Varcarolis’ Essentials of Psychiatric Mental Health Nursing
(5th Ed.) Complete Chapters 1–28 Test Bank & Study
Guide 2026-2027
Section 1: Mental Health Foundations & Theories (Chapters 1–5)
1. A nurse is assessing a client who has lost their job and is going through a
divorce. The client states, "I just can't take it anymore." Which of the following is
the priority nursing action?
A) Assist the client in problem-solving the immediate stressors.
B) Ask the client directly if they have a plan to harm themselves.
C) Administer a prescribed PRN anxiolytic medication.
D) Encourage the client to attend a support group.
ANSWERS>: B - When a client expresses an inability to cope, the priority is to
assess for suicide risk. Asking directly about a plan, intent, and means is the most
critical intervention.
2. Which neurotransmitter is primarily implicated in the positive symptoms of
schizophrenia (e.g., hallucinations, delusions)?
A) Serotonin
B) Gamma-aminobutyric acid (GABA)
C) Dopamine
D) Norepinephrine
ANSWERS>: C - The dopamine hypothesis suggests that an excess of dopamine in
the mesolimbic pathway causes positive symptoms of schizophrenia.
Antipsychotics work by blocking dopamine receptors.
,3. A nurse is caring for a client who recently experienced a severe trauma. The
client is utilizing the defense mechanism of "projection." Which statement by the
client indicates this?
A) "I didn't get the promotion because my boss is incompetent."
B) "I am angry that I didn't get the promotion, but I will try again next year."
C) "I don't care that I didn't get the promotion; it doesn't matter to me."
D) "I am going to work twice as hard to show my boss I deserve a promotion."
ANSWERS>: A - Projection involves attributing one's own unacceptable feelings or
thoughts to someone else. The client is projecting their own feelings of
incompetence onto the boss.
4. According to Maslow’s Hierarchy of Needs, which client issue should the nurse
address first?
A) A client feeling isolated from their family.
B) A client expressing a desire to achieve their full potential in art.
C) A client experiencing hallucinations telling them to harm others.
D) A client lacking the financial means to buy groceries.
ANSWERS>: C - Maslow's hierarchy prioritizes physiological and safety needs first.
Harm to self or others is a safety threat, which must be addressed before esteem
or self-actualization needs.
5. In Peplau’s Therapeutic Nurse-Patient Relationship, which phase involves the
nurse and client establishing mutual goals and a contract for care?
A) Orientation phase
B) Working phase
C) Termination phase
, D) Pre-interaction phase
ANSWERS>: A - During the orientation phase, trust is established, roles are
defined, and the contract (goals and expectations) for the relationship is set.
Section 2: Communication & the Therapeutic Relationship (Chapters 6–9)
6. A client states, "I'm really worried about the test results." The nurse replies,
"You're worried about the test results?" Which therapeutic communication
technique is the nurse using?
A) Restating
B) Reflecting
C) Exploring
D) Focusing
ANSWERS>: A - Restating involves repeating the main idea of the client's message
to encourage further elaboration and confirm understanding.
7. Which of the following responses by the nurse is an example of a non-
therapeutic "giving false reassurance"?
A) "I understand this is difficult for you."
B) "Everything will be okay; the doctor is the best in the city."
C) "Can you tell me more about how you are feeling right now?"
D) "What do you think is the most important thing for us to focus on today?"
ANSWERS>: B - Giving false reassurance dismisses the client's feelings and offers a
guarantee of an outcome the nurse cannot guarantee.
(5th Ed.) Complete Chapters 1–28 Test Bank & Study
Guide 2026-2027
Section 1: Mental Health Foundations & Theories (Chapters 1–5)
1. A nurse is assessing a client who has lost their job and is going through a
divorce. The client states, "I just can't take it anymore." Which of the following is
the priority nursing action?
A) Assist the client in problem-solving the immediate stressors.
B) Ask the client directly if they have a plan to harm themselves.
C) Administer a prescribed PRN anxiolytic medication.
D) Encourage the client to attend a support group.
ANSWERS>: B - When a client expresses an inability to cope, the priority is to
assess for suicide risk. Asking directly about a plan, intent, and means is the most
critical intervention.
2. Which neurotransmitter is primarily implicated in the positive symptoms of
schizophrenia (e.g., hallucinations, delusions)?
A) Serotonin
B) Gamma-aminobutyric acid (GABA)
C) Dopamine
D) Norepinephrine
ANSWERS>: C - The dopamine hypothesis suggests that an excess of dopamine in
the mesolimbic pathway causes positive symptoms of schizophrenia.
Antipsychotics work by blocking dopamine receptors.
,3. A nurse is caring for a client who recently experienced a severe trauma. The
client is utilizing the defense mechanism of "projection." Which statement by the
client indicates this?
A) "I didn't get the promotion because my boss is incompetent."
B) "I am angry that I didn't get the promotion, but I will try again next year."
C) "I don't care that I didn't get the promotion; it doesn't matter to me."
D) "I am going to work twice as hard to show my boss I deserve a promotion."
ANSWERS>: A - Projection involves attributing one's own unacceptable feelings or
thoughts to someone else. The client is projecting their own feelings of
incompetence onto the boss.
4. According to Maslow’s Hierarchy of Needs, which client issue should the nurse
address first?
A) A client feeling isolated from their family.
B) A client expressing a desire to achieve their full potential in art.
C) A client experiencing hallucinations telling them to harm others.
D) A client lacking the financial means to buy groceries.
ANSWERS>: C - Maslow's hierarchy prioritizes physiological and safety needs first.
Harm to self or others is a safety threat, which must be addressed before esteem
or self-actualization needs.
5. In Peplau’s Therapeutic Nurse-Patient Relationship, which phase involves the
nurse and client establishing mutual goals and a contract for care?
A) Orientation phase
B) Working phase
C) Termination phase
, D) Pre-interaction phase
ANSWERS>: A - During the orientation phase, trust is established, roles are
defined, and the contract (goals and expectations) for the relationship is set.
Section 2: Communication & the Therapeutic Relationship (Chapters 6–9)
6. A client states, "I'm really worried about the test results." The nurse replies,
"You're worried about the test results?" Which therapeutic communication
technique is the nurse using?
A) Restating
B) Reflecting
C) Exploring
D) Focusing
ANSWERS>: A - Restating involves repeating the main idea of the client's message
to encourage further elaboration and confirm understanding.
7. Which of the following responses by the nurse is an example of a non-
therapeutic "giving false reassurance"?
A) "I understand this is difficult for you."
B) "Everything will be okay; the doctor is the best in the city."
C) "Can you tell me more about how you are feeling right now?"
D) "What do you think is the most important thing for us to focus on today?"
ANSWERS>: B - Giving false reassurance dismisses the client's feelings and offers a
guarantee of an outcome the nurse cannot guarantee.
