NUR 253 Final Exam 1 | Concepts of Mental Health
Nursing (2026) Q&A | Galen College
1. Which of the following best describes the primary purpose of the mental status
examination in psychiatric nursing?
A) To diagnose specific psychiatric disorders based on DSM-5-TR criteria
B) To assess the client's current cognitive, emotional, and behavioral functioning
C) To determine the appropriate psychopharmacological treatment regimen
D) To evaluate the client's potential for violence toward self or others
Correct Answer: To assess the client's current cognitive, emotional, and behavioral
functioning
Rationale: The mental status examination is a structured assessment tool used to
evaluate a client's current level of functioning across multiple domains, including
appearance, behavior, mood, affect, thought processes, cognition, and insight. It
provides a baseline for comparison over time and informs nursing interventions. It does
not independently diagnose disorders, prescribe medications, or solely assess violence
risk.
2. A nurse is caring for a client who states, "I don't trust any of you. My thoughts are
being broadcast over the hospital intercom." Which initial response by the nurse
is most therapeutic?
A) "That sounds frightening. I can assure you the intercom is only used for staff
announcements."
B) "You're safe here. Nobody is broadcasting your thoughts."
C) "I'd like to understand more about what you're experiencing. Can you tell me what
you're hearing?"
D) "Let's focus on something else. Would you like to go to the day room?"
Correct Answer: "I'd like to understand more about what you're experiencing. Can you
tell me what you're hearing?"
Rationale: The therapeutic response acknowledges the client's experience without
confirming or challenging the delusion. Exploring the client's perception builds trust and
gathers assessment data. Directly denying the delusion may increase anxiety and
defensiveness. Redirecting without acknowledging the concern dismisses the client's
experience.
3. Which term refers to a fixed, false belief that is resistant to reason or contrary to
the client's cultural background?
,A) Hallucination
B) Delusion
C) Illusion
D) Flight of ideas
Correct Answer: Delusion
Rationale: A delusion is a fixed, false belief that cannot be corrected by reasoning or
evidence and is not consistent with the client's culture or religion. A hallucination is a
sensory perception without external stimuli. An illusion is a misperception of a real
external stimulus. Flight of ideas is a rapid, fragmented flow of speech.
4. A client with generalized anxiety disorder is prescribed a selective serotonin
reuptake inhibitor. The nurse understands that the therapeutic effect of SSRIs
typically takes how long to manifest?
A) 24 to 48 hours
B) 3 to 5 days
C) 2 to 4 weeks
D) 6 to 8 weeks
Correct Answer: 2 to 4 weeks
Rationale: SSRIs require 2 to 4 weeks or longer to achieve full therapeutic effect. Clients
should be educated about this delay to prevent premature discontinuation. During the
initial period, the risk of increased anxiety and suicidal ideation should be monitored.
Other medication classes, such as benzodiazepines, act more rapidly.
5. In the context of the nurse-client relationship, which phase is characterized by
the nurse and client working together to solve problems and promote growth?
A) Preinteraction phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: According to Peplau's theory, the working phase is when the nurse and client
collaboratively identify and resolve problems. The preinteraction phase occurs before
meeting the client. The orientation phase establishes trust and defines the relationship.
The termination phase concludes the relationship and evaluates progress.
6. What is the most likely outcome if a client with schizophrenia is experiencing
acute auditory hallucinations?
,A) The client will be able to participate fully in group therapy.
B) The client may appear distracted and have difficulty concentrating on conversation.
C) The client will deny hearing any voices.
D) The client will demonstrate improved insight into their illness.
Correct Answer: The client may appear distracted and have difficulty concentrating on
conversation.
Rationale: Auditory hallucinations are sensory perceptions of sound without external
stimuli. During acute episodes, clients may appear distracted, pause mid-sentence, or
have difficulty focusing on external conversations. Participating in group therapy,
denying voices, and demonstrating insight are less likely during acute hallucinatory
episodes.
7. Which neurotransmitter is most closely associated with the positive symptoms of
schizophrenia?
A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
Correct Answer: Dopamine
Rationale: The dopamine hypothesis suggests that excessive dopaminergic activity in
certain brain pathways contributes to positive symptoms such as hallucinations and
delusions. Serotonin, norepinephrine, and GABA are associated with other psychiatric
conditions, including depression, anxiety, and mood regulation.
8. A nurse is assessing a client with bipolar disorder who is experiencing acute
mania. Which finding is most consistent with this condition?
