NUR 253 Exam 3 Actual Exam 2026 | 100 Verified Questions &
Answers | Complete Study Guide for Nursing Students | Comprehensive
Review for Pharmacology, Patient Care, Safety, NCLEX Preparation &
Final Exam Success |
1. A patient with schizophrenia tells the nurse, “Aliens are controlling my
thoughts.” Which therapeutic response is most appropriate?
A. “That must be frightening for you.”
B. “There are no aliens in this room.”
C. “Why do you think aliens are controlling you?”
D. “Let’s talk about something real.”
Answer: A
Rationale: Acknowledging the patient’s feeling without reinforcing the delusion
validates their experience and preserves trust. Asking “why” challenges the delusion;
denying it or changing the topic dismisses feelings.
,2. Which statement by the nurse best demonstrates empathy?
A. “I know exactly how you feel.”
B. “You seem upset about the diagnosis.”
C. “You should be grateful it’s not worse.”
D. “Don’t worry, everything will be fine.”
Answer: B
Rationale: Empathy involves recognizing and reflecting the patient’s emotion without
judgment or false reassurance. “I know exactly how you feel” is sympathy/assumption; C
and D are dismissive or false reassurance.
3. A patient says, “I don’t want to take medication anymore. It makes me feel like
a zombie.” The nurse’s best response is:
A. “You must take it or the doctor will be angry.”
B. “Tell me more about how the medication makes you feel.”
C. “That’s not true—you will get worse without it.”
D. “I’ll ask the doctor to stop all your meds.”
Answer: B
Rationale: Exploring the patient’s subjective experience fosters collaboration and
,identifies side effects that could be managed. Threatening or dismissing feelings
damages therapeutic alliance; stopping all meds without assessment is unsafe.
4. During a group therapy session, a patient constantly interrupts others. Which
leader response is most effective?
A. “Stop interrupting. You’re being rude.”
B. “I notice you have a lot to say. Let’s let Mark finish first.”
C. “Everyone, please ignore the interruptions.”
D. “That’s enough. Leave the room now.”
Answer: B
Rationale: Redirection with clear, respectful limit-setting maintains group norms and
models assertive communication. Shaming or removing without warning is punitive;
ignoring reinforces behavior.
5. Which phase of the therapeutic relationship focuses on identifying problems
and setting goals?
A. Pre-interaction
, B. Orientation
C. Working
D. Termination
Answer: B
Rationale: During orientation, the nurse and patient establish trust, define problems,
and set mutual goals. The working phase uses interventions; termination focuses on
ending the relationship.
6. A patient with borderline personality disorder tells the nurse, “You’re the only
one who understands me. The other nurses are cruel.” The nurse should:
A. Agree that the other nurses are cruel.
B. Validate the feeling but avoid splitting.
C. Tell the patient not to speak badly of others.
D. Immediately transfer the patient to another nurse.
Answer: B
Rationale: Splitting (idealizing one staff, devaluing another) is common in BPD. The
nurse validates the feeling (“It sounds like you’re feeling closer to me right now”)
without reinforcing the split, then maintains consistent team approach.
Answers | Complete Study Guide for Nursing Students | Comprehensive
Review for Pharmacology, Patient Care, Safety, NCLEX Preparation &
Final Exam Success |
1. A patient with schizophrenia tells the nurse, “Aliens are controlling my
thoughts.” Which therapeutic response is most appropriate?
A. “That must be frightening for you.”
B. “There are no aliens in this room.”
C. “Why do you think aliens are controlling you?”
D. “Let’s talk about something real.”
Answer: A
Rationale: Acknowledging the patient’s feeling without reinforcing the delusion
validates their experience and preserves trust. Asking “why” challenges the delusion;
denying it or changing the topic dismisses feelings.
,2. Which statement by the nurse best demonstrates empathy?
A. “I know exactly how you feel.”
B. “You seem upset about the diagnosis.”
C. “You should be grateful it’s not worse.”
D. “Don’t worry, everything will be fine.”
Answer: B
Rationale: Empathy involves recognizing and reflecting the patient’s emotion without
judgment or false reassurance. “I know exactly how you feel” is sympathy/assumption; C
and D are dismissive or false reassurance.
3. A patient says, “I don’t want to take medication anymore. It makes me feel like
a zombie.” The nurse’s best response is:
A. “You must take it or the doctor will be angry.”
B. “Tell me more about how the medication makes you feel.”
C. “That’s not true—you will get worse without it.”
D. “I’ll ask the doctor to stop all your meds.”
Answer: B
Rationale: Exploring the patient’s subjective experience fosters collaboration and
,identifies side effects that could be managed. Threatening or dismissing feelings
damages therapeutic alliance; stopping all meds without assessment is unsafe.
4. During a group therapy session, a patient constantly interrupts others. Which
leader response is most effective?
A. “Stop interrupting. You’re being rude.”
B. “I notice you have a lot to say. Let’s let Mark finish first.”
C. “Everyone, please ignore the interruptions.”
D. “That’s enough. Leave the room now.”
Answer: B
Rationale: Redirection with clear, respectful limit-setting maintains group norms and
models assertive communication. Shaming or removing without warning is punitive;
ignoring reinforces behavior.
5. Which phase of the therapeutic relationship focuses on identifying problems
and setting goals?
A. Pre-interaction
, B. Orientation
C. Working
D. Termination
Answer: B
Rationale: During orientation, the nurse and patient establish trust, define problems,
and set mutual goals. The working phase uses interventions; termination focuses on
ending the relationship.
6. A patient with borderline personality disorder tells the nurse, “You’re the only
one who understands me. The other nurses are cruel.” The nurse should:
A. Agree that the other nurses are cruel.
B. Validate the feeling but avoid splitting.
C. Tell the patient not to speak badly of others.
D. Immediately transfer the patient to another nurse.
Answer: B
Rationale: Splitting (idealizing one staff, devaluing another) is common in BPD. The
nurse validates the feeling (“It sounds like you’re feeling closer to me right now”)
without reinforcing the split, then maintains consistent team approach.
