NUR 245 Exam 1 Prep 2026 | 200 Practice Questions with Answers &
Rationales | Nursing Study Guide
Section 1: Foundations of Psychiatric Nursing (Questions 1–25)
1. The most important element in the nurse‑patient relationship is:
A) The nurse’s clinical knowledge
B) Trust
C) The physical environment
D) Medication administration
Answer: B
Rationale: Trust is the foundation of the therapeutic relationship; without trust, other interventions are
ineffective.
2. True or False: The therapeutic relationship is a social friendship that develops over time.
Answer: False
Rationale: The therapeutic relationship is professional, goal‑oriented, and bound by ethical guidelines; it
is not a social friendship.
3. Which phase of the therapeutic relationship involves establishing rapport and setting goals?
A) Orientation (introductory) phase
B) Working phase
C) Termination phase
D) Pre‑interaction phase
Answer: A
Rationale: The orientation phase includes building trust, establishing boundaries, and identifying
problems.
,4. True or False: Self‑awareness is not essential for psychiatric nurses.
Answer: False
Rationale: Self‑awareness helps nurses recognize their own biases and emotional responses, preventing
countertransference.
5. The concept of “transference” in the therapeutic relationship refers to:
A) The nurse’s emotional reaction to the patient
B) The patient’s unconscious redirection of feelings from past relationships onto the nurse
C) The nurse’s ability to transfer knowledge
D) The patient’s transfer to another unit
Answer: B
Rationale: Transference is the patient’s projection of past feelings onto the nurse. Countertransference
is the nurse’s reaction.
6. True or False: Countertransference occurs when the nurse unconsciously responds to the patient as if
the patient were someone from the nurse’s past.
Answer: True
Rationale: Countertransference can interfere with objectivity and must be managed through
self‑awareness and supervision.
7. Which of the following is a therapeutic communication technique?
A) Giving advice
B) Asking “why” questions
C) Reflecting
D) Changing the subject
Answer: C
Rationale: Reflection encourages the patient to explore their own feelings. “Why” questions can feel
accusatory; advice giving may undermine autonomy.
,8. True or False: Silence is always a non‑therapeutic communication technique.
Answer: False
Rationale: Therapeutic silence allows the patient time to reflect and express feelings without pressure.
9. A patient says, “I’m nothing. I can’t do anything right.” Which response by the nurse is most
therapeutic?
A) “Don’t say that; you are a good person.”
B) “You sound very down on yourself. Tell me more about what’s been happening.”
C) “You should look at the positive side.”
D) “That’s not true.”
Answer: B
Rationale: This response uses reflecting and encouraging expression. False reassurance and arguing are
not therapeutic.
10. True or False: Boundaries in the therapeutic relationship are flexible and may include accepting gifts
or self‑disclosure without limits.
Answer: False
Rationale: Clear professional boundaries protect both the patient and the nurse. Gifts are generally not
accepted except small tokens with supervisor approval.
11. Which of the following is a barrier to therapeutic communication?
A) Active listening
B) Clarification
C) Giving advice prematurely
D) Summarizing
Answer: C
Rationale: Premature advice blocks the patient’s exploration of feelings and solutions.
, 12. True or False: The nurse should use “closed‑ended” questions to encourage the patient to express
feelings.
Answer: False
Rationale: Open‑ended questions encourage expression; closed‑ended questions elicit specific
information but can limit discussion.
13. The termination phase of the therapeutic relationship focuses on:
A) Identifying problems
B) Exploring transference
C) Reviewing progress and discussing feelings about ending the relationship
D) Starting new interventions
Answer: C
Rationale: Termination helps the patient consolidate gains and cope with the ending of the relationship.
14. True or False: The psychiatric nurse should avoid any self‑disclosure to the patient.
Answer: False
Rationale: Limited, purposeful self‑disclosure (e.g., “I also feel nervous before a presentation”) can be
therapeutic, but it must be used sparingly and for the patient’s benefit.
15. A patient tells the nurse, “You are the only one who understands me. I love you.” The nurse’s best
response is:
A) “I love you too.”
B) “You are confused; you don’t really love me.”
C) “Our relationship is professional. Let’s talk about what you are feeling.”
