2026 NR 326 EXAM 1 MENTAL HEALTH/MENTAL
HEALTH NR 326 REAL EXAM QUESTION AND
ANSWERS A GRADE.
Which client statement demonstrates improvement in anger and aggression
management?
A. “I realize I have a problem expressing my anger appropriately.”
B. “I know I can’t use physical force anymore, but I can intimidate someone
with my words.”
C. “It’s bad to feel as angry as I feel. I’m working on eliminating this poisonous
emotion entirely.”
D. “Because my wife seems to be the one to set me off, I’ve decided to remain
separated from her.”
CORRECT ANS: A. “I realize I have a problem expressing my anger
appropriately.”
Expert Rationale: The first step in anger management is self-awareness and
acknowledgment of the problem. The statement “I realize I have a problem
expressing my anger appropriately” demonstrates insight, acceptance of
responsibility, and a willingness to change, which are foundational to
improvement. Option B indicates a continuing pattern of aggression
(intimidation). Option C reflects a maladaptive belief that anger itself is bad
and should be eliminated, which is unrealistic and unhealthy. Option D
demonstrates avoidance rather than addressing the underlying issue. Insight
and ownership of the problem are key indicators of progress.
A nurse is caring for four clients. Which client does the nurse identify is least
prone to developing problems with anger and aggression?
A. A child raised by a physically abusive parent
B. An adult with a history of epilepsy
C. A young adult living in the ghetto of an inner city
D. An adolescent raised by immigrant parents
,CORRECT ANS: D. An adolescent raised by immigrant parents.
Expert Rationale: While environmental and genetic factors contribute to anger
and aggression, the adolescent raised by immigrant parents does not
inherently present with risk factors for aggression. Being raised by immigrant
parents does not necessarily predispose an individual to anger problems.
Option A (child raised by a physically abusive parent) is a significant risk factor
due to learned behavior and trauma. Option B (adult with epilepsy) may have
aggression related to neurological factors. Option C (young adult living in the
ghetto of an inner city) faces environmental stressors that increase the risk of
aggression. The adolescent raised by immigrant parents has the least
identifiable risk factors.
An adult client assaults another client and is placed in restraints. Which client
statement alerts the nurse that further assessment is necessary?
A. “I hate all of you!”
B. “My fingers are tingly.”
C. “You wait until I tell my lawyer.”
D. “I have a sinus headache.”
CORRECT ANS: B. “My fingers are tingly.”
Expert Rationale: A client who is restrained must be closely monitored for
physical complications, including neurovascular compromise. The statement
“My fingers are tingly” indicates a potential issue with circulation or nerve
function, which requires immediate further assessment. This could be a sign
of impaired blood flow or nerve compression from the restraints. Options A,
C, and D reflect emotional and psychological responses, which are also
important but do not indicate an immediate physical safety concern. The
physical safety of the client in restraints is the priority.
A client diagnosed with Schizophrenia functions well and is bright,
spontaneous, and interactive during hospitalization but then decompensates
after discharge. What does the milieu provide that may be missing in the home
environment?
A. Peer pressure
B. Structured programming
C. Visitor restrictions
D. Mandated activities
,CORRECT ANS: B. Structured programming.
Expert Rationale: A therapeutic milieu provides a structured, supportive
environment with consistent routines, schedules, and therapeutic activities.
This structure helps clients with schizophrenia maintain stability and function.
The structured programming provides predictability, reduces anxiety, and
promotes adaptive coping. At home, this structure is often missing, leading to
decompensation. Peer pressure, visitor restrictions, and mandated activities
are not the primary factors that the milieu provides to maintain stability.
A client tells the nurse she is anxious and loudly demands the nurse give her
Ativan right now. The nurse replies, “I understand you are having anxiety;
however, demanding medication in a loud voice is unacceptable behavior.”
Which type of intervention is this nurse implementing?
A. Establishing trust
B. Limit setting
C. Validating feelings
D. Patient teaching
CORRECT ANS: B. Limit setting.
Expert Rationale: The nurse is implementing a limit-setting intervention. By
stating “demanding medication in a loud voice is unacceptable behavior,” the
nurse is establishing a clear boundary and identifying what behavior is not
acceptable. The nurse also validates the client's feelings (“I understand you are
having anxiety”) but sets a limit on the behavior. This is a key intervention in
psychiatric nursing to promote appropriate behavior and maintain a
therapeutic environment.
The nurse recognizes which principle underlies effective patient teaching?
