,D449 Psychiatric and Mental Health
Nursing Exam Prep — Comprehensive
Review + Practice MCQs — Western
Governors University 2025/2026
1. A client tells the nurse, “I don’t think I can go on anymore. Everything is hopeless.” Which response by the
nurse is most therapeutic?
A. “You have so much to live for. Things will get better.”
B. “I understand how you feel. I’ve been there myself.”
C. “It sounds like you are feeling hopeless. Tell me more about what’s going on.”
D. “You need to focus on the positive things in your life.”
Correct Answer: C
Rationale: This response uses reflection of feelings and encourages the client to express themselves further. It
validates the client’s feelings without minimizing them. Telling the client to be positive (A and D) dismisses
their feelings, and sharing personal experiences (B) shifts focus away from the client.
2. Which therapeutic communication technique involves the nurse repeating the patient’s words to encourage
deeper exploration?
A. Clarification
B. Reflection
C. Validation
D. Active listening
Correct Answer: B
,Rationale: Reflection involves paraphrasing or echoing the patient’s words, encouraging them to elaborate on
their feelings. Active listening is attending fully; clarification seeks more information; validation acknowledges
emotions.
3. A client tells the nurse, “I don’t think I can go on anymore.” Which response by the nurse is most
therapeutic?
A. “Everyone feels that way sometimes.”
B. “Are you thinking about hurting yourself?”
C. “You have so much to live for.”
D. “I know how you feel; it will get better.”
Correct Answer: B
Rationale: Directly asking about suicidal ideation is therapeutic and does not increase the risk of suicide. The
other responses are dismissive, provide false reassurance, or assume the client’s feelings.
4. A nurse is interviewing a client who is experiencing auditory hallucinations. The client says, “The voices are
telling me I am evil.” Which response is most therapeutic?
A. “I don’t hear any voices.”
B. “The voices are not real; they are a symptom of your illness.”
C. “I understand you are hearing voices. Tell me what they are saying.”
D. “You need to ignore the voices.”
Correct Answer: C
, Rationale: Acknowledging the client’s experience and asking about the content of the hallucinations is
therapeutic. It validates the client’s feelings while not confirming the reality of the hallucinations. Telling the
client to ignore the voices or that they are not real is dismissive.
5. A client is pacing and appears anxious. The nurse says, “You look very anxious today. Can you tell me what is
bothering you?” This is an example of which therapeutic technique?
A. Making an observation
B. Giving advice
C. Being judgmental
D. Sympathy
Correct Answer: A
Rationale: Making an observation is a therapeutic technique where the nurse shares what they are observing
about the client. It helps the client become aware of their behavior and opens the door for discussion.
6. The use of silence as a therapeutic communication technique is most appropriate when:
A. The client is angry and yelling
B. The client needs time to process thoughts and feelings
C. The nurse does not know what to say
D. The client is asking for advice
Correct Answer: B
Nursing Exam Prep — Comprehensive
Review + Practice MCQs — Western
Governors University 2025/2026
1. A client tells the nurse, “I don’t think I can go on anymore. Everything is hopeless.” Which response by the
nurse is most therapeutic?
A. “You have so much to live for. Things will get better.”
B. “I understand how you feel. I’ve been there myself.”
C. “It sounds like you are feeling hopeless. Tell me more about what’s going on.”
D. “You need to focus on the positive things in your life.”
Correct Answer: C
Rationale: This response uses reflection of feelings and encourages the client to express themselves further. It
validates the client’s feelings without minimizing them. Telling the client to be positive (A and D) dismisses
their feelings, and sharing personal experiences (B) shifts focus away from the client.
2. Which therapeutic communication technique involves the nurse repeating the patient’s words to encourage
deeper exploration?
A. Clarification
B. Reflection
C. Validation
D. Active listening
Correct Answer: B
,Rationale: Reflection involves paraphrasing or echoing the patient’s words, encouraging them to elaborate on
their feelings. Active listening is attending fully; clarification seeks more information; validation acknowledges
emotions.
3. A client tells the nurse, “I don’t think I can go on anymore.” Which response by the nurse is most
therapeutic?
A. “Everyone feels that way sometimes.”
B. “Are you thinking about hurting yourself?”
C. “You have so much to live for.”
D. “I know how you feel; it will get better.”
Correct Answer: B
Rationale: Directly asking about suicidal ideation is therapeutic and does not increase the risk of suicide. The
other responses are dismissive, provide false reassurance, or assume the client’s feelings.
4. A nurse is interviewing a client who is experiencing auditory hallucinations. The client says, “The voices are
telling me I am evil.” Which response is most therapeutic?
A. “I don’t hear any voices.”
B. “The voices are not real; they are a symptom of your illness.”
C. “I understand you are hearing voices. Tell me what they are saying.”
D. “You need to ignore the voices.”
Correct Answer: C
, Rationale: Acknowledging the client’s experience and asking about the content of the hallucinations is
therapeutic. It validates the client’s feelings while not confirming the reality of the hallucinations. Telling the
client to ignore the voices or that they are not real is dismissive.
5. A client is pacing and appears anxious. The nurse says, “You look very anxious today. Can you tell me what is
bothering you?” This is an example of which therapeutic technique?
A. Making an observation
B. Giving advice
C. Being judgmental
D. Sympathy
Correct Answer: A
Rationale: Making an observation is a therapeutic technique where the nurse shares what they are observing
about the client. It helps the client become aware of their behavior and opens the door for discussion.
6. The use of silence as a therapeutic communication technique is most appropriate when:
A. The client is angry and yelling
B. The client needs time to process thoughts and feelings
C. The nurse does not know what to say
D. The client is asking for advice
Correct Answer: B
