NUR 253 EXAM 3 – MENTAL HEALTH NURSING |
GALEN COLLEGE OF NURSING | COMPREHENSIVE
PRACTICE EXAMINATION | 2026 UPDATE | STUDY
GUIDE | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice examination is meticulously designed for students preparing for the
NUR 253 Concepts of Mental Health Nursing Exam 3 at Galen College of Nursing. Aligned with
the 2026/2027 curriculum, this document serves as a definitive study guide and exam review,
featuring questions that mirror the complexity and rigor of the actual examination. It covers all
essential domains, including therapeutic communication, anxiety and stress-related disorders,
mood disorders (depression and bipolar), psychotic disorders (schizophrenia), personality
disorders, substance use disorders, psychopharmacology, crisis intervention, suicide prevention,
legal and ethical issues in mental health nursing, and neurocognitive disorders. Each question is
accompanied by a detailed, verified solution and clinical rationale to ensure 100% correct
answers and a deep, integrated understanding of mental health nursing principles, guaranteeing
distinction-level preparation for this critical nursing credential.
TABLE OF CONTENTS
1. Therapeutic Communication and Nurse-Patient Relationship (Questions 1-10)
2. Anxiety Disorders and Stress-Related Disorders (Questions 11-20)
3. Mood Disorders: Depression and Bipolar Disorder (Questions 21-30)
4. Psychotic Disorders: Schizophrenia and Related Conditions (Questions 31-40)
5. Personality Disorders and Impulse Control (Questions 41-48)
6. Substance Use Disorders and Dual Diagnosis (Questions 49-55)
7. Psychopharmacology: Antidepressants, Mood Stabilizers, Antipsychotics, Anxiolytics
(Questions 56-63)
8. Crisis Intervention and Suicide Prevention (Questions 64-70)
9. Legal and Ethical Issues in Mental Health Nursing (Questions 71-76)
10. Neurocognitive Disorders and Geriatric Psychiatry (Questions 77-84)
11. Comprehensive Integrated Questions (Questions 85-100)
,SECTION 1: THERAPEUTIC COMMUNICATION AND NURSE-PATIENT
RELATIONSHIP
Question 1
The nurse is caring for a client who is withdrawn and refuses to speak. Which therapeutic
communication technique should the nurse use initially?
A) Ask open-ended questions to encourage conversation
B) Sit quietly with the client and use therapeutic silence
C) Ask the client why they are refusing to speak
D) Leave the client alone until they are ready to talk
Correct Answer: B
Sitting quietly with the client and using therapeutic silence demonstrates acceptance and gives
the client control over when to initiate communication. It allows the client to feel safe without
pressure. Open-ended questions (A) may be perceived as demanding. Asking "why" (C) can be
judgmental. Leaving the client alone (D) may reinforce isolation.
Question 2
A nurse is caring for a client who states, "I don't think I can go on anymore." What is the nurse's
priority response?
A) "You have so much to live for."
B) "Why do you feel that way?"
C) "Are you thinking about harming yourself?"
D) "Let's focus on the positive things in your life."
Correct Answer: C
The client's statement indicates potential suicidal ideation. The priority is to directly assess for
suicide risk by asking a clear, direct question about thoughts of self-harm. Reassurance (A) or
focusing on positives (D) may dismiss the client's feelings. Asking "why" (B) can be perceived as
judgmental and does not directly assess safety.
,Question 3
The nurse is caring for a client who is expressing anger and frustration. Which of the following is
the most therapeutic nursing response?
A) "Calm down. There's no reason to be upset."
B) "It sounds like you are feeling really frustrated."
C) "You shouldn't be angry about that."
D) "Let's talk about something else."
Correct Answer: B
Reflecting the client's feelings back to them ("It sounds like you are feeling really frustrated")
validates the client's emotions and encourages further expression. Telling the client to calm
down (A) or that they shouldn't be angry (C) dismisses their feelings. Changing the subject (D)
avoids addressing the issue.
Question 4
The nurse is caring for a client who is sharing their life story in great detail. Which of the
following is the most appropriate nursing response?
A) "That's interesting. Tell me more."
B) "Let's focus on what brought you here today."
C) "I don't have time to listen to all of this."
D) "Why are you telling me all of this?"
Correct Answer: B
Focusing (B) is a therapeutic technique used to redirect the conversation to relevant topics when
the client is tangential or over-sharing. Telling the client that the story is interesting and asking
for more (A) encourages tangentiality. Telling the client you don't have time (C) is dismissive.
Asking "why" (D) is confrontational.
, Question 5
Which of the following is an example of a non-therapeutic communication technique?
A) Restating
B) Reflecting
C) Giving advice
D) Clarifying
Correct Answer: C*
Giving advice is non-therapeutic because it imposes the nurse's values on the patient and
discourages patient autonomy. Restating, reflecting, and clarifying are all therapeutic
communication techniques that encourage the patient to express themselves and explore their
own feelings and solutions.
Question 6
The nurse is caring for a client who says, "I'm so anxious about this surgery. I don't know if I can
do it." Which of the following is the most therapeutic response?
A) "You'll be fine. The surgery is very safe."
B) "It sounds like you're feeling really scared about the surgery."
C) "Everyone gets nervous before surgery."
D) "Why are you so anxious?"
Correct Answer: B*
Reflecting the client's feelings ("It sounds like you're feeling really scared") validates the client's
emotions and encourages further exploration. Minimizing the client's concerns (A or C)
dismisses their feelings. Asking "why" (D) can be perceived as judgmental.
Question 7
The nurse is preparing to discharge a client and is providing education about medication
adherence. Which statement reflects effective therapeutic communication?
A) "You need to take your medication every day."
