* NLE * NCLEX * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH
COACHING WITH THE ICONS
MENTAL HEALTH AND PSYCHIATRIC NURSING
Prepared by: Dr. Lucila Espinosa
PHILIPPINE NURSE LICENSURE EXAMINATION
NAME:
INSTRUCTION: Choose the BEST answer, write only
the letter.
1. Therapeutic Communication:
A. Involves intimacy and spontaneity between
clients and nurses.
B. Resembles the give and take of social
communication.
C. Is structured with a plan and a purpose.
D. Is dominated by the nurse.
2. One goal of therapeutic communication is to:
A. Assist clients with learning communication skills.
B. Allow the nurse to express feelings.
C. Become the client’s friend.
D. Develop consistent communication techniques.
3. Encouraging a description of perception is reflected in
which of the following statements?
A. What do you mean by “feeling alienated?”
B. “I know what you mean.”
C. “It sounds as if you have been depressed.”
D. d. “What can you say about what is happening
in your marriage?”
4. Listening is an aspect of therapeutic communication
that:
A. Encouraging patients to guide the interview.
B. Allows the nurse to interpret and validate data.
C. Is easy for most people to do.
D. Reflect what clients say.
5. Which of the following reflects a common interference
in nurse client communication?
A. Discussing fear about client with a colleague.
B. Validating client information with the family.
C. Admitting and apologizing to a patient for a
mistake.
D. Avoiding issues that are uncomfortable for
clients.
6. On the adult psychiatric unit, you see the client
smoking and smoking is not allowed in the unit. What do
you do?
A. Confront the behavior.
B. Tell the charge nurse.
C. Ignore the behavior.
D. Remind all patient of the nonsmoking policy.
7. Kaye says to the nurse, “I do not know anything
about those pills, I can’t take them.” The nurse answers,
“I can tell you about the medicine.” The dialogue
indicated the therapeutic technique of:
A. Giving a correct information.
B. Confronting
C. Restating
D. Clarification
8. The nurse sees the client restless; the nurse shares
her observation to the client. The client says, “I am very
nervous talking to my husband today.” The nurse says,
“Tell me exactly what you will tell your husband today?”
This therapeutic communication technique:
A. General Leads C. Rehearsing
B. Clarification D. Advising
SCORE:
9. Dennis says to his nurse, “I am feeling sick inside.”
The nurse responses, “What do you mean by feeling sick
inside?” Label the technique used in this dialogue:
A. Clarification C. Reflecting
B. Open-ended D. Restating
10. What technique did the nurse uses in this dialogue.
Client: “I do not know what to say. I can’t talk
anymore.”
Nurse: “I’ll just sit with you for few minutes.”
A. Empathy C. Offering self
B. Focusing D. Broad opening
11. A 35-year-old man has been hospitalized for two
days for treatment of hepatitis A. When the nurse enters
the client’s room, he asks the nurse to leave him alone
and stop bothering him. Which of the following
responses by the nurse would be MOST appropriate?
A. “I understand, and I will leave you alone for
now.”
B. “Why are you angry with me?”
C. “Are you upset because you do not feel better?”
D. “You seem upset this morning.”
12. A 58-year-old woman states she is afraid to have her
cast remove from her fractured arm. Which of the
following is the most appropriate response by the nurse?
A. “I know it is unpleasant. Try not to be afraid. I
will help you.”
B. “You seem very anxious. I will stay with you
while the cast is removed.”
C. “I don’t blame you. I’d be afraid also.”
D. “My aunt just had a cast removed and she’s just
fine.”
13. A 28-year-old woman comes to the clinic because
she thinks she is pregnant. She tells the nurse she wants
the pregnancy terminated because she and her husband
do not want to have children, and then begins to cry.
Which of the following statements by the nurse is the
MOST appropriate?
A. “Are you upset because you forgot to use birth
control?”
B. “Why are you so upset? You’re married. There is
no reason not to have the baby.”
C. “If you’re so upset, why don’t you have the baby
and put it up for adoption?”
D. “You seem upset. Let’s talk about how you’re
feeling.”
14. A 68-year-old man is in the terminal stage of
carcinoma of the lungs. A family member asks the nurse,
“How much longer will it be?” Which of the following
responses by the nurse would be MOST appropriate?
A. “I cannot say exactly. What are your concerns at
this time?”
B. “I don’t know. I’ll call the doctor.”
C. “This must be a terrible situation for you.”
D. “Don’t worry, it will be very soon.”
15. A 51-year-old man is admitted to the hospital with a
diagnosis of bipolar disorder. The man approaches the
nurse and says, “Hi, baby” and opens his robe, under
which he is naked. Which of the following comments by
the nurse would be MOST appropriate?
A. “This is inappropriate behavior. Please close
your robe and return to your room.”
