NU 160: Mental Health Nursing Concepts | Exam 3 Review | 2026/2027
Galen College of Nursing — 65 Practice Questions with Verified Answers and Evidence-Based
Rationales
Section 1: Therapeutic Communication Techniques
1. A nurse is caring for a patient who states, "I don't know why I even bother coming here. Nothing ever changes."
Which of the following responses by the nurse demonstrates the therapeutic technique of reflection?
A) I understand how frustrating that must be for you. B) You're feeling like coming here hasn't made a
difference.
C) Can you tell me more about what hasn't changed? D) Many patients feel that way at first, but things will
improve.
Correct Answer: B) You're feeling like coming here hasn't made a difference.
Rationale: Reflection directs back to the patient the feelings and meaning they have expressed, encouraging further
exploration. Option B mirrors the patient's underlying emotion of hopelessness without adding the nurse's
interpretation. Option A offers general empathy but does not specifically reflect the patient's statement. Option C uses
an open-ended question rather than reflection. Option D is a non-therapeutic response involving false reassurance
(Varcarolis, Foundations of Psychiatric-Mental Health Nursing).
2. A nurse is interviewing a new patient in an inpatient psychiatric unit. Which of the following is an example of
an open-ended question that promotes therapeutic communication?
A) Are you feeling sad B) Have you taken your C) What has been D) Do you have any
today? medications? happening in your life thoughts of harming
recently? yourself?
Correct Answer: C) What has been happening in your life recently?
Rationale: Open-ended questions encourage patients to express themselves broadly and reveal what is most important
to them. Option C invites a narrative response and cannot be answered with a simple yes or no. Options A, B, and D
are closed-ended questions that elicit limited one-word responses and do not promote therapeutic dialogue (NCSBN,
Therapeutic Communication Guidelines).
3. A patient with depression is sitting quietly and not speaking during a group therapy session. The nurse remains
seated nearby and does not press the patient to talk. Which therapeutic communication technique is the nurse
using?
A) Restating B) Clarification C) Therapeutic silence D) Summarizing
Correct Answer: C) Therapeutic silence
Rationale: Therapeutic silence allows the patient time to collect thoughts, process feelings, and decide when to share.
It communicates acceptance and patience without pressuring the patient. Restating involves repeating the patient's
main idea, clarification seeks to make ambiguous statements clearer, and summarizing condenses a longer discussion.
Silence is a powerful tool in mental health nursing (Varcarolis).
,4. A patient with schizophrenia says, "The voices told me that the cafeteria is poisoning the food." Which of the
following is the most therapeutic nursing response?
A) Nobody is poisoning the food; that's just a delusion. B) I can see you're frightened by what the voices are
telling you.
C) You shouldn't listen to those voices. Just ignore them. D) Let me show you the kitchen so you can see the food
is safe.
Correct Answer: B) I can see you're frightened by what the voices are telling you.
Rationale: The nurse should acknowledge the patient's feelings without reinforcing the delusion or directly arguing
with it. Option B validates the emotional experience (fear) without confirming the content of the hallucination. Arguing
or trying to prove the delusion wrong (options A and D) increases defensiveness and damages the therapeutic
relationship. Telling the patient to ignore voices (option C) is dismissive (APA, Schizophrenia Treatment Guidelines).
5. A nurse is nearing the end of a therapeutic conversation with a patient. Which of the following responses best
demonstrates the technique of summarizing?
A) What you're saying is that you feel overwhelmed by family expectations and work stress.
B) Tell me more about your family situation.
C) I think you should consider talking to a therapist about this.
D) It sounds like you're having a hard time.
Correct Answer: A) What you're saying is that you feel overwhelmed by family expectations and work
stress.
Rationale: Summarizing organizes and condenses the key points discussed during the conversation to demonstrate
understanding and provide closure. Option A weaves together multiple themes (family expectations and work stress)
that were presumably discussed earlier in the conversation. Option B opens a new topic rather than closing. Option C
gives advice, which is non-therapeutic. Option D is too vague to serve as an effective summary (NCSBN).
