Question 1

Which of the following qualities is NOT a quality of a nurse?

Accepted Answer

Answer reason: Caring, honesty, and maintaining a balanced life are positive professional qualities. Being talkative can hinder therapeutic communication and active listening, so it is not a desired nursing quality.

Question 2

A 14-year-old client is scheduled for a below-knee (BK) amputation following a motorcycle accident. The nurse knows preoperative teaching for this client should include?

Accepted Answer

Answer reason: Therapeutic communication is a key preoperative intervention for adolescents facing body image–altering surgery. Promising early prosthesis use is unrealistic, minors cannot provide informed consent, and schoolwork planning is not a preoperative teaching priority.

Question 3

The nurse is planning care for a client with a diagnosis of paranoid schizophrenia. The nurse knows that questioning the client about his false ideas will?

Accepted Answer

Answer reason: Challenging or questioning a client’s delusions typically increases defensiveness and strengthens the delusional belief; the nurse should instead focus on feelings and present reality without arguing.

Question 4

An eighty five year old man was admitted for surgery for benign prostatic hypertrophy. Preoperatively he was alert, oriented, cooperative, and knowledgeable about his surgery. Several hours after surgery, the evening nurse found him acutely confused, agitated, and trying to climb over the protective side rails on his bed. The most appropriate nursing intervention that will calm an agitated client is?

Accepted Answer

Answer reason: Postoperative acute confusion in an elderly client is best managed by reducing stimuli and using calm, reassuring communication. Speaking soothingly and providing quiet music promotes orientation and decreases agitation. A bright, busy area and multiple phone calls increase stimulation; limiting staff visits reduces supervision and may worsen disorientation.

Question 5

The nurse working with clients from many different cultures recognizes that it is a PRIORITY to?

Accepted Answer

Answer reason: Self-awareness of one’s own attitudes and biases is the priority for providing culturally competent, therapeutic care. Speaking another language, learning all cultures, or referring to experts may help but are not foundational priorities.

Question 6

After talking with her spouse, a client voluntarily admitted herself to the substance abuse unit. After the second day on the unit the client states to the nurse "My husband told me to get treatment or he would divorce me. I don't believe I really need treatment but I don't want my husband to leave me." Which of the following responses by the nurse would assist the client?

Accepted Answer

Answer reason: Option D acknowledges ambivalence common in early recovery and redirects to explore personal benefits of sobriety, a therapeutic and motivational interviewing approach. A is judgmental, B focuses on external pressure, and C prematurely suggests a different treatment setting.

Question 7

The nurse is assessing a client on admission to a community mental health center. The client discloses that she has been thinking about ending her life. The nurse's BEST response would be?

Accepted Answer

Answer reason: Assessing suicide risk requires determining plan, means, and intent. Asking if the client has thought about how she would do it directly explores lethality and intent. Other options are nontherapeutic or dismissive.

Question 8

The nurse is taking a health history on a 14 year-old client. The BEST way to accomplish this is to?

Accepted Answer

Answer reason: Adolescents communicate best when given privacy and a chance to express feelings; having a parent present may inhibit openness, and matching slang or focusing on peer risks does not address the core need for therapeutic communication.

Question 9

The mother of a 15 month-old child asks the nurse to explain her child's lab results and how they show her child has iron deficiency anemia. The nurse's BEST response is?

Accepted Answer

Answer reason: Iron deficiency anemia results in decreased RBC and hemoglobin; a clear, simple explanation is that the child has fewer oxygen-carrying red blood cells. A defers responsibility, C is inaccurate, and D is vague/non-specific.

Question 10

A client is experiencing hallucinations that are markedly increased at night. The client is very frightened by the hallucinations. The client's spouse asked to stay a few hours beyond the visiting time, in the client's private room. What would be the BEST response by the nurse demonstrating emotional support for the client?

Accepted Answer

Answer reason: Allowing the spouse to stay provides reassurance and orientation, which reduces anxiety and confusion associated with hallucinations. The other options either deny helpful support or are less appropriate for the request.

Question 11

A postpartum Hispanic client refuses the hospital food because it is "cold." The BEST initial action by the nurse is to?

Accepted Answer

Answer reason: Respect cultural beliefs about hot–cold foods and use therapeutic communication first by asking the client which foods are acceptable. Reheating, insisting on eating, or immediate referral can follow after clarifying preferences.

