GALEN COLLEGE OF NURSING — NUR 256 MENTAL HEALTH EXAM FALL 2026 EXAM STUDY PAPER
GALEN COLLEGE OF NURSING
NUR 256: MENTAL HEALTH NURSING — COMPREHENSIVE EXAM PAPER
FALL 2026 SEMESTER | LECTURER EXAM REVIEW & RATIONALE STUDY GUIDE
Student Name: ___________________________ Date: ______________ Score: ______ / 100
EXAMINATION INSTRUCTIONS: This exam paper covers key content across Exams 1, 2, 3, and 4. Each question
presents multiple-choice options (A, B, C, D) with randomized correct answer positions. Correct choices are highlighted with
a green tick (✔) and accompanied by detailed yellow-styled rationales grounded strictly in course materials.
SECTION 1: EXAM 1 — FOUNDATIONS & ETHICO-LEGAL PRACTICE
Question 1. A home health nurse is caring for a terminally ill client with acquired immune
deficiency syndrome (AIDS) who is incompetent and asks the nurse to assist with suicide. The
nurse informs the client that they will not assist with the request. Which ethical
principle/liberty is the nurse demonstrating?
A. Autonomy
[✔] B. Nonmaleficence
C. Individual liberty
D. Beneficence
Rationale: Nonmaleficence is the duty to do no harm and protect human life. Assisting with suicide violates the
fundamental ethical obligation of nonmaleficence. Autonomy respects individual decision-making, but nurses cannot
perform illegal or harmful acts requested by incompetent clients.
Question 2. A nurse is reviewing admission criteria for involuntary commitment to an
inpatient psychiatric facility. Which requirement must be met for court-ordered involuntary
admission?
A. The client applies in writing for admission to the facility.
B. The client is unwilling to seek outpatient therapy due to financial constraints.
C. The client refuses to follow medication instructions given by the physician.
[✔] D. The client has a diagnosed mental illness and poses a dangerous threat to self or others.
Rationale: Involuntary commitment (assisted inpatient treatment) is a court-ordered admission that requires two
primary criteria: a diagnosed mental illness and an immediate, credible danger to self or others (or severe inability to
care for basic needs).
Black text: Default | Green tick ✔: Correct Answer | Yellow box: Rationale Page 1
, GALEN COLLEGE OF NURSING — NUR 256 MENTAL HEALTH EXAM FALL 2026 EXAM STUDY PAPER
Question 3. During a nurse-client interview, the nurse realizes they are feeling overly
protective toward a client because the client closely resembles the nurse's younger sibling.
What phenomenon is the nurse experiencing?
[✔] A. Countertransference
B. Transference
C. Projective identification
D. Reaction formation
Rationale: Countertransference occurs when the nurse unconsciously displaces feelings, attitudes, and behaviors
related to significant figures in the nurse's past onto the client. A common sign is over-identification with the client.
Question 4. A nurse educator is presenting a staff development session on the
Diathesis-Stress Model of psychiatric illness. Which statement best explains this model?
A. Psychiatric disorders stem exclusively from environmental trauma during early childhood.
B. Genetic vulnerability alone causes mental illness regardless of life stressors.
[✔] C. Most psychiatric disorders result from a combination of genetic vulnerability (diathesis)
and environmental stressors.
D. Resilience completely neutralizes biological risk factors in all individuals.
Rationale: The Diathesis-Stress Model represents the nature-plus-nurture explanation, asserting that psychiatric
illness results from a biological/genetic predisposition (diathesis) interacting with environmental trauma or stress.
Question 5. A newly hired nurse assists staff members in holding down a combative client
while a chemical restraint is administered. After obtaining the primary health care provider's
prescription, which action should be performed next?
A. Lead the debriefing with the client immediately.
[✔] B. Assess the client and document physical findings and vital signs.
C. Collect written statements from other clients who witnessed the incident.
D. Notify the client's next of kin listed in the medical record.
Rationale: Immediate assessment of the client's physical status, vital signs, injury check, and documentation are
mandatory initial nursing actions following restraint administration to ensure client safety.
Question 6. The nurse is caring for a terminally ill client on a psychiatric palliative unit. Which
statement by the nurse best demonstrates the 'art of presence'?
[✔] A. 'Would you like to talk about what this experience is like for you?'
B. 'I am going to sit here and read a book, just pretend I am not here.'
C. 'I am going to the other room so you can be alone and reflect on your life.'
D. 'Are you feeling guilty about leaving your family behind?'
Rationale: The 'art of presence' involves empathetic, non-judgmental availability and open inquiry ('Would you tell
me what this is like for you?'), allowing the client to share feelings spontaneously.
