NUR2459: Mental & Behavioral Health Nursing FINAL EXAM
(2026/2027) – Rasmussen University
SECTION 1: Therapeutic Communication & Nurse-Patient Relationship (Q1-Q10)
Q1: A 32-year-old patient with depression states, "I just feel like nothing will ever get
better." Which therapeutic communication response by the nurse is most appropriate?
A. "Don't worry, things will improve soon if you just stay positive."
B. "You should talk to your doctor about changing your medication."
C. "You feel hopeless right now. Tell me more about what you're experiencing."
[CORRECT]
D. "Why do you think you feel this way?"
Correct Answer: C
Rationale: Reflection validates the patient's feelings and encourages further exploration,
which is a core therapeutic communication technique. False reassurance (A) minimizes
feelings, giving advice (B) is non-therapeutic, and asking "why" (D) can be perceived as
judgmental and puts the patient on the defensive. [100% VERIFIED – Rasmussen
NUR2459]
Q2: During the working phase of the nurse-patient relationship, a patient with borderline
personality disorder becomes angry and states, "You're just like my mother—always
judging me!" The nurse recognizes this as:
A. Countertransference
B. Transference [CORRECT]
C. Projection
D. Splitting
Correct Answer: B
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person onto the nurse; this differs from countertransference (the nurse's
,emotional reaction to the patient), projection (attributing one's own feelings to another),
and splitting (viewing others as all good or all bad). [100% VERIFIED – Rasmussen
NUR2459]
Q3: A nurse is caring for a patient experiencing acute anxiety. The patient is pacing and
speaking rapidly. Which nursing intervention is most therapeutic?
A. "Calm down and sit in this chair right now."
B. Remain with the patient, speak slowly, and use short, simple sentences [CORRECT]
C. Leave the room to give the patient space to process emotions independently.
D. "You have nothing to be anxious about. Everything is fine here."
Correct Answer: B
Rationale: Remaining present and using calm, simple communication provides security
and helps reduce anxiety without being dismissive or confrontational. Leaving the room
(C) increases anxiety, while commands (A) and false reassurance (D) are
non-therapeutic techniques that invalidate the patient's experience. [100% VERIFIED –
Rasmussen NUR2459]
Q4: A patient with schizophrenia states, "The voices are telling me to hurt myself."
Which therapeutic response demonstrates the principle of focusing?
A. "What do the voices sound like? Are they male or female?"
B. "Let's talk about your medication schedule instead."
C. "You are hearing voices that are frightening you. Are you having thoughts of harming
yourself?" [CORRECT]
D. "I don't hear any voices. You must be imagining things."
Correct Answer: C
Rationale: Focusing directs the conversation toward the most critical issue—suicidal
ideation—while validating the patient's distress. Avoiding the topic (B) or arguing about
hallucinations (D) is non-therapeutic, and exploring voice characteristics (A) does not
address immediate safety concerns. [100% VERIFIED – Rasmussen NUR2459]
,Q5: During the termination phase of the nurse-patient relationship, a patient with major
depressive disorder becomes withdrawn and misses the last two scheduled
appointments. The nurse recognizes this behavior as most likely representing:
A. Countertransference
B. Regression [CORRECT]
C. Intellectualization
D. Sublimation
Correct Answer: B
Rationale: Regression is a defense mechanism in which an individual reverts to earlier,
less mature behaviors to cope with stress; missing appointments during termination
reflects avoidance of the emotional distress associated with ending the therapeutic
relationship. [100% VERIFIED – Rasmussen NUR2459]
Q6: A nurse is using active listening while a patient describes a traumatic experience.
Which nonverbal behavior best demonstrates active listening?
A. Checking the electronic health record while the patient speaks
B. Maintaining eye contact, leaning slightly forward, and nodding appropriately
[CORRECT]
C. Standing with arms crossed and looking at the clock
D. Interrupting periodically to offer advice and solutions
Correct Answer: B
Rationale: Active listening requires full attention demonstrated through appropriate eye
contact, forward-leaning posture, and affirming nonverbal cues. Divided attention (A),
closed body language (C), and interrupting (D) are barriers to therapeutic
communication and convey disinterest or judgment. [100% VERIFIED – Rasmussen
NUR2459]
Q7: A patient states, "I can't stand being in this hospital. The food is terrible and the
nurses are mean." Which therapeutic response uses the technique of clarification?
