,NU 160 Exam 4 | Mental Health Concepts
(2026/2027) PDF | Nursing | Galen College
1. A hospice nurse is caring for a terminally ill client who has become withdrawn
and states, "What is the point of anything anymore?" The nurse remains silent
and sits with the client. This action best demonstrates which therapeutic
technique?
A) Active listening
B) Art of presence
C) Validation
D) Reflection
Correct Answer: B) Art of presence
Rationale: The art of presence involves being fully with the patient, offering
comfort through silence and attention without needing to fill the space with
words. Active listening requires verbal and non-verbal feedback, validation
confirms feelings, and reflection paraphrases the client's message. Presence is
the most appropriate response to provide emotional support during existential
distress.
2. Which statement best describes the purpose of sleep according to mental
health concepts?
A) The body increases metabolic rate to digest nutrients
B) The body conserves energy, functions slow, and workload on the heart
decreases
C) The body enters a state of heightened awareness for survival
D) The body produces increased levels of stress hormones
,Correct Answer: B) The body conserves energy, functions slow, and workload on
the heart decreases
Rationale: During sleep, the body conserves energy, metabolic rate slows, the
workload on the heart decreases, and muscles relax. Sleep allows for physical
restoration and repair, with growth hormone released during deep sleep and
memory consolidation during REM sleep.
3. Which of the following is the correct sequence of the sleep cycle?
A) Presleep → REM → NREM stage 4 → NREM stage 3 → NREM stage 2 → NREM
stage 1
B) Presleep → NREM stage 1 → NREM stage 2 → NREM stage 3 → NREM stage 4
→ NREM stage 3 → NREM stage 2 → REM
C) Presleep → NREM stage 4 → NREM stage 3 → NREM stage 2 → NREM stage 1
→ REM
D) Presleep → NREM stage 2 → NREM stage 3 → NREM stage 4 → REM → NREM
stage 3 → NREM stage 2
Correct Answer: B) Presleep → NREM stage 1 → NREM stage 2 → NREM stage 3
→ NREM stage 4 → NREM stage 3 → NREM stage 2 → REM
Rationale: The sleep cycle progresses from presleep (10-30 minutes) through
NREM stages 1-4, then reverses back through stages 3 and 2 before entering
REM sleep. Stage 4 is the deepest sleep and most difficult to wake from. A
complete cycle lasts about 90-110 minutes.
, 4. The 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.
5. A client with anorexia nervosa 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
(2026/2027) PDF | Nursing | Galen College
1. A hospice nurse is caring for a terminally ill client who has become withdrawn
and states, "What is the point of anything anymore?" The nurse remains silent
and sits with the client. This action best demonstrates which therapeutic
technique?
A) Active listening
B) Art of presence
C) Validation
D) Reflection
Correct Answer: B) Art of presence
Rationale: The art of presence involves being fully with the patient, offering
comfort through silence and attention without needing to fill the space with
words. Active listening requires verbal and non-verbal feedback, validation
confirms feelings, and reflection paraphrases the client's message. Presence is
the most appropriate response to provide emotional support during existential
distress.
2. Which statement best describes the purpose of sleep according to mental
health concepts?
A) The body increases metabolic rate to digest nutrients
B) The body conserves energy, functions slow, and workload on the heart
decreases
C) The body enters a state of heightened awareness for survival
D) The body produces increased levels of stress hormones
,Correct Answer: B) The body conserves energy, functions slow, and workload on
the heart decreases
Rationale: During sleep, the body conserves energy, metabolic rate slows, the
workload on the heart decreases, and muscles relax. Sleep allows for physical
restoration and repair, with growth hormone released during deep sleep and
memory consolidation during REM sleep.
3. Which of the following is the correct sequence of the sleep cycle?
A) Presleep → REM → NREM stage 4 → NREM stage 3 → NREM stage 2 → NREM
stage 1
B) Presleep → NREM stage 1 → NREM stage 2 → NREM stage 3 → NREM stage 4
→ NREM stage 3 → NREM stage 2 → REM
C) Presleep → NREM stage 4 → NREM stage 3 → NREM stage 2 → NREM stage 1
→ REM
D) Presleep → NREM stage 2 → NREM stage 3 → NREM stage 4 → REM → NREM
stage 3 → NREM stage 2
Correct Answer: B) Presleep → NREM stage 1 → NREM stage 2 → NREM stage 3
→ NREM stage 4 → NREM stage 3 → NREM stage 2 → REM
Rationale: The sleep cycle progresses from presleep (10-30 minutes) through
NREM stages 1-4, then reverses back through stages 3 and 2 before entering
REM sleep. Stage 4 is the deepest sleep and most difficult to wake from. A
complete cycle lasts about 90-110 minutes.
, 4. The 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.
5. A client with anorexia nervosa 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
