NSG 3450 Mental Health Key - Comprehensive Exam
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1. A nurse is assessing a client who is experiencing a panic attack. Which of the following actions should
the nurse take first?
A. Ask the client to describe their feelings.
B. Stay with the client and provide a quiet environment.
C. Encourage the client to practice deep breathing exercises.
D. Teach the client about the physiological causes of anxiety.
Correct answers: B. Stay with the client and provide a quiet environment.
Rationale: During a panic attack, the client's anxiety is at its peak, and their ability to process
information is severely impaired. The priority is to provide for safety and decrease stimuli. Staying with
the client offers reassurance and prevents feelings of abandonment. Teaching or asking for descriptions
requires cognitive processing that is not possible during a panic state.
2. A client tells the nurse, "I feel like I'm going crazy." Which is the most therapeutic initial response?
A. "You are not going crazy. You are just under a lot of stress."
B. "Tell me more about what you are feeling right now."
C. "I understand how you feel. I've been there myself."
D. "Why do you think you feel that way?"
Correct answers: B. "Tell me more about what you are feeling right now."
Rationale: This response is therapeutic because it uses an open-ended question to encourage the client
to explore and express their feelings. It validates the client's experience without dismissing it ("You are
not going crazy") or making it about the nurse ("I've been there").
3. Which of the following is a therapeutic communication technique?
,A. Giving advice
B. Asking "why" questions
C. Offering self
D. Using reassurance
Correct answers: C. Offering self
Rationale: Offering self, such as saying, "I'll stay with you for a while," shows willingness to spend time
and be supportive. Giving advice and reassurance are non-therapeutic as they can invalidate feelings
and foster dependency. "Why" questions often put the client on the defensive and are non-therapeutic.
4. A nurse is working with a client who is withdrawn and silent. Which statement is most therapeutic?
A. "You seem to be quiet today. I'll sit with you for a while if you'd like."
B. "I'm going to leave now, but I'll be back in an hour."
C. "Talking about your feelings will make you feel better."
D. "You must be feeling depressed if you don't want to talk."
Correct answers: A. "You seem to be quiet today. I'll sit with you for a while if you'd like."
Rationale: This response is therapeutic because it uses observation ("You seem to be quiet") and offers
self ("I'll sit with you"). It allows the client to have control over the interaction and provides a non-
threatening presence. It does not force the client to speak or make assumptions.
5. A client says to the nurse, "Everyone here is ignoring me. Nobody cares." What is the best response?
A. "That's not true. The staff is very busy, but they care."
B. "You feel like people are ignoring you?"
C. "Did you try talking to your doctor about this?"
D. "Why do you think people are ignoring you?"
Correct answers: B. "You feel like people are ignoring you?"
Rationale: This is an example of restating (or reflecting). It focuses on the client's feelings and validates
their perception without agreeing with it. This encourages the client to continue expressing their
feelings.
,6. A nurse is caring for a client who is making sexual advances. What is the most appropriate boundary-
setting response?
A. "I am here as your nurse, and I need to maintain a professional relationship with you."
B. "If you keep doing that, I'll have to leave the room."
C. "I think you have feelings for me, but we can't act on them."
D. "Let's just forget about that and focus on your treatment."
Correct answers: A. "I am here as your nurse, and I need to maintain a professional relationship
with you."
Rationale: This response clearly and professionally re-establishes the therapeutic nurse-client
relationship boundaries. It is direct, non-punitive, and maintains the focus on the client's care.
7. The nurse is teaching a client about the biological basis of mental illness. Which statement by the
client indicates understanding?
A. "My mental illness is caused by a weakness of character."
B. "I can control my symptoms with willpower alone."
C. "There may be imbalances in the chemicals in my brain."
D. "My illness is a punishment for something I did wrong."
Correct answers: C. "There may be imbalances in the chemicals in my brain."
Rationale: This statement reflects an understanding of the neurobiological model, which implicates
neurotransmitter imbalances (e.g., serotonin, dopamine, norepinephrine) in the pathophysiology of
mental illness. The other options reflect outdated, stigmatizing views.
