Wilkes University NSG 526 Exam 1 – Clinical Modalities in
Advanced Psychiatric Mental Health Nursing Practice
(2026/2027) | Actual Questions & Answers (Verified) with
Detailed Rationales, 100% Guaranteed Pass || Complete
A+ Guide
Question 1. A nurse therapist notices that a client reminds them of their own
sibling and begins to feel unusually protective. This is an example of:
A. Transference
B. Countertransference
C. Resistance
D. Projection
Correct Answer: B
Rationale:
Countertransference occurs when the clinician projects personal feelings onto the client.
Transference (A) is the client’s projection onto the clinician. Resistance (C) is client
avoidance. Projection (D) is a defense mechanism.
Question 2. A client states, "You remind me of my mother." This is most consistent
with:
A. Transference
B. Countertransference
C. Boundary violation
D. Malingering
Correct Answer: A
Rationale:
Transference is the client’s unconscious redirection of feelings from a significant person
onto the therapist. Countertransference (B) is the therapist’s reaction. Boundary violation
(C) is different. Malingering (D) is intentional feigning.
Question 3. Which therapeutic communication technique encourages the client to
continue talking?
,A. Giving advice
B. Broad opening
C. False reassurance
D. Changing the subject
Correct Answer: B
Rationale:
A broad opening such as "Tell me more" encourages exploration. Giving advice (A) is
nontherapeutic. False reassurance (C) minimizes feelings. Changing the subject (D)
blocks communication.
Question 4. The nurse says, "I notice you are clenching your fists." This is an
example of:
A. Making observations
B. Reflecting
C. Restating
D. Summarizing
Correct Answer: A
Rationale:
Making observations describes what is perceived. Reflecting (B) mirrors feelings.
Restating (C) repeats content. Summarizing (D) reviews key points.
Question 5. Which is a nontherapeutic communication technique?
A. Silence
B. Exploring
C. Giving approval
D. Clarifying
Correct Answer: C
Rationale:
Giving approval implies judgment and can create dependence. Silence (A), exploring (B),
and clarifying (D) are therapeutic.
Question 6. The primary purpose of the nurse-client relationship is to:
A. Socialize the client
B. Promote client growth and adaptive functioning
,C. Diagnose the client
D. Prescribe medication
Correct Answer: B
Rationale:
The therapeutic relationship promotes growth, coping, and adaptation. Socialization (A)
is not the goal. Diagnosis (C) and prescribing (D) are not the primary purpose of the
relationship.
Question 7. Which phase of the nurse-client relationship involves setting goals and
boundaries?
A. Preinteraction
B. Orientation
C. Working
D. Termination
Correct Answer: B
Rationale:
The orientation phase involves establishing trust, goals, and boundaries. Preinteraction
(A) is preparation. Working (C) is intervention. Termination (D) is ending.
Question 8. A client says, "I can't go on anymore." The nurse's best initial response
is:
A. "You have so much to live for."
B. "Are you thinking about killing yourself?"
C. "Let's talk about something else."
D. "I'm sure you don't mean that."
Correct Answer: B
Rationale:
Directly asking about suicide is appropriate and does not increase risk. The other
responses minimize or avoid the concern.
Question 9. Which factor is most associated with increased suicide risk?
A. Female gender
B. Married status
, C. Access to lethal means
D. Young age
Correct Answer: C
Rationale:
Access to lethal means increases risk. Female gender (A) is associated with attempts but
lower completion. Married status (B) is protective. Young age (D) is not the strongest
risk factor.
Question 10. A client with borderline personality disorder is most likely to use
which defense mechanism?
A. Splitting
B. Sublimation
C. Intellectualization
D. Altruism
Correct Answer: A
Rationale:
Splitting is common in borderline personality disorder. Sublimation (B),
intellectualization (C), and altruism (D) are mature defenses.
Question 11. Which medication class is first-line for generalized anxiety disorder?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Correct Answer: B
Rationale:
SSRIs are first-line for GAD due to efficacy and safety. Benzodiazepines (A) are short-
term. Antipsychotics (C) and mood stabilizers (D) are not first-line.
Question 12. Which side effect is a medical emergency in a client taking clozapine?
