Galen College NSG 3450 Exam 3 (pdf) | 2026/2027 | Mental Health
Q&A | Mental Health Nursing
1. Which symptom is a defining characteristic of major depressive disorder
(MDD) that must be present for at least two weeks according to DSM-5-TR
criteria?
A) Agitation and restlessness
B) Depressed mood or anhedonia
C) Grandiose delusions
D) Increased energy and goal-directed activity
Correct Answer: Depressed mood or anhedonia
Rationale: The DSM-5-TR criteria for MDD require the presence of either
depressed mood or anhedonia (loss of interest or pleasure) for at least 2
weeks, plus additional symptoms such as changes in appetite, sleep, energy,
concentration, or suicidal ideation. Grandiose delusions and increased
energy are associated with mania, not depression.
2. A patient with major depressive disorder states, "I'm worthless. Nothing
ever goes right for me." Which nursing intervention is most appropriate?
A) Tell the patient to stop thinking negatively
B) Acknowledge the patient's feelings and explore the basis of these
thoughts
C) Ignore the statement to avoid reinforcing it
D) Reassure the patient that they are not worthless
Correct Answer: Acknowledge the patient's feelings and explore the basis of
these thoughts
,Rationale: Acknowledging the patient's feelings validates their experience
and opens the door for therapeutic exploration of cognitive distortions.
Reassurance may be dismissive, and ignoring the statement is not
therapeutic. Telling the patient to stop thinking negatively is not effective.
3. The nurse is caring for a patient with schizophrenia who hears voices
telling them to harm themselves. Which intervention is most appropriate?
A) Tell the patient the voices are not real
B) Help the patient identify triggers and develop coping strategies
C) Isolate the patient to prevent self-harm
D) Immediately increase the antipsychotic dose
Correct Answer: Help the patient identify triggers and develop coping
strategies
Rationale: Teaching the patient to recognize triggers and use coping skills
(e.g., humming, listening to music) empowers the patient and reduces
distress. Denying the voices damages trust; isolation is not therapeutic;
medication changes require a prescriber's order.
4. A patient with borderline personality disorder is learning DBT skills. Which
statement indicates correct use of the DEAR MAN interpersonal effectiveness
skill?
A) "I'm upset, and I don't care what you think."
B) "You always ignore me, and I'm sick of it."
C) "I fell behind on my bill because I was in the hospital. I feel anxious. Would
you help me pay it? It would really help me get back on my feet."
D) "I know you won't help me, so I won't even ask."
,Correct Answer: "I fell behind on my bill because I was in the hospital. I feel
anxious. Would you help me pay it? It would really help me get back on my
feet."
Rationale: DEAR MAN stands for Describe, Express, Assert, Reinforce, stay
Mindful, Appear confident, Negotiate. This statement correctly describes the
situation, expresses feelings, asserts the request, and reinforces the benefit.
The other responses are aggressive, accusatory, or avoidant.
5. According to the interpersonal theory of suicide, which two factors must
be present along with the capability for suicide?
A) Thwarted belongingness and perceived burdensomeness
B) Financial stress and unemployment
C) Childhood trauma and substance abuse
D) Genetic predisposition and neurotransmitter imbalance
Correct Answer: Thwarted belongingness and perceived burdensomeness
Rationale: The interpersonal theory of suicide posits that suicide occurs when
an individual experiences both thwarted belongingness (feeling disconnected
from others) and perceived burdensomeness (feeling like a burden),
combined with the acquired capability for suicide. This theory guides suicide
risk assessment and intervention.
6. A patient with schizophrenia is prescribed clozapine. Which laboratory
value must the nurse monitor closely?
A) Serum glucose
B) Complete blood count (CBC) for agranulocytosis
C) Liver function tests
D) Serum creatinine
, Correct Answer: Complete blood count (CBC) for agranulocytosis
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular CBC
monitoring through a REMS program. Serum glucose, liver function, and
creatinine are monitored for other medications but are not the primary
concern with clozapine.
7. A patient with bipolar disorder is in a manic episode. Which symptom is
characteristic of this episode?
A) Depressed mood most of the day
B) Decreased need for sleep
C) Anhedonia
D) Psychomotor retardation
Correct Answer: Decreased need for sleep
Rationale: A manic episode is characterized by a distinct period of
abnormally elevated, expansive, or irritable mood and increased activity or
energy. Decreased need for sleep is a key symptom, along with grandiosity,
talkativeness, flight of ideas, and risky behaviors. Depressed mood and
anhedonia are characteristic of depressive episodes.
8. A nurse is assessing a patient for signs of escalating aggression. Which
finding indicates the patient may be escalating toward violence?
