NSG 350 Mental Health Week 2 Exam
ACTUAL EXAM 2026/2027 | Psychiatric-
Mental Health Nursing | Verified Q&A |
Pass Guaranteed - A+ Graded
[Section 1: Therapeutic Communication & Defense Mechanisms]
(Questions 1–25)
Q1: A client diagnosed with schizophrenia tells the nurse, "The voices are telling me to hurt myself."
Which response by the nurse demonstrates the most therapeutic communication?
A. "You know the voices aren't real, so just ignore them."
B. "That must be frightening. Tell me more about what the voices are saying." [CORRECT]
C. "Have you taken your medication today? That's why you're hearing voices."
D. "Lots of people hear voices. It's not a big deal."
Correct Answer: B
Rationale: The therapeutic response validates the client's experience and invites further exploration,
which builds trust and assesses suicide risk. Telling the client to ignore the voices dismisses their reality
and may increase distress. Asking about medication shifts focus away from the immediate concern and
sounds accusatory. Minimizing the experience is nontherapeutic and unsafe.
Q2: During a group therapy session, a client with borderline personality disorder states, "No one here
cares about me. You're all just pretending." Which response by the nurse demonstrates the therapeutic
technique of restating?
A. "You feel that no one in this group genuinely cares about you." [CORRECT]
B. "It sounds like you're feeling rejected and angry right now."
C. "Why do you think we don't care about you?"
D. "That's not true. We all care very much about you."
,Correct Answer: A
Rationale: Restating involves repeating the client's main idea in similar words to show understanding
and encourage elaboration. This response mirrors the client's statement without adding interpretation
or emotion. Reflecting feelings would address the underlying emotion rather than the content. Asking
"why" puts the client on the defensive. Reassuring without exploration is nontherapeutic and dismissive.
Q3: A client whose mother recently died says, "I'm fine. She lived a good life, and I'm ready to move on."
The client then begins organizing a massive charity event in her mother's name within 48 hours of the
death. The nurse recognizes this behavior as which defense mechanism?
A. Sublimation
B. Denial
C. Reaction formation
D. Intellectualization [CORRECT]
Correct Answer: D
Rationale: Intellectualization involves using excessive reasoning or logic to avoid emotional distress. The
client focuses on productive activity and rational statements rather than processing grief. Sublimation
would channel unacceptable impulses into socially acceptable actions over time, not immediately after a
loss. Denial would involve refusing to acknowledge the death entirely. Reaction formation would involve
expressing the opposite emotion, such as appearing joyful.
Q4: A nurse is working with a client who has been involuntarily committed. The client states, "I don't
belong here. I want to leave right now." Which is the nurse's best response?
A. "You can leave whenever you want. This is a free country."
B. "Let's talk about why the doctor felt you needed to be here right now." [CORRECT]
C. "If you try to leave, I'll have to restrain you."
D. "You signed the papers, so you have to stay."
Correct Answer: B
Rationale: This response opens therapeutic dialogue while acknowledging the commitment status
without being confrontational or threatening. Stating the client can leave freely is inaccurate and unsafe
for an involuntary commitment. Threatening restraint escalates tension and violates therapeutic
principles. Claiming the client signed papers is factually incorrect for involuntary status and dismissive.
Q5: A client with depression tells the nurse, "I just don't see the point in anything anymore." Which
response demonstrates active listening?
, A. "You sound hopeless. Have you thought about hurting yourself?" [CORRECT]
B. "Things will get better. You just need to stay positive."
C. "Why do you feel that way? You have so much to live for."
D. "Let's talk about your medication schedule instead."
Correct Answer: A
Rationale: Active listening involves attending to both verbal and nonverbal cues, then responding to the
underlying message while assessing safety. This response names the emotion and directly evaluates
suicidal ideation, which is the priority. Offering false reassurance minimizes the client's pain. Asking
"why" and listing reasons to live is dismissive and nontherapeutic. Changing the subject avoids the
critical issue.
Q6: A client with obsessive-compulsive disorder repeatedly washes their hands until they bleed. When
confronted, the client says, "I know it's excessive, but I can't stop. It helps me feel in control." The nurse
recognizes this explanation as:
A. A display of poor insight
B. An example of intellectualization
C. A sign of good insight with ego-dystonic symptoms [CORRECT]
D. Evidence of delusional thinking
Correct Answer: C
Rationale: The client demonstrates awareness that the behavior is problematic (good insight) and
experiences the symptoms as distressing and foreign to their sense of self (ego-dystonic). Poor insight
would involve believing the behavior is necessary and reasonable. Intellectualization would involve
excessive rationalization without emotional awareness. Delusional thinking would involve fixed false
beliefs not amenable to reason.
Q7: During a home visit, a client with bipolar disorder in mania tells the nurse, "I haven't slept in three
days because I'm writing a novel that will change the world!" The nurse's best therapeutic response is:
A. "That's amazing! Can I read it when you're done?"
B. "You haven't slept in three days. How is your body feeling right now?" [CORRECT]
C. "You need to stop writing and go to bed immediately."
D. "There's no way you can write a novel in three days. Be realistic."
Correct Answer: B
Rationale: This response uses the therapeutic technique of focusing, bringing the client back to
physiologic reality without arguing or reinforcing grandiosity. Reinforcing the grandiose plan encourages
continued manic behavior. Ordering the client to stop is authoritarian and likely to provoke resistance.
Challenging the client's belief directly is confrontational and nontherapeutic.