A. "I understand you're unhappy. Let's discuss your discharge plan."
, B. "You sound angry about your experience here. Can you give me a specific example of
what has been difficult for you?" [CORRECT]
C. "Other patients have told me they love the food here."
D. "You should be grateful you have a place to stay and people caring for you."
Correct Answer: B
Rationale: Clarification seeks to understand the patient's meaning by asking for specific
examples, which promotes accurate communication. Changing the subject (A), making
comparisons (C), and minimizing feelings (D) are non-therapeutic techniques that avoid
addressing the patient's concerns. [100% VERIFIED – Rasmussen NUR2459]
Q8: A nurse notices a patient with bipolar disorder in the manic phase has not slept in
36 hours and is reorganizing the unit's supply closet. Which boundary-related nursing
action is most appropriate?
A. Join the patient in reorganizing to build rapport and trust.
B. Set clear, consistent limits on behavior and redirect to a structured, low-stimulation
activity [CORRECT]
C. Ignore the behavior to avoid a power struggle with the patient.
D. Allow the behavior to continue until the patient becomes exhausted and sleeps
naturally.
Correct Answer: B
Rationale: Maintaining professional boundaries requires setting clear, consistent limits
on inappropriate or unsafe behavior while providing structured alternatives. Joining the
behavior (A) blurs professional boundaries, while ignoring (C) or allowing escalation (D)
compromises patient safety and milieu management. [100% VERIFIED – Rasmussen
NUR2459]
Q9: A patient with anxiety disorder tells the nurse, "I feel like my heart is going to
explode and I'm going to die." The nurse responds, "I can see you're frightened. Your vital
signs are stable and you are safe right now. Let's practice deep breathing together." This
response demonstrates which therapeutic techniques?
A. False reassurance and giving advice
(2026/2027) – Rasmussen University
SECTION 1: Therapeutic Communication & Nurse-Patient Relationship (Q1-Q10)
Q1: A 32-year-old patient with depression states, "I just feel like nothing will ever get
better." Which therapeutic communication response by the nurse is most appropriate?
A. "Don't worry, things will improve soon if you just stay positive."
B. "You should talk to your doctor about changing your medication."
C. "You feel hopeless right now. Tell me more about what you're experiencing."
[CORRECT]
D. "Why do you think you feel this way?"
Correct Answer: C
Rationale: Reflection validates the patient's feelings and encourages further exploration,
which is a core therapeutic communication technique. False reassurance (A) minimizes
feelings, giving advice (B) is non-therapeutic, and asking "why" (D) can be perceived as
judgmental and puts the patient on the defensive. [100% VERIFIED – Rasmussen
NUR2459]
Q2: During the working phase of the nurse-patient relationship, a patient with borderline
personality disorder becomes angry and states, "You're just like my mother—always
judging me!" The nurse recognizes this as:
A. Countertransference
B. Transference [CORRECT]
C. Projection
D. Splitting
Correct Answer: B
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person onto the nurse; this differs from countertransference (the nurse's
,emotional reaction to the patient), projection (attributing one's own feelings to another),
and splitting (viewing others as all good or all bad). [100% VERIFIED – Rasmussen
NUR2459]
Q3: A nurse is caring for a patient experiencing acute anxiety. The patient is pacing and
speaking rapidly. Which nursing intervention is most therapeutic?
A. "Calm down and sit in this chair right now."
B. Remain with the patient, speak slowly, and use short, simple sentences [CORRECT]
C. Leave the room to give the patient space to process emotions independently.
D. "You have nothing to be anxious about. Everything is fine here."
Correct Answer: B
Rationale: Remaining present and using calm, simple communication provides security
and helps reduce anxiety without being dismissive or confrontational. Leaving the room
(C) increases anxiety, while commands (A) and false reassurance (D) are
non-therapeutic techniques that invalidate the patient's experience. [100% VERIFIED –
Rasmussen NUR2459]
Q4: A patient with schizophrenia states, "The voices are telling me to hurt myself."
