NR 326 Exam 3 (New 2026/2027 Update) Mental
Health Nursing – Complete Solutions Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Foundations of Mental Health Nursing
Psychopharmacology and Biological Interventions
Mood Disorders and Anxiety Disorders
Psychotic Disorders and Personality Disorders
Crisis, Safety, and Special Populations
Foundations of Mental Health Nursing
Q1: A newly admitted patient sits with his arms crossed and says, "I don't know why
everyone keeps asking me questions. Talking to people never helps me." Which response by
the nurse is best?
A. "Talking with the staff here has helped a lot of patients feel better."
B. "Why do you think talking never helps?"
C. "It sounds like you're not convinced that talking with anyone will make a difference."
[CORRECT]
D. "Let's set that aside for now and talk about your family instead."
Correct Answer: C
Rationale: The best answer is the reflective statement because it validates what the patient
just said and invites him to say more, which is the heart of therapeutic communication.
Giving advice, asking "why," and changing the subject all close the door on the conversation
instead of opening it.
Q2: A patient begins to cry quietly after receiving news that her father has died. Which
action by the nurse is most appropriate?
A. Leave the room to give the patient privacy and return later.
B. Stay with the patient in silence, offering a tissue and a calm presence. [CORRECT]
C. Tell the patient, "Everything happens for a reason."
D. Call the provider to request a PRN medication.
Correct Answer: B
Rationale: This choice is correct because quiet, supportive presence communicates
acceptance and reassures the patient she is not alone, which matches the principle that
therapeutic use of self often matters more than words. Walking away, offering clichés, or
reaching for medication would shut down her emotional expression.
,Q3: During the first meeting, the nurse explains the purpose of the relationship, sets the
time and place for future meetings, and discusses confidentiality and its limits. The nurse is
functioning within which phase of the nurse-patient relationship?
A. Orientation phase [CORRECT]
B. Working phase
C. Termination phase
D. Preinteraction phase
Correct Answer: A
Rationale: The best answer is the orientation phase because this is when the nurse and
patient get acquainted and establish the contract, goals, and parameters of the relationship.
Problem-solving happens in the working phase, termination focuses on ending the
relationship, and the preinteraction phase occurs before the nurse ever meets the patient.
Q4: A patient being discharged next week tells the nurse, "You're the only one who really
understands me. Would you meet me for coffee after I'm out?" Which response best
maintains a professional boundary?
A. "Sure, one cup of coffee won't hurt now that you're going home."
B. "I'll ask my supervisor if we can stay in touch by personal email."
C. "I'll promise to meet you if you promise to stay safe."
D. "I care about how you do after discharge, but our relationship needs to stay
professional." [CORRECT]
Correct Answer: D
Rationale: This choice is correct because it acknowledges the patient's feelings while clearly
restating the professional limits of the relationship, which protects both the patient and the
nurse. Agreeing to personal contact or bargaining would blur the boundary and feed
dependency rather than the patient's growth.
Q5: A woman calls the unit and identifies herself as the daughter of a patient, asking what
her mother is being treated for. Which response by the nurse is most appropriate?
A. "I'm not able to share any information about patients, but I can pass your name and
number along so she can decide whether to contact you." [CORRECT]
B. "She is on the unit, but you'll need to ask her physician about the diagnosis."
C. "If you come to the unit, we can update you at the family meeting."
D. "We have no patient here under that name."
Correct Answer: A
Rationale: The best answer is this response because it protects patient confidentiality while
still treating the family member respectfully and leaving the choice of what to share with
the patient. Confirming admission details, promising information, or simply denying the
patient's presence mishandles the situation.
Q6: What is the primary goal of milieu therapy on an inpatient psychiatric unit?
A. Keeping the unit quiet and free of stimulation at all times
B. Using the entire environment, including staff interactions, peer relationships, and
structured activities, as a therapeutic tool [CORRECT]
C. Ensuring each patient takes medications as prescribed
D. Restricting patient interactions to prevent conflicts
Correct Answer: B
, Rationale: This choice is correct because milieu therapy treats the total environment itself as
part of the treatment, so safety, structure, peer feedback, and consistent staff expectations
all work together to support recovery. The other options describe isolation and medication
administration, which may occur on the unit but are not the organizing purpose of the
milieu.
