NUR 253 Exam 4 Mental Health (2026 / 2027) PDF | Galen College of Nursing

NUR 253 Exam 4 Mental Health (2026
/ 2027) PDF | Galen College of
Nursing
1. A nurse is using active listening. Which response is most therapeutic?
A. “Why did you do that?”
B. “Tell me more about what you are feeling.”
C. “You shouldn’t feel that way.”
D. “I know exactly how you feel.”
Correct Answer: B. “Tell me more about what you are feeling.”
Rationale: Active listening encourages the client to express feelings
without judgment. “Why” questions can feel accusatory, and minimizing or
claiming to know exactly how the client feels blocks communication.
2. A client says, “I’m worthless.” Which nurse response is best?
A. “You are not worthless.”
B. “You’re feeling worthless right now?”
C. “Everyone feels that way sometimes.”
D. “Let’s talk about something else.”
Correct Answer: B. “You’re feeling worthless right now?”
Rationale: Restating the client’s feeling validates it and encourages
further expression. Arguing or minimizing the feeling is not therapeutic.
3. A nurse may breach confidentiality when:
A. The client refuses medication.
B. The client threatens to harm another person.
C. The client asks about their diagnosis.
D. The client wants to leave against medical advice.
Correct Answer: B. The client threatens to harm another person.
Rationale: Confidentiality must be broken when there is a duty to

, warn/protect an identifiable victim from serious harm. This is based on the
Tarasoff principle.
4. A client is placed in restraints. How often should the nurse assess the client?
A. Every 5 minutes
B. Every 15 minutes
C. Every 30 minutes
D. Every 2 hours
Correct Answer: B. Every 15 minutes
Rationale: Clients in restraints require frequent assessment, typically
every 15 minutes, including circulation, skin integrity, vital signs, and
psychological status.
5. A voluntarily admitted client wants to leave the hospital. What should the
nurse do first?
A. Allow the client to leave immediately.
B. Assess the client for suicidal or homicidal ideation.
C. Call security to restrain the client.
D. Ask the provider to discharge the client.
Correct Answer: B. Assess the client for suicidal or homicidal ideation.
Rationale: A voluntary client may sign out, but the nurse must first
assess for danger to self or others. If the client is a danger, the provider may
initiate involuntary hold.
6. Who is responsible for obtaining informed consent?
A. The nurse
B. The client’s family
C. The provider
D. The hospital administrator
Correct Answer: C. The provider
Rationale: The provider performing the procedure is responsible for
obtaining informed consent. The nurse may witness the signature and
clarify information.

, 7. A client with schizophrenia has command hallucinations. What is the
priority?
A. Encourage group therapy.
B. Assess for suicidal or homicidal commands.
C. Give the client a journal.
D. Ignore the hallucination.
Correct Answer: B. Assess for suicidal or homicidal commands.
Rationale: Command hallucinations can instruct the client to harm self
or others. Safety is the priority.
8. Milieu therapy primarily focuses on:
A. Medication administration.
B. Creating a safe, therapeutic environment.
C. Restraining aggressive clients.
D. Isolating clients from peers.
Correct Answer: B. Creating a safe, therapeutic environment.
Rationale: Milieu therapy uses the therapeutic environment and daily
structure to promote safety, social skills, and independence.
9. A client tells the nurse, “You remind me of my mother.” This is an example
of:
A. Transference
B. Countertransference
C. Projection
D. Splitting
Correct Answer: A. Transference
Rationale: Transference occurs when the client displaces feelings about
a significant person onto the nurse.
10.A nurse feels overly protective of a client and wants to rescue them. This is:
A. Transference
B. Countertransference
C. Denial
D. Regression