Which therapeutic response demonstrates the principle of focusing?
A. "What do the voices sound like? Are they male or female?"
B. "Let's talk about your medication schedule instead."
C. "You are hearing voices that are frightening you. Are you having thoughts of harming
yourself?" [CORRECT]
D. "I don't hear any voices. You must be imagining things."
Correct Answer: C
Rationale: Focusing directs the conversation toward the most critical issue—suicidal
ideation—while validating the patient's distress. Avoiding the topic (B) or arguing about
hallucinations (D) is non-therapeutic, and exploring voice characteristics (A) does not
address immediate safety concerns. [100% VERIFIED – Rasmussen NUR2459]
,Q5: During the termination phase of the nurse-patient relationship, a patient with major
depressive disorder becomes withdrawn and misses the last two scheduled
appointments. The nurse recognizes this behavior as most likely representing:
A. Countertransference
B. Regression [CORRECT]
C. Intellectualization
D. Sublimation
Correct Answer: B
Rationale: Regression is a defense mechanism in which an individual reverts to earlier,
less mature behaviors to cope with stress; missing appointments during termination
reflects avoidance of the emotional distress associated with ending the therapeutic
relationship. [100% VERIFIED – Rasmussen NUR2459]
Q6: A nurse is using active listening while a patient describes a traumatic experience.
Which nonverbal behavior best demonstrates active listening?
A. Checking the electronic health record while the patient speaks
B. Maintaining eye contact, leaning slightly forward, and nodding appropriately
[CORRECT]
C. Standing with arms crossed and looking at the clock
D. Interrupting periodically to offer advice and solutions
Correct Answer: B
Rationale: Active listening requires full attention demonstrated through appropriate eye
contact, forward-leaning posture, and affirming nonverbal cues. Divided attention (A),
closed body language (C), and interrupting (D) are barriers to therapeutic
communication and convey disinterest or judgment. [100% VERIFIED – Rasmussen
NUR2459]
Q7: A patient states, "I can't stand being in this hospital. The food is terrible and the
nurses are mean." Which therapeutic response uses the technique of clarification?
A. "I understand you're unhappy. Let's discuss your discharge plan."
, B. "You sound angry about your experience here. Can you give me a specific example of
what has been difficult for you?" [CORRECT]
C. "Other patients have told me they love the food here."
D. "You should be grateful you have a place to stay and people caring for you."
Correct Answer: B
Rationale: Clarification seeks to understand the patient's meaning by asking for specific
examples, which promotes accurate communication. Changing the subject (A), making
comparisons (C), and minimizing feelings (D) are non-therapeutic techniques that avoid
addressing the patient's concerns. [100% VERIFIED – Rasmussen NUR2459]
Q8: A nurse notices a patient with bipolar disorder in the manic phase has not slept in
36 hours and is reorganizing the unit's supply closet. Which boundary-related nursing
action is most appropriate?
A. Join the patient in reorganizing to build rapport and trust.
B. Set clear, consistent limits on behavior and redirect to a structured, low-stimulation
activity [CORRECT]
C. Ignore the behavior to avoid a power struggle with the patient.
D. Allow the behavior to continue until the patient becomes exhausted and sleeps
naturally.
Correct Answer: B
Rationale: Maintaining professional boundaries requires setting clear, consistent limits
on inappropriate or unsafe behavior while providing structured alternatives. Joining the
behavior (A) blurs professional boundaries, while ignoring (C) or allowing escalation (D)
compromises patient safety and milieu management. [100% VERIFIED – Rasmussen
NUR2459]
Q9: A patient with anxiety disorder tells the nurse, "I feel like my heart is going to
explode and I'm going to die." The nurse responds, "I can see you're frightened. Your vital
signs are stable and you are safe right now. Let's practice deep breathing together." This
response demonstrates which therapeutic techniques?
A. False reassurance and giving advice
