,NU 160 Exam 4 | Mental Health Concepts | Galen
College of Nursing | Q & A | 2026/2027 Edition
1. A nurse is assessing an older adult client who reports difficulty falling asleep and frequent
nighttime awakenings. Which statement best explains the age-related changes affecting this
client's sleep?
A) Older adults spend more time in deep sleep stages 3 and 4
B) Older adults experience less deep sleep and more frequent awakenings
C) Older adults have longer REM sleep periods than younger adults
D) Older adults require significantly more total sleep time
Correct Answer: B) Older adults experience less deep sleep and more frequent awakenings
Rationale: Aging is associated with changes in sleep architecture, including decreased time in
deep sleep stages 3 and 4, more frequent awakenings, and difficulty maintaining sleep. Older
adults do not require more total sleep and actually spend less time in deep sleep.
2. The nurse is planning care for a client with anorexia nervosa who is withdrawn and
nonverbal. Which nursing intervention should be prioritized?
A) Encouraging the client to verbalize feelings about weight
B) Establishing a trusting therapeutic relationship
C) Initiating forced oral feedings
D) Confronting the client about denial of illness
Correct Answer: B) Establishing a trusting therapeutic relationship
,Rationale: Building a trusting therapeutic relationship is the foundation of care for clients with
eating disorders. The withdrawn, nonverbal presentation reflects shame, denial, and emotional
guardedness. Confrontation would damage trust, and forced feedings are a last resort.
3. A client diagnosed with borderline personality disorder is admitted to the psychiatric unit.
Which behavior pattern would the nurse expect to observe?
A) Social isolation and avoidance of others
B) Bizarre speech patterns and loose associations
C) Generation of conflict among staff members
D) Suspiciousness and paranoid ideation
Correct Answer: C) Generation of conflict among staff members
Rationale: Clients with borderline personality disorder commonly exhibit splitting behaviors that
generate conflict among staff members as they idealize some staff and devalue others. Social
isolation is more characteristic of schizoid personality disorder; bizarre speech suggests
schizophrenia.
4. A 17-year-old female is admitted with significant weight loss and is withdrawn and nonverbal.
Which disorder is most consistent with this presentation?
A) Strep throat
B) Anorexia nervosa
C) Renal calculus
D) Attention-deficit/hyperactivity disorder
Correct Answer: B) Anorexia nervosa
, Rationale: Anorexia nervosa most commonly affects adolescent females aged 14 to 18 years and
presents with significant weight loss combined with social withdrawal and emotional
guardedness. Strep throat, renal calculi, and ADHD do not account for this clinical picture.
5. Sleep disorders characterized by abnormal behavioral or physical events during sleep are
called:
A) Hypersomnias
B) Dyssomnias
C) Parasomnias
D) Insomnias
Correct Answer: C) Parasomnias
Rationale: Parasomnias are sleep disorders characterized by abnormal behavioral, physical, or
experiential events during sleep, including sleepwalking, sleep terrors, nightmares, and REM
sleep behavior disorder. Dyssomnias affect sleep quantity or timing; hypersomnias involve
excessive daytime sleepiness.
6. A client with antisocial personality disorder is found in a female client's room. When
instructed to leave, the client states, "I'll do exactly as I please!" Which action by the nurse is the
priority?
A) Reassure the client about opportunities after discharge
B) Reinforce the rules of the treatment program
C) Escort the client to a seclusion room
D) Make an exception to build a trusting relationship
Correct Answer: B) Reinforce the rules of the treatment program
College of Nursing | Q & A | 2026/2027 Edition
1. A nurse is assessing an older adult client who reports difficulty falling asleep and frequent
nighttime awakenings. Which statement best explains the age-related changes affecting this
client's sleep?
A) Older adults spend more time in deep sleep stages 3 and 4
B) Older adults experience less deep sleep and more frequent awakenings
C) Older adults have longer REM sleep periods than younger adults
D) Older adults require significantly more total sleep time
Correct Answer: B) Older adults experience less deep sleep and more frequent awakenings
Rationale: Aging is associated with changes in sleep architecture, including decreased time in
deep sleep stages 3 and 4, more frequent awakenings, and difficulty maintaining sleep. Older
adults do not require more total sleep and actually spend less time in deep sleep.
2. The nurse is planning care for a client with anorexia nervosa who is withdrawn and
nonverbal. Which nursing intervention should be prioritized?
A) Encouraging the client to verbalize feelings about weight
B) Establishing a trusting therapeutic relationship
C) Initiating forced oral feedings
D) Confronting the client about denial of illness
Correct Answer: B) Establishing a trusting therapeutic relationship
,Rationale: Building a trusting therapeutic relationship is the foundation of care for clients with
eating disorders. The withdrawn, nonverbal presentation reflects shame, denial, and emotional
guardedness. Confrontation would damage trust, and forced feedings are a last resort.
3. A client diagnosed with borderline personality disorder is admitted to the psychiatric unit.
Which behavior pattern would the nurse expect to observe?
A) Social isolation and avoidance of others
B) Bizarre speech patterns and loose associations
C) Generation of conflict among staff members
D) Suspiciousness and paranoid ideation
Correct Answer: C) Generation of conflict among staff members
Rationale: Clients with borderline personality disorder commonly exhibit splitting behaviors that
generate conflict among staff members as they idealize some staff and devalue others. Social
isolation is more characteristic of schizoid personality disorder; bizarre speech suggests
schizophrenia.
4. A 17-year-old female is admitted with significant weight loss and is withdrawn and nonverbal.
Which disorder is most consistent with this presentation?
A) Strep throat
B) Anorexia nervosa
C) Renal calculus
D) Attention-deficit/hyperactivity disorder
Correct Answer: B) Anorexia nervosa
, Rationale: Anorexia nervosa most commonly affects adolescent females aged 14 to 18 years and
presents with significant weight loss combined with social withdrawal and emotional
guardedness. Strep throat, renal calculi, and ADHD do not account for this clinical picture.
5. Sleep disorders characterized by abnormal behavioral or physical events during sleep are
called:
A) Hypersomnias
B) Dyssomnias
C) Parasomnias
D) Insomnias
Correct Answer: C) Parasomnias
Rationale: Parasomnias are sleep disorders characterized by abnormal behavioral, physical, or
experiential events during sleep, including sleepwalking, sleep terrors, nightmares, and REM
sleep behavior disorder. Dyssomnias affect sleep quantity or timing; hypersomnias involve
excessive daytime sleepiness.
6. A client with antisocial personality disorder is found in a female client's room. When
instructed to leave, the client states, "I'll do exactly as I please!" Which action by the nurse is the
priority?
A) Reassure the client about opportunities after discharge
B) Reinforce the rules of the treatment program
C) Escort the client to a seclusion room
D) Make an exception to build a trusting relationship
Correct Answer: B) Reinforce the rules of the treatment program
