Exam 2 – Mental Health
1. The nurse is following up with a patient who previously demonstrated therapeutic
communication skills. Which statement by the patient requires further teaching?
a. “I tried to listen and wait before responding when my partner was upset.”
b. “I told my partner he was wrong and needed to calm down.”
c. “I tried to use ‘I-statements’ when I felt frustrated.”
d. “I paused and asked for clarification before reacting.”
Correct answer: b
Rationale: Telling someone they are wrong and should calm down is a non-therapeutic,
judgmental response that escalates conflict. Therapeutic communication focuses on
empathy, validation, and open-ended discussion. The other options demonstrate
appropriate therapeutic techniques.
2. During a mental status examination (MSE), which finding best reflects the patient’s
mood?
a. “I feel hopeless and empty most of the time.”
b. Flat facial expression and monotone voice.
c. Poor eye contact and disheveled clothing.
d. Reports auditory hallucinations commanding harm.
Correct answer: a
Rationale: Mood is the patient’s self-reported emotional state (“I feel hopeless”). A ect
refers to observable expression of emotion (option b). Appearance (option c) and thought
content (option d) are separate components of the MSE.
3. The nurse teaches a student about altruism as a defense mechanism. Which statement
indicates incorrect understanding?
a. “Altruism means helping others to cope with my own stress in a positive way.”
b. “Altruism is a maladaptive defense mechanism that worsens anxiety.”
c. “Nurses often demonstrate altruism when they care for others after personal loss.”
, d. “Altruism can transform painful feelings into constructive actions.”
Correct answer: b
Rationale: Altruism is an adaptive defense mechanism that channels emotional conflict
into helping others. Option b is incorrect because altruism is considered healthy, not
maladaptive.
4. A nurse compares the working phase and termination phase of the nurse–patient
relationship. Which statement accurately describes the di erence?
a. The working phase focuses on goal attainment, while the termination phase emphasizes
summarizing progress.
b. The working phase involves introductions and establishing trust.
c. The termination phase occurs before goals are established.
d. Both phases involve identifying problems but not evaluating outcomes.
Correct answer: a
Rationale: During the working phase, therapeutic goals are implemented and progress is
made. The termination phase reviews progress, summarizes learning, and plans for
independence. Options b–d confuse the sequence or purpose of the phases.
5. A nurse recognizes that a patient begins relating to her as though she were his older
sister, expressing the same anger he felt toward his sibling. The nurse identifies this
behavior as:
a. Countertransference
b. Projection
c. Transference
d. Regression
Correct answer: c
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person onto the nurse. Countertransference is the nurse’s emotional response
to the patient. Projection and regression are separate defense mechanisms.
1. The nurse is following up with a patient who previously demonstrated therapeutic
communication skills. Which statement by the patient requires further teaching?
a. “I tried to listen and wait before responding when my partner was upset.”
b. “I told my partner he was wrong and needed to calm down.”
c. “I tried to use ‘I-statements’ when I felt frustrated.”
d. “I paused and asked for clarification before reacting.”
Correct answer: b
Rationale: Telling someone they are wrong and should calm down is a non-therapeutic,
judgmental response that escalates conflict. Therapeutic communication focuses on
empathy, validation, and open-ended discussion. The other options demonstrate
appropriate therapeutic techniques.
2. During a mental status examination (MSE), which finding best reflects the patient’s
mood?
a. “I feel hopeless and empty most of the time.”
b. Flat facial expression and monotone voice.
c. Poor eye contact and disheveled clothing.
d. Reports auditory hallucinations commanding harm.
Correct answer: a
Rationale: Mood is the patient’s self-reported emotional state (“I feel hopeless”). A ect
refers to observable expression of emotion (option b). Appearance (option c) and thought
content (option d) are separate components of the MSE.
3. The nurse teaches a student about altruism as a defense mechanism. Which statement
indicates incorrect understanding?
a. “Altruism means helping others to cope with my own stress in a positive way.”
b. “Altruism is a maladaptive defense mechanism that worsens anxiety.”
c. “Nurses often demonstrate altruism when they care for others after personal loss.”
, d. “Altruism can transform painful feelings into constructive actions.”
Correct answer: b
Rationale: Altruism is an adaptive defense mechanism that channels emotional conflict
into helping others. Option b is incorrect because altruism is considered healthy, not
maladaptive.
4. A nurse compares the working phase and termination phase of the nurse–patient
relationship. Which statement accurately describes the di erence?
a. The working phase focuses on goal attainment, while the termination phase emphasizes
summarizing progress.
b. The working phase involves introductions and establishing trust.
c. The termination phase occurs before goals are established.
d. Both phases involve identifying problems but not evaluating outcomes.
Correct answer: a
Rationale: During the working phase, therapeutic goals are implemented and progress is
made. The termination phase reviews progress, summarizes learning, and plans for
independence. Options b–d confuse the sequence or purpose of the phases.
5. A nurse recognizes that a patient begins relating to her as though she were his older
sister, expressing the same anger he felt toward his sibling. The nurse identifies this
behavior as:
a. Countertransference
b. Projection
c. Transference
d. Regression
Correct answer: c
Rationale: Transference occurs when a patient unconsciously redirects feelings about a
significant person onto the nurse. Countertransference is the nurse’s emotional response
to the patient. Projection and regression are separate defense mechanisms.