Question 12

The emergency room nurse admits a child who experienced a seizure at school. The father comments that this is the first occurrence, and denies any family history of epilepsy. What is the BEST response by the nurse?

Accepted Answer

Answer reason: A single seizure does not diagnose epilepsy; many causes are possible. The nurse should avoid false reassurance and provide balanced, accurate information.

Question 13

A nurse and client are talking about the client's progress toward understanding his behavior under stress. This is typical of which phase in the therapeutic relationship?

Accepted Answer

Answer reason: Discussion of the client’s progress in understanding behaviors and stress indicates the working phase, where insight is developed and behaviors are explored.

Question 14

A nurse has just received a medication order which is not legible. Which statement BEST reflects assertive communication?

Accepted Answer

Answer reason: Assertive communication is clear, direct, and respectful, requesting needed information without blame. Option B asks for clarification to ensure safe medication administration.

Question 15

A six year-old child diagnosed with acute glomerulonephritis (AGN) is experiencing anorexia, moderate edema and elevated blood urea nitrogen (BUN) levels. He requests a peanut butter sandwich for lunch. What would be the nurse's BEST response to this request?

Accepted Answer

Answer reason: Children with AGN often require dietary restrictions (e.g., limiting sodium, fluids, and protein). The best response acknowledges the child’s preference and therapeutically guides selection of an appropriate alternative rather than permitting the restricted food or responding punitively.

Question 16

A mother calls the clinic, concerned that her 5 week-old infant is "sleeping more than her brother did." The nurse's best INITIAL response would be?

Accepted Answer

Answer reason: Initial responses should use therapeutic, open-ended questions to explore the caller’s concern. Option C invites elaboration; the others are closed-ended or less relevant.

Question 17

A nurse in a pediatric unit is preparing to insert an IV catheter for 7-year-old. Which of the following actions should the nurse take?

Accepted Answer

Answer reason: For a school-age child, provide honest, developmentally appropriate information about procedures to reduce anxiety and build trust. Restraints are last resort and parents need not be forced to leave.

Question 18

A nurse is caring for a client who is at 14 weeks gestation and reports feelings of ambivalence about being pregnant. Which of the following responses should the nurse make?

Accepted Answer

Answer reason: Open-ended, therapeutic prompt that encourages the client to explore and express feelings; alternatives are closed or deflect responsibility.

Question 19

A client with schizophrenia reports hearing voices. Which action should the nurse take first?

Accepted Answer

Answer reason: First assess the hallucinations to determine their content and potential for harm (e.g., command hallucinations). Assessment guides safety and subsequent interventions; ignoring, immediate medication, or distraction may follow but are not first steps.

Question 20

When the nurse becomes aware of feeling reluctant to interact with a manipulative client, the BEST action by the nurse is to?

Accepted Answer

Answer reason: Self-awareness and supervision help the nurse manage countertransference and maintain a therapeutic, objective relationship. Limiting contact, confronting the client, or independently creating a behavior plan are less appropriate initial actions.

Question 21

A nurse is working with family members of a newly diagnosed client with Alzheimer's disease. Which of the following interventions is MOST helpful?

Accepted Answer

Answer reason: For families of clients with Alzheimer's, learning effective communication techniques (simple cues, validation, avoiding confrontation) most directly improves care and interactions; exercise, nutrition, and relaxation are helpful but less specific to caregiver-client communication needs.

Question 22

The mother of a two year-old hospitalized child asks the nurse's advice about the child's screaming every time the mother gets ready to leave the hospital room. The BEST response of the nurse would be to?

Accepted Answer

Answer reason: A toddler’s crying when the parent leaves is the protest phase of separation anxiety and is expected with hospitalization. The best nursing response is to educate and reassure the mother that this is normal, rather than advising constant presence, promising it will quickly stop, or sneaking out.

Question 23

Therapeutic nurse-client interaction occurs when the nurse?

Accepted Answer

Answer reason: Clarification is a core therapeutic communication technique that helps clients express and understand their messages. Interpreting covert messages, giving advice, or offering approval are non-therapeutic and can block communication.

Question 24

Which nursing intervention will be MOST effective in helping a withdrawn client to develop relationship skills?