Q7: A patient admitted on a voluntary basis tells the nurse, "I want to sign out of here
today." Which action is most appropriate?
A. Tell the patient he cannot leave until the psychiatrist approves it.
B. Restrict the patient to his room until an evaluation can be completed.
C. Explain the discharge request process and notify the provider of the request while
continuing to assess the patient's safety. [CORRECT]
D. Call security to escort the patient back to his room.
Correct Answer: C
Rationale: This choice is correct because voluntary patients retain the right to request
discharge, so the nurse's role is to explain the process, inform the provider, and keep
evaluating safety. Blocking the patient or using security without meeting legal criteria for an
involuntary hold would risk false imprisonment.
Q8: A patient is pacing, shouting, and clenching his fists but agrees to take an oral
medication when the nurse offers it. Which principle guides the nurse's next step?
A. Obtain a stat IM dose to control the behavior quickly.
B. Apply wrist restraints to prevent harm to staff.
C. Place the patient in seclusion until the behavior stops completely.
D. Use the least restrictive intervention that is effective for the situation. [CORRECT]
Correct Answer: D
Rationale: The best answer is the least restrictive alternative, because when the patient
accepts an oral medication and verbal intervention, injections, restraints, or seclusion would
escalate beyond what the situation requires. Interventions always begin with the least
intrusive option that keeps everyone safe.
Q9: A patient becomes tearful and says, "You're just like my ex-wife — you say you care, but
you're going to abandon me too." The nurse recognizes this behavior as:
A. Countertransference
B. Resistance
C. Boundary testing
D. Transference [CORRECT]
Correct Answer: D
Rationale: This choice is correct because transference occurs when the patient
unconsciously redirects feelings from significant past relationships onto the nurse.
Countertransference is the reverse — the nurse's feelings toward the patient — while
resistance and boundary testing don't describe displacing old relationship patterns onto the
caregiver.
Q10: A nurse notices she consistently feels irritable and short-tempered when caring for a
particular patient because he reminds her of her estranged brother. What is the nurse's best
action?
Health Nursing – Complete Solutions Actual Exam
2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Foundations of Mental Health Nursing
Psychopharmacology and Biological Interventions
Mood Disorders and Anxiety Disorders
Psychotic Disorders and Personality Disorders
Crisis, Safety, and Special Populations
Foundations of Mental Health Nursing
Q1: A newly admitted patient sits with his arms crossed and says, "I don't know why
everyone keeps asking me questions. Talking to people never helps me." Which response by
the nurse is best?
A. "Talking with the staff here has helped a lot of patients feel better."
B. "Why do you think talking never helps?"
C. "It sounds like you're not convinced that talking with anyone will make a difference."
[CORRECT]
D. "Let's set that aside for now and talk about your family instead."
Correct Answer: C
Rationale: The best answer is the reflective statement because it validates what the patient
just said and invites him to say more, which is the heart of therapeutic communication.
Giving advice, asking "why," and changing the subject all close the door on the conversation
instead of opening it.
Q2: A patient begins to cry quietly after receiving news that her father has died. Which
action by the nurse is most appropriate?
A. Leave the room to give the patient privacy and return later.
B. Stay with the patient in silence, offering a tissue and a calm presence. [CORRECT]
C. Tell the patient, "Everything happens for a reason."
D. Call the provider to request a PRN medication.
Correct Answer: B
Rationale: This choice is correct because quiet, supportive presence communicates
acceptance and reassures the patient she is not alone, which matches the principle that
therapeutic use of self often matters more than words. Walking away, offering clichés, or
reaching for medication would shut down her emotional expression.
,Q3: During the first meeting, the nurse explains the purpose of the relationship, sets the
time and place for future meetings, and discusses confidentiality and its limits. The nurse is
functioning within which phase of the nurse-patient relationship?
A. Orientation phase [CORRECT]
B. Working phase
C. Termination phase
D. Preinteraction phase
Correct Answer: A
Rationale: The best answer is the orientation phase because this is when the nurse and
patient get acquainted and establish the contract, goals, and parameters of the relationship.