ACTUAL EXAM 2026/2027 | Psychiatric-
Mental Health Nursing | Verified Q&A |
Pass Guaranteed - A+ Graded
[Section 1: Therapeutic Communication & Defense Mechanisms]
(Questions 1–25)
Q1: A client diagnosed with schizophrenia tells the nurse, "The voices are telling me to hurt myself."
Which response by the nurse demonstrates the most therapeutic communication?
A. "You know the voices aren't real, so just ignore them."
B. "That must be frightening. Tell me more about what the voices are saying." [CORRECT]
C. "Have you taken your medication today? That's why you're hearing voices."
D. "Lots of people hear voices. It's not a big deal."
Correct Answer: B
Rationale: The therapeutic response validates the client's experience and invites further exploration,
which builds trust and assesses suicide risk. Telling the client to ignore the voices dismisses their reality
and may increase distress. Asking about medication shifts focus away from the immediate concern and
sounds accusatory. Minimizing the experience is nontherapeutic and unsafe.
Q2: During a group therapy session, a client with borderline personality disorder states, "No one here
cares about me. You're all just pretending." Which response by the nurse demonstrates the therapeutic
technique of restating?
A. "You feel that no one in this group genuinely cares about you." [CORRECT]
B. "It sounds like you're feeling rejected and angry right now."
C. "Why do you think we don't care about you?"
D. "That's not true. We all care very much about you."
,Correct Answer: A
Rationale: Restating involves repeating the client's main idea in similar words to show understanding
and encourage elaboration. This response mirrors the client's statement without adding interpretation
or emotion. Reflecting feelings would address the underlying emotion rather than the content. Asking
"why" puts the client on the defensive. Reassuring without exploration is nontherapeutic and dismissive.
Q3: A client whose mother recently died says, "I'm fine. She lived a good life, and I'm ready to move on."
The client then begins organizing a massive charity event in her mother's name within 48 hours of the
death. The nurse recognizes this behavior as which defense mechanism?
A. Sublimation
B. Denial
C. Reaction formation
D. Intellectualization [CORRECT]
Correct Answer: D
Rationale: Intellectualization involves using excessive reasoning or logic to avoid emotional distress. The
client focuses on productive activity and rational statements rather than processing grief. Sublimation
would channel unacceptable impulses into socially acceptable actions over time, not immediately after a
loss. Denial would involve refusing to acknowledge the death entirely. Reaction formation would involve
expressing the opposite emotion, such as appearing joyful.
Q4: A nurse is working with a client who has been involuntarily committed. The client states, "I don't
belong here. I want to leave right now." Which is the nurse's best response?
A. "You can leave whenever you want. This is a free country."
B. "Let's talk about why the doctor felt you needed to be here right now." [CORRECT]
C. "If you try to leave, I'll have to restrain you."
D. "You signed the papers, so you have to stay."
Correct Answer: B
Rationale: This response opens therapeutic dialogue while acknowledging the commitment status
without being confrontational or threatening. Stating the client can leave freely is inaccurate and unsafe
for an involuntary commitment. Threatening restraint escalates tension and violates therapeutic
principles. Claiming the client signed papers is factually incorrect for involuntary status and dismissive.
Q5: A client with depression tells the nurse, "I just don't see the point in anything anymore." Which
response demonstrates active listening?
, A. "You sound hopeless. Have you thought about hurting yourself?" [CORRECT]
B. "Things will get better. You just need to stay positive."
C. "Why do you feel that way? You have so much to live for."
D. "Let's talk about your medication schedule instead."
Correct Answer: A
Rationale: Active listening involves attending to both verbal and nonverbal cues, then responding to the
underlying message while assessing safety. This response names the emotion and directly evaluates
suicidal ideation, which is the priority. Offering false reassurance minimizes the client's pain. Asking
"why" and listing reasons to live is dismissive and nontherapeutic. Changing the subject avoids the
critical issue.
Q6: A client with obsessive-compulsive disorder repeatedly washes their hands until they bleed. When
confronted, the client says, "I know it's excessive, but I can't stop. It helps me feel in control." The nurse
recognizes this explanation as:
A. A display of poor insight
B. An example of intellectualization
C. A sign of good insight with ego-dystonic symptoms [CORRECT]
D. Evidence of delusional thinking
Correct Answer: C
Rationale: The client demonstrates awareness that the behavior is problematic (good insight) and
experiences the symptoms as distressing and foreign to their sense of self (ego-dystonic). Poor insight
would involve believing the behavior is necessary and reasonable. Intellectualization would involve
excessive rationalization without emotional awareness. Delusional thinking would involve fixed false
beliefs not amenable to reason.
Q7: During a home visit, a client with bipolar disorder in mania tells the nurse, "I haven't slept in three
days because I'm writing a novel that will change the world!" The nurse's best therapeutic response is:
A. "That's amazing! Can I read it when you're done?"
B. "You haven't slept in three days. How is your body feeling right now?" [CORRECT]
C. "You need to stop writing and go to bed immediately."
D. "There's no way you can write a novel in three days. Be realistic."
Correct Answer: B
Rationale: This response uses the therapeutic technique of focusing, bringing the client back to
physiologic reality without arguing or reinforcing grandiosity. Reinforcing the grandiose plan encourages
continued manic behavior. Ordering the client to stop is authoritarian and likely to provoke resistance.
Challenging the client's belief directly is confrontational and nontherapeutic.