8. According to the DSM-5, what is the primary purpose of a diagnosis?
A. To provide a complete understanding of the client's life story.
B. To determine a client's prognosis without a doubt.
C. To provide a common language for clinicians and guide treatment.
D. To label a client for insurance billing purposes only.
, Correct answers: C. To provide a common language for clinicians and guide treatment.
Rationale: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides standardized
criteria for diagnosing mental disorders, which allows for consistent communication among clinicians
and helps in formulating a treatment plan.
9. A client is admitted involuntarily. The client expresses anger and states, "I'm going to leave right
now." The nurse knows that:
A. The client must be immediately restrained if they attempt to leave.
B. The client cannot leave the unit as they are a danger to themselves.
C. The client has the right to refuse all treatment, including medication.
D. The client can leave, but the police will bring them back.
Correct answers: B. The client cannot leave the unit as they are a danger to themselves.
Rationale: Involuntary admission is for clients who are a danger to themselves, others, or are gravely
disabled. They do not have the right to leave the unit until their condition has improved and they are no
longer a threat.
10. A nurse is preparing a client for Electroconvulsive Therapy (ECT). Which is an appropriate nursing
action?
A. Administer the client's daily antipsychotic medication prior to treatment.
B. Ensure the client has a full meal 2 hours before the procedure.
C. Explain the procedure and inform the client they will be under general anesthesia.
D. Place the client in a supine position with arms restrained.
Correct answers: C. Explain the procedure and inform the client they will be under general
anesthesia.
Rationale: Clients receiving ECT receive general anesthesia and a muscle relaxant. The nurse should
provide a thorough explanation of the procedure. The client should be NPO for 6-8 hours before the
procedure (not a full meal), and routine psych meds are often held.
11. Which ethical principle is being practiced when a nurse ensures a client's right to make their own
decisions about their care?
(EXAM 1 & 2) | Complete Study Guide | Verified
Questions & Answers | Latest Updated Version |
Exam Prep | 100% Pass Success Resource | Instant
Download PDF
1. A nurse is assessing a client who is experiencing a panic attack. Which of the following actions should
the nurse take first?
A. Ask the client to describe their feelings.
B. Stay with the client and provide a quiet environment.
C. Encourage the client to practice deep breathing exercises.
D. Teach the client about the physiological causes of anxiety.
Correct answers: B. Stay with the client and provide a quiet environment.
Rationale: During a panic attack, the client's anxiety is at its peak, and their ability to process
information is severely impaired. The priority is to provide for safety and decrease stimuli. Staying with
the client offers reassurance and prevents feelings of abandonment. Teaching or asking for descriptions
requires cognitive processing that is not possible during a panic state.
2. A client tells the nurse, "I feel like I'm going crazy." Which is the most therapeutic initial response?
A. "You are not going crazy. You are just under a lot of stress."
B. "Tell me more about what you are feeling right now."
C. "I understand how you feel. I've been there myself."
D. "Why do you think you feel that way?"
Correct answers: B. "Tell me more about what you are feeling right now."
Rationale: This response is therapeutic because it uses an open-ended question to encourage the client
to explore and express their feelings. It validates the client's experience without dismissing it ("You are
not going crazy") or making it about the nurse ("I've been there").
3. Which of the following is a therapeutic communication technique?
,A. Giving advice
B. Asking "why" questions
C. Offering self
D. Using reassurance
Correct answers: C. Offering self
Rationale: Offering self, such as saying, "I'll stay with you for a while," shows willingness to spend time
and be supportive. Giving advice and reassurance are non-therapeutic as they can invalidate feelings
and foster dependency. "Why" questions often put the client on the defensive and are non-therapeutic.
