NUR 2459 Rasmussen Mental Health Exam 1 2026/2027 50
Questions with Detailed Rationales | Complete Exam-Style
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SECTION I: Therapeutic Communication and the Nurse-Patient Relationship
Question 1
A client newly admitted to the psychiatric unit states, "I don't think I can do this
anymore. Nothing is ever going to change." Which response by the nurse demonstrates
therapeutic communication?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about hurting yourself right now?"
C. "Things always seem worse when you first come in. You'll feel better soon."
D. "Tell me more about what you mean when you say you can't do this anymore."
Correct Answer: D
Rationale: Option D is correct because it uses the therapeutic technique of exploring,
which encourages the client to elaborate on feelings and concerns without making
assumptions or offering false reassurance. Option A minimizes the client's feelings and
is non-therapeutic. Option B, while assessing suicidal ideation, is premature and may
shut down communication before rapport is established; direct assessment is needed
but exploring first is more therapeutic. Option C offers false reassurance, which is a
non-therapeutic communication technique.
Question 2
A nurse is caring for a client with schizophrenia who is pacing rapidly and muttering
under his breath. The client suddenly stops and says, "The voices are telling me you are
trying to poison me." Which therapeutic response should the nurse provide first?
,A. "I am not trying to poison you. Your medicine is to help you."
B. "You seem frightened. I am here to help you, not hurt you."
C. "The voices are not real. They are a symptom of your illness."
D. "If you don't take your medication, you will have to be restrained."
Correct Answer: B
Rationale: Option B is correct because it validates the client's emotional experience
(fear) without arguing about the reality of the hallucination, which aligns with the
therapeutic principle of acknowledging feelings while not reinforcing delusional content.
Option A argues with the delusion and may increase suspicion. Option C challenges the
client's reality and is likely to increase distrust. Option D is threatening and coercive,
violating therapeutic relationship principles.
Question 3
During an initial interview, a client with bipolar disorder begins to share intimate details
about sexual relationships. The nurse recognizes that maintaining professional
boundaries is essential. Which response best demonstrates appropriate professional
boundary management?
A. "I am not comfortable discussing this. Can we talk about something else?"
B. "As your nurse, I need to focus on your health and treatment goals today. We can
discuss how your relationships affect your mood."
C. "That information is too personal. Please keep those details to yourself."
D. "I am here to listen to whatever you want to share. Go ahead."
Correct Answer: B
Rationale: Option B is correct because it gently redirects the conversation toward
therapeutic goals while acknowledging the relevance of relationships to mental health,
maintaining professional boundaries without shaming the client. Option A is dismissive
and may make the client feel rejected. Option C is judgmental and shuts down
communication. Option D fails to maintain professional boundaries and could lead to
inappropriate self-disclosure or boundary violations.
, Question 4
A nurse is using the PEPLAU model of interpersonal relations to guide care for a client
with major depressive disorder. In which phase of the nurse-client relationship does the
nurse collaboratively establish goals with the client?
A. Orientation phase
B. Identification phase
C. Exploitation phase
D. Resolution phase
Correct Answer: C
Rationale: Option C is correct because in Peplau's model, the exploitation phase
involves the client using professional assistance to address problems and
collaboratively working toward established goals. Option A, the orientation phase,
involves meeting, establishing rapport, and clarifying roles. Option B, the identification
phase, involves the client identifying with the nurse and feeling a sense of belonging.
Option D, the resolution phase, involves the client's problems being resolved and the
relationship terminating.
Question 5
A client with borderline personality disorder becomes angry during a group session and
screams at the nurse, "You are the worst nurse ever! You don't care about me at all!"
Which response by the nurse demonstrates the most effective use of limit setting?
A. "I understand you are upset, but yelling is not acceptable. I will speak with you when
you can use a calm voice."
B. "You are being very disrespectful right now. You need to apologize immediately."
C. "I do care about you. Let me give you a hug to show you that I am here for you."
D. "Why are you so angry? What did I do to make you feel this way?"
Correct Answer: A
Rationale: Option A is correct because it validates the client's feelings while clearly
setting a behavioral limit (no yelling) and offering to continue the interaction when the
Questions with Detailed Rationales | Complete Exam-Style
Questions | Graded A+ Pass Guaranteed
SECTION I: Therapeutic Communication and the Nurse-Patient Relationship
Question 1
A client newly admitted to the psychiatric unit states, "I don't think I can do this
anymore. Nothing is ever going to change." Which response by the nurse demonstrates
therapeutic communication?