D) “I’ll transfer you to another nurse.”
Answer: C
Rationales | Nursing Study Guide
Section 1: Foundations of Psychiatric Nursing (Questions 1–25)
1. The most important element in the nurse‑patient relationship is:
A) The nurse’s clinical knowledge
B) Trust
C) The physical environment
D) Medication administration
Answer: B
Rationale: Trust is the foundation of the therapeutic relationship; without trust, other interventions are
ineffective.
2. True or False: The therapeutic relationship is a social friendship that develops over time.
Answer: False
Rationale: The therapeutic relationship is professional, goal‑oriented, and bound by ethical guidelines; it
is not a social friendship.
3. Which phase of the therapeutic relationship involves establishing rapport and setting goals?
A) Orientation (introductory) phase
B) Working phase
C) Termination phase
D) Pre‑interaction phase
Answer: A
Rationale: The orientation phase includes building trust, establishing boundaries, and identifying
problems.
,4. True or False: Self‑awareness is not essential for psychiatric nurses.
Answer: False
Rationale: Self‑awareness helps nurses recognize their own biases and emotional responses, preventing
countertransference.
5. The concept of “transference” in the therapeutic relationship refers to:
A) The nurse’s emotional reaction to the patient
B) The patient’s unconscious redirection of feelings from past relationships onto the nurse
C) The nurse’s ability to transfer knowledge
D) The patient’s transfer to another unit
Answer: B
Rationale: Transference is the patient’s projection of past feelings onto the nurse. Countertransference
is the nurse’s reaction.
6. True or False: Countertransference occurs when the nurse unconsciously responds to the patient as if
the patient were someone from the nurse’s past.
Answer: True
Rationale: Countertransference can interfere with objectivity and must be managed through
self‑awareness and supervision.
7. Which of the following is a therapeutic communication technique?
A) Giving advice
B) Asking “why” questions
C) Reflecting
D) Changing the subject
Answer: C
Rationale: Reflection encourages the patient to explore their own feelings. “Why” questions can feel
accusatory; advice giving may undermine autonomy.
,8. True or False: Silence is always a non‑therapeutic communication technique.
Answer: False
Rationale: Therapeutic silence allows the patient time to reflect and express feelings without pressure.
9. A patient says, “I’m nothing. I can’t do anything right.” Which response by the nurse is most
therapeutic?
A) “Don’t say that; you are a good person.”
B) “You sound very down on yourself. Tell me more about what’s been happening.”
C) “You should look at the positive side.”
D) “That’s not true.”
Answer: B
Rationale: This response uses reflecting and encouraging expression. False reassurance and arguing are
not therapeutic.
10. True or False: Boundaries in the therapeutic relationship are flexible and may include accepting gifts
or self‑disclosure without limits.
Answer: False
Rationale: Clear professional boundaries protect both the patient and the nurse. Gifts are generally not
accepted except small tokens with supervisor approval.
11. Which of the following is a barrier to therapeutic communication?
A) Active listening
B) Clarification
C) Giving advice prematurely
D) Summarizing
Answer: C
Rationale: Premature advice blocks the patient’s exploration of feelings and solutions.
, 12. True or False: The nurse should use “closed‑ended” questions to encourage the patient to express
feelings.
Answer: False
Rationale: Open‑ended questions encourage expression; closed‑ended questions elicit specific
information but can limit discussion.
13. The termination phase of the therapeutic relationship focuses on:
A) Identifying problems
B) Exploring transference
C) Reviewing progress and discussing feelings about ending the relationship
D) Starting new interventions
Answer: C
Rationale: Termination helps the patient consolidate gains and cope with the ending of the relationship.
14. True or False: The psychiatric nurse should avoid any self‑disclosure to the patient.
Answer: False
Rationale: Limited, purposeful self‑disclosure (e.g., “I also feel nervous before a presentation”) can be
therapeutic, but it must be used sparingly and for the patient’s benefit.
15. A patient tells the nurse, “You are the only one who understands me. I love you.” The nurse’s best
response is:
A) “I love you too.”
B) “You are confused; you don’t really love me.”
C) “Our relationship is professional. Let’s talk about what you are feeling.”
D) “I’ll transfer you to another nurse.”
Answer: C
