,NUR253/NUR 253 Exam 1 | Mental Health Nursing
1. A newly admitted client tells the nurse, "I don't know why I'm here. I'm not crazy." Which response
by the nurse best demonstrates therapeutic communication?
A) "You are here because the provider determined you need treatment."
B) "Why do you think you were brought to the hospital?"
C) "You seem upset about being here. Tell me more about your thoughts."
D) "I understand you feel that way, but you are in a safe place now."
Correct Answer: You seem upset about being here. Tell me more about your thoughts.
Rationale: This response validates the client's emotion while using an open-ended invitation to
explore their perspective, which builds trust and encourages expression. Option A is dismissive and
blocks further discussion. Option B uses a "why" question, which can feel accusatory and non-
therapeutic. Option D offers false reassurance and avoids addressing the client's expressed concern.
2. A client with schizophrenia tells the nurse, "The voices are telling me that the food is poisoned."
Which nursing action is the priority?
A) Reassure the client that the food is safe and not poisoned
B) Document the client's statement and continue with mealtime
C) Assess the client for risk of harm and explore the content of the hallucination
D) Administer a PRN antipsychotic medication immediately
Correct Answer: Assess the client for risk of harm and explore the content of the hallucination
Rationale: Safety is the priority; the nurse must determine if the command hallucination instructs the
client to harm self or others. Exploring the content provides essential safety data. Reassurance alone
dismisses the client's reality without assessment. Documentation is important but not the first action.
Medication may be indicated but requires assessment and a provider order.
3. The nurse is caring for a client who was involuntarily committed to a psychiatric unit. The client
demands to leave and states, "You can't keep me here against my will." Which response by the nurse
is most appropriate?
,A) "You are correct; you have the right to leave at any time."
B) "Because you were involuntarily committed, you do not have the right to refuse treatment."
C) "I understand you want to leave. Let's review the criteria for your commitment together."
D) "If you leave now, we will have to call security to bring you back."
Correct Answer: I understand you want to leave. Let's review the criteria for your commitment
together.
Rationale: This response acknowledges the client's feelings while providing factual information about
the legal basis for involuntary commitment, which promotes understanding and reduces power
struggles. Option A is incorrect as involuntary clients cannot leave freely. Option B is legally inaccurate
—involuntary clients retain many rights, including the right to refuse treatment in many
circumstances. Option D is threatening and escalates conflict.
4. A nurse is preparing to discharge a client who was hospitalized for major depressive disorder.
Which statement by the client best indicates understanding of the medication regimen?
A) "I will stop taking my antidepressant when I start feeling better."
B) "I should take my medication at the same time each day, even if I feel well."
C) "If I miss a dose, I should double the next dose to catch up."
D) "Antidepressants work immediately, so I will feel better by tomorrow."
Correct Answer: I should take my medication at the same time each day, even if I feel well.
Rationale: Consistent daily dosing maintains therapeutic blood levels and prevents relapse. Stopping
medication prematurely (A) is a leading cause of recurrence. Doubling doses (C) is dangerous and can
cause toxicity. Antidepressants typically take 2-6 weeks for full effect (D), not immediate action.
5. The nurse is assessing a client who reports persistent anxiety, difficulty sleeping, and intrusive
thoughts about a traumatic event that occurred 3 months ago. The client avoids driving near the
location where the event happened. Which diagnosis should the nurse suspect?
A) Generalized anxiety disorder
B) Acute stress disorder
, C) Post-traumatic stress disorder
D) Panic disorder
Correct Answer: Post-traumatic stress disorder
Rationale: PTSD is diagnosed when symptoms of re-experiencing, avoidance, hyperarousal, and
negative cognition persist for more than one month following a traumatic event. Acute stress disorder
(B) is diagnosed when symptoms occur within the first month. Generalized anxiety disorder (A)
involves excessive worry about everyday events. Panic disorder (D) is characterized by recurrent,
unexpected panic attacks.
6. A client with obsessive-compulsive disorder (OCD) spends 2 hours each day washing her hands until
they are raw and bleeding. The nurse recognizes this behavior as which type of symptom?
A) Compulsion
B) Obsession
C) Delusion
D) Hallucination
Correct Answer: Compulsion
Rationale: Compulsions are repetitive behaviors or mental acts that a person feels driven to perform
in response to an obsession. Hand washing is a classic compulsive behavior aimed at reducing anxiety
about contamination. Obsessions (B) are intrusive thoughts, urges, or images. Delusions (C) are fixed
false beliefs. Hallucinations (D) are perceptual disturbances.
7. The nurse is using the therapeutic communication technique of "reflection" with a client. Which
statement by the nurse best exemplifies this technique?
A) "You mentioned that you felt angry. Tell me more about that."
B) "It sounds like you are feeling frustrated with your family."
C) "Let's focus on what you can do to improve your situation."
