Rasmussen: Mental Health Exam 2
Latest Version(Updated 2024) with
complete solution
Section 1: Foundations & Therapeutic Communication (1–25)
1. A nurse is conducting a mental status examination. To assess a client's remote memory,
which technique should the nurse use?
A. Ask the client to repeat three objects immediately.
B. Ask the client to count backward from 100 by 7s.
C. Ask the client to recall a significant historical event or personal past experience.
D. Ask the client to write a complete sentence about any topic.
Correct Answer: C
Rationale: Remote memory involves recalling past events stored over a long period .
Repeating objects tests immediate memory; counting backward assesses concentration; writing
a sentence assesses language ability.
2. A nurse is establishing a therapeutic relationship. During which phase should the nurse
primarily focus on establishing trust and setting the framework?
A. Working phase
B. Orientation phase
C. Termination phase
D. Pre-interaction phase
Correct Answer: B
Rationale: The orientation phase is the first phase, where the nurse establishes trust,
rapport, and boundaries . The working phase focuses on problem-solving; termination focuses
on summarizing progress.
3. A client tells the nurse, "It's just a bad cold. The tests are probably wrong." Which defense
mechanism is the client using?
A. Rationalization
B. Repression
C. Denial
D. Displacement
, Correct Answer: C
Rationale: Denial is refusing to acknowledge the reality of a painful situation by attributing
symptoms to a less serious cause . Rationalization involves creating logical explanations for
unacceptable behavior.
4. A nurse states, "I will stay with you until you go for your electroconvulsive therapy (ECT)
treatment." Which therapeutic communication technique is demonstrated?
A. Accepting
B. Giving recognition
C. Offering self
D. Formulating a plan
Correct Answer: C
Rationale: Offering self involves offering presence, support, and assistance to the patient
during a stressful time . This builds trust and rapport.
5. A client with social anxiety tells the nurse, "I'm so stupid for not being able to give a simple
speech." Which response is most therapeutic?
A. "You are very intelligent."
B. "Why do you think you are stupid?"
C. "You see yourself as stupid because you struggled with the speech?"
D. "It sounds like you are being very hard on yourself for having difficulty with public speaking."
Correct Answer: D
Rationale: This response uses validation and reflection without agreeing with the negative
self-label . It acknowledges the feeling while reframing the situation objectively.
6. A client says, "My brother is the only one who understands me, but he moved away last
month." The nurse responds, "It sounds like you feel lonely since your brother left." This is an
example of:
A. Restating
B. Clarifying
C. Reflecting
D. Paraphrasing
Correct Answer: C
Rationale: Reflection involves putting into words the emotional tone the client is expressing
. The nurse identified the underlying feeling of loneliness, not just the content.
7. A nurse tells a client, "You must complete your morning hygiene before breakfast." This is
an example of:
,A. Limit setting
B. Giving advice
C. Making an observation
D. Requesting an explanation
Correct Answer: A
Rationale: Limit setting establishes boundaries and expectations for behavior in a
therapeutic manner . It provides structure and safety.
8. A client with borderline personality disorder yells, "You're the worst nurse ever! You never
help me!" The nurse's most therapeutic response is:
A. "That is not true. I have helped you many times."
B. "I can see you're upset. Let's talk about what just happened."
C. "You need to lower your voice right now."
D. "I'm going to leave until you can speak respectfully."
Correct Answer: B
Rationale: This response uses validation of emotion while redirecting to problem-solving . It
avoids power struggles and maintains the therapeutic relationship.
9. During a therapeutic interaction, a client states, "I just can't sleep at night. I keep tossing
and turning." Which response demonstrates the technique of restating?
A. "Why do you think you're having trouble sleeping?"
B. "You are having difficulty sleeping?"
C. "Tell me more about what's been happening at night."
D. "I understand how frustrating that must be for you."
Correct Answer: B
Rationale: Restating involves repeating the main idea of what the client said to convey
understanding and encourage further exploration .
10. A nurse is assessing a client's cognitive function. The nurse asks the client to name the
current president and count backward from 100 by sevens. Which domain is being assessed?
A. Thought process
B. Concentration and orientation
C. Judgment and insight
D. Abstract reasoning
Correct Answer: B
Rationale: Naming the president assesses orientation; counting backward by sevens
assesses concentration . These are standard components of the mental status examination.
, 11. A patient with schizophrenia begins to talk about "volmers" hiding in the warehouse at
work. The term "volmers" should be documented as:
A. Concrete thinking
B. Thought insertion
C. Neologism
D. Idea of reference
Correct Answer: C
Rationale: A neologism is a newly coined word with special meaning to the patient,
common in schizophrenia . Concrete thinking is literal interpretation; thought insertion is
external thoughts imposed.
12. A nurse asks a client, "What brings you to the hospital today?" The client replies, "I was
watching TV and then the dog barked, and my mother used to make cookies, and then I
couldn't find my shoes, so I came here." This speech pattern is best documented as:
A. Incoherence
B. Tangential speech
C. Circumstantiality
D. Flight of ideas
Correct Answer: C
Rationale: Circumstantiality involves including unnecessary details and unusual thoughts
before getting to the central idea . Incoherence is disorganized speech that is not
understandable.
13. A nurse states, "Let me see if I understand. You feel angry when your mother visits
because she criticizes your weight." This communication technique is:
A. Summarizing
B. Clarifying
C. Focusing
D. Translating
Correct Answer: B
Rationale: Clarifying checks the accuracy of the nurse's understanding and helps the client
hear their own thoughts organized coherently .