[ --- END OF EXAM 1 SECTION --- ]
Black text: Default | Green tick ✔: Correct Answer | Yellow box: Rationale Page 2
GALEN COLLEGE OF NURSING
NUR 256: MENTAL HEALTH NURSING — COMPREHENSIVE EXAM PAPER
FALL 2026 SEMESTER | LECTURER EXAM REVIEW & RATIONALE STUDY GUIDE
Student Name: ___________________________ Date: ______________ Score: ______ / 100
EXAMINATION INSTRUCTIONS: This exam paper covers key content across Exams 1, 2, 3, and 4. Each question
presents multiple-choice options (A, B, C, D) with randomized correct answer positions. Correct choices are highlighted with
a green tick (✔) and accompanied by detailed yellow-styled rationales grounded strictly in course materials.
SECTION 1: EXAM 1 — FOUNDATIONS & ETHICO-LEGAL PRACTICE
Question 1. A home health nurse is caring for a terminally ill client with acquired immune
deficiency syndrome (AIDS) who is incompetent and asks the nurse to assist with suicide. The
nurse informs the client that they will not assist with the request. Which ethical
principle/liberty is the nurse demonstrating?
A. Autonomy
[✔] B. Nonmaleficence
C. Individual liberty
D. Beneficence
Rationale: Nonmaleficence is the duty to do no harm and protect human life. Assisting with suicide violates the
fundamental ethical obligation of nonmaleficence. Autonomy respects individual decision-making, but nurses cannot
perform illegal or harmful acts requested by incompetent clients.
Question 2. A nurse is reviewing admission criteria for involuntary commitment to an
inpatient psychiatric facility. Which requirement must be met for court-ordered involuntary
admission?
A. The client applies in writing for admission to the facility.
B. The client is unwilling to seek outpatient therapy due to financial constraints.
C. The client refuses to follow medication instructions given by the physician.
[✔] D. The client has a diagnosed mental illness and poses a dangerous threat to self or others.
Rationale: Involuntary commitment (assisted inpatient treatment) is a court-ordered admission that requires two
primary criteria: a diagnosed mental illness and an immediate, credible danger to self or others (or severe inability to
care for basic needs).
Black text: Default | Green tick ✔: Correct Answer | Yellow box: Rationale Page 1
, GALEN COLLEGE OF NURSING — NUR 256 MENTAL HEALTH EXAM FALL 2026 EXAM STUDY PAPER
Question 3. During a nurse-client interview, the nurse realizes they are feeling overly
protective toward a client because the client closely resembles the nurse's younger sibling.
What phenomenon is the nurse experiencing?
[✔] A. Countertransference
B. Transference
C. Projective identification
D. Reaction formation
Rationale: Countertransference occurs when the nurse unconsciously displaces feelings, attitudes, and behaviors
related to significant figures in the nurse's past onto the client. A common sign is over-identification with the client.
Question 4. A nurse educator is presenting a staff development session on the
Diathesis-Stress Model of psychiatric illness. Which statement best explains this model?
A. Psychiatric disorders stem exclusively from environmental trauma during early childhood.
B. Genetic vulnerability alone causes mental illness regardless of life stressors.
[✔] C. Most psychiatric disorders result from a combination of genetic vulnerability (diathesis)
and environmental stressors.
D. Resilience completely neutralizes biological risk factors in all individuals.
Rationale: The Diathesis-Stress Model represents the nature-plus-nurture explanation, asserting that psychiatric
illness results from a biological/genetic predisposition (diathesis) interacting with environmental trauma or stress.
Question 5. A newly hired nurse assists staff members in holding down a combative client
while a chemical restraint is administered. After obtaining the primary health care provider's
prescription, which action should be performed next?
A. Lead the debriefing with the client immediately.
[✔] B. Assess the client and document physical findings and vital signs.
C. Collect written statements from other clients who witnessed the incident.
D. Notify the client's next of kin listed in the medical record.
Rationale: Immediate assessment of the client's physical status, vital signs, injury check, and documentation are
mandatory initial nursing actions following restraint administration to ensure client safety.
Question 6. The nurse is caring for a terminally ill client on a psychiatric palliative unit. Which
statement by the nurse best demonstrates the 'art of presence'?
[✔] A. 'Would you like to talk about what this experience is like for you?'
B. 'I am going to sit here and read a book, just pretend I am not here.'
C. 'I am going to the other room so you can be alone and reflect on your life.'
D. 'Are you feeling guilty about leaving your family behind?'
Rationale: The 'art of presence' involves empathetic, non-judgmental availability and open inquiry ('Would you tell
me what this is like for you?'), allowing the client to share feelings spontaneously.
[ --- END OF EXAM 1 SECTION --- ]
Black text: Default | Green tick ✔: Correct Answer | Yellow box: Rationale Page 2
