Galen NUR 256 Exam 1 2026
Galen NUR 256 Exam 1 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales
1. A nurse is caring for a client admitted with major depressive disorder. Which
assessment finding requires immediate intervention?
A. Decreased appetite
B. Reports difficulty sleeping
C. States, "Everyone would be better off without me."
D. Appears withdrawn during group therapy
✅ Correct Answer: C
Rationale: Expressions of hopelessness or suicidal ideation always take priority because
they indicate immediate risk for self-harm.
2. During the mental status examination, the nurse assesses thought process. Which
finding indicates circumstantial thinking?
A. Client suddenly changes topics.
B. Client eventually answers after excessive unnecessary details.
C. Client repeats the same word continuously.
D. Client invents new words.
✅ Correct Answer: B
Rationale: Circumstantial thinking includes unnecessary details but eventually reaches
the intended point.
3. Which therapeutic communication technique is most appropriate when a client says,
"Nobody understands me"?
A. "Why do you feel that way?"
B. "Everything will be okay."
, Galen NUR 256 Exam 1 2026
C. "Tell me more about that."
D. "You shouldn't think like that."
✅ Correct Answer: C
Rationale: Open-ended statements encourage further expression without judgment.
4. Which client has the highest priority for suicide precautions?
A. Newly diagnosed anxiety disorder
B. Client beginning to feel better after severe depression
C. Mild insomnia
D. Generalized anxiety disorder
✅ Correct Answer: B
Rationale: Suicide risk often increases as energy returns before mood fully improves.
5. A client with schizophrenia reports hearing voices telling him to harm himself. What
is the nurse's priority?
A. Tell the client the voices are imaginary.
B. Assess whether the client will act on the voices.
C. Leave the client alone to reduce stimulation.
D. Encourage journaling.
✅ Correct Answer: B
Rationale: The nurse must first determine command hallucination content and the
likelihood of acting on them.
6. Which symptom is considered a positive symptom of schizophrenia?
A. Flat affect
B. Social withdrawal
C. Hallucinations
D. Lack of motivation
, Galen NUR 256 Exam 1 2026
✅ Correct Answer: C
Rationale: Positive symptoms include hallucinations, delusions, and disorganized
speech.
7. Which intervention best promotes trust during the orientation phase of the nurse-
client relationship?
A. Sharing personal experiences
B. Clearly explaining confidentiality and expectations
C. Giving advice
D. Avoiding discussion of feelings
✅ Correct Answer: B
Rationale: Establishing boundaries and explaining the therapeutic relationship builds
trust.
8. A client experiencing a panic attack should first receive which intervention?
A. Encourage deep discussion of stressors.
B. Stay with the client and speak calmly.
C. Teach meditation.
D. Ask family members to intervene.
✅ Correct Answer: B
Rationale: During panic, reducing anxiety through calm presence and reassurance is
the priority.
9. Which behavior is characteristic of mania?
A. Slow speech
B. Flight of ideas
C. Flat affect
D. Memory loss
✅ Correct Answer: B
, Galen NUR 256 Exam 1 2026
Rationale: Flight of ideas is a hallmark symptom of mania.
10. Which medication requires monitoring for lithium toxicity?
A. Sertraline
B. Haloperidol
C. Lithium carbonate
D. Lorazepam
✅ Correct Answer: C
Rationale: Signs include tremor, vomiting, diarrhea, confusion, and ataxia.
11. Which lithium level is therapeutic?
A. 0.2 mEq/L
B. 0.6–1.2 mEq/L
C. 2.5 mEq/L
D. 3.0 mEq/L
✅ Correct Answer: B
Rationale: The therapeutic range is generally 0.6–1.2 mEq/L.
12. Which statement by a client taking MAOIs requires immediate teaching?
A. "I'll avoid aged cheese."
B. "I'll check with my provider before taking cold medicine."
C. "I enjoy pepperoni pizza every weekend."
D. "I'll report severe headaches."
✅ Correct Answer: C
Rationale: Tyramine-containing foods can precipitate a hypertensive crisis.
