Answers | Latest Version | 2025/2026 |
Correct & Verified
What is the first step a nurse should take when establishing a therapeutic relationship with a
client?
✔✔ Build trust and establish boundaries
What is the most appropriate response to a client who begins crying during a session?
✔✔ Sit with the client and offer emotional presence
What action should the nurse take when a client shares auditory hallucinations about self-harm?
✔✔ Notify the provider immediately and ensure safety
What is the main focus during the orientation phase of the nurse-client relationship?
✔✔ Establishing goals and building trust
What should a nurse do if a client refuses to take prescribed medication?
✔✔ Explore the client’s reason and document the refusal
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,What defense mechanism is a client using when they blame the nurse for their problems?
✔✔ Projection
What is a priority intervention for a client showing signs of escalating aggression?
✔✔ Use a calm voice and maintain a safe distance
What is the purpose of using open-ended questions during a mental health assessment?
✔✔ To encourage the client to express thoughts freely
What is the most therapeutic response when a client says, “I feel worthless”?
✔✔ “Tell me more about what you’re feeling right now.”
What is the first thing a nurse should assess in a client who reports recent suicidal thoughts?
✔✔ Whether the client has a plan
What is the nurse’s role when a client is admitted involuntarily to a mental health facility?
✔✔ Ensure the client’s rights are protected
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,What is the priority nursing action when a client experiences a panic attack?
✔✔ Stay with the client and speak in a calm voice
What is the most appropriate setting for a client needing daily mental health support but who can
sleep at home?
✔✔ Partial hospitalization program
What is the purpose of using silence as a communication technique in mental health?
✔✔ To give the client time to process and express feelings
What is an appropriate short-term goal for a client with depression?
✔✔ The client will get out of bed and attend one group session
What is the best action for a nurse to take if a client begins pacing and clenching fists?
✔✔ Assess for potential violence and take safety precautions
What is the expected effect of therapeutic communication?
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, ✔✔ It helps the client feel heard and understood
What is the best way to respond to a client experiencing a delusion?
✔✔ Focus on the client’s feelings rather than agreeing with the delusion
What is the nurse’s legal obligation if a client threatens to harm another person?
✔✔ Report the threat and ensure protection for the intended person
What intervention supports a client with OCD who washes hands repeatedly?
✔✔ Identify triggers and encourage alternative coping strategies
What is the nurse’s priority when caring for a client after a suicide attempt?
✔✔ Ensure a safe environment and continuous monitoring
What is the most effective way to encourage a withdrawn client to participate in activities?
✔✔ Invite the client without pressure and provide encouragement
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