A. Moderate to severe anxiety increases patient learning.
B. Mild anxiety enhances patient learning.
C. Panic-level anxiety improves nurses’ teaching.
D. Severe anxiety intensifies concentration and enhances attention.
CORRECT ANS: B. Mild anxiety enhances patient learning.
Expert Rationale: Mild anxiety can actually enhance learning by increasing
motivation, focus, and attention. It puts the individual in a state of alertness
that is conducive to processing new information. Moderate to severe anxiety
can impair concentration and learning. Panic-level anxiety is debilitating and
, prevents learning. Severe anxiety does not enhance attention or
concentration; it typically impairs cognitive function. Therefore, mild anxiety
is the optimal level for effective patient teaching.
A male high school student is attracted to a female teacher. The school nurse
overhears the student say, “I know she wants me.” The nurse recognizes the
student is using which defense mechanism?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
CORRECT ANS: B. Projection.
Expert Rationale: Projection is a defense mechanism in which an individual
attributes their own unacceptable thoughts, feelings, or impulses to another
person. The student is attracted to the teacher but cannot accept this feeling,
so he projects it onto the teacher, believing that she wants him. Displacement
involves redirecting emotions to a safer target. Rationalization involves
creating logical explanations for unacceptable behavior. Sublimation involves
channeling unacceptable impulses into socially acceptable activities.
Which client statement indicates the nurse’s teaching about the effect of
circadian rhythms is effective?
A. “When I dream about my mother’s horrible train accident, I become
hysterical.”
B. “I get really irritable during my menstrual cycle.”
C. “I’m a morning person, so I get my best work done in the a.m.”
D. “Every February, I tend to experience periods of sadness.”
CORRECT ANS: C. “I’m a morning person, so I get my best work done in the
a.m.”
Expert Rationale: Circadian rhythms are the physical, mental, and behavioral
changes that follow a 24-hour cycle, responding primarily to light and darkness
in an organism's environment. They regulate the sleep-wake cycle. The
statement “I’m a morning person, so I get my best work done in the a.m.”
indicates an understanding of personal circadian rhythms. Options A, B, and D
relate to other phenomena: dreams, menstrual cycles, and seasonal affective
disorder, respectively, not circadian rhythms.
HEALTH NR 326 REAL EXAM QUESTION AND
ANSWERS A GRADE.
Which client statement demonstrates improvement in anger and aggression
management?
A. “I realize I have a problem expressing my anger appropriately.”
B. “I know I can’t use physical force anymore, but I can intimidate someone
with my words.”
C. “It’s bad to feel as angry as I feel. I’m working on eliminating this poisonous
emotion entirely.”
D. “Because my wife seems to be the one to set me off, I’ve decided to remain
separated from her.”
CORRECT ANS: A. “I realize I have a problem expressing my anger
appropriately.”
Expert Rationale: The first step in anger management is self-awareness and
acknowledgment of the problem. The statement “I realize I have a problem
expressing my anger appropriately” demonstrates insight, acceptance of
responsibility, and a willingness to change, which are foundational to
improvement. Option B indicates a continuing pattern of aggression
(intimidation). Option C reflects a maladaptive belief that anger itself is bad
and should be eliminated, which is unrealistic and unhealthy. Option D
demonstrates avoidance rather than addressing the underlying issue. Insight
and ownership of the problem are key indicators of progress.
A nurse is caring for four clients. Which client does the nurse identify is least
prone to developing problems with anger and aggression?
A. A child raised by a physically abusive parent
B. An adult with a history of epilepsy
C. A young adult living in the ghetto of an inner city
D. An adolescent raised by immigrant parents
,CORRECT ANS: D. An adolescent raised by immigrant parents.
Expert Rationale: While environmental and genetic factors contribute to anger
and aggression, the adolescent raised by immigrant parents does not
inherently present with risk factors for aggression. Being raised by immigrant
parents does not necessarily predispose an individual to anger problems.
Option A (child raised by a physically abusive parent) is a significant risk factor
due to learned behavior and trauma. Option B (adult with epilepsy) may have
aggression related to neurological factors. Option C (young adult living in the
ghetto of an inner city) faces environmental stressors that increase the risk of
aggression. The adolescent raised by immigrant parents has the least
identifiable risk factors.
An adult client assaults another client and is placed in restraints. Which client
statement alerts the nurse that further assessment is necessary?