4. A nurse is working with a client who is withdrawn and silent. Which statement is most therapeutic?
A. "You seem to be quiet today. I'll sit with you for a while if you'd like."
B. "I'm going to leave now, but I'll be back in an hour."
C. "Talking about your feelings will make you feel better."
D. "You must be feeling depressed if you don't want to talk."
Correct answers: A. "You seem to be quiet today. I'll sit with you for a while if you'd like."
Rationale: This response is therapeutic because it uses observation ("You seem to be quiet") and offers
self ("I'll sit with you"). It allows the client to have control over the interaction and provides a non-
threatening presence. It does not force the client to speak or make assumptions.
5. A client says to the nurse, "Everyone here is ignoring me. Nobody cares." What is the best response?
A. "That's not true. The staff is very busy, but they care."
B. "You feel like people are ignoring you?"
C. "Did you try talking to your doctor about this?"
D. "Why do you think people are ignoring you?"
Correct answers: B. "You feel like people are ignoring you?"
Rationale: This is an example of restating (or reflecting). It focuses on the client's feelings and validates
their perception without agreeing with it. This encourages the client to continue expressing their
feelings.
,6. A nurse is caring for a client who is making sexual advances. What is the most appropriate boundary-
setting response?
A. "I am here as your nurse, and I need to maintain a professional relationship with you."
B. "If you keep doing that, I'll have to leave the room."
C. "I think you have feelings for me, but we can't act on them."
D. "Let's just forget about that and focus on your treatment."
Correct answers: A. "I am here as your nurse, and I need to maintain a professional relationship
with you."
Rationale: This response clearly and professionally re-establishes the therapeutic nurse-client
relationship boundaries. It is direct, non-punitive, and maintains the focus on the client's care.
7. The nurse is teaching a client about the biological basis of mental illness. Which statement by the
client indicates understanding?
A. "My mental illness is caused by a weakness of character."
B. "I can control my symptoms with willpower alone."
C. "There may be imbalances in the chemicals in my brain."
D. "My illness is a punishment for something I did wrong."
Correct answers: C. "There may be imbalances in the chemicals in my brain."
Rationale: This statement reflects an understanding of the neurobiological model, which implicates
neurotransmitter imbalances (e.g., serotonin, dopamine, norepinephrine) in the pathophysiology of
mental illness. The other options reflect outdated, stigmatizing views.
8. According to the DSM-5, what is the primary purpose of a diagnosis?
A. To provide a complete understanding of the client's life story.
B. To determine a client's prognosis without a doubt.
C. To provide a common language for clinicians and guide treatment.
D. To label a client for insurance billing purposes only.
, Correct answers: C. To provide a common language for clinicians and guide treatment.
Rationale: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides standardized
criteria for diagnosing mental disorders, which allows for consistent communication among clinicians
and helps in formulating a treatment plan.
9. A client is admitted involuntarily. The client expresses anger and states, "I'm going to leave right
now." The nurse knows that:
A. The client must be immediately restrained if they attempt to leave.
B. The client cannot leave the unit as they are a danger to themselves.
C. The client has the right to refuse all treatment, including medication.
D. The client can leave, but the police will bring them back.
Correct answers: B. The client cannot leave the unit as they are a danger to themselves.
Rationale: Involuntary admission is for clients who are a danger to themselves, others, or are gravely
disabled. They do not have the right to leave the unit until their condition has improved and they are no
longer a threat.
10. A nurse is preparing a client for Electroconvulsive Therapy (ECT). Which is an appropriate nursing
action?
A. Administer the client's daily antipsychotic medication prior to treatment.
B. Ensure the client has a full meal 2 hours before the procedure.
C. Explain the procedure and inform the client they will be under general anesthesia.
D. Place the client in a supine position with arms restrained.
Correct answers: C. Explain the procedure and inform the client they will be under general
anesthesia.
Rationale: Clients receiving ECT receive general anesthesia and a muscle relaxant. The nurse should
provide a thorough explanation of the procedure. The client should be NPO for 6-8 hours before the
procedure (not a full meal), and routine psych meds are often held.
11. Which ethical principle is being practiced when a nurse ensures a client's right to make their own
decisions about their care?