Section 2: Non-Therapeutic Responses & Phases of the Nurse-Patient Relationship
6. A nurse tells a patient who is worried about an upcoming procedure, "Don't worry, everything will be fine. I've
seen this procedure done many times without any problems." Which non-therapeutic response is the nurse
demonstrating?
A) Giving advice B) False reassurance C) Defensiveness D) Changing the subject
Correct Answer: B) False reassurance
Rationale: False reassurance dismisses the patient's legitimate concerns by offering unfounded guarantees of a
positive outcome. This non-therapeutic technique blocks further expression of anxiety and undermines trust. Giving
advice would involve telling the patient what to do, defensiveness involves protecting oneself from criticism, and
changing the subject avoids the patient's concern entirely (Varcarolis).
7. A patient states, "You nurses don't really care about us. You're just here to collect a paycheck." The nurse
responds, "That's not true at all! We work very hard and care deeply about every patient." Which non-therapeutic
response is the nurse using?
A) Stereotyping B) Disagreeing C) Defensiveness D) Probing
Correct Answer: C) Defensiveness
, Rationale: Defensiveness occurs when the nurse takes the patient's statement personally and reacts by justifying or
defending themselves rather than exploring the patient's underlying feelings. The patient's statement likely reflects
feelings of abandonment or fear, not a genuine assessment of the nurse's motivation. The therapeutic response would
explore what has made the patient feel uncared for. Disagreeing is related but involves rejecting the patient's ideas
rather than defending oneself (Varcarolis, NCSBN).
8. A nurse is meeting a patient for the first time on the psychiatric unit. The nurse introduces themselves, explains
the purpose of the meeting, and discusses the roles of the treatment team. Which phase of the nurse-patient
relationship is the nurse in?
A) Orientation phase B) Working phase C) Termination phase D) Pre-interaction phase
Correct Answer: A) Orientation phase
Rationale: The orientation phase (also called the introductory phase) involves establishing trust, setting expectations,
clarifying roles, and formulating a contract for the therapeutic relationship. The working phase involves problem-
solving and implementing interventions. The termination phase focuses on evaluating progress and saying goodbye.
The pre-interaction phase occurs before the first meeting and involves the nurse preparing (Varcarolis).
9. A patient who was severely neglected as a child becomes angry and accuses the nurse of not caring, similar to
how they felt about their parent. Which of the following best describes this phenomenon?
A) Countertransference B) Transference C) Resistance D) Regression
Correct Answer: B) Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings about a significant person from their
past onto the nurse or therapist. This is a normal part of psychodynamic therapy and should be addressed
therapeutically. Countertransference is the reverse, when the nurse projects their own feelings onto the patient.
Resistance is the unconscious defense against exploring painful material, and regression is reverting to an earlier
developmental stage (Varcarolis, APA).
10. A nurse finds themselves feeling unusually protective of a patient who reminds them of their deceased sibling.
The nurse begins giving the patient special privileges. Which phenomenon should the nurse recognize?
A) Transference B) Countertransference C) Therapeutic boundary D) Empathetic responding
crossing
Correct Answer: B) Countertransference
Rationale: Countertransference occurs when the nurse's own unresolved feelings or personal experiences are projected
onto the patient, potentially distorting the therapeutic relationship. Giving special privileges based on personal
identification crosses professional boundaries. The nurse should seek supervision to process these feelings. This is
distinct from transference (patient's projection), and while it starts as a boundary crossing, if unchecked it can become
a boundary violation (NCSBN, Varcarolis).
Section 3: Psychiatric Assessment & Mental Status Examination
11. A nurse is performing a mental status examination (MSE) and observes that the patient's speech is rapid and
difficult to interrupt. Which component of the MSE is the nurse assessing?
