NR 326
EXAM 1
Test Covering Weeks 1 through 3
Verified Questions & Answers With Rationales
(Mental Health Nursing)
Chamberlain
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,1. The nurse is caring for four clients. Which client need should the nurse
address first based on Maslow's Hierarchy of Needs?
A. A client who reports feeling isolated after a recent divorce
B. A client who has not eaten since admission 12 hours ago
C. A client who is anxious about an upcoming diagnostic test
D. A client who wants to discuss career goals after discharge
Correct Answer: B
Rationale:
B. Correct — Physiological needs (like food, water, air, sleep) are foundational on
Maslow's hierarchy and must be met first.
A. Incorrect — Love/belonging needs (emotional connection) are important, but lower-
level physiological needs take priority.
C. Incorrect — Anxiety relates to safety, which is prioritized after physiological needs.
D. Incorrect — Discussing career goals is a self-actualization need, the highest level
and least urgent.
Test-Taking Tip: When answering prioritization questions, think Maslow: Always meet
the most basic human needs (like airway, breathing, circulation, food, and safety) before
psychosocial or emotional needs. Use the hierarchy to eliminate distractors!
---
2. Which client statement best reflects mental health, according to standard
nursing definitions?
A. "I've been isolating myself and haven't gone to work in two weeks."
B. "I have trouble managing my anger, and I often yell at my coworkers."
C. "Even though I lost my job, I'm staying focused on caring for my family."
D. "Sometimes I hear voices, but I don't think they're a problem."
Correct Answer: C
Rationale:
C. Correct — This reflects a successful adaptation to stress, maintaining functionality in
daily life and relationships — the core definition of mental health.
A. Incorrect — Social withdrawal and occupational dysfunction suggest impaired
functioning, which aligns with mental illness.
B. Incorrect — Maladaptive anger responses and interpersonal issues may indicate
mental illness.
,D. Incorrect — Hallucinations (even if not perceived as problematic) represent a
deviation from cultural and behavioral norms.
Test-Taking Tip: Look for clues in the client's ability to function despite stress. Mental
health is about adaptation and stability, while mental illness involves maladaptive
behavior and role impairment. When in doubt, ask: Is this helping or hurting their daily
life and relationships?
---
3. A nurse is caring for a client experiencing prolonged stress due to a family
crisis. The client now exhibits fatigue, frequent illness, and difficulty
concentrating. Based on Selye's General Adaptation Syndrome (GAS), which
stage of stress is the client most likely experiencing?
A. Alarm
B. Resistance
C. Exhaustion
D. Adaptation
Correct Answer: C
Rationale:
C. Correct — The exhaustion stage is marked by depleted energy, weakened immune
system, and increased risk for illness or even death if the stress is unresolved.
A. Incorrect — The alarm stage is the initial fight-or-flight response (↑HR,
bronchodilation, ↓digestion).
B. Incorrect — In the resistance stage, the body tries to adapt, and symptoms may
temporarily stabilize.
D. Incorrect — "Adaptation" is part of the resistance stage, but does not describe the
full decompensation seen here.
Test-Taking Tip: GAS follows a progressive pattern: Alarm → Resistance →
Exhaustion. If the client shows physical or cognitive breakdown, it's likely exhaustion.
Focus on duration and impact on health to identify the correct stage.
---
4. A nurse is assessing a client experiencing anxiety. Which nursing interventions
are appropriate based on the client's anxiety level? (Select all that apply.)
A. Provide new medication education when the client is mildly anxious.
,B. Use short, simple sentences when the client is moderately anxious.
C. Encourage the client in panic to express feelings using journaling.
D. Remain with the client who is experiencing panic-level anxiety.
E. Reduce environmental stimuli for a client with severe anxiety.
F. Attempt to explain discharge instructions during a panic attack.
Correct Answers: A, B, D, E
Rationale:
A. Correct — Mild anxiety enhances learning; it's the best time to teach.
B. Correct — With moderate anxiety, the client can follow instructions with clear, simple
redirection.
C. Incorrect — A client in panic cannot concentrate or self-reflect; journaling is not
appropriate.