A. Weight gain
B. Agranulocytosis
C. Sedation
D. Constipation
Advanced Psychiatric Mental Health Nursing Practice
(2026/2027) | Actual Questions & Answers (Verified) with
Detailed Rationales, 100% Guaranteed Pass || Complete
A+ Guide
Question 1. A nurse therapist notices that a client reminds them of their own
sibling and begins to feel unusually protective. This is an example of:
A. Transference
B. Countertransference
C. Resistance
D. Projection
Correct Answer: B
Rationale:
Countertransference occurs when the clinician projects personal feelings onto the client.
Transference (A) is the client’s projection onto the clinician. Resistance (C) is client
avoidance. Projection (D) is a defense mechanism.
Question 2. A client states, "You remind me of my mother." This is most consistent
with:
A. Transference
B. Countertransference
C. Boundary violation
D. Malingering
Correct Answer: A
Rationale:
Transference is the client’s unconscious redirection of feelings from a significant person
onto the therapist. Countertransference (B) is the therapist’s reaction. Boundary violation
(C) is different. Malingering (D) is intentional feigning.
Question 3. Which therapeutic communication technique encourages the client to
continue talking?
,A. Giving advice
B. Broad opening
C. False reassurance
D. Changing the subject
Correct Answer: B
Rationale:
A broad opening such as "Tell me more" encourages exploration. Giving advice (A) is
nontherapeutic. False reassurance (C) minimizes feelings. Changing the subject (D)
blocks communication.
Question 4. The nurse says, "I notice you are clenching your fists." This is an
example of:
A. Making observations
B. Reflecting
C. Restating
D. Summarizing
Correct Answer: A
Rationale:
Making observations describes what is perceived. Reflecting (B) mirrors feelings.
Restating (C) repeats content. Summarizing (D) reviews key points.
Question 5. Which is a nontherapeutic communication technique?
A. Silence
B. Exploring
C. Giving approval
D. Clarifying
Correct Answer: C
Rationale:
Giving approval implies judgment and can create dependence. Silence (A), exploring (B),
and clarifying (D) are therapeutic.
Question 6. The primary purpose of the nurse-client relationship is to:
A. Socialize the client
B. Promote client growth and adaptive functioning
,C. Diagnose the client
D. Prescribe medication
Correct Answer: B
Rationale:
The therapeutic relationship promotes growth, coping, and adaptation. Socialization (A)
is not the goal. Diagnosis (C) and prescribing (D) are not the primary purpose of the
relationship.
Question 7. Which phase of the nurse-client relationship involves setting goals and
boundaries?
A. Preinteraction
B. Orientation
C. Working
D. Termination
Correct Answer: B
Rationale:
The orientation phase involves establishing trust, goals, and boundaries. Preinteraction
(A) is preparation. Working (C) is intervention. Termination (D) is ending.
Question 8. A client says, "I can't go on anymore." The nurse's best initial response
is:
A. "You have so much to live for."
B. "Are you thinking about killing yourself?"
C. "Let's talk about something else."
D. "I'm sure you don't mean that."
Correct Answer: B
Rationale:
Directly asking about suicide is appropriate and does not increase risk. The other
responses minimize or avoid the concern.
Question 9. Which factor is most associated with increased suicide risk?
A. Female gender
B. Married status
, C. Access to lethal means
D. Young age
Correct Answer: C
Rationale:
Access to lethal means increases risk. Female gender (A) is associated with attempts but
lower completion. Married status (B) is protective. Young age (D) is not the strongest
risk factor.
Question 10. A client with borderline personality disorder is most likely to use
which defense mechanism?
A. Splitting
B. Sublimation
C. Intellectualization
D. Altruism
Correct Answer: A
Rationale:
Splitting is common in borderline personality disorder. Sublimation (B),
intellectualization (C), and altruism (D) are mature defenses.
Question 11. Which medication class is first-line for generalized anxiety disorder?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Correct Answer: B
Rationale:
SSRIs are first-line for GAD due to efficacy and safety. Benzodiazepines (A) are short-
term. Antipsychotics (C) and mood stabilizers (D) are not first-line.
Question 12. Which side effect is a medical emergency in a client taking clozapine?
A. Weight gain
B. Agranulocytosis
C. Sedation
D. Constipation