B. “Please wear your clothes and join us for lunch
in the dining room.”
C. “I am offended by your behavior and will have
to report you.”
D. “Do you need some assistance while dressing
today?”
16. An 82-year-old woman is placed in Buck’s traction.
The nurse assigned to her prepares to assist her with a
bath. The woman says, “You’re too young to know how
to do this. Get me somebody who knows what they’re
doing.” Which of the following responses by the student
nurse would be MOST appropriate?
A. “I am young, but I graduated from nursing
school.”
B. “If I don’t bathe you now, you’ll have to wait
until I’m finished with my other clients.”
C. “Can you be more specific about your
concerns?”
D. “Your concerns are unnecessary. I know what
I’m doing.”
17. A 72-year-old woman is admitted to the hospital
with an abdominal mass and is scheduled for an
exploratory laparotomy. She asks the nurse admitting
her, “Do you think I have cancer?” Which of the
following responses by the nurse would be MOST
appropriate?
A. “Would you like me to call your doctor so that
you can discuss your specific concerns?”
B. “Your test showed a mass. It must be hard not
knowing what is wrong.”
C. “It sounds like you are afraid that you are going
to die from cancer.”
D. “Don’t worry about it now. I’m sure you have
many healthy years ahead of you.”
18. A 23-year-old woman is admitted to the post-partum
unit following a miscarriage. The next day the nurse
finds the woman crying while looking at the babies in
the newborn nursery. What would be MOST
appropriate?
A. Assure the woman that the loss was “for the
best.”
B. Explain to her that she is young enough to have
more children.
C. Ask her why she is looking at the babies.
D. Acknowledge the loss and be supportive.
19. An 84-year-old man is hospitalized with Alzheimer’s
Disease. His daughter tells the nurse that caring for him
is too hard, and that she feels guilty placing him in a
nursing home. Which of the following statements by the
nurse is MOST appropriate?
A. “It’s hard to be caught between taking care of
your needs and your father’s needs.
B. “Would you like me to help you find a nursing
home?”
C. “Don’t feel guilty. The only solution is to place
your father in a nursing home.”
D. “I think I would feel guilty too if I had placed my
father in a nursing home.”
Direction: Place N if you find the communication non-
therapeutic and T if you find it therapeutic.
___________ 20. When did this happen?
___________ 21. Was this something like?
___________ 22. Tell me about it.
___________ 23. That is bad.
___________ 24. But how can you be the President of
the U.S.?
___________ 25. I don’t want to hear about it.
___________ 26. But Dr. B is a very able psychiatrist.
___________ 27. I’ll sit with you for a while.
___________ 28. Where would you like to begin?
___________ 29. Patient: “Do you think I should tell
the doctor?”
Nurse: “Do you think you should?”
___________ 30. What makes you think the FBI is
here?
___________ 31. Let’s not talk about that now. Just
focus on getting well.
___________ 32. Is there something you’d like to talk
about?
___________ 33. Tell me when you feel anxious.
___________ 34. I think you should…….
___________ 35. Everything will be alright.
___________ 36. Have you had similar experiences?
___________ 37. Go on………….
___________ 38. This hospital has a fine reputation.
___________ 39. Who told you that you were Jesus?
___________ 40. “Go on, I’m listening. I hear what
you are saying.”
___________ 41. “What do you mean by feeling sick
inside?” Give me an example of
feeling lost.
___________ 42. “You seem restless. I noticed you
had trouble deciding about.”
___________ 43. “I know the voices are real to you, but
I didn’t hear them. I don’t see it the same way.”
_________ 44. “What is different about your feeling
today compared to the last time?”
_________ 45. Client: “I was so afraid I was going
to have another panic attack.”
Nurse: “What does your husband
think about panic attacks?”
_________ 46. “I don’t see any reason for you to
think that way.”
_________ 47. “What would you like to work
today?”
_________ 48. “I notice you are wearing a red dress.”
_________ 49. “Don’t be silly just think of getting
well.”
_________ 50. “No, I think that is a silly response
to your mother.”
_________ 51. “I can imagine how that might feel.”
_________ 52. “I’m puzzled, you are smiling, but you
sound so resentful.”
_________ 53. “Is that a valid reason to become
angry?”
_________ 54. “Why did you react that way?”
_________ 55. “Which came first?”
_________ 56. “This is what I heard you say… Is that
correct?”
_________ 57. “Tell me what secrets you keep from
your wife.”
_________ 58. “I think you should divorce your wife.”
_________ 59. “When did you first notice that?”
_________ 60. “I’ll sit with you until it is time for your
family session.”
_________ 61. “Don’t worry anymore.”
_________ 62. “That was four years ago, that should
not bother you anymore.”
_________ 63. “What can you say about what
happened.”
_________ 64. “What is the best thing that happened
to you this week?”