Accepted Answer

Answer reason: Withdrawn clients are uncomfortable with social interaction; structured 1:1 nurse-client contact provides a safe corrective relationship to practice and build relationship skills. The other options rely on peer interaction or analysis before trust and comfort are established.

Question 25

A female client is admitted for a breast biopsy. She says, tearfully to the nurse, "If this turns out to be cancer and I have to have my breast removed, my husband will never come near me." The nurse's BEST response would be?

Accepted Answer

Answer reason: Option D is an open-ended, therapeutic response that explores the client's feelings about potential body-image changes without making assumptions. A offers false reassurance, and B and C narrowly focus on specific issues (husband/sexual relations) that may not reflect the client’s primary concern.

Question 26

While interviewing a client, the nurse notices that the client is shifting positions, wringing her hands, and avoiding eye contact. It is important for the nurse to?

Accepted Answer

Answer reason: Restlessness, hand-wringing, and avoiding eye contact indicate anxiety. The priority is to assess and acknowledge feelings using therapeutic communication; asking what she is feeling identifies and explores the anxiety. Other options either assume another problem or avoid addressing the anxiety.

Question 27

The client's self-esteem is MOST damaged by the nurse's?

Accepted Answer

Answer reason: Indifference communicates lack of caring or value for the client, undermining the therapeutic relationship and most damaging self-esteem compared with emotions that at least convey engagement.

Question 28

A client states, "People think I'm no good, you know what I mean?" Which of the following nursing responses would be MOST therapeutic for this client?

Accepted Answer

Answer reason: Option C uses clarification and encourages exploration in a nonjudgmental manner, which is therapeutic. A interprets, B offers false reassurance/approval, and D is probing and potentially accusatory.

Question 29

Handshaking is the preferred form of touch or contact used with clients in a psychiatric setting. The rationale behind this limited touch practice is that?

Accepted Answer

Answer reason: In psychiatric settings, touch can be misinterpreted; hugs or more intimate contact may be seen as sexual advances. A handshake sets safer boundaries.

Question 30

A 64 year-old client scheduled for surgery with a general anesthetic refuses to remove her dentures prior to leaving the unit for the operating room. The MOST appropriate intervention by the nurse is?

Accepted Answer

Answer reason: Offering the client a choice about when to remove dentures supports control and reduces preoperative anxiety while still ensuring safety; the other options are either authoritarian, irrelevant to the immediate concern, or escalate unnecessarily.

Question 31

An American nurse tries to speak with a Korean client who cannot understand the English language. To effectively communicate to a client with a different language, which of the following should the nurse implement?

Accepted Answer

Answer reason: The most effective and safe method to overcome a language barrier is to use a qualified medical interpreter, ensuring accurate information exchange and informed consent. Speaking slowly or loudly does not resolve a language mismatch and may be perceived as disrespectful. Using family members can introduce errors, bias, and breaches of confidentiality. Therefore, arranging a trained interpreter is the best practice.

Question 32

A client is experiencing anxiety attack. The most appropriate nursing intervention should include?

Accepted Answer

Answer reason: During an acute anxiety or panic attack, the priority is to provide a calm, reassuring presence and simple, clear communication. Staying with the client reduces feelings of isolation and fear while short, direct sentences are easier to process when concentration is impaired. Leaving the client alone can worsen anxiety and safety risk, and distractions like TV or social play are ineffective until anxiety subsides. Therefore, the best intervention is to remain with the client and speak briefly and calmly.

Question 33

A nurse is caring for a patient with hearing loss who has forgotten his hearing aids at home. Which method of communication would the nurse most likely use to communicate with this patient?

Accepted Answer

Answer reason: For a patient with hearing impairment who is without hearing aids, written communication is clear and reliable. Shouting into the ear can distort sound and is uncomfortable, while standing very close for lip reading is not necessary and may impede understanding; speaking at a normal distance with good lighting is preferred. Miming is imprecise and prone to misinterpretation. Therefore, writing down key information is the best option.

Question 34

A patient has admitted to the nurse that he thinks he has a problem with drinking too much alcohol. The nurse talks with the patient about substance abuse and the negative effects of alcoholism. Which describes how personal engagement with a patient is effective as a method of change?