A) Relaxed posture and soft speech
B) Pacing, muscle tension, and intense eye contact
C) Sleeping excessively
D) Withdrawn and avoidant behavior
Q&A | Mental Health Nursing
1. Which symptom is a defining characteristic of major depressive disorder
(MDD) that must be present for at least two weeks according to DSM-5-TR
criteria?
A) Agitation and restlessness
B) Depressed mood or anhedonia
C) Grandiose delusions
D) Increased energy and goal-directed activity
Correct Answer: Depressed mood or anhedonia
Rationale: The DSM-5-TR criteria for MDD require the presence of either
depressed mood or anhedonia (loss of interest or pleasure) for at least 2
weeks, plus additional symptoms such as changes in appetite, sleep, energy,
concentration, or suicidal ideation. Grandiose delusions and increased
energy are associated with mania, not depression.
2. A patient with major depressive disorder states, "I'm worthless. Nothing
ever goes right for me." Which nursing intervention is most appropriate?
A) Tell the patient to stop thinking negatively
B) Acknowledge the patient's feelings and explore the basis of these
thoughts
C) Ignore the statement to avoid reinforcing it
D) Reassure the patient that they are not worthless
Correct Answer: Acknowledge the patient's feelings and explore the basis of
these thoughts
,Rationale: Acknowledging the patient's feelings validates their experience
and opens the door for therapeutic exploration of cognitive distortions.
Reassurance may be dismissive, and ignoring the statement is not
therapeutic. Telling the patient to stop thinking negatively is not effective.
3. The nurse is caring for a patient with schizophrenia who hears voices
telling them to harm themselves. Which intervention is most appropriate?
A) Tell the patient the voices are not real
B) Help the patient identify triggers and develop coping strategies
C) Isolate the patient to prevent self-harm
D) Immediately increase the antipsychotic dose
Correct Answer: Help the patient identify triggers and develop coping
strategies
Rationale: Teaching the patient to recognize triggers and use coping skills
(e.g., humming, listening to music) empowers the patient and reduces
distress. Denying the voices damages trust; isolation is not therapeutic;
medication changes require a prescriber's order.
4. A patient with borderline personality disorder is learning DBT skills. Which
statement indicates correct use of the DEAR MAN interpersonal effectiveness
skill?
A) "I'm upset, and I don't care what you think."
B) "You always ignore me, and I'm sick of it."
C) "I fell behind on my bill because I was in the hospital. I feel anxious. Would
you help me pay it? It would really help me get back on my feet."
D) "I know you won't help me, so I won't even ask."
,Correct Answer: "I fell behind on my bill because I was in the hospital. I feel
anxious. Would you help me pay it? It would really help me get back on my
feet."
Rationale: DEAR MAN stands for Describe, Express, Assert, Reinforce, stay
Mindful, Appear confident, Negotiate. This statement correctly describes the
situation, expresses feelings, asserts the request, and reinforces the benefit.
The other responses are aggressive, accusatory, or avoidant.
5. According to the interpersonal theory of suicide, which two factors must
be present along with the capability for suicide?
A) Thwarted belongingness and perceived burdensomeness
B) Financial stress and unemployment
C) Childhood trauma and substance abuse
D) Genetic predisposition and neurotransmitter imbalance
Correct Answer: Thwarted belongingness and perceived burdensomeness
Rationale: The interpersonal theory of suicide posits that suicide occurs when
an individual experiences both thwarted belongingness (feeling disconnected
from others) and perceived burdensomeness (feeling like a burden),
combined with the acquired capability for suicide. This theory guides suicide
risk assessment and intervention.
6. A patient with schizophrenia is prescribed clozapine. Which laboratory
value must the nurse monitor closely?
A) Serum glucose
B) Complete blood count (CBC) for agranulocytosis
C) Liver function tests
D) Serum creatinine
, Correct Answer: Complete blood count (CBC) for agranulocytosis
Rationale: Clozapine carries a risk of agranulocytosis, requiring regular CBC
monitoring through a REMS program. Serum glucose, liver function, and
creatinine are monitored for other medications but are not the primary
concern with clozapine.
7. A patient with bipolar disorder is in a manic episode. Which symptom is
characteristic of this episode?
A) Depressed mood most of the day
B) Decreased need for sleep
C) Anhedonia
D) Psychomotor retardation
Correct Answer: Decreased need for sleep
Rationale: A manic episode is characterized by a distinct period of
abnormally elevated, expansive, or irritable mood and increased activity or
energy. Decreased need for sleep is a key symptom, along with grandiosity,
talkativeness, flight of ideas, and risky behaviors. Depressed mood and
anhedonia are characteristic of depressive episodes.
8. A nurse is assessing a patient for signs of escalating aggression. Which
finding indicates the patient may be escalating toward violence?
A) Relaxed posture and soft speech
B) Pacing, muscle tension, and intense eye contact
C) Sleeping excessively
D) Withdrawn and avoidant behavior