14. Which statement by the nurse best demonstrates empathy?
A. "I know exactly how you feel. I went through the same thing."
B. "I understand you are feeling sad. That must be very difficult."
Latest Version(Updated 2024) with
complete solution
Section 1: Foundations & Therapeutic Communication (1–25)
1. A nurse is conducting a mental status examination. To assess a client's remote memory,
which technique should the nurse use?
A. Ask the client to repeat three objects immediately.
B. Ask the client to count backward from 100 by 7s.
C. Ask the client to recall a significant historical event or personal past experience.
D. Ask the client to write a complete sentence about any topic.
Correct Answer: C
Rationale: Remote memory involves recalling past events stored over a long period .
Repeating objects tests immediate memory; counting backward assesses concentration; writing
a sentence assesses language ability.
2. A nurse is establishing a therapeutic relationship. During which phase should the nurse
primarily focus on establishing trust and setting the framework?
A. Working phase
B. Orientation phase
C. Termination phase
D. Pre-interaction phase
Correct Answer: B
Rationale: The orientation phase is the first phase, where the nurse establishes trust,
rapport, and boundaries . The working phase focuses on problem-solving; termination focuses
on summarizing progress.
3. A client tells the nurse, "It's just a bad cold. The tests are probably wrong." Which defense
mechanism is the client using?
A. Rationalization
B. Repression
C. Denial
D. Displacement
, Correct Answer: C
Rationale: Denial is refusing to acknowledge the reality of a painful situation by attributing
symptoms to a less serious cause . Rationalization involves creating logical explanations for
unacceptable behavior.
4. A nurse states, "I will stay with you until you go for your electroconvulsive therapy (ECT)
treatment." Which therapeutic communication technique is demonstrated?
A. Accepting
B. Giving recognition
C. Offering self
D. Formulating a plan
Correct Answer: C
Rationale: Offering self involves offering presence, support, and assistance to the patient
during a stressful time . This builds trust and rapport.
5. A client with social anxiety tells the nurse, "I'm so stupid for not being able to give a simple
speech." Which response is most therapeutic?
A. "You are very intelligent."
B. "Why do you think you are stupid?"
C. "You see yourself as stupid because you struggled with the speech?"
D. "It sounds like you are being very hard on yourself for having difficulty with public speaking."
Correct Answer: D
Rationale: This response uses validation and reflection without agreeing with the negative
self-label . It acknowledges the feeling while reframing the situation objectively.
6. A client says, "My brother is the only one who understands me, but he moved away last
month." The nurse responds, "It sounds like you feel lonely since your brother left." This is an
example of:
A. Restating
B. Clarifying
C. Reflecting
D. Paraphrasing
Correct Answer: C
Rationale: Reflection involves putting into words the emotional tone the client is expressing
. The nurse identified the underlying feeling of loneliness, not just the content.
7. A nurse tells a client, "You must complete your morning hygiene before breakfast." This is
an example of:
,A. Limit setting
B. Giving advice
C. Making an observation
D. Requesting an explanation
Correct Answer: A
Rationale: Limit setting establishes boundaries and expectations for behavior in a
therapeutic manner . It provides structure and safety.
8. A client with borderline personality disorder yells, "You're the worst nurse ever! You never
help me!" The nurse's most therapeutic response is:
A. "That is not true. I have helped you many times."
B. "I can see you're upset. Let's talk about what just happened."
C. "You need to lower your voice right now."
D. "I'm going to leave until you can speak respectfully."
Correct Answer: B
Rationale: This response uses validation of emotion while redirecting to problem-solving . It
avoids power struggles and maintains the therapeutic relationship.
9. During a therapeutic interaction, a client states, "I just can't sleep at night. I keep tossing
and turning." Which response demonstrates the technique of restating?
A. "Why do you think you're having trouble sleeping?"
B. "You are having difficulty sleeping?"
C. "Tell me more about what's been happening at night."
D. "I understand how frustrating that must be for you."
Correct Answer: B
Rationale: Restating involves repeating the main idea of what the client said to convey
understanding and encourage further exploration .
10. A nurse is assessing a client's cognitive function. The nurse asks the client to name the
current president and count backward from 100 by sevens. Which domain is being assessed?
A. Thought process
B. Concentration and orientation
C. Judgment and insight
D. Abstract reasoning
Correct Answer: B
Rationale: Naming the president assesses orientation; counting backward by sevens
assesses concentration . These are standard components of the mental status examination.
, 11. A patient with schizophrenia begins to talk about "volmers" hiding in the warehouse at
work. The term "volmers" should be documented as:
A. Concrete thinking
B. Thought insertion
C. Neologism
D. Idea of reference
Correct Answer: C
Rationale: A neologism is a newly coined word with special meaning to the patient,
common in schizophrenia . Concrete thinking is literal interpretation; thought insertion is
external thoughts imposed.
12. A nurse asks a client, "What brings you to the hospital today?" The client replies, "I was
watching TV and then the dog barked, and my mother used to make cookies, and then I
couldn't find my shoes, so I came here." This speech pattern is best documented as:
A. Incoherence
B. Tangential speech
C. Circumstantiality
D. Flight of ideas
Correct Answer: C
Rationale: Circumstantiality involves including unnecessary details and unusual thoughts
before getting to the central idea . Incoherence is disorganized speech that is not
understandable.
13. A nurse states, "Let me see if I understand. You feel angry when your mother visits
because she criticizes your weight." This communication technique is:
A. Summarizing
B. Clarifying
C. Focusing
D. Translating
Correct Answer: B
Rationale: Clarifying checks the accuracy of the nurse's understanding and helps the client
hear their own thoughts organized coherently .
14. Which statement by the nurse best demonstrates empathy?
A. "I know exactly how you feel. I went through the same thing."
B. "I understand you are feeling sad. That must be very difficult."
