Question 1. **Which principle primarily guides the therapeutic relationship in mental health nursing?**
A) Authority and control
B) Empathy and trust
C) Symptom suppression
D) Strict adherence to protocol
Answer: B
Explanation: Empathy and trust form the foundation of a therapeutic relationship, fostering safety and
collaboration with the client.
Question 2. **Informed consent requires that the client be able to:**
A) Sign any document presented by the provider
B) Understand the nature, risks, benefits, and alternatives of treatment
C) Agree without the option to ask questions
D) Receive treatment only after a court order
Answer: B
Explanation: True informed consent means the client comprehends all aspects of the proposed
intervention and can make an autonomous decision.
Question 3. **Which of the following is an exception to HIPAA confidentiality?**
A) Routine progress notes
B) Duty to warn of imminent harm to self or others
C) Sharing medication lists with family without consent
D) Posting client photos on social media for educational purposes
Answer: B
Explanation: The “duty to warn” allows breaching confidentiality when a client poses a serious,
imminent danger.
Question 4. **Active listening includes all EXCEPT:**
A) Restating the client’s words in your own language
B) Asking “Why did you do that?” after every statement
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C] Clarifying ambiguous statements
D) Reflecting feelings expressed by the client
Answer: B
Explanation: “Why” questions are non-therapeutic because they can be perceived as judgmental and
may hinder openness.
Question 5. **During the orientation phase of the nurse-client relationship, the nurse should:**
A) Begin termination planning
B) Establish boundaries, roles, and expectations
C) Challenge the client’s beliefs aggressively
D) Focus solely on medication administration
Answer: B
Explanation: Orientation is the stage where rapport, expectations, and the framework for care are
established.
Question 6. **Which concept best defines countertransference?**
A) The client’s projection onto the therapist
B) The therapist’s emotional reaction to the client’s material
C) A defense mechanism used by the client
D) The client’s resistance to treatment
Answer: B
Explanation: Countertransference occurs when the therapist experiences personal emotions triggered
by the client’s experiences.
Question 7. **Erikson’s stage characterized by “identity vs. role confusion” occurs during:**
A) Early childhood
B) Adolescence
C) Middle adulthood
D) Late adulthood
Answer: B
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Explanation: Adolescents grapple with forming a personal identity versus experiencing confusion about
their role in society.
Question 8. **Maslow’s hierarchy places which need at the base for a psychiatric patient?**
A) Self-actualization
B) Esteem
C) Physiological needs
D) Love and belonging
Answer: C
Explanation: Physiological needs (food, sleep, safety) must be met first before higher-order
psychological needs can be addressed.
Question 9. **In CBT, the primary goal of cognitive restructuring is to:**
A) Increase the frequency of maladaptive thoughts
B) Replace distorted thoughts with balanced alternatives
C) Eliminate all emotional experiences
D) Focus exclusively on past trauma
Answer: B
Explanation: Cognitive restructuring helps clients identify and modify irrational beliefs, leading to
healthier emotional responses.
Question 10. **Dialectical Behavior Therapy (DBT) was originally developed to treat:**
A) Schizophrenia
B) Borderline Personality Disorder
C) Major Depressive Disorder
D) Generalized Anxiety Disorder
Answer: B
Explanation: DBT was created by Marsha Linehan to address emotional dysregulation and self-harm in
borderline personality disorder.
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Question 11. **General Adaptation Syndrome’s “resistance” stage is characterized by:**
A) Immediate fight-or-flight response
B) Decreased hormone production
C) Adaptation to the stressor with sustained physiological arousal
D) Complete recovery and return to baseline
Answer: C
Explanation: During resistance, the body attempts to cope with the stressor, maintaining heightened
activity to preserve function.
Question 12. **Which defense mechanism involves attributing one’s own unacceptable impulses to
another person?**
A) Displacement
B) Projection
C) Sublimation
D) Reaction formation
Answer: B
Explanation: Projection is the unconscious process of ascribing one’s own thoughts or feelings onto
someone else.
Question 13. **A key risk factor for suicide is:**
A) Having a supportive social network
B) Recent discharge from psychiatric hospitalization
C) Stable employment
D) Regular exercise routine
Answer: B
Explanation: Transition periods, such as discharge, often increase vulnerability due to reduced
supervision and support.
Question 14. **When conducting a lethality assessment, the nurse should prioritize which question?**
A) “Do you enjoy your hobbies?”