Accepted Answer

Answer reason: Personal engagement through therapeutic communication fosters rapport, empathy, and trust, which increases a patient’s intrinsic motivation to change maladaptive behaviors such as alcohol misuse. Motivational interviewing principles emphasize connection and collaboration to enhance readiness for change. Options about electronic presentation, litigation risk, or making a new friend do not reflect the clinical goal of enhancing motivation for health behavior change.

Question 35

Communication helps to fulfill?

Accepted Answer

Answer reason: According to Maslow’s hierarchy, communication primarily meets love and belonging needs by enabling connection, support, and interaction with others. While good communication can contribute to esteem, its core function is social relatedness. Physiological needs (e.g., oxygen, food) and safety needs are met through other interventions rather than communication itself.

Question 36

Providing emotional support meets?

Accepted Answer

Answer reason: Emotional support primarily addresses Maslow's love and belonging needs by fostering connection, acceptance, and a sense of being cared for. It helps reduce isolation and supports coping through empathy, presence, and active listening. Esteem needs relate more to confidence and respect, while safety needs focus on protection from harm and physiological needs are basic survival requirements.

Question 37

A way of communicating our feelings, thoughts and beliefs in an open honest manner without violating the rights of others is known as .........?

Accepted Answer

Answer reason: Assertive behavior is expressing one’s feelings, needs, and beliefs clearly and honestly while respecting the rights and boundaries of others. It balances passive communication (not expressing needs) and aggressive communication (violating others’ rights). This definition aligns directly with assertiveness as a core therapeutic communication skill. The other options describe communication modalities or a contradictory term, not the specific respectful communication style described.

Question 38

For a patient with severe hearing disability, the nurse should?

Accepted Answer

Answer reason: Facing the patient supports lip-reading and allows the patient to use visual cues such as facial expression and articulation. Speaking clearly and distinctly at a normal pace improves comprehension more than increasing volume. Shouting and exaggerated mouth movements distort speech sounds and can be perceived as disrespectful, reducing effective communication. The nurse should communicate directly with the patient whenever possible to maintain autonomy and accurate assessment.

Question 39

Patient education is an integral part of the nursing process. What are the positive aspects of providing the patient with information?

Accepted Answer

Answer reason: Patient education supports a collaborative nurse–patient partnership by promoting trust, shared decision-making, and patient participation in care, which strengthens the therapeutic relationship. This aligns with an interdependent relationship where the patient becomes more engaged and empowered. The other options are not consistent, primary benefits of education: concentration is not a standard outcome, decreased depression may occur but is not a direct/guaranteed effect, and sharing personal details is not an intended goal of teaching.

Question 40

You are discharging a 4-year-old patient from the emergency department. The patient was seen for an insect bite that became swollen and reddened and warm and painful to touch. The patient's are all within normal range. While giving discharge instructions to the patient's father, you are asked why the child is not going to get antibiotics for the infected insect bite. What would be your best response?

Accepted Answer

Answer reason: Option A is the best therapeutic response because it clearly explains the clinical rationale: the described findings (localized redness, warmth, swelling, tenderness with normal vital signs) are consistent with an inflammatory reaction to an insect bite rather than a bacterial infection requiring antibiotics. It also addresses the parent’s concern directly and provides accurate education about why antibiotics would not be beneficial. The other options are dismissive or less complete, and D lacks the key point that antibiotics would not help.

Question 41

Which response would the nurse make to a client who says, "I feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual?

Accepted Answer

Answer reason: Option B uses therapeutic communication by reflecting the client’s expressed feelings and concern about judgment, which encourages further exploration without validating the distorted belief or criticizing the behavior. In clients with compulsive rituals (e.g., OCD), nonjudgmental reflection helps build rapport and supports assessment of anxiety and guilt. Option A is judgmental (“bizarre”) and can increase shame. Options C and D offer false reassurance and minimizing/lecturing, which can shut down communication.

Question 42

A confused and disoriented client is begging to go home. The nurse aide's BEST response to this client is?

Accepted Answer

Answer reason: For a confused, disoriented client, the best response uses therapeutic communication and validation by engaging the client in reminiscence and allowing expression of feelings. Asking the client to talk about their home redirects attention in a calm, non-confrontational way and can reduce anxiety without escalating agitation. Telling the client “This is your home” may be perceived as arguing and can increase distress, while promising “later” is false reassurance. Simply taking the client to the activity room may redirect but does not address the client’s emotional need or provide supportive communication.