D) "I notice you are clenching your fists as you talk about your job."
1. A newly admitted client tells the nurse, "I don't know why I'm here. I'm not crazy." Which response
by the nurse best demonstrates therapeutic communication?
A) "You are here because the provider determined you need treatment."
B) "Why do you think you were brought to the hospital?"
C) "You seem upset about being here. Tell me more about your thoughts."
D) "I understand you feel that way, but you are in a safe place now."
Correct Answer: You seem upset about being here. Tell me more about your thoughts.
Rationale: This response validates the client's emotion while using an open-ended invitation to
explore their perspective, which builds trust and encourages expression. Option A is dismissive and
blocks further discussion. Option B uses a "why" question, which can feel accusatory and non-
therapeutic. Option D offers false reassurance and avoids addressing the client's expressed concern.
2. A client with schizophrenia tells the nurse, "The voices are telling me that the food is poisoned."
Which nursing action is the priority?
A) Reassure the client that the food is safe and not poisoned
B) Document the client's statement and continue with mealtime
C) Assess the client for risk of harm and explore the content of the hallucination
D) Administer a PRN antipsychotic medication immediately
Correct Answer: Assess the client for risk of harm and explore the content of the hallucination
Rationale: Safety is the priority; the nurse must determine if the command hallucination instructs the
client to harm self or others. Exploring the content provides essential safety data. Reassurance alone
dismisses the client's reality without assessment. Documentation is important but not the first action.
Medication may be indicated but requires assessment and a provider order.
3. The nurse is caring for a client who was involuntarily committed to a psychiatric unit. The client
demands to leave and states, "You can't keep me here against my will." Which response by the nurse
is most appropriate?
,A) "You are correct; you have the right to leave at any time."
B) "Because you were involuntarily committed, you do not have the right to refuse treatment."
C) "I understand you want to leave. Let's review the criteria for your commitment together."
D) "If you leave now, we will have to call security to bring you back."
Correct Answer: I understand you want to leave. Let's review the criteria for your commitment
together.
Rationale: This response acknowledges the client's feelings while providing factual information about
the legal basis for involuntary commitment, which promotes understanding and reduces power
struggles. Option A is incorrect as involuntary clients cannot leave freely. Option B is legally inaccurate
—involuntary clients retain many rights, including the right to refuse treatment in many
circumstances. Option D is threatening and escalates conflict.
4. A nurse is preparing to discharge a client who was hospitalized for major depressive disorder.
Which statement by the client best indicates understanding of the medication regimen?
A) "I will stop taking my antidepressant when I start feeling better."
B) "I should take my medication at the same time each day, even if I feel well."
C) "If I miss a dose, I should double the next dose to catch up."
D) "Antidepressants work immediately, so I will feel better by tomorrow."
Correct Answer: I should take my medication at the same time each day, even if I feel well.
Rationale: Consistent daily dosing maintains therapeutic blood levels and prevents relapse. Stopping
medication prematurely (A) is a leading cause of recurrence. Doubling doses (C) is dangerous and can
cause toxicity. Antidepressants typically take 2-6 weeks for full effect (D), not immediate action.
5. The nurse is assessing a client who reports persistent anxiety, difficulty sleeping, and intrusive
thoughts about a traumatic event that occurred 3 months ago. The client avoids driving near the
location where the event happened. Which diagnosis should the nurse suspect?
A) Generalized anxiety disorder
B) Acute stress disorder
, C) Post-traumatic stress disorder
D) Panic disorder
Correct Answer: Post-traumatic stress disorder
Rationale: PTSD is diagnosed when symptoms of re-experiencing, avoidance, hyperarousal, and
negative cognition persist for more than one month following a traumatic event. Acute stress disorder
(B) is diagnosed when symptoms occur within the first month. Generalized anxiety disorder (A)
involves excessive worry about everyday events. Panic disorder (D) is characterized by recurrent,
unexpected panic attacks.
6. A client with obsessive-compulsive disorder (OCD) spends 2 hours each day washing her hands until
they are raw and bleeding. The nurse recognizes this behavior as which type of symptom?
A) Compulsion
B) Obsession
C) Delusion
D) Hallucination
Correct Answer: Compulsion
Rationale: Compulsions are repetitive behaviors or mental acts that a person feels driven to perform
in response to an obsession. Hand washing is a classic compulsive behavior aimed at reducing anxiety
about contamination. Obsessions (B) are intrusive thoughts, urges, or images. Delusions (C) are fixed
false beliefs. Hallucinations (D) are perceptual disturbances.
7. The nurse is using the therapeutic communication technique of "reflection" with a client. Which
statement by the nurse best exemplifies this technique?
A) "You mentioned that you felt angry. Tell me more about that."
B) "It sounds like you are feeling frustrated with your family."
C) "Let's focus on what you can do to improve your situation."
D) "I notice you are clenching your fists as you talk about your job."
