NUR 2459: Mental and Behavioral Health Nursing
Exam 1
Rasmussen University | 2026-2027 Curriculum
75 Questions | Comprehensive Rationales | A+ Graded Content
Exam Sections Questions Cognitive Levels
NUR 2459 Exam 1 6 Sections 75 Total 25% Recall, 55% Application, 20% Analysis
Page 1
, NUR 2459 Mental and Behavioral Health Nursing Exam 1 | Rasmussen University | 2026-2027
Section 1: Foundations of Mental Health Nursing (Q1-Q20)
Therapeutic Communication, Nurse-Client Relationship, Ethics, and Legal Issues
Q1. A nurse is caring for a client diagnosed with major depressive disorder. The client states, "Nobody cares
about me. I am completely alone." Which response by the nurse demonstrates the therapeutic communication
technique of reflecting?
A. "You are feeling very lonely and uncared for right now." [CORRECT]
B. "I understand how you feel. Everything will get better soon."
C. "Can you tell me more about what makes you feel alone?"
D. "Why do you think nobody cares about you?"
Correct Answer: A
Reflecting mirrors the feelings expressed by the client to promote understanding and validation. Option A restates the client's
emotional experience of loneliness and perceived abandonment. Option B uses false reassurance ("everything will get
better"), which is non-therapeutic because it minimizes the client's distress. Option C uses clarification, not reflection. Option
D uses a "why" question, which can be perceived as accusatory and is considered non-therapeutic in Peplau's interpersonal
model.
Q2. A nursing student is preparing for an initial interaction with a client admitted for suicidal ideation.
According to Peplau's Interpersonal Theory, which phase of the nurse-client relationship involves the nurse
reviewing the client's chart and examining personal biases before the first meeting?
A. Orientation phase
B. Working phase
C. Termination phase
D. Pre-orientation phase [CORRECT]
Correct Answer: D
The pre-orientation phase occurs before the nurse and client first meet. During this phase, the nurse engages in
self-awareness, reviews the client's medical record, and examines personal feelings and potential biases that could affect the
therapeutic relationship. The orientation phase (Option A) involves establishing rapport, setting boundaries, and defining
goals during initial meetings. The working phase (Option B) is when active problem-solving occurs. The termination phase
(Option C) involves summarizing progress and planning for discharge.
Q3. A client on an involuntary psychiatric hold tells the nurse, "I want to leave right now. You have no right to
keep me here." Which response by the nurse is most appropriate?
A. "I understand you are frustrated, but you were admitted under a physician's order because of
concerns for your safety. Let me explain your rights." [CORRECT]
B. "You cannot leave because you are a danger to yourself. You need to stay here until the doctor says
otherwise."
C. "If you calm down and cooperate with treatment, the doctor may consider releasing you sooner."
D. "I will call your family to come pick you up so you can go home."
Page 2
, NUR 2459 Mental and Behavioral Health Nursing Exam 1 | Rasmussen University | 2026-2027
Correct Answer: A
Clients on involuntary admission cannot leave AMA (Against Medical Advice), but they retain specific legal rights that must
be protected and communicated. Option A acknowledges the client's frustration (therapeutic) while providing factual
information about the legal basis for admission and offering to explain rights, which is ethically required. Option B is
confrontational and dismissive. Option C uses giving advice and implies a conditional release that may not be accurate.
Option D is inappropriate because discharge from involuntary hold requires physician authorization, not family consent.
Q4. A nurse is documenting the use of restraints on a client who is exhibiting aggressive behavior. Which of the
following is a required component of restraint documentation according to Rasmussen University NUR 2459
standards and federal regulations?
A. Continuous observation every 30 minutes with vital signs
B. Documentation of a physician's order, client condition, type of restraint, and reassessment every 15
minutes [CORRECT]
C. Documentation of restraint application every hour with a focus on client comfort
D. A single note at the end of the shift summarizing restraint use
Correct Answer: B
Restraint documentation requires a physician's order, description of the client's behavior and condition, type of restraint
applied, and reassessment documentation at a minimum of every 15 minutes. The 15-minute documentation interval is a
federal requirement (CMS/TJC standards). Option A is incorrect because observation must be continuous, not every 30
minutes. Option C is incorrect because the standard reassessment interval is 15 minutes, not hourly. Option D is incorrect
because documentation must be ongoing and time-specific, not a single summary note.
Q5. A client diagnosed with schizophrenia tells the nurse, "The CIA is monitoring my thoughts through the
electrical outlets in my room." Which nursing response is most therapeutic?
A. "That is not true. The CIA does not monitor people through electrical outlets."
B. "I do not share that belief, but I understand you are frightened. Let's talk about what is making you
feel unsafe right now." [CORRECT]
C. "Why would the CIA be interested in your thoughts?"
D. "I will check your room for any surveillance devices so you can feel better."
Correct Answer: B
When a client expresses a delusion, the nurse should neither agree with nor argue against the false belief. Option B
acknowledges the client's emotional experience (fear) without reinforcing the delusional content, which is the standard
therapeutic approach for working with psychotic patients in the Rasmussen NUR 2459 curriculum. Option A argues with the
delusion, which can escalate agitation and damage the therapeutic relationship. Option C uses a "why" question, which is
non-therapeutic and may be perceived as challenging. Option D reinforces the delusion by offering to check for surveillance
devices.
Q6. During a therapeutic interaction, a client suddenly becomes tearful and says, "I just cannot do this anymore."
The nurse remains silent and maintains eye contact. Which therapeutic communication technique is the nurse
using?