Question 43

What should the nurse consider as the most appropriate initial response to Sarah's concerns regarding her irregular menstrual cycles?

Accepted Answer

Answer reason: The most appropriate initial response uses therapeutic communication and an assessment-first approach, inviting the client to share relevant history before offering interventions. Weight changes, stress, and changes in exercise are common, nonpathologic contributors to menstrual irregularities and should be explored early. Option A is dismissive and can minimize the client’s concern; option C prematurely recommends treatment without assessment; option D is alarmist and jumps to diagnostic action without first collecting data.

Question 44

During admission to the psychiatric unit, a female client is extremely anxious and states that she is worried about the son coming up the next day. What intervention is most important for the RN to implement during the admission process?

Accepted Answer

Answer reason: During psychiatric admission, the priority is to reduce acute anxiety using therapeutic, nonpharmacologic nursing interventions and to support adaptive coping. Helping the client identify and practice alternative coping skills addresses the underlying anxiety and promotes long-term self-management. Asking “why” can feel judgmental and may escalate anxiety, and administering a sedative is not the first-line nursing intervention during admission unless anxiety is severe and other measures fail or safety is at risk. Remaining calm is appropriate, but it is less direct and comprehensive than actively assisting with coping strategies.

Question 45

Which of the following is an example of nonverbal communication?

Accepted Answer

Answer reason: Nonverbal communication is conveyed without words through facial expressions, gestures, posture, and eye contact. Smiling is a facial expression that communicates warmth and acceptance without using spoken or written language. Writing in a chart and giving an oral report are verbal/written communication, and speaking with an encouraging tone is paraverbal (a vocal quality accompanying words), not purely nonverbal.

Question 46

How should the OTR respond to the client's concerns about splinting?

Accepted Answer

Answer reason: The best response addresses the client’s concerns while promoting function and adherence by using collaborative problem-solving to adapt activities, which supports engagement in meaningful occupations despite splinting. This approach aligns with client-centered care and helps reduce frustration while maintaining therapeutic goals. Simply reassuring (A) may validate feelings but does not provide a functional plan. Options B and D are overly restrictive and may unnecessarily limit use, potentially reducing independence and carryover of skills.

Question 47

SCENARIO: A 15-year-old adolescent inpatient has renal disease. The patient has been socially isolated as a consequence of the multiple medical procedures. One of the patient's goals is to “be with other kids”. During an OT session, the patient begins to work on a simple task, but suddenly moves to a corner of the clinic to be alone, stating “The other kids can always do things better.” Which intervention strategy could be MOST BENEFICIAL for meeting the patient’s emotional and social needs during task completion?

Accepted Answer

Answer reason: The patient’s statement reflects low self-esteem and social comparison anxiety; a small, supportive group of peers with similar skill level promotes belonging while minimizing perceived failure. This approach directly targets the goal of being with other kids and supports social participation in a graded, non-threatening way. A competitive activity could intensify feelings of inadequacy, and working alone reinforces isolation. One-to-one step assistance may improve performance but does not adequately address the primary social and emotional need during task completion.

Question 48

Which of the following is appropriate care for a resident who is agitated and talking loudly?

Accepted Answer

Answer reason: An agitated resident talking loudly should be approached first with de-escalation and therapeutic communication. Speaking in a calm, comforting manner can reduce anxiety, help the resident regain self-control, and prevents escalation that could lead to unsafe behavior. Telling the resident to be quiet is confrontational and may worsen agitation, while changing the assignment avoids care responsibilities. Reporting to the nurse may be appropriate if safety risks persist, but the initial nursing assistant response is calming communication.

Question 49

A client with schizophrenia is pacing and muttering. What is the nurse's best initial action?

Accepted Answer

Answer reason: Pacing and muttering may indicate increasing anxiety, agitation, or response to internal stimuli, so the safest initial nursing action is a calm, supportive approach that promotes engagement and de-escalation. Offering to walk with the client uses therapeutic communication and provides a nonthreatening way to reduce tension while the nurse assesses for escalating risk. Calling security is not the best initial step unless there is imminent danger. Asking the client to sit quietly or ignoring the behavior can increase distress and does not address underlying agitation.

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