D. Correct — In panic, the nurse must stay with the client and prioritize safety.
E. Correct — Severe anxiety requires environmental control to reduce symptoms and
promote safety.
F. Incorrect — Teaching is ineffective during severe or panic anxiety.
Test-Taking Tip: Use the Mild/Moderate = Teach/Redirect and Severe/Panic = Safety
First rule. Eliminate options involving teaching during high anxiety and focus on
supportive presence and environmental control.
---
5. A nurse is caring for a client whose spouse died 11 months ago. The client
continues to avoid social interactions, reports persistent hopelessness, and says,
"I still expect them to walk through the door." Which response best indicates
complicated grief?
A. "I sometimes still feel angry that they're gone."
B. "I cry occasionally, but I've been getting back to work."
C. "It still hurts, but I'm finding ways to move forward."
D. "I still expect them to walk through the door."
Correct Answer: D
Rationale:
D. Correct — Ongoing denial and inability to accept the loss nearly a year later, paired
with functional impairment, reflect complicated (maladaptive) grief.
A. Incorrect — Anger is a normal part of the Kubler-Ross stages of grief.
,B. Incorrect — Returning to daily functioning and acknowledging pain indicates healthy
adaptation.
C. Incorrect — Acceptance and reintegration are signs of normal grief progression.
Test-Taking Tip: Look at duration and functionality when identifying complicated grief.
NCLEX often tests your ability to recognize when normal grieving becomes
maladaptive. If it's been a long time and the client can't function or accept reality, it's
more than normal grief.
---
6. A nurse is reviewing client cases to determine where each falls on the mental
health-illness continuum. Which examples reflect moderate or severe mental
illness? (Select all that apply.)
A. A client experiencing persistent low mood and fatigue for 2 years but still able to work
B. A client with auditory hallucinations telling them to harm others
C. A client who avoids social events due to constant worry and restlessness
D. A client who occasionally feels down after work but cheers up with family time
E. A client who believes they are being monitored by the government through the TV
Correct Answers: B, C, E
Rationale:
A. Incorrect — This describes mild chronic depression (likely dysthymia), not moderate
or severe illness.
B. Correct — Auditory hallucinations indicate severe mental illness (psychosis, e.g.,
schizophrenia).
C. Correct — Generalized anxiety disorder (GAD) reflects moderate mental illness with
impaired coping.
D. Incorrect — Occasional sadness relieved by social support is considered normal or
mild distress.
E. Correct — Delusions of persecution (e.g., being monitored) are signs of severe
mental illness.
Test-Taking Tip: Focus on functionality and symptom severity. The more impaired,
persistent, or detached from reality the client is, the higher they fall on the illness
continuum. Watch for hallucinations and delusions — those always indicate severe
illness.
---
,7. A nurse is teaching a client about healthy coping mechanisms for managing
chronic stress. Which of the following strategies should the nurse identify as
adaptive coping methods? (Select all that apply.)
A. Going for a walk when feeling overwhelmed
B. Drinking alcohol to unwind after a stressful day
C. Talking to a friend or therapist about emotions
D. Ignoring stressful thoughts and avoiding responsibilities
E. Writing in a journal at night
F. Spending time playing music or with a pet
Correct Answers: A, C, E, F
Rationale:
A. Correct — Physical activity is an adaptive and evidence-based way to manage
stress.
B. Incorrect — Alcohol use is a maladaptive coping mechanism that may worsen
mental health.
C. Correct — Talking is a healthy outlet and supports emotional regulation.
D. Incorrect — Avoidance and withdrawal are maladaptive coping strategies.
E. Correct — Journaling promotes reflection and emotional processing.
F. Correct — Music, pets, and hobbies are all considered adaptive coping techniques.
Test-Taking Tip: On the NCLEX, adaptive = constructive and improves functioning.
Maladaptive = escape/avoidance and often worsens health. Eliminate anything involving
substance use, violence, or emotional suppression.
---
8. A nurse is assessing a client coping with recent job loss. Which of the
following client statements or behaviors demonstrate maladaptive ego defense
mechanisms? (Select all that apply.)
