase defensiveness.
Option C oversimplifies a complex symptom.
Question 3
A client newly diagnosed with cancer asks, "Am I going to
die?" Which response is most therapeutic?
A. "No, you'll be fine."
B. "Many people survive cancer."
C. "What concerns you most about your diagnosis?"
D. "Try not to think about dying."
,Answer: C. "What concerns you most about your
diagnosis?"
This response encourages expression of fears and concerns
rather than offering premature reassurance. Therapeutic
communication focuses on understanding the client's
perspective. The other responses redirect or minimize the
client's emotions.
Question 4
A client begins crying silently during an interview. Which
nursing action is most therapeutic?
A. Immediately change the subject.
B. Ask numerous assessment questions.
C. Leave the room to provide privacy.
D. Sit quietly with the client and allow time for expression.
Answer: D. Sit quietly with the client and allow time for
expression.
Therapeutic use of silence allows clients to process emotions
and communicate when ready. Silence demonstrates
acceptance and support. Changing the subject or asking
excessive questions may interrupt emotional expression.
Question 5
Which statement by the nurse is an example of reflection?
, A. "Tell me more."
B. "You seem frustrated about your treatment."
C. "Everything will work out."
D. "Why are you frustrated?"
Answer: B. "You seem frustrated about your treatment."
Reflection directs attention back to the client's feelings and
encourages deeper exploration. It helps clients examine
emotions and perceptions. The other responses either offer
reassurance, request information, or ask a potentially
defensive "why" question.
Question 6
A client states, "I know everyone on the unit hates me."
Which response uses the technique of presenting reality?
A. "That's not true."
B. "What evidence makes you think everyone hates you?"
C. "You are being irrational."
D. "Nobody hates you."
Answer: B. "What evidence makes you think everyone hates
you?"
This response gently encourages the client to evaluate
perceptions against objective evidence. It promotes reality
testing without confrontation. The remaining responses are
dismissive and may hinder communication.