_________ 65. “You should not feel that all men are
bad.”
_________ 66. “I’m here to listen. I can’t help you if
you won’t tell everything to me.”
_________ 67. “How can you handle your anger in a
non-threatening way?”
_________ 68. “Could we continue talking about you
and your husband right now?”
_________ 69. “Perhaps, together we can figure it
out.”
_________ 62. “That was four years ago, that should
not bother you anymore.”
_________ 63. “What can you say about what
happened.”
_________ 64. “What is the best thing that happened
to you this week?”
_________ 65. “You should not feel that all men are
bad.”
_________ 66. “I’m here to listen. I can’t help you if
you won’t tell everything to me.”
_________ 67. “How can you handle your anger in a
non-threatening way?”
_________ 68. “Could we continue talking about you
and your husband right now?”
_________ 69. “Perhaps, together we can figure it
out.”
THERAPEUTIC RELATIONSHIPS
70. The client says to the nurse, “I feel really close to
you. You are the only true friend I have.” The most
therapeutic response the nurse can make is:
A. “I am sure there are other people in your life
who are your friends; besides, we have just
met.”
B. “It makes me feel good that you trust me so
much; it is important we are doing our work
together.”
C. “Since ours is a professional relationship, let’s
explore other opportunities in your life for
friendship.”
D. “We are not friends. This is strictly professional.”
71. A client in a substance abuse treatment program
asks the nurse for a date after the client is discharged.
The nurse talks to the client about the importance of a
therapeutic relationship and its characteristics. The
nurse is using which of the following techniques?
A. Defining boundaries
B. Defining therapy
C. Letting the client down gently
D. Reprimanding the client
72. The nurse is explaining the therapeutic nurse-client
relationship to a new client. The focus of this
relationship is on the client’s:
A. Need as he or she perceives them.
B. Need as the nurse perceives them.
C. Problems as identified by the admitting
diagnosis.
D. Problems as identified by the psychiatrist.
73. One of the primary differences between social and
therapeutic relationships is the:
A. Amount of emotion invested.
B. Degree of satisfaction obtained.
C. Kind of information given.
D. Type of responsibility involved.
74. Suppression of information, intellectualizing, and
superficial conversation are examples of:
A. Counter-resistance C. Resistance
B. Countertransference D. Transference
75. A nurse is assigned to care for a client whose sexual
orientation differs from her own. She would need to
seek clinical supervision if she attempted to:
A. Assist the client to change values.
B. Discuss her feelings about the client with a
supervisor.
C. Empathize with the client.
D. Identify anxieties regarding the client’s values
and sexuality.
76. The nurse initiating a therapeutic relationship with a
client should explain the purpose which is to:
A. Alleviate stressors in life.
B. Become stabilized on medications.
C. Establish relationships.
D. Facilitate a positive change.
77. Which of the following is the essential component
the nurse must bring to the therapeutic nurse-client
relationship?
A. Confrontation C. Trust
B. Empathy D. Reframing
78. To promote the client’s self-awareness, the nurse
must possess:
A. Self-awareness C. Understanding
B. Sympathy D. Values
79. In what phase of the therapeutic nurse-client
relationship is transference most likely to occur?
A. Pre-orientation C. Working
B. Orientation D. Termination
80. The client tells the nurse, “I don’t think you can help
me. Every time I talk to you, I am reminded of my
mother, and I hated her.” The nurse should recognize
this as:
A. Confrontations C. Incongruence
B. Countertransference D. Transference
81. Which of the following statements is true about a
nurse’s self-disclosure?
A. It is the basis for effective communication.
B. Self-disclosure should be used with all clients to
some degree.
C. The more the nurse discloses, the more the
client will disclose.
D. Self-disclosure on the nurse’s part should benefit
the client.
82. The primary goal of a therapeutic nurse-client
relationship is:
A. Developing the nurse’s professional identity.
B. Establishing an intimate, purposeful interaction.
C. Establishing therapeutic boundaries.
D. Promoting the client’s growth.
83. During a regular home health visit to an elderly
client, the nurse observes that the client has feelings of
hopelessness and despair. The client says, “I’m old, and
my life has no purpose anymore. But promise me you
won’t tell anyone.” How should the nurse respond?
A. “Don’t worry, I won’t tell anyone else.”
B. “I’m sorry but I can’t keep that kind of secret.”
C. “Let’s talk about something to cheer you up.”
D. “What can we do to help you feel better?
 THERAPEUTIC USE OF SELF AND THERAPEUTIC
NURSE-PATIENT RELATIONSHIP
84. During the working phase of a therapeutic
relationship, which of the following actions by the nurse
would best help the client to explore problems?
A. Comparing past and present coping strategies.
B. Encouraging the client to clarify feelings and
behavior.
C. Identifying possible solutions for the client’s
problems.
