NUR 253 Exam 4 Mental Health (2026
/ 2027) PDF | Galen College of
Nursing
Section 1: Therapeutic Communication & Nurse-Patient
Relationship (Questions 1-20)
1. A patient tells the nurse, "I don't think I can go on
anymore." Which response by the nurse is MOST therapeutic?
A) "You have so much to live for."
B) "Are you thinking about harming yourself?"
C) "Don't say that. Everything will be okay."
D) "I understand how you feel."
Rationale: The nurse must directly assess for suicidal ideation
when a patient expresses hopelessness. Asking directly about self-
harm is therapeutic and does not plant the idea.
2. A patient states, "Nobody cares about me." Which response
demonstrates therapeutic communication?
A) "That's not true. Your family visits every week."
B) "What makes you feel that way?"
C) "I care about you."
D) "You shouldn't feel that way."
Rationale: Exploring the patient's feelings encourages expression
and helps identify the source of their distress. This open-ended
,question validates the patient's feelings while promoting further
discussion.
3. Which communication technique is MOST effective when a
patient is exhibiting manipulative behavior?
A) Setting firm, consistent limits
B) Ignoring the behavior
C) Giving in to demands to avoid conflict
D) Confronting the patient aggressively
Rationale: Patients with manipulative behaviors require clear,
consistent boundaries. This approach provides structure and
prevents reinforcement of maladaptive patterns while maintaining
a therapeutic relationship.
4. A patient with schizophrenia tells the nurse, "The CIA is
monitoring my thoughts." Which response is MOST
therapeutic?
A) "That's not true. You're having a delusion."
B) "I don't believe anyone is monitoring your thoughts."
C) "Tell me more about that experience."
D) "Why do you think the CIA would be interested in you?"
Rationale: Acknowledging the patient's experience without
confirming the delusion encourages discussion and helps the
nurse understand the patient's perspective.
5. The nurse is interviewing a patient who is hesitant to speak.
Which technique should the nurse use to encourage
communication?
, A) Sit silently and wait
B) Ask closed-ended questions
C) Use silence and allow the patient to initiate
D) Change the subject to something lighter
Rationale: Silence provides the patient with space to gather
thoughts and decide what to share. It communicates respect and
patience without pressuring the patient.
6. A nurse uses silence after a client shares a traumatic
experience. What is the therapeutic purpose of this
technique?
A) To change the subject to something less distressing
B) To encourage further expression and allow the client
to process thoughts
C) To show disapproval for the client's emotional reaction
D) To signal the end of the conversation
Rationale: Silence gives the client time to reflect, organize
thoughts, and continue at their own pace. It is a powerful
therapeutic tool that conveys acceptance and respect.
7. Which statement by the nurse is the best example of
therapeutic communication?
A) "You shouldn't feel that way about your family."
B) "Everything will be okay; don't worry so much."
C) "Tell me more about how you feel."
D) "I know exactly what you mean; the same thing happened
to me."
, Rationale: "Tell me more" is an open-ended invitation that
encourages the client to express feelings without judgment. The
other options either invalidate feelings, offer false reassurance, or
shift focus to the nurse.
8. A patient tells the nurse, "I feel like nobody cares about
me." Which response by the nurse is most therapeutic?
A) "I care about you."
B) "Tell me more about what you're feeling."
C) "I'm sure your family cares about you."
D) "Why do you feel that way?"
Rationale: Open-ended statements encourage the patient to
express feelings without minimizing or deflecting.
9. The nurse is providing support to the family of a recently
deceased client. A family member states, "My father took me
fishing all the time. He can't physically take me anymore, but
he will be watching over me. I really miss him." The nurse
recognizes the family member is experiencing:
A. Mourning
B. Anticipatory grief
C. Disenfranchised grief
D. Bereavement
Rationale: Mourning is the process of adapting to a loss and
includes the outward expression of grief, such as discussing the
deceased and their ongoing connection to them.
10. Which nursing action best demonstrates the therapeutic
use of self?