A) Psychomotor retardation and hypersomnia
B) Decreased need for sleep and pressured speech
C) Anhedonia and social withdrawal
D) Obsessive thoughts and compulsive behaviors
Correct Answer: Decreased need for sleep and pressured speech
Rationale: Acute mania is characterized by decreased need for sleep, pressured speech,
flight of ideas, grandiosity, and increased goal-directed activity. Psychomotor retardation
and hypersomnia are seen in depression. Anhedonia and social withdrawal are
depressive symptoms. Obsessive thoughts and compulsions are associated with OCD.
9. Which laboratory value should the nurse monitor closely in a client taking lithium
carbonate?
, A) Serum sodium
B) Serum lithium level
C) Serum potassium
D) Serum calcium
Correct Answer: Serum lithium level
Rationale: Lithium has a narrow therapeutic index, with therapeutic levels typically
ranging from 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can cause toxicity. Serum lithium
levels must be monitored regularly. Sodium, potassium, and calcium are not the primary
laboratory values for lithium monitoring.
10. A client with borderline personality disorder is admitted to the unit. Which
nursing approach is most appropriate?
A) Rotating staff assignments frequently to prevent manipulation
B) Setting clear, consistent boundaries and limits
C) Allowing the client to make all decisions about their care
D) Avoiding discussing the client's feelings to prevent escalation
Correct Answer: Setting clear, consistent boundaries and limits
Rationale: Clients with borderline personality disorder benefit from structured,
consistent boundaries that are reinforced by all staff members. Rotating staff, allowing
unlimited decision-making, or avoiding emotional discussions can increase anxiety and
maladaptive behaviors. Consistency promotes a sense of safety and predictability.
11. Which of the following is a priority nursing intervention for a client experiencing a
panic attack?
A) Encouraging the client to identify the source of their anxiety
B) Staying with the client and providing a calm, quiet environment
C) Administering a PRN benzodiazepine immediately
D) Teaching the client diaphragmatic breathing techniques
Correct Answer: Staying with the client and providing a calm, quiet environment
Rationale: During a panic attack, the client's ability to process information is severely
impaired. The priority is to ensure safety by remaining with the client and reducing
environmental stimuli. Teaching coping skills and exploring the source of anxiety are
appropriate after the acute episode resolves.
12. What is the primary purpose of using silence as a therapeutic communication
technique?
A) To punish the client for inappropriate behavior
B) To allow the client time to process thoughts and feelings
Nursing (2026) Q&A | Galen College
1. Which of the following best describes the primary purpose of the mental status
examination in psychiatric nursing?
A) To diagnose specific psychiatric disorders based on DSM-5-TR criteria
B) To assess the client's current cognitive, emotional, and behavioral functioning
C) To determine the appropriate psychopharmacological treatment regimen
D) To evaluate the client's potential for violence toward self or others
Correct Answer: To assess the client's current cognitive, emotional, and behavioral
functioning
Rationale: The mental status examination is a structured assessment tool used to
evaluate a client's current level of functioning across multiple domains, including
appearance, behavior, mood, affect, thought processes, cognition, and insight. It
provides a baseline for comparison over time and informs nursing interventions. It does
not independently diagnose disorders, prescribe medications, or solely assess violence
risk.
2. A nurse is caring for a client who states, "I don't trust any of you. My thoughts are
being broadcast over the hospital intercom." Which initial response by the nurse
is most therapeutic?
A) "That sounds frightening. I can assure you the intercom is only used for staff
announcements."
B) "You're safe here. Nobody is broadcasting your thoughts."
C) "I'd like to understand more about what you're experiencing. Can you tell me what
you're hearing?"
D) "Let's focus on something else. Would you like to go to the day room?"
Correct Answer: "I'd like to understand more about what you're experiencing. Can you
tell me what you're hearing?"
Rationale: The therapeutic response acknowledges the client's experience without
confirming or challenging the delusion. Exploring the client's perception builds trust and
gathers assessment data. Directly denying the delusion may increase anxiety and
defensiveness. Redirecting without acknowledging the concern dismisses the client's
experience.
3. Which term refers to a fixed, false belief that is resistant to reason or contrary to
the client's cultural background?
,A) Hallucination
B) Delusion
C) Illusion
D) Flight of ideas
Correct Answer: Delusion
Rationale: A delusion is a fixed, false belief that cannot be corrected by reasoning or
evidence and is not consistent with the client's culture or religion. A hallucination is a
sensory perception without external stimuli. An illusion is a misperception of a real
external stimulus. Flight of ideas is a rapid, fragmented flow of speech.
4. A client with generalized anxiety disorder is prescribed a selective serotonin
reuptake inhibitor. The nurse understands that the therapeutic effect of SSRIs
typically takes how long to manifest?