A. "You have so much to live for. Think about your family."
B. "Are you thinking about hurting yourself right now?"
C. "Things always seem worse when you first come in. You'll feel better soon."
D. "Tell me more about what you mean when you say you can't do this anymore."
Correct Answer: D
Rationale: Option D is correct because it uses the therapeutic technique of exploring,
which encourages the client to elaborate on feelings and concerns without making
assumptions or offering false reassurance. Option A minimizes the client's feelings and
is non-therapeutic. Option B, while assessing suicidal ideation, is premature and may
shut down communication before rapport is established; direct assessment is needed
but exploring first is more therapeutic. Option C offers false reassurance, which is a
non-therapeutic communication technique.
Question 2
A nurse is caring for a client with schizophrenia who is pacing rapidly and muttering
under his breath. The client suddenly stops and says, "The voices are telling me you are
trying to poison me." Which therapeutic response should the nurse provide first?
,A. "I am not trying to poison you. Your medicine is to help you."
B. "You seem frightened. I am here to help you, not hurt you."
C. "The voices are not real. They are a symptom of your illness."
D. "If you don't take your medication, you will have to be restrained."
Correct Answer: B
Rationale: Option B is correct because it validates the client's emotional experience
(fear) without arguing about the reality of the hallucination, which aligns with the
therapeutic principle of acknowledging feelings while not reinforcing delusional content.
Option A argues with the delusion and may increase suspicion. Option C challenges the
client's reality and is likely to increase distrust. Option D is threatening and coercive,
violating therapeutic relationship principles.
Question 3
During an initial interview, a client with bipolar disorder begins to share intimate details
about sexual relationships. The nurse recognizes that maintaining professional
boundaries is essential. Which response best demonstrates appropriate professional
boundary management?
A. "I am not comfortable discussing this. Can we talk about something else?"
B. "As your nurse, I need to focus on your health and treatment goals today. We can
discuss how your relationships affect your mood."
C. "That information is too personal. Please keep those details to yourself."
D. "I am here to listen to whatever you want to share. Go ahead."
Correct Answer: B
Rationale: Option B is correct because it gently redirects the conversation toward
therapeutic goals while acknowledging the relevance of relationships to mental health,
maintaining professional boundaries without shaming the client. Option A is dismissive
and may make the client feel rejected. Option C is judgmental and shuts down
communication. Option D fails to maintain professional boundaries and could lead to
inappropriate self-disclosure or boundary violations.
, Question 4
A nurse is using the PEPLAU model of interpersonal relations to guide care for a client
with major depressive disorder. In which phase of the nurse-client relationship does the
nurse collaboratively establish goals with the client?
A. Orientation phase
B. Identification phase
C. Exploitation phase
D. Resolution phase
Correct Answer: C
Rationale: Option C is correct because in Peplau's model, the exploitation phase
involves the client using professional assistance to address problems and
collaboratively working toward established goals. Option A, the orientation phase,
involves meeting, establishing rapport, and clarifying roles. Option B, the identification
phase, involves the client identifying with the nurse and feeling a sense of belonging.
Option D, the resolution phase, involves the client's problems being resolved and the
relationship terminating.
Question 5
A client with borderline personality disorder becomes angry during a group session and
screams at the nurse, "You are the worst nurse ever! You don't care about me at all!"
Which response by the nurse demonstrates the most effective use of limit setting?
A. "I understand you are upset, but yelling is not acceptable. I will speak with you when
you can use a calm voice."
B. "You are being very disrespectful right now. You need to apologize immediately."
C. "I do care about you. Let me give you a hug to show you that I am here for you."
D. "Why are you so angry? What did I do to make you feel this way?"
Correct Answer: A
Rationale: Option A is correct because it validates the client's feelings while clearly
setting a behavioral limit (no yelling) and offering to continue the interaction when the