Problem-solving happens in the working phase, termination focuses on ending the
relationship, and the preinteraction phase occurs before the nurse ever meets the patient.
Q4: A patient being discharged next week tells the nurse, "You're the only one who really
understands me. Would you meet me for coffee after I'm out?" Which response best
maintains a professional boundary?
A. "Sure, one cup of coffee won't hurt now that you're going home."
B. "I'll ask my supervisor if we can stay in touch by personal email."
C. "I'll promise to meet you if you promise to stay safe."
D. "I care about how you do after discharge, but our relationship needs to stay
professional." [CORRECT]
Correct Answer: D
Rationale: This choice is correct because it acknowledges the patient's feelings while clearly
restating the professional limits of the relationship, which protects both the patient and the
nurse. Agreeing to personal contact or bargaining would blur the boundary and feed
dependency rather than the patient's growth.
Q5: A woman calls the unit and identifies herself as the daughter of a patient, asking what
her mother is being treated for. Which response by the nurse is most appropriate?
A. "I'm not able to share any information about patients, but I can pass your name and
number along so she can decide whether to contact you." [CORRECT]
B. "She is on the unit, but you'll need to ask her physician about the diagnosis."
C. "If you come to the unit, we can update you at the family meeting."
D. "We have no patient here under that name."
Correct Answer: A
Rationale: The best answer is this response because it protects patient confidentiality while
still treating the family member respectfully and leaving the choice of what to share with
the patient. Confirming admission details, promising information, or simply denying the
patient's presence mishandles the situation.
Q6: What is the primary goal of milieu therapy on an inpatient psychiatric unit?
A. Keeping the unit quiet and free of stimulation at all times
B. Using the entire environment, including staff interactions, peer relationships, and
structured activities, as a therapeutic tool [CORRECT]
C. Ensuring each patient takes medications as prescribed
D. Restricting patient interactions to prevent conflicts
Correct Answer: B
, Rationale: This choice is correct because milieu therapy treats the total environment itself as
part of the treatment, so safety, structure, peer feedback, and consistent staff expectations
all work together to support recovery. The other options describe isolation and medication
administration, which may occur on the unit but are not the organizing purpose of the
milieu.
Q7: A patient admitted on a voluntary basis tells the nurse, "I want to sign out of here
today." Which action is most appropriate?
A. Tell the patient he cannot leave until the psychiatrist approves it.
B. Restrict the patient to his room until an evaluation can be completed.
C. Explain the discharge request process and notify the provider of the request while
continuing to assess the patient's safety. [CORRECT]
D. Call security to escort the patient back to his room.
Correct Answer: C
Rationale: This choice is correct because voluntary patients retain the right to request
discharge, so the nurse's role is to explain the process, inform the provider, and keep
evaluating safety. Blocking the patient or using security without meeting legal criteria for an
involuntary hold would risk false imprisonment.
Q8: A patient is pacing, shouting, and clenching his fists but agrees to take an oral
medication when the nurse offers it. Which principle guides the nurse's next step?
A. Obtain a stat IM dose to control the behavior quickly.
B. Apply wrist restraints to prevent harm to staff.
C. Place the patient in seclusion until the behavior stops completely.
D. Use the least restrictive intervention that is effective for the situation. [CORRECT]
Correct Answer: D
Rationale: The best answer is the least restrictive alternative, because when the patient
accepts an oral medication and verbal intervention, injections, restraints, or seclusion would
escalate beyond what the situation requires. Interventions always begin with the least
intrusive option that keeps everyone safe.
Q9: A patient becomes tearful and says, "You're just like my ex-wife — you say you care, but
you're going to abandon me too." The nurse recognizes this behavior as:
A. Countertransference
B. Resistance
C. Boundary testing
D. Transference [CORRECT]
Correct Answer: D
Rationale: This choice is correct because transference occurs when the patient
unconsciously redirects feelings from significant past relationships onto the nurse.
Countertransference is the reverse — the nurse's feelings toward the patient — while
resistance and boundary testing don't describe displacing old relationship patterns onto the
caregiver.
Q10: A nurse notices she consistently feels irritable and short-tempered when caring for a
particular patient because he reminds her of her estranged brother. What is the nurse's best
action?