A. Clarifying
B. Paraphrasing
C. Silence [CORRECT]
Page 3
Exam 1
Rasmussen University | 2026-2027 Curriculum
75 Questions | Comprehensive Rationales | A+ Graded Content
Exam Sections Questions Cognitive Levels
NUR 2459 Exam 1 6 Sections 75 Total 25% Recall, 55% Application, 20% Analysis
Page 1
, NUR 2459 Mental and Behavioral Health Nursing Exam 1 | Rasmussen University | 2026-2027
Section 1: Foundations of Mental Health Nursing (Q1-Q20)
Therapeutic Communication, Nurse-Client Relationship, Ethics, and Legal Issues
Q1. A nurse is caring for a client diagnosed with major depressive disorder. The client states, "Nobody cares
about me. I am completely alone." Which response by the nurse demonstrates the therapeutic communication
technique of reflecting?
A. "You are feeling very lonely and uncared for right now." [CORRECT]
B. "I understand how you feel. Everything will get better soon."
C. "Can you tell me more about what makes you feel alone?"
D. "Why do you think nobody cares about you?"
Correct Answer: A
Reflecting mirrors the feelings expressed by the client to promote understanding and validation. Option A restates the client's
emotional experience of loneliness and perceived abandonment. Option B uses false reassurance ("everything will get
better"), which is non-therapeutic because it minimizes the client's distress. Option C uses clarification, not reflection. Option
D uses a "why" question, which can be perceived as accusatory and is considered non-therapeutic in Peplau's interpersonal
model.
Q2. A nursing student is preparing for an initial interaction with a client admitted for suicidal ideation.
According to Peplau's Interpersonal Theory, which phase of the nurse-client relationship involves the nurse
reviewing the client's chart and examining personal biases before the first meeting?
A. Orientation phase
B. Working phase
C. Termination phase
D. Pre-orientation phase [CORRECT]
Correct Answer: D
The pre-orientation phase occurs before the nurse and client first meet. During this phase, the nurse engages in
self-awareness, reviews the client's medical record, and examines personal feelings and potential biases that could affect the
therapeutic relationship. The orientation phase (Option A) involves establishing rapport, setting boundaries, and defining
goals during initial meetings. The working phase (Option B) is when active problem-solving occurs. The termination phase
(Option C) involves summarizing progress and planning for discharge.
Q3. A client on an involuntary psychiatric hold tells the nurse, "I want to leave right now. You have no right to
keep me here." Which response by the nurse is most appropriate?
A. "I understand you are frustrated, but you were admitted under a physician's order because of
concerns for your safety. Let me explain your rights." [CORRECT]
B. "You cannot leave because you are a danger to yourself. You need to stay here until the doctor says
otherwise."
C. "If you calm down and cooperate with treatment, the doctor may consider releasing you sooner."
D. "I will call your family to come pick you up so you can go home."
Page 2
, NUR 2459 Mental and Behavioral Health Nursing Exam 1 | Rasmussen University | 2026-2027
Correct Answer: A
Clients on involuntary admission cannot leave AMA (Against Medical Advice), but they retain specific legal rights that must
be protected and communicated. Option A acknowledges the client's frustration (therapeutic) while providing factual
information about the legal basis for admission and offering to explain rights, which is ethically required. Option B is
confrontational and dismissive. Option C uses giving advice and implies a conditional release that may not be accurate.
Option D is inappropriate because discharge from involuntary hold requires physician authorization, not family consent.
Q4. A nurse is documenting the use of restraints on a client who is exhibiting aggressive behavior. Which of the
following is a required component of restraint documentation according to Rasmussen University NUR 2459
standards and federal regulations?
A. Continuous observation every 30 minutes with vital signs
B. Documentation of a physician's order, client condition, type of restraint, and reassessment every 15
minutes [CORRECT]
C. Documentation of restraint application every hour with a focus on client comfort
D. A single note at the end of the shift summarizing restraint use
Correct Answer: B
Restraint documentation requires a physician's order, description of the client's behavior and condition, type of restraint
applied, and reassessment documentation at a minimum of every 15 minutes. The 15-minute documentation interval is a
federal requirement (CMS/TJC standards). Option A is incorrect because observation must be continuous, not every 30
minutes. Option C is incorrect because the standard reassessment interval is 15 minutes, not hourly. Option D is incorrect
because documentation must be ongoing and time-specific, not a single summary note.
Q5. A client diagnosed with schizophrenia tells the nurse, "The CIA is monitoring my thoughts through the
electrical outlets in my room." Which nursing response is most therapeutic?
A. "That is not true. The CIA does not monitor people through electrical outlets."
B. "I do not share that belief, but I understand you are frightened. Let's talk about what is making you
feel unsafe right now." [CORRECT]
C. "Why would the CIA be interested in your thoughts?"
D. "I will check your room for any surveillance devices so you can feel better."
Correct Answer: B
When a client expresses a delusion, the nurse should neither agree with nor argue against the false belief. Option B
acknowledges the client's emotional experience (fear) without reinforcing the delusional content, which is the standard
therapeutic approach for working with psychotic patients in the Rasmussen NUR 2459 curriculum. Option A argues with the
delusion, which can escalate agitation and damage the therapeutic relationship. Option C uses a "why" question, which is
non-therapeutic and may be perceived as challenging. Option D reinforces the delusion by offering to check for surveillance
devices.
Q6. During a therapeutic interaction, a client suddenly becomes tearful and says, "I just cannot do this anymore."
The nurse remains silent and maintains eye contact. Which therapeutic communication technique is the nurse
using?
A. Clarifying
B. Paraphrasing
C. Silence [CORRECT]
Page 3
