Psychiatric Nursing Comprehensive Exam
Questions And Answers | Latest 2026 Update Verified
Questions | Verified Rationales Graded A+
Section 1: Therapeutic Communication & The Nurse-Patient
Relationship (Questions 1–15)
1. A client with schizophrenia tells the nurse, “The FBI is
poisoning my food.” Which therapeutic response is most
appropriate?
A. “That’s ridiculous. Why would the FBI poison you?”
B. “I understand you believe that, but I don’t see any evidence
of that.”
C. “You must be very frightened. Tell me more about what
makes you think that.”
D. “Let’s talk about something else.”
Answer: C
Rationale: Validate the client’s feeling (fear) without validating
the delusion. Option C acknowledges the emotion and invites
discussion. Arguing (A) or dismissing (B, D) damages rapport.
,2. A nurse is sitting with a depressed client who has been
silent for 10 minutes. The nurse’s best action is to:
A. Leave the room because the client does not want to talk.
B. Say, “I’ll sit here with you for a while.”
C. Ask, “Why won’t you talk to me?”
D. Tell the client, “You’ll feel better if you talk.”
Answer: B
Rationale: Offering presence without pressure is therapeutic.
Silence can be therapeutic; the nurse should stay and provide
support without demanding conversation.
3. Which nursing statement is an example of focusing?
A. “Tell me more about your relationship with your father.”
B. “You seem angry today.”
C. “What happened after you felt that way?”
D. “I notice you are avoiding eye contact.”
Answer: A
Rationale: Focusing directs the conversation to a specific topic.
Option A asks for more detail about a specific relationship.
Option C is exploring; B is making an observation; D is
clarifying.
,4. A client says, “I’m worthless. I can’t do anything right.”
The nurse’s best response is:
A. “You are not worthless; you have many strengths.”
B. “Everyone feels that way sometimes.”
C. “It sounds like you are feeling very down on yourself. Can
you tell me about a time you felt successful?”
D. “Stop being so negative.”
Answer: C
Rationale: Acknowledge the feeling and gently challenge the
distorted thinking by asking for evidence of success (cognitive
reframing). False reassurance (A) and platitudes (B) are not
therapeutic.
5. A client with borderline personality disorder tells the
nurse, “You’re the only one who understands me. The other
nurses are cruel.” The nurse should:
A. Agree that the other nurses are less caring.
B. Ignore the comment.
C. Say, “I will talk to the other nurses for you.”
D. Say, “I hear that you are feeling close to me, but the other
nurses also care about you. Let’s talk about what happened.”
, Answer: D
Rationale: This is splitting (idealizing one staff, devaluing
others). The nurse should address the behavior directly,
maintain boundaries, and explore the client’s perception
without taking sides.
6. A client who is suicidal says, “There’s no point in going
on.” The nurse’s priority response is:
A. “Life is worth living.”
B. “Do you have a plan to hurt yourself?”
C. “Think about your family.”
D. “You have so much to live for.”
Answer: B
Rationale: The priority is to assess suicidal risk directly,
including asking about plan, intent, and means. This is not too
blunt; it is essential safety practice.
7. The nurse is caring for a client who is very quiet and
withdrawn. Which communication technique is most likely
to encourage conversation?
A. Asking closed-ended questions
B. Sitting quietly with the client and occasionally making an
observation
Questions And Answers | Latest 2026 Update Verified
Questions | Verified Rationales Graded A+
Section 1: Therapeutic Communication & The Nurse-Patient
Relationship (Questions 1–15)
1. A client with schizophrenia tells the nurse, “The FBI is
poisoning my food.” Which therapeutic response is most
appropriate?
A. “That’s ridiculous. Why would the FBI poison you?”
B. “I understand you believe that, but I don’t see any evidence
of that.”
C. “You must be very frightened. Tell me more about what
makes you think that.”
D. “Let’s talk about something else.”
Answer: C
Rationale: Validate the client’s feeling (fear) without validating
the delusion. Option C acknowledges the emotion and invites
discussion. Arguing (A) or dismissing (B, D) damages rapport.
,2. A nurse is sitting with a depressed client who has been
silent for 10 minutes. The nurse’s best action is to:
A. Leave the room because the client does not want to talk.
B. Say, “I’ll sit here with you for a while.”
C. Ask, “Why won’t you talk to me?”
D. Tell the client, “You’ll feel better if you talk.”
Answer: B
Rationale: Offering presence without pressure is therapeutic.
Silence can be therapeutic; the nurse should stay and provide
support without demanding conversation.
3. Which nursing statement is an example of focusing?
A. “Tell me more about your relationship with your father.”
B. “You seem angry today.”
C. “What happened after you felt that way?”
D. “I notice you are avoiding eye contact.”
Answer: A
Rationale: Focusing directs the conversation to a specific topic.
Option A asks for more detail about a specific relationship.
Option C is exploring; B is making an observation; D is
clarifying.
,4. A client says, “I’m worthless. I can’t do anything right.”
The nurse’s best response is:
A. “You are not worthless; you have many strengths.”
B. “Everyone feels that way sometimes.”
C. “It sounds like you are feeling very down on yourself. Can
you tell me about a time you felt successful?”
D. “Stop being so negative.”
Answer: C
Rationale: Acknowledge the feeling and gently challenge the
distorted thinking by asking for evidence of success (cognitive
reframing). False reassurance (A) and platitudes (B) are not
therapeutic.
5. A client with borderline personality disorder tells the
nurse, “You’re the only one who understands me. The other
nurses are cruel.” The nurse should:
A. Agree that the other nurses are less caring.
B. Ignore the comment.
C. Say, “I will talk to the other nurses for you.”
D. Say, “I hear that you are feeling close to me, but the other
nurses also care about you. Let’s talk about what happened.”
, Answer: D
Rationale: This is splitting (idealizing one staff, devaluing
others). The nurse should address the behavior directly,
maintain boundaries, and explore the client’s perception
without taking sides.
6. A client who is suicidal says, “There’s no point in going
on.” The nurse’s priority response is:
A. “Life is worth living.”
B. “Do you have a plan to hurt yourself?”
C. “Think about your family.”
D. “You have so much to live for.”
Answer: B
Rationale: The priority is to assess suicidal risk directly,
including asking about plan, intent, and means. This is not too
blunt; it is essential safety practice.
7. The nurse is caring for a client who is very quiet and
withdrawn. Which communication technique is most likely
to encourage conversation?
A. Asking closed-ended questions
B. Sitting quietly with the client and occasionally making an
observation