A. “I hate all of you!”
B. “My fingers are tingly.”
C. “You wait until I tell my lawyer.”
D. “I have a sinus headache.”
CORRECT ANS: B. “My fingers are tingly.”
Expert Rationale: A client who is restrained must be closely monitored for
physical complications, including neurovascular compromise. The statement
“My fingers are tingly” indicates a potential issue with circulation or nerve
function, which requires immediate further assessment. This could be a sign
of impaired blood flow or nerve compression from the restraints. Options A,
C, and D reflect emotional and psychological responses, which are also
important but do not indicate an immediate physical safety concern. The
physical safety of the client in restraints is the priority.
A client diagnosed with Schizophrenia functions well and is bright,
spontaneous, and interactive during hospitalization but then decompensates
after discharge. What does the milieu provide that may be missing in the home
environment?
A. Peer pressure
B. Structured programming
C. Visitor restrictions
D. Mandated activities
,CORRECT ANS: B. Structured programming.
Expert Rationale: A therapeutic milieu provides a structured, supportive
environment with consistent routines, schedules, and therapeutic activities.
This structure helps clients with schizophrenia maintain stability and function.
The structured programming provides predictability, reduces anxiety, and
promotes adaptive coping. At home, this structure is often missing, leading to
decompensation. Peer pressure, visitor restrictions, and mandated activities
are not the primary factors that the milieu provides to maintain stability.
A client tells the nurse she is anxious and loudly demands the nurse give her
Ativan right now. The nurse replies, “I understand you are having anxiety;
however, demanding medication in a loud voice is unacceptable behavior.”
Which type of intervention is this nurse implementing?
A. Establishing trust
B. Limit setting
C. Validating feelings
D. Patient teaching
CORRECT ANS: B. Limit setting.
Expert Rationale: The nurse is implementing a limit-setting intervention. By
stating “demanding medication in a loud voice is unacceptable behavior,” the
nurse is establishing a clear boundary and identifying what behavior is not
acceptable. The nurse also validates the client's feelings (“I understand you are
having anxiety”) but sets a limit on the behavior. This is a key intervention in
psychiatric nursing to promote appropriate behavior and maintain a
therapeutic environment.
The nurse recognizes which principle underlies effective patient teaching?
A. Moderate to severe anxiety increases patient learning.
B. Mild anxiety enhances patient learning.
C. Panic-level anxiety improves nurses’ teaching.
D. Severe anxiety intensifies concentration and enhances attention.
CORRECT ANS: B. Mild anxiety enhances patient learning.
Expert Rationale: Mild anxiety can actually enhance learning by increasing
motivation, focus, and attention. It puts the individual in a state of alertness
that is conducive to processing new information. Moderate to severe anxiety
can impair concentration and learning. Panic-level anxiety is debilitating and
, prevents learning. Severe anxiety does not enhance attention or
concentration; it typically impairs cognitive function. Therefore, mild anxiety
is the optimal level for effective patient teaching.
A male high school student is attracted to a female teacher. The school nurse
overhears the student say, “I know she wants me.” The nurse recognizes the
student is using which defense mechanism?
A. Displacement
B. Projection
C. Rationalization
D. Sublimation
CORRECT ANS: B. Projection.
Expert Rationale: Projection is a defense mechanism in which an individual
attributes their own unacceptable thoughts, feelings, or impulses to another
person. The student is attracted to the teacher but cannot accept this feeling,
so he projects it onto the teacher, believing that she wants him. Displacement
involves redirecting emotions to a safer target. Rationalization involves
creating logical explanations for unacceptable behavior. Sublimation involves
channeling unacceptable impulses into socially acceptable activities.
Which client statement indicates the nurse’s teaching about the effect of
circadian rhythms is effective?
A. “When I dream about my mother’s horrible train accident, I become
hysterical.”
B. “I get really irritable during my menstrual cycle.”
C. “I’m a morning person, so I get my best work done in the a.m.”
D. “Every February, I tend to experience periods of sadness.”
CORRECT ANS: C. “I’m a morning person, so I get my best work done in the
a.m.”
Expert Rationale: Circadian rhythms are the physical, mental, and behavioral
changes that follow a 24-hour cycle, responding primarily to light and darkness
in an organism's environment. They regulate the sleep-wake cycle. The
statement “I’m a morning person, so I get my best work done in the a.m.”
indicates an understanding of personal circadian rhythms. Options A, B, and D
relate to other phenomena: dreams, menstrual cycles, and seasonal affective
disorder, respectively, not circadian rhythms.