D. Referring the client to a self-help group
85. Which of the following situations best illustrates the
positive process of introspection and self-analysis on the
part of the nurse?
A. Mary has elected not to work with battered
women clients, since she continues to live
with her violent husband.
B. Tom has elected to work on chemical
dependency even though he severely abuses
alcohol on weekends.
C. Talia wants to start a co-dependency group for
partners of alcoholics despite her denial of her
husband’s alcoholism.
D. John had elected to lead a grieving group since
he has been unable to get over his wife’s suicide
a year ago
86. The nurse can use self-disclosure with a patient if:
A. She has experienced the same situation as the
patient.
B. The patient asks her directly about his
experience.
C. It helps the patient to talk more easily.
D. It achieves a specific therapeutic goal.
87. The nurse who uses self-disclosure should:
A. Refocus on the patient’s experience as quickly
as possible.
B. Allow the patient to ask questions about her
experience.
C. Discuss her experience in detail.
D. Have the patient explain his perception of what
the nurse has revealed.
88. Mentally healthy individuals can be defined as those
who:
A. Have insight into their problems.
B. Do not exhibit pathologic symptoms.
C. Can meet their own basic needs.
D. Are free from both physical and emotional
problems.
89. Which of the following is a generally accepted
criterion of mental health?
A. Self-acceptance
B. Absence of anxiety
C. Ability to control others.
D. Happiness
SITUATION: The nurse has been caring for G, a 58-
year-old chronic paranoid schizophrenic patient for
several months. She has held several one-to-one
sessions with him. During this session, he appears more
anxious than usual.
90. At the beginning of the session, G speaks quite
rapidly and loudly. This behavior indicates a possible
change in which form of non-verbal communication
A. Appearance
B. Kinesics
C. Paralanguage
D. Proxemics
91. Besides his loud rapid speech, G swings his feet and
rapidly taps his fingers on the arm of the chair. Yet he
says, “I certainly feel calm today, I don’t know life could
be so tranquil.” Which response by the nurse is most
appropriate?
A. “I’m glad to hear you are feeling calm and
settled this morning.”
B. “You tell me that you are calm, but your body
seems to be sending a different message.”
C. “I think we should talk about how calm the
weather is today.”
D. “I’m glad you are feeling so calm. Things will be
better for you now-you can count on that.”
92. G’s anxiety level takes a toll on the nurse, and she
feels her body tensing. The nurse momentarily questions
the therapeutic quality of her listening skills. Which
behavior on the nurse’s part indicates her decreased
attention to G’s problem?
A. Moving her chair, so she directly faces G.
B. Leaning forward toward G.
C. Maintaining eye contact.
D. Crossing her arms and legs.
93. During a special meeting to discuss the unexpected
suicide of one of the female clients while on a weekend
pass, the nurse overhears another client moan softly,
“I’m next. Oh my God, I’m next. They couldn’t prevent
her, and they can’t protect me.” It would be most
therapeutic for the nurse to respond by saying:
A. “You are afraid you will hurt yourself?”
B. “The other client was a lot sicker than you are.”
C. “It’s different, the other client was home, you
are here.”
D. “There is no need to worry. All passes will be
canceled for a while.”
94. The basis for therapeutic nurse-patient relationship
begins with the nurse’s:
A. Sincere desire to help others.
B. Acceptance of others.
C. Self-awareness and understanding
D. Sound knowledge of psychiatric nursing
95. The nurse should introduce information about the
end of nurse-patient relationship:
A. During the orientation phase.
B. As the goals of the relationship is reached.
C. At least one or two sessions before the last
meeting.
D. When the patient can tolerate it.
96. The nurse must possess the capacity to initiate and
sustain a therapeutic relationship. An essential part of
the therapeutic process is:
A. Understanding goals
B. Free association
C. Development of insight
D. Therapeutic use of self
97. For most nurses, the most difficult part of the nurse-
patient relationship is:
A. Always remaining therapeutic and professional.
B. Being able to understand and accept the client’s
behavior.
C. Developing an awareness of self and the
professional role in the relationship.
D. Accepting responsibility for identifying and
evaluating the real needs of the client.
98. The essential foundation that must be established
early in the therapeutic relationship is:
A. Confidence C. Trust
B. Insight D. Change
99. Which of the following should occur during the
working phase of the nurse-patient relationship?
A. The nurse assesses the patient’s needs and
develops a plan of care.
B. The nurse and the patient together evaluate and
modify the goals of the relationship.
C. The nurse and the patient discuss their feelings
regarding the termination of the relationship.
D. The nurse and the patient explore each other’s
expectations of the relationship.
100. The final stage of nurse-patient relationship is the
termination phase where the:
A. Problems are identified
B. Problems are resolved
C. Problems are examined
D. Contract is specific