A) Mood and affect B) Thought process C) Perceptual disturbances D) Insight and judgment
Correct Answer: B) Thought process
Galen College of Nursing — 65 Practice Questions with Verified Answers and Evidence-Based
Rationales
Section 1: Therapeutic Communication Techniques
1. A nurse is caring for a patient who states, "I don't know why I even bother coming here. Nothing ever changes."
Which of the following responses by the nurse demonstrates the therapeutic technique of reflection?
A) I understand how frustrating that must be for you. B) You're feeling like coming here hasn't made a
difference.
C) Can you tell me more about what hasn't changed? D) Many patients feel that way at first, but things will
improve.
Correct Answer: B) You're feeling like coming here hasn't made a difference.
Rationale: Reflection directs back to the patient the feelings and meaning they have expressed, encouraging further
exploration. Option B mirrors the patient's underlying emotion of hopelessness without adding the nurse's
interpretation. Option A offers general empathy but does not specifically reflect the patient's statement. Option C uses
an open-ended question rather than reflection. Option D is a non-therapeutic response involving false reassurance
(Varcarolis, Foundations of Psychiatric-Mental Health Nursing).
2. A nurse is interviewing a new patient in an inpatient psychiatric unit. Which of the following is an example of
an open-ended question that promotes therapeutic communication?
A) Are you feeling sad B) Have you taken your C) What has been D) Do you have any
today? medications? happening in your life thoughts of harming
recently? yourself?
Correct Answer: C) What has been happening in your life recently?
Rationale: Open-ended questions encourage patients to express themselves broadly and reveal what is most important
to them. Option C invites a narrative response and cannot be answered with a simple yes or no. Options A, B, and D
are closed-ended questions that elicit limited one-word responses and do not promote therapeutic dialogue (NCSBN,
Therapeutic Communication Guidelines).
3. A patient with depression is sitting quietly and not speaking during a group therapy session. The nurse remains
seated nearby and does not press the patient to talk. Which therapeutic communication technique is the nurse
using?
A) Restating B) Clarification C) Therapeutic silence D) Summarizing
Correct Answer: C) Therapeutic silence
Rationale: Therapeutic silence allows the patient time to collect thoughts, process feelings, and decide when to share.
It communicates acceptance and patience without pressuring the patient. Restating involves repeating the patient's
main idea, clarification seeks to make ambiguous statements clearer, and summarizing condenses a longer discussion.
Silence is a powerful tool in mental health nursing (Varcarolis).
,4. A patient with schizophrenia says, "The voices told me that the cafeteria is poisoning the food." Which of the
following is the most therapeutic nursing response?
A) Nobody is poisoning the food; that's just a delusion. B) I can see you're frightened by what the voices are
telling you.
C) You shouldn't listen to those voices. Just ignore them. D) Let me show you the kitchen so you can see the food
is safe.
Correct Answer: B) I can see you're frightened by what the voices are telling you.
Rationale: The nurse should acknowledge the patient's feelings without reinforcing the delusion or directly arguing
with it. Option B validates the emotional experience (fear) without confirming the content of the hallucination. Arguing
or trying to prove the delusion wrong (options A and D) increases defensiveness and damages the therapeutic
relationship. Telling the patient to ignore voices (option C) is dismissive (APA, Schizophrenia Treatment Guidelines).
5. A nurse is nearing the end of a therapeutic conversation with a patient. Which of the following responses best
demonstrates the technique of summarizing?
A) What you're saying is that you feel overwhelmed by family expectations and work stress.
B) Tell me more about your family situation.
C) I think you should consider talking to a therapist about this.
D) It sounds like you're having a hard time.
Correct Answer: A) What you're saying is that you feel overwhelmed by family expectations and work
stress.
Rationale: Summarizing organizes and condenses the key points discussed during the conversation to demonstrate
understanding and provide closure. Option A weaves together multiple themes (family expectations and work stress)
that were presumably discussed earlier in the conversation. Option B opens a new topic rather than closing. Option C
gives advice, which is non-therapeutic. Option D is too vague to serve as an effective summary (NCSBN).