A. "I don't even remember getting fired — it's like it never happened."
B. The client begins yelling at their partner after receiving the news.
C. "I've started running every morning to clear my head."
D. "It wasn't me with the attitude — he was the one being rude!"
E. The client starts sleeping with a childhood blanket and talking in a baby voice.
Correct Answers: A, B, D, E
,Rationale:
A. Repression — Involuntary blocking of distressing memories — maladaptive.
B. Displacement — Redirecting emotions to a safer outlet — maladaptive.
C. Sublimation — Channeling stress into healthy activity — adaptive.
D. Projection — Misattributing one's own feelings to others — maladaptive.
E. Regression — Returning to earlier developmental behaviors — maladaptive.
Test-Taking Tip: Know your keywords — running = sublimation, yelling = displacement,
forgetting = repression, blaming = projection, and acting like a child = regression. Use
the context to determine if it's healthy or maladaptive.
---
9. A nurse is caring for a client recently diagnosed with cancer. When asked how
they're feeling, the client responds, "I feel great. There's nothing wrong with me."
The nurse recognizes this as which ego defense mechanism?
A. Sublimation
B. Denial
C. Displacement
D. Repression
Correct Answer: B
Rationale:
B. Correct — Denial involves refusing to accept reality or the seriousness of a situation
(e.g., a cancer diagnosis).
A. Incorrect — Sublimation is the healthy redirection of unacceptable impulses.
C. Incorrect — Displacement involves taking out emotions on a safer target.
D. Incorrect — Repression is unconscious forgetting, not conscious refusal.
Test-Taking Tip: Denial is common immediately after a diagnosis and is often tested. If
the client completely rejects reality, it's denial. Look for refusal language like "I'm fine" or
"Nothing's wrong."
---
10. A nurse is reviewing ethical principles while caring for a client in a mental
health unit. Which of the following nursing actions demonstrate appropriate
application of these ethical principles? (Select all that apply.)
A. Respecting a client's decision to refuse group therapy, even if the nurse disagrees
EXAM 1
Test Covering Weeks 1 through 3
Verified Questions & Answers With Rationales
(Mental Health Nursing)
Chamberlain
,PREVIEW PAGES BELOW
A colorful preview of the pages that follow
GET THE COMPLETE PDF AFTER
PURCHASE
Need further clarification or study resources?
If you require further clarification or in need of any study
resources, feel free to Message me.
MESSAGE ME ANYTIME
,1. The nurse is caring for four clients. Which client need should the nurse
address first based on Maslow's Hierarchy of Needs?
A. A client who reports feeling isolated after a recent divorce
B. A client who has not eaten since admission 12 hours ago
C. A client who is anxious about an upcoming diagnostic test
D. A client who wants to discuss career goals after discharge
Correct Answer: B
Rationale:
B. Correct — Physiological needs (like food, water, air, sleep) are foundational on
Maslow's hierarchy and must be met first.
A. Incorrect — Love/belonging needs (emotional connection) are important, but lower-
level physiological needs take priority.
C. Incorrect — Anxiety relates to safety, which is prioritized after physiological needs.
D. Incorrect — Discussing career goals is a self-actualization need, the highest level
and least urgent.
Test-Taking Tip: When answering prioritization questions, think Maslow: Always meet
the most basic human needs (like airway, breathing, circulation, food, and safety) before
psychosocial or emotional needs. Use the hierarchy to eliminate distractors!
---
2. Which client statement best reflects mental health, according to standard
nursing definitions?
A. "I've been isolating myself and haven't gone to work in two weeks."
B. "I have trouble managing my anger, and I often yell at my coworkers."
C. "Even though I lost my job, I'm staying focused on caring for my family."
D. "Sometimes I hear voices, but I don't think they're a problem."
Correct Answer: C
Rationale:
C. Correct — This reflects a successful adaptation to stress, maintaining functionality in
daily life and relationships — the core definition of mental health.
A. Incorrect — Social withdrawal and occupational dysfunction suggest impaired
functioning, which aligns with mental illness.
B. Incorrect — Maladaptive anger responses and interpersonal issues may indicate
mental illness.
,D. Incorrect — Hallucinations (even if not perceived as problematic) represent a
deviation from cultural and behavioral norms.
