,Galen NSG 3450 Exam 3 | Nursing Practice: Mental Health
(2026) Actual Q&A PDF
1. A nurse is reviewing the care plan of a client with borderline personality disorder. Which
defense mechanism is most characteristic of this condition?
A) Splitting
B) Projection
C) Denial
D) Rationalization
Correct Answer: Splitting
Rationale: Splitting is a hallmark defense mechanism in borderline personality disorder
where individuals categorize people as all good or all bad. This behavior often leads to
conflict and manipulation among staff members on the unit. The nurse must recognize this to
maintain a consistent team approach and prevent the client's attempts to divide the staff.
2. Which physical finding should the nurse prioritize when assessing a client with anorexia
nervosa?
A) Hypertension
B) Tachycardia
C) Hyperthermia
D) Bradycardia
Correct Answer: Bradycardia
Rationale: Anorexia nervosa often leads to physiological adaptations to starvation, such as
bradycardia and hypotension. These changes occur as the body attempts to conserve energy
and can lead to life-threatening cardiac arrhythmias. Monitoring vital signs is critical for early
detection of medical instability in eating disorder patients.
,3. A nurse is assessing an older adult client for delirium. Which characteristic distinguishes
delirium from dementia?
A) Gradual onset of symptoms over several years
B) Permanent and irreversible cognitive decline
C) Sudden onset with fluctuating levels of consciousness
D) Normal level of attention and alertness
Correct Answer: Sudden onset with fluctuating levels of consciousness
Rationale: Delirium is characterized by a rapid, acute onset of confusion and fluctuations in
consciousness throughout the day. Unlike dementia, which is progressive and chronic,
delirium is often secondary to an underlying medical condition like a UTI or electrolyte
imbalance. Identifying the root cause of delirium is essential for reversal and patient safety.
4. What is the primary goal of nursing interventions for a client with antisocial personality
disorder?
A) Set clear, consistent limits on manipulative behavior
B) Encourage the client to express deep-seated emotions
C) Promote dependence on the nursing staff for decision-making
D) Allow the client to lead group therapy sessions
Correct Answer: Set clear, consistent limits on manipulative behavior
Rationale: Individuals with antisocial personality disorder often disregard the rights of others
and use manipulation to achieve their own goals. Setting firm and consistent limits is the
most effective nursing strategy to manage these behaviors and maintain unit safety. This
approach helps the client understand boundaries and reduces the opportunity for exploitative
interactions.
, 5. A child is prescribed methylphenidate for ADHD. Which side effect should the nurse
instruct the parents to monitor?
A) Insomnia and weight loss
B) Excessive sleepiness and lethargy
C) Increased appetite and weight gain
D) Bradypnea and hypotension
Correct Answer: Insomnia and weight loss
Rationale: Methylphenidate is a stimulant medication that commonly causes insomnia and
weight loss due to appetite suppression. Parents should be instructed to administer the
medication early in the day to minimize insomnia and to monitor the child's growth and
nutritional intake. Excessive sleepiness, increased appetite, and bradypnea are not typical side
effects.
6. A client with major depressive disorder tells the nurse, "My family would be better off
without me." The client has recently given away several valued possessions. Which nursing
action is the priority?
A) Encourage the client to describe positive aspects of the family relationship
B) Ask directly whether the client has a specific suicide plan and access to means
C) Place the client in a quiet room to reduce environmental stimulation
D) Encourage participation in a structured recreational activity
Correct Answer: Ask directly whether the client has a specific suicide plan and access to
means
Rationale: Giving away possessions and expressing perceived burdensomeness are
significant suicide warning signs. Direct assessment of suicidal intent, plan, means, and
immediacy is necessary to determine the level of risk and immediate safety interventions. The
other options do not address the immediate risk of self-harm.
(2026) Actual Q&A PDF
1. A nurse is reviewing the care plan of a client with borderline personality disorder. Which
defense mechanism is most characteristic of this condition?
A) Splitting
B) Projection
C) Denial
D) Rationalization
Correct Answer: Splitting
Rationale: Splitting is a hallmark defense mechanism in borderline personality disorder
where individuals categorize people as all good or all bad. This behavior often leads to
conflict and manipulation among staff members on the unit. The nurse must recognize this to
maintain a consistent team approach and prevent the client's attempts to divide the staff.
2. Which physical finding should the nurse prioritize when assessing a client with anorexia
nervosa?
A) Hypertension
B) Tachycardia
C) Hyperthermia
D) Bradycardia
Correct Answer: Bradycardia
Rationale: Anorexia nervosa often leads to physiological adaptations to starvation, such as
bradycardia and hypotension. These changes occur as the body attempts to conserve energy
and can lead to life-threatening cardiac arrhythmias. Monitoring vital signs is critical for early
detection of medical instability in eating disorder patients.
,3. A nurse is assessing an older adult client for delirium. Which characteristic distinguishes
delirium from dementia?
A) Gradual onset of symptoms over several years
B) Permanent and irreversible cognitive decline
C) Sudden onset with fluctuating levels of consciousness
D) Normal level of attention and alertness
Correct Answer: Sudden onset with fluctuating levels of consciousness
Rationale: Delirium is characterized by a rapid, acute onset of confusion and fluctuations in
consciousness throughout the day. Unlike dementia, which is progressive and chronic,
delirium is often secondary to an underlying medical condition like a UTI or electrolyte
imbalance. Identifying the root cause of delirium is essential for reversal and patient safety.
4. What is the primary goal of nursing interventions for a client with antisocial personality
disorder?
A) Set clear, consistent limits on manipulative behavior
B) Encourage the client to express deep-seated emotions
C) Promote dependence on the nursing staff for decision-making
D) Allow the client to lead group therapy sessions
Correct Answer: Set clear, consistent limits on manipulative behavior
Rationale: Individuals with antisocial personality disorder often disregard the rights of others
and use manipulation to achieve their own goals. Setting firm and consistent limits is the
most effective nursing strategy to manage these behaviors and maintain unit safety. This
approach helps the client understand boundaries and reduces the opportunity for exploitative
interactions.
, 5. A child is prescribed methylphenidate for ADHD. Which side effect should the nurse
instruct the parents to monitor?
A) Insomnia and weight loss
B) Excessive sleepiness and lethargy
C) Increased appetite and weight gain
D) Bradypnea and hypotension
Correct Answer: Insomnia and weight loss
Rationale: Methylphenidate is a stimulant medication that commonly causes insomnia and
weight loss due to appetite suppression. Parents should be instructed to administer the
medication early in the day to minimize insomnia and to monitor the child's growth and
nutritional intake. Excessive sleepiness, increased appetite, and bradypnea are not typical side
effects.
6. A client with major depressive disorder tells the nurse, "My family would be better off
without me." The client has recently given away several valued possessions. Which nursing
action is the priority?
A) Encourage the client to describe positive aspects of the family relationship
B) Ask directly whether the client has a specific suicide plan and access to means
C) Place the client in a quiet room to reduce environmental stimulation
D) Encourage participation in a structured recreational activity
Correct Answer: Ask directly whether the client has a specific suicide plan and access to
means
Rationale: Giving away possessions and expressing perceived burdensomeness are
significant suicide warning signs. Direct assessment of suicidal intent, plan, means, and
immediacy is necessary to determine the level of risk and immediate safety interventions. The
other options do not address the immediate risk of self-harm.