Section 2: Non-Therapeutic Responses & Phases of the Nurse-Patient Relationship
6. A nurse tells a patient who is worried about an upcoming procedure, "Don't worry, everything will be fine. I've
seen this procedure done many times without any problems." Which non-therapeutic response is the nurse
demonstrating?
A) Giving advice B) False reassurance C) Defensiveness D) Changing the subject
Correct Answer: B) False reassurance
Rationale: False reassurance dismisses the patient's legitimate concerns by offering unfounded guarantees of a
positive outcome. This non-therapeutic technique blocks further expression of anxiety and undermines trust. Giving
advice would involve telling the patient what to do, defensiveness involves protecting oneself from criticism, and
changing the subject avoids the patient's concern entirely (Varcarolis).
7. A patient states, "You nurses don't really care about us. You're just here to collect a paycheck." The nurse
responds, "That's not true at all! We work very hard and care deeply about every patient." Which non-therapeutic
response is the nurse using?
A) Stereotyping B) Disagreeing C) Defensiveness D) Probing
Correct Answer: C) Defensiveness
, Rationale: Defensiveness occurs when the nurse takes the patient's statement personally and reacts by justifying or
defending themselves rather than exploring the patient's underlying feelings. The patient's statement likely reflects
feelings of abandonment or fear, not a genuine assessment of the nurse's motivation. The therapeutic response would
explore what has made the patient feel uncared for. Disagreeing is related but involves rejecting the patient's ideas
rather than defending oneself (Varcarolis, NCSBN).
8. A nurse is meeting a patient for the first time on the psychiatric unit. The nurse introduces themselves, explains
the purpose of the meeting, and discusses the roles of the treatment team. Which phase of the nurse-patient
relationship is the nurse in?
A) Orientation phase B) Working phase C) Termination phase D) Pre-interaction phase
Correct Answer: A) Orientation phase
Rationale: The orientation phase (also called the introductory phase) involves establishing trust, setting expectations,
clarifying roles, and formulating a contract for the therapeutic relationship. The working phase involves problem-
solving and implementing interventions. The termination phase focuses on evaluating progress and saying goodbye.
The pre-interaction phase occurs before the first meeting and involves the nurse preparing (Varcarolis).
9. A patient who was severely neglected as a child becomes angry and accuses the nurse of not caring, similar to
how they felt about their parent. Which of the following best describes this phenomenon?
A) Countertransference B) Transference C) Resistance D) Regression
Correct Answer: B) Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings about a significant person from their
past onto the nurse or therapist. This is a normal part of psychodynamic therapy and should be addressed
therapeutically. Countertransference is the reverse, when the nurse projects their own feelings onto the patient.
Resistance is the unconscious defense against exploring painful material, and regression is reverting to an earlier
developmental stage (Varcarolis, APA).
10. A nurse finds themselves feeling unusually protective of a patient who reminds them of their deceased sibling.
The nurse begins giving the patient special privileges. Which phenomenon should the nurse recognize?
A) Transference B) Countertransference C) Therapeutic boundary D) Empathetic responding
crossing
Correct Answer: B) Countertransference
Rationale: Countertransference occurs when the nurse's own unresolved feelings or personal experiences are projected
onto the patient, potentially distorting the therapeutic relationship. Giving special privileges based on personal
identification crosses professional boundaries. The nurse should seek supervision to process these feelings. This is
distinct from transference (patient's projection), and while it starts as a boundary crossing, if unchecked it can become
a boundary violation (NCSBN, Varcarolis).
Section 3: Psychiatric Assessment & Mental Status Examination
11. A nurse is performing a mental status examination (MSE) and observes that the patient's speech is rapid and
difficult to interrupt. Which component of the MSE is the nurse assessing?
A) Mood and affect B) Thought process C) Perceptual disturbances D) Insight and judgment
Correct Answer: B) Thought process