13. Which behavior demonstrates effective coping?
Galen NUR 256 Exam 1 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales
1. A nurse is caring for a client admitted with major depressive disorder. Which
assessment finding requires immediate intervention?
A. Decreased appetite
B. Reports difficulty sleeping
C. States, "Everyone would be better off without me."
D. Appears withdrawn during group therapy
✅ Correct Answer: C
Rationale: Expressions of hopelessness or suicidal ideation always take priority because
they indicate immediate risk for self-harm.
2. During the mental status examination, the nurse assesses thought process. Which
finding indicates circumstantial thinking?
A. Client suddenly changes topics.
B. Client eventually answers after excessive unnecessary details.
C. Client repeats the same word continuously.
D. Client invents new words.
✅ Correct Answer: B
Rationale: Circumstantial thinking includes unnecessary details but eventually reaches
the intended point.
3. Which therapeutic communication technique is most appropriate when a client says,
"Nobody understands me"?
A. "Why do you feel that way?"
B. "Everything will be okay."
, Galen NUR 256 Exam 1 2026
C. "Tell me more about that."
D. "You shouldn't think like that."
✅ Correct Answer: C
Rationale: Open-ended statements encourage further expression without judgment.
4. Which client has the highest priority for suicide precautions?
A. Newly diagnosed anxiety disorder
B. Client beginning to feel better after severe depression
C. Mild insomnia
D. Generalized anxiety disorder
✅ Correct Answer: B
Rationale: Suicide risk often increases as energy returns before mood fully improves.
5. A client with schizophrenia reports hearing voices telling him to harm himself. What
is the nurse's priority?
A. Tell the client the voices are imaginary.
B. Assess whether the client will act on the voices.
C. Leave the client alone to reduce stimulation.
D. Encourage journaling.
✅ Correct Answer: B
Rationale: The nurse must first determine command hallucination content and the
likelihood of acting on them.
6. Which symptom is considered a positive symptom of schizophrenia?
A. Flat affect
B. Social withdrawal
C. Hallucinations
D. Lack of motivation
, Galen NUR 256 Exam 1 2026
✅ Correct Answer: C
Rationale: Positive symptoms include hallucinations, delusions, and disorganized
speech.
7. Which intervention best promotes trust during the orientation phase of the nurse-
client relationship?
A. Sharing personal experiences
B. Clearly explaining confidentiality and expectations
C. Giving advice
D. Avoiding discussion of feelings
✅ Correct Answer: B
Rationale: Establishing boundaries and explaining the therapeutic relationship builds
trust.
8. A client experiencing a panic attack should first receive which intervention?
A. Encourage deep discussion of stressors.
B. Stay with the client and speak calmly.
C. Teach meditation.
D. Ask family members to intervene.
✅ Correct Answer: B
Rationale: During panic, reducing anxiety through calm presence and reassurance is
the priority.
9. Which behavior is characteristic of mania?
A. Slow speech
B. Flight of ideas
C. Flat affect
D. Memory loss
✅ Correct Answer: B
, Galen NUR 256 Exam 1 2026
Rationale: Flight of ideas is a hallmark symptom of mania.
10. Which medication requires monitoring for lithium toxicity?
A. Sertraline
B. Haloperidol
C. Lithium carbonate
D. Lorazepam
✅ Correct Answer: C
Rationale: Signs include tremor, vomiting, diarrhea, confusion, and ataxia.
11. Which lithium level is therapeutic?
A. 0.2 mEq/L
B. 0.6–1.2 mEq/L
C. 2.5 mEq/L
D. 3.0 mEq/L
✅ Correct Answer: B
Rationale: The therapeutic range is generally 0.6–1.2 mEq/L.
12. Which statement by a client taking MAOIs requires immediate teaching?
A. "I'll avoid aged cheese."
B. "I'll check with my provider before taking cold medicine."
C. "I enjoy pepperoni pizza every weekend."
D. "I'll report severe headaches."
✅ Correct Answer: C
Rationale: Tyramine-containing foods can precipitate a hypertensive crisis.
13. Which behavior demonstrates effective coping?