/ 2027) PDF | Galen College of
Nursing
Section 1: Therapeutic Communication & Nurse-Patient
Relationship (Questions 1-20)
1. A patient tells the nurse, "I don't think I can go on
anymore." Which response by the nurse is MOST therapeutic?
A) "You have so much to live for."
B) "Are you thinking about harming yourself?"
C) "Don't say that. Everything will be okay."
D) "I understand how you feel."
Rationale: The nurse must directly assess for suicidal ideation
when a patient expresses hopelessness. Asking directly about self-
harm is therapeutic and does not plant the idea.
2. A patient states, "Nobody cares about me." Which response
demonstrates therapeutic communication?
A) "That's not true. Your family visits every week."
B) "What makes you feel that way?"
C) "I care about you."
D) "You shouldn't feel that way."
Rationale: Exploring the patient's feelings encourages expression
and helps identify the source of their distress. This open-ended
,question validates the patient's feelings while promoting further
discussion.
3. Which communication technique is MOST effective when a
patient is exhibiting manipulative behavior?
A) Setting firm, consistent limits
B) Ignoring the behavior
C) Giving in to demands to avoid conflict
D) Confronting the patient aggressively
Rationale: Patients with manipulative behaviors require clear,
consistent boundaries. This approach provides structure and
prevents reinforcement of maladaptive patterns while maintaining
a therapeutic relationship.
4. A patient with schizophrenia tells the nurse, "The CIA is
monitoring my thoughts." Which response is MOST
therapeutic?
A) "That's not true. You're having a delusion."
B) "I don't believe anyone is monitoring your thoughts."
C) "Tell me more about that experience."
D) "Why do you think the CIA would be interested in you?"
Rationale: Acknowledging the patient's experience without
confirming the delusion encourages discussion and helps the
nurse understand the patient's perspective.
5. The nurse is interviewing a patient who is hesitant to speak.
Which technique should the nurse use to encourage
communication?
, A) Sit silently and wait
B) Ask closed-ended questions
C) Use silence and allow the patient to initiate
D) Change the subject to something lighter
Rationale: Silence provides the patient with space to gather
thoughts and decide what to share. It communicates respect and
patience without pressuring the patient.
6. A nurse uses silence after a client shares a traumatic
experience. What is the therapeutic purpose of this
technique?
A) To change the subject to something less distressing
B) To encourage further expression and allow the client
to process thoughts
C) To show disapproval for the client's emotional reaction
D) To signal the end of the conversation
Rationale: Silence gives the client time to reflect, organize
thoughts, and continue at their own pace. It is a powerful
therapeutic tool that conveys acceptance and respect.
7. Which statement by the nurse is the best example of
therapeutic communication?
A) "You shouldn't feel that way about your family."
B) "Everything will be okay; don't worry so much."
C) "Tell me more about how you feel."
D) "I know exactly what you mean; the same thing happened
to me."
, Rationale: "Tell me more" is an open-ended invitation that
encourages the client to express feelings without judgment. The
other options either invalidate feelings, offer false reassurance, or
shift focus to the nurse.
8. A patient tells the nurse, "I feel like nobody cares about
me." Which response by the nurse is most therapeutic?
A) "I care about you."
B) "Tell me more about what you're feeling."
C) "I'm sure your family cares about you."
D) "Why do you feel that way?"
Rationale: Open-ended statements encourage the patient to
express feelings without minimizing or deflecting.
9. The nurse is providing support to the family of a recently
deceased client. A family member states, "My father took me
fishing all the time. He can't physically take me anymore, but
he will be watching over me. I really miss him." The nurse
recognizes the family member is experiencing:
A. Mourning
B. Anticipatory grief
C. Disenfranchised grief
D. Bereavement
Rationale: Mourning is the process of adapting to a loss and
includes the outward expression of grief, such as discussing the
deceased and their ongoing connection to them.
10. Which nursing action best demonstrates the therapeutic
use of self?