Test-Taking Tip: Look for clues in the client's ability to function despite stress. Mental
health is about adaptation and stability, while mental illness involves maladaptive
behavior and role impairment. When in doubt, ask: Is this helping or hurting their daily
life and relationships?
---
3. A nurse is caring for a client experiencing prolonged stress due to a family
crisis. The client now exhibits fatigue, frequent illness, and difficulty
concentrating. Based on Selye's General Adaptation Syndrome (GAS), which
stage of stress is the client most likely experiencing?
A. Alarm
B. Resistance
C. Exhaustion
D. Adaptation
Correct Answer: C
Rationale:
C. Correct — The exhaustion stage is marked by depleted energy, weakened immune
system, and increased risk for illness or even death if the stress is unresolved.
A. Incorrect — The alarm stage is the initial fight-or-flight response (↑HR,
bronchodilation, ↓digestion).
B. Incorrect — In the resistance stage, the body tries to adapt, and symptoms may
temporarily stabilize.
D. Incorrect — "Adaptation" is part of the resistance stage, but does not describe the
full decompensation seen here.
Test-Taking Tip: GAS follows a progressive pattern: Alarm → Resistance →
Exhaustion. If the client shows physical or cognitive breakdown, it's likely exhaustion.
Focus on duration and impact on health to identify the correct stage.
---
4. A nurse is assessing a client experiencing anxiety. Which nursing interventions
are appropriate based on the client's anxiety level? (Select all that apply.)
A. Provide new medication education when the client is mildly anxious.
,B. Use short, simple sentences when the client is moderately anxious.
C. Encourage the client in panic to express feelings using journaling.
D. Remain with the client who is experiencing panic-level anxiety.
E. Reduce environmental stimuli for a client with severe anxiety.
F. Attempt to explain discharge instructions during a panic attack.
Correct Answers: A, B, D, E
Rationale:
A. Correct — Mild anxiety enhances learning; it's the best time to teach.
B. Correct — With moderate anxiety, the client can follow instructions with clear, simple
redirection.
C. Incorrect — A client in panic cannot concentrate or self-reflect; journaling is not
appropriate.
D. Correct — In panic, the nurse must stay with the client and prioritize safety.
E. Correct — Severe anxiety requires environmental control to reduce symptoms and
promote safety.
F. Incorrect — Teaching is ineffective during severe or panic anxiety.
Test-Taking Tip: Use the Mild/Moderate = Teach/Redirect and Severe/Panic = Safety
First rule. Eliminate options involving teaching during high anxiety and focus on
supportive presence and environmental control.
---
5. A nurse is caring for a client whose spouse died 11 months ago. The client
continues to avoid social interactions, reports persistent hopelessness, and says,
"I still expect them to walk through the door." Which response best indicates
complicated grief?
A. "I sometimes still feel angry that they're gone."
B. "I cry occasionally, but I've been getting back to work."
C. "It still hurts, but I'm finding ways to move forward."
D. "I still expect them to walk through the door."
Correct Answer: D
Rationale:
D. Correct — Ongoing denial and inability to accept the loss nearly a year later, paired
with functional impairment, reflect complicated (maladaptive) grief.
A. Incorrect — Anger is a normal part of the Kubler-Ross stages of grief.
,B. Incorrect — Returning to daily functioning and acknowledging pain indicates healthy
adaptation.
C. Incorrect — Acceptance and reintegration are signs of normal grief progression.
Test-Taking Tip: Look at duration and functionality when identifying complicated grief.
NCLEX often tests your ability to recognize when normal grieving becomes
maladaptive. If it's been a long time and the client can't function or accept reality, it's
more than normal grief.
---
6. A nurse is reviewing client cases to determine where each falls on the mental
health-illness continuum. Which examples reflect moderate or severe mental
illness? (Select all that apply.)
A. A client experiencing persistent low mood and fatigue for 2 years but still able to work
B. A client with auditory hallucinations telling them to harm others
C. A client who avoids social events due to constant worry and restlessness
D. A client who occasionally feels down after work but cheers up with family time
E. A client who believes they are being monitored by the government through the TV
Correct Answers: B, C, E
Rationale:
A. Incorrect — This describes mild chronic depression (likely dysthymia), not moderate
or severe illness.
