Mental Health NCLEX-PN Practice Quiz

Reflecting names the feeling behind the client's words and keeps the focus on the client, inviting exploration. "Everything is going to be fine" is false reassurance that dismisses real feelings; a "why" question sounds accusatory; "you should" is advice that removes the client's autonomy. Key takeaway: the best therapeutic answer usually reflects or explores the client's feelings rather than reassuring, advising, or judging.

Trust is established in the orientation phase, along with the contract, boundaries, confidentiality, and initial problem identification. Exploring and resolving problems is the working phase; summarizing and addressing feelings about ending is termination; reviewing the chart and examining one's biases is pre-interaction (preparation before meeting). Key takeaway: orientation = trust + contract + boundaries + confidentiality.

This statement is a possible suicide cue, so the nurse acknowledges the feeling and then asks about suicide directly and specifically — asking does NOT plant the idea; it opens the door to help and lets the nurse assess risk. "Things will get better" is false reassurance, "you have so much to live for" gives advice and minimizes, and changing the subject ignores the cue. Key takeaway: when a client hints at hopelessness, ask directly, "Are you thinking about killing yourself?"

Torticollis appearing hours after starting an antipsychotic is acute dystonia, a sudden painful muscle spasm. Treat with IM benztropine or diphenhydramine to reverse dopamine blockade. Repositioning will not relieve it, more haloperidol worsens it, and an ECG addresses QT concerns, not EPS.

Confidentiality is the default but not absolute. Two legally required disclosure exceptions are a reportable communicable disease (applicable law requires notifying public health) and suspected abuse or neglect of a child or vulnerable adult (mandatory reporting). A curious peer, an employer, an uninformed family member, and an uninvolved coworker have no need-to-know and no legal basis — disclosing to them would breach confidentiality. The nurse discloses only the minimum necessary and follows applicable law and facility policy. Key takeaway: legally required disclosures — a reportable disease, mandated abuse reporting, and other legal bases like a credible imminent threat to an identifiable person or a court order — override confidentiality; ordinary curiosity does not.