NUR2459 FINAL EXAM 2026
Mental & Behavioral Health Nursing – Therapeutic
Communication, Psychopharmacology, and
Disorder Management Questions with Answers
and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
the NUR2459 Final Exam at Rasmussen University. Topics include therapeutic communication,
nurse-patient relationship phases, psychopharmacology, mood disorders, schizophrenia,
anxiety disorders, personality disorders, and crisis intervention.
1. A 32-year-old patient with depression states, "I just feel like nothing will ever
get better." Which therapeutic communication response by the nurse is most
appropriate?
A. "Don't worry, things will improve soon if you just stay positive."
B. "You should talk to your doctor about changing your medication."
C. "You feel hopeless right now. Tell me more about what you're experiencing."
D. "Why do you think you feel this way?"
Correct Answer: C — "You feel hopeless right now. Tell me more about what
you're experiencing."
Rationale: Reflection validates the patient's feelings and encourages further
exploration, which is a core therapeutic communication technique. False
,reassurance (A) minimizes feelings, giving advice (B) is non-therapeutic, and
asking "why" (D) can be perceived as judgmental and puts the patient on the
defensive .
2. During the working phase of the nurse-patient relationship, a patient with
borderline personality disorder becomes angry and states, "You're just like my
mother—always judging me!" The nurse recognizes this as:
A. Countertransference
B. Transference
C. Projection
D. Splitting
Correct Answer: B — Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings
about a significant person onto the nurse; this differs from countertransference
(the nurse's emotional reaction to the patient), projection (attributing one's own
feelings to another), and splitting (viewing others as all good or all bad) .
3. A nurse is caring for a patient experiencing acute anxiety. The patient is pacing
and speaking rapidly. Which nursing intervention is most therapeutic?
,A. "Calm down and sit in this chair right now."
B. Remain with the patient, speak slowly, and use short, simple sentences
C. Leave the room to give the patient space to process emotions independently.
D. "You have nothing to be anxious about. Everything is fine here."
Correct Answer: B — Remain with the patient, speak slowly, and use short, simple
sentences
Rationale: Remaining present and using calm, simple communication provides
security and helps reduce anxiety without being dismissive or confrontational.
Leaving the room (C) increases anxiety, while commands (A) and false
reassurance (D) are non-therapeutic techniques that invalidate the patient's
experience .
4. A patient with schizophrenia states, "The voices are telling me to hurt myself."
Which therapeutic response demonstrates the principle of focusing?
A. "What do the voices sound like? Are they male or female?"
B. "Let's talk about your medication schedule instead."
C. "You are hearing voices that are frightening you. Are you having thoughts of
harming yourself?"
D. "I don't hear any voices. You must be imagining things."
, Correct Answer: C — "You are hearing voices that are frightening you. Are you
having thoughts of harming yourself?"
Rationale: Focusing directs the conversation toward the most critical issue—
suicidal ideation—while validating the patient's distress. Avoiding the topic (B) or
arguing about hallucinations (D) is non-therapeutic, and exploring voice
characteristics (A) does not address immediate safety concerns .
5. During the termination phase of the nurse-patient relationship, a patient with
major depressive disorder becomes withdrawn and misses the last two scheduled
appointments. The nurse recognizes this behavior as most likely representing:
A. Denial
B. Regression
C. Intellectualization
D. Sublimation
Correct Answer: B — Regression
Rationale: Regression is a defense mechanism in which an individual reverts to
earlier, less mature behaviors to cope with stress; missing appointments during
termination reflects avoidance of the emotional distress associated with ending
the therapeutic relationship .
Mental & Behavioral Health Nursing – Therapeutic
Communication, Psychopharmacology, and
Disorder Management Questions with Answers
and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
the NUR2459 Final Exam at Rasmussen University. Topics include therapeutic communication,
nurse-patient relationship phases, psychopharmacology, mood disorders, schizophrenia,
anxiety disorders, personality disorders, and crisis intervention.
1. A 32-year-old patient with depression states, "I just feel like nothing will ever
get better." Which therapeutic communication response by the nurse is most
appropriate?
A. "Don't worry, things will improve soon if you just stay positive."
B. "You should talk to your doctor about changing your medication."
C. "You feel hopeless right now. Tell me more about what you're experiencing."
D. "Why do you think you feel this way?"
Correct Answer: C — "You feel hopeless right now. Tell me more about what
you're experiencing."
Rationale: Reflection validates the patient's feelings and encourages further
exploration, which is a core therapeutic communication technique. False
,reassurance (A) minimizes feelings, giving advice (B) is non-therapeutic, and
asking "why" (D) can be perceived as judgmental and puts the patient on the
defensive .
2. During the working phase of the nurse-patient relationship, a patient with
borderline personality disorder becomes angry and states, "You're just like my
mother—always judging me!" The nurse recognizes this as:
A. Countertransference
B. Transference
C. Projection
D. Splitting
Correct Answer: B — Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings
about a significant person onto the nurse; this differs from countertransference
(the nurse's emotional reaction to the patient), projection (attributing one's own
feelings to another), and splitting (viewing others as all good or all bad) .
3. A nurse is caring for a patient experiencing acute anxiety. The patient is pacing
and speaking rapidly. Which nursing intervention is most therapeutic?
,A. "Calm down and sit in this chair right now."
B. Remain with the patient, speak slowly, and use short, simple sentences
C. Leave the room to give the patient space to process emotions independently.
D. "You have nothing to be anxious about. Everything is fine here."
Correct Answer: B — Remain with the patient, speak slowly, and use short, simple
sentences
Rationale: Remaining present and using calm, simple communication provides
security and helps reduce anxiety without being dismissive or confrontational.
Leaving the room (C) increases anxiety, while commands (A) and false
reassurance (D) are non-therapeutic techniques that invalidate the patient's
experience .
4. A patient with schizophrenia states, "The voices are telling me to hurt myself."
Which therapeutic response demonstrates the principle of focusing?
A. "What do the voices sound like? Are they male or female?"
B. "Let's talk about your medication schedule instead."
C. "You are hearing voices that are frightening you. Are you having thoughts of
harming yourself?"
D. "I don't hear any voices. You must be imagining things."
, Correct Answer: C — "You are hearing voices that are frightening you. Are you
having thoughts of harming yourself?"
Rationale: Focusing directs the conversation toward the most critical issue—
suicidal ideation—while validating the patient's distress. Avoiding the topic (B) or
arguing about hallucinations (D) is non-therapeutic, and exploring voice
characteristics (A) does not address immediate safety concerns .
5. During the termination phase of the nurse-patient relationship, a patient with
major depressive disorder becomes withdrawn and misses the last two scheduled
appointments. The nurse recognizes this behavior as most likely representing:
A. Denial
B. Regression
C. Intellectualization
D. Sublimation
Correct Answer: B — Regression
Rationale: Regression is a defense mechanism in which an individual reverts to
earlier, less mature behaviors to cope with stress; missing appointments during
termination reflects avoidance of the emotional distress associated with ending
the therapeutic relationship .