A) 24 to 48 hours
B) 3 to 5 days
C) 2 to 4 weeks
D) 6 to 8 weeks
Correct Answer: 2 to 4 weeks
Rationale: SSRIs require 2 to 4 weeks or longer to achieve full therapeutic effect. Clients
should be educated about this delay to prevent premature discontinuation. During the
initial period, the risk of increased anxiety and suicidal ideation should be monitored.
Other medication classes, such as benzodiazepines, act more rapidly.
5. In the context of the nurse-client relationship, which phase is characterized by
the nurse and client working together to solve problems and promote growth?
A) Preinteraction phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: According to Peplau's theory, the working phase is when the nurse and client
collaboratively identify and resolve problems. The preinteraction phase occurs before
meeting the client. The orientation phase establishes trust and defines the relationship.
The termination phase concludes the relationship and evaluates progress.
6. What is the most likely outcome if a client with schizophrenia is experiencing
acute auditory hallucinations?
,A) The client will be able to participate fully in group therapy.
B) The client may appear distracted and have difficulty concentrating on conversation.
C) The client will deny hearing any voices.
D) The client will demonstrate improved insight into their illness.
Correct Answer: The client may appear distracted and have difficulty concentrating on
conversation.
Rationale: Auditory hallucinations are sensory perceptions of sound without external
stimuli. During acute episodes, clients may appear distracted, pause mid-sentence, or
have difficulty focusing on external conversations. Participating in group therapy,
denying voices, and demonstrating insight are less likely during acute hallucinatory
episodes.
7. Which neurotransmitter is most closely associated with the positive symptoms of
schizophrenia?
A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
Correct Answer: Dopamine
Rationale: The dopamine hypothesis suggests that excessive dopaminergic activity in
certain brain pathways contributes to positive symptoms such as hallucinations and
delusions. Serotonin, norepinephrine, and GABA are associated with other psychiatric
conditions, including depression, anxiety, and mood regulation.
8. A nurse is assessing a client with bipolar disorder who is experiencing acute
mania. Which finding is most consistent with this condition?
A) Psychomotor retardation and hypersomnia
B) Decreased need for sleep and pressured speech
C) Anhedonia and social withdrawal
D) Obsessive thoughts and compulsive behaviors
Correct Answer: Decreased need for sleep and pressured speech
Rationale: Acute mania is characterized by decreased need for sleep, pressured speech,
flight of ideas, grandiosity, and increased goal-directed activity. Psychomotor retardation
and hypersomnia are seen in depression. Anhedonia and social withdrawal are
depressive symptoms. Obsessive thoughts and compulsions are associated with OCD.
9. Which laboratory value should the nurse monitor closely in a client taking lithium
carbonate?
, A) Serum sodium
B) Serum lithium level
C) Serum potassium
D) Serum calcium
Correct Answer: Serum lithium level
Rationale: Lithium has a narrow therapeutic index, with therapeutic levels typically
ranging from 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can cause toxicity. Serum lithium
levels must be monitored regularly. Sodium, potassium, and calcium are not the primary
laboratory values for lithium monitoring.
10. A client with borderline personality disorder is admitted to the unit. Which
nursing approach is most appropriate?
A) Rotating staff assignments frequently to prevent manipulation
B) Setting clear, consistent boundaries and limits
C) Allowing the client to make all decisions about their care
D) Avoiding discussing the client's feelings to prevent escalation
Correct Answer: Setting clear, consistent boundaries and limits
Rationale: Clients with borderline personality disorder benefit from structured,
consistent boundaries that are reinforced by all staff members. Rotating staff, allowing
unlimited decision-making, or avoiding emotional discussions can increase anxiety and
maladaptive behaviors. Consistency promotes a sense of safety and predictability.
11. Which of the following is a priority nursing intervention for a client experiencing a
panic attack?
A) Encouraging the client to identify the source of their anxiety
B) Staying with the client and providing a calm, quiet environment
C) Administering a PRN benzodiazepine immediately
D) Teaching the client diaphragmatic breathing techniques
Correct Answer: Staying with the client and providing a calm, quiet environment
Rationale: During a panic attack, the client's ability to process information is severely
impaired. The priority is to ensure safety by remaining with the client and reducing
environmental stimuli. Teaching coping skills and exploring the source of anxiety are
appropriate after the acute episode resolves.
12. What is the primary purpose of using silence as a therapeutic communication
technique?
A) To punish the client for inappropriate behavior
B) To allow the client time to process thoughts and feelings