B. Correct — Auditory hallucinations indicate severe mental illness (psychosis, e.g.,
schizophrenia).
C. Correct — Generalized anxiety disorder (GAD) reflects moderate mental illness with
impaired coping.
D. Incorrect — Occasional sadness relieved by social support is considered normal or
mild distress.
E. Correct — Delusions of persecution (e.g., being monitored) are signs of severe
mental illness.
Test-Taking Tip: Focus on functionality and symptom severity. The more impaired,
persistent, or detached from reality the client is, the higher they fall on the illness
continuum. Watch for hallucinations and delusions — those always indicate severe
illness.
---
,7. A nurse is teaching a client about healthy coping mechanisms for managing
chronic stress. Which of the following strategies should the nurse identify as
adaptive coping methods? (Select all that apply.)
A. Going for a walk when feeling overwhelmed
B. Drinking alcohol to unwind after a stressful day
C. Talking to a friend or therapist about emotions
D. Ignoring stressful thoughts and avoiding responsibilities
E. Writing in a journal at night
F. Spending time playing music or with a pet
Correct Answers: A, C, E, F
Rationale:
A. Correct — Physical activity is an adaptive and evidence-based way to manage
stress.
B. Incorrect — Alcohol use is a maladaptive coping mechanism that may worsen
mental health.
C. Correct — Talking is a healthy outlet and supports emotional regulation.
D. Incorrect — Avoidance and withdrawal are maladaptive coping strategies.
E. Correct — Journaling promotes reflection and emotional processing.
F. Correct — Music, pets, and hobbies are all considered adaptive coping techniques.
Test-Taking Tip: On the NCLEX, adaptive = constructive and improves functioning.
Maladaptive = escape/avoidance and often worsens health. Eliminate anything involving
substance use, violence, or emotional suppression.
---
8. A nurse is assessing a client coping with recent job loss. Which of the
following client statements or behaviors demonstrate maladaptive ego defense
mechanisms? (Select all that apply.)
A. "I don't even remember getting fired — it's like it never happened."
B. The client begins yelling at their partner after receiving the news.
C. "I've started running every morning to clear my head."
D. "It wasn't me with the attitude — he was the one being rude!"
E. The client starts sleeping with a childhood blanket and talking in a baby voice.
Correct Answers: A, B, D, E
,Rationale:
A. Repression — Involuntary blocking of distressing memories — maladaptive.
B. Displacement — Redirecting emotions to a safer outlet — maladaptive.
C. Sublimation — Channeling stress into healthy activity — adaptive.
D. Projection — Misattributing one's own feelings to others — maladaptive.
E. Regression — Returning to earlier developmental behaviors — maladaptive.
Test-Taking Tip: Know your keywords — running = sublimation, yelling = displacement,
forgetting = repression, blaming = projection, and acting like a child = regression. Use
the context to determine if it's healthy or maladaptive.
---
9. A nurse is caring for a client recently diagnosed with cancer. When asked how
they're feeling, the client responds, "I feel great. There's nothing wrong with me."
The nurse recognizes this as which ego defense mechanism?
A. Sublimation
B. Denial
C. Displacement
D. Repression
Correct Answer: B
Rationale:
B. Correct — Denial involves refusing to accept reality or the seriousness of a situation
(e.g., a cancer diagnosis).
A. Incorrect — Sublimation is the healthy redirection of unacceptable impulses.
C. Incorrect — Displacement involves taking out emotions on a safer target.
D. Incorrect — Repression is unconscious forgetting, not conscious refusal.
Test-Taking Tip: Denial is common immediately after a diagnosis and is often tested. If
the client completely rejects reality, it's denial. Look for refusal language like "I'm fine" or
"Nothing's wrong."
---
10. A nurse is reviewing ethical principles while caring for a client in a mental
health unit. Which of the following nursing actions demonstrate appropriate
application of these ethical principles? (Select all that apply.)
A. Respecting a client's decision to refuse group therapy, even if the nurse disagrees