B) "Tell me what concerns you have about taking your medication."
GALEN COLLEGE OF NURSING | COMPREHENSIVE
PRACTICE EXAMINATION | 2026 UPDATE | STUDY
GUIDE | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS
This comprehensive practice examination is meticulously designed for students preparing for the
NUR 253 Concepts of Mental Health Nursing Exam 3 at Galen College of Nursing. Aligned with
the 2026/2027 curriculum, this document serves as a definitive study guide and exam review,
featuring questions that mirror the complexity and rigor of the actual examination. It covers all
essential domains, including therapeutic communication, anxiety and stress-related disorders,
mood disorders (depression and bipolar), psychotic disorders (schizophrenia), personality
disorders, substance use disorders, psychopharmacology, crisis intervention, suicide prevention,
legal and ethical issues in mental health nursing, and neurocognitive disorders. Each question is
accompanied by a detailed, verified solution and clinical rationale to ensure 100% correct
answers and a deep, integrated understanding of mental health nursing principles, guaranteeing
distinction-level preparation for this critical nursing credential.
TABLE OF CONTENTS
1. Therapeutic Communication and Nurse-Patient Relationship (Questions 1-10)
2. Anxiety Disorders and Stress-Related Disorders (Questions 11-20)
3. Mood Disorders: Depression and Bipolar Disorder (Questions 21-30)
4. Psychotic Disorders: Schizophrenia and Related Conditions (Questions 31-40)
5. Personality Disorders and Impulse Control (Questions 41-48)
6. Substance Use Disorders and Dual Diagnosis (Questions 49-55)
7. Psychopharmacology: Antidepressants, Mood Stabilizers, Antipsychotics, Anxiolytics
(Questions 56-63)
8. Crisis Intervention and Suicide Prevention (Questions 64-70)
9. Legal and Ethical Issues in Mental Health Nursing (Questions 71-76)
10. Neurocognitive Disorders and Geriatric Psychiatry (Questions 77-84)
11. Comprehensive Integrated Questions (Questions 85-100)
,SECTION 1: THERAPEUTIC COMMUNICATION AND NURSE-PATIENT
RELATIONSHIP
Question 1
The nurse is caring for a client who is withdrawn and refuses to speak. Which therapeutic
communication technique should the nurse use initially?
A) Ask open-ended questions to encourage conversation
B) Sit quietly with the client and use therapeutic silence
C) Ask the client why they are refusing to speak
D) Leave the client alone until they are ready to talk
Correct Answer: B
Sitting quietly with the client and using therapeutic silence demonstrates acceptance and gives
the client control over when to initiate communication. It allows the client to feel safe without
pressure. Open-ended questions (A) may be perceived as demanding. Asking "why" (C) can be
judgmental. Leaving the client alone (D) may reinforce isolation.
Question 2
A nurse is caring for a client who states, "I don't think I can go on anymore." What is the nurse's
priority response?
A) "You have so much to live for."
B) "Why do you feel that way?"
C) "Are you thinking about harming yourself?"
D) "Let's focus on the positive things in your life."
Correct Answer: C
The client's statement indicates potential suicidal ideation. The priority is to directly assess for
suicide risk by asking a clear, direct question about thoughts of self-harm. Reassurance (A) or
focusing on positives (D) may dismiss the client's feelings. Asking "why" (B) can be perceived as
judgmental and does not directly assess safety.
,Question 3
The nurse is caring for a client who is expressing anger and frustration. Which of the following is
the most therapeutic nursing response?
A) "Calm down. There's no reason to be upset."
B) "It sounds like you are feeling really frustrated."
C) "You shouldn't be angry about that."
D) "Let's talk about something else."
Correct Answer: B
Reflecting the client's feelings back to them ("It sounds like you are feeling really frustrated")
validates the client's emotions and encourages further expression. Telling the client to calm
down (A) or that they shouldn't be angry (C) dismisses their feelings. Changing the subject (D)
avoids addressing the issue.
Question 4
The nurse is caring for a client who is sharing their life story in great detail. Which of the
following is the most appropriate nursing response?
A) "That's interesting. Tell me more."
B) "Let's focus on what brought you here today."
C) "I don't have time to listen to all of this."
D) "Why are you telling me all of this?"
Correct Answer: B
Focusing (B) is a therapeutic technique used to redirect the conversation to relevant topics when
the client is tangential or over-sharing. Telling the client that the story is interesting and asking
for more (A) encourages tangentiality. Telling the client you don't have time (C) is dismissive.
Asking "why" (D) is confrontational.
, Question 5
Which of the following is an example of a non-therapeutic communication technique?
A) Restating
B) Reflecting
C) Giving advice
D) Clarifying
Correct Answer: C*
Giving advice is non-therapeutic because it imposes the nurse's values on the patient and
discourages patient autonomy. Restating, reflecting, and clarifying are all therapeutic
communication techniques that encourage the patient to express themselves and explore their
own feelings and solutions.
Question 6
The nurse is caring for a client who says, "I'm so anxious about this surgery. I don't know if I can
do it." Which of the following is the most therapeutic response?
A) "You'll be fine. The surgery is very safe."
B) "It sounds like you're feeling really scared about the surgery."
C) "Everyone gets nervous before surgery."
D) "Why are you so anxious?"
Correct Answer: B*
Reflecting the client's feelings ("It sounds like you're feeling really scared") validates the client's
emotions and encourages further exploration. Minimizing the client's concerns (A or C)
dismisses their feelings. Asking "why" (D) can be perceived as judgmental.
Question 7
The nurse is preparing to discharge a client and is providing education about medication
adherence. Which statement reflects effective therapeutic communication?
A) "You need to take your medication every day."
B) "Tell me what concerns you have about taking your medication."
