NUR 253 Exam1,2,3 & 4 Mental Health () PDF | Galen
College of Nursing
NUR 253 Exam 1: Foundations of Mental Health Nursing
1. A client with a history of schizophrenia is admitted to the psychiatric unit. The
nurse notes the client is exhibiting echolalia. Which of the following best describes
this symptom?
A) Repeating the words of others.
B) Making up new words.
C) Stopping speech in the middle of a sentence.
D) Speaking in a monotone voice.
Correct Answer: A
Explanation: Echolalia is the pathological repetition of another's words, often seen in
schizophrenia. It is a form of disorganized speech. Option B is neologism, C is thought
blocking, and D is a flat affect.
2. A nurse is caring for a client who is experiencing a panic attack. Which of the
following interventions should the nurse implement first?
A) Encourage the client to talk about feelings.
B) Administer prescribed PRN lorazepam.
C) Remain with the client and speak in a calm, brief manner.
D) Place the client in a quiet room alone.
Correct Answer: C
Explanation: The priority during a panic attack is to provide safety and reduce stimuli.
Remaining with the client provides a sense of security. Calm, brief directions (like "sit
down" or "breathe with me") help the client focus. Medication is important but not the
first step; leaving the client alone can increase fear.
3. The nurse is assessing a client’s risk for suicide. Which question is most
appropriate for the nurse to ask first?
A) "Do you feel like hurting yourself?"
B) "Have you thought about how you would kill yourself?"
C) "Do you have a plan to commit suicide?"
D) "Have you ever attempted suicide before?"
,Correct Answer: A
Explanation: The nurse should first assess for suicidal ideation with a direct, non-
judgmental question. While assessing the plan (B), means (C), and history (D) are crucial,
the initial screening is to determine if the client is having thoughts of self-harm. Asking
about it does not plant the idea.
4. A client diagnosed with major depressive disorder states, "I am a terrible person
and everyone would be better off without me." Which is the nurse's best
response?
A) "That is a very negative way to think."
B) "You have so much to live for."
C) "It sounds like you are feeling hopeless right now."
D) "I don't think that's true at all."
Correct Answer: C
Explanation: This response uses therapeutic communication by reflecting the client's
feeling of hopelessness, which validates the emotion. Options A and D are judgmental
and dismissive. Option B is a cliché and offers false reassurance, which does not help the
client explore their feelings.
5. A client is admitted involuntarily to a psychiatric unit. Which of the following
rights is the client legally guaranteed?
A) The right to refuse all medication.
B) The right to vote.
C) The right to have a telephone call within 24 hours.
D) The right to leave the unit at any time.
Correct Answer: C
Explanation: Involuntary commitment means the client is held against their will for
safety reasons, but they retain most civil rights, including the right to communicate with
others. They cannot leave the unit freely (D). They can refuse some medications but not
all if a court order is in place (A). Voting rights depend on state laws but are generally
retained.
6. The nurse is planning care for a client with histrionic personality disorder. Which
communication style is most likely to be effective?
A) Direct, matter-of-fact, and avoiding power struggles.
B) Gentle, empathetic, and focused on feelings.
C) Firm, consistent, and focused on objective facts.
D) Highly structured, rigid, and formal.
Correct Answer: C
Explanation: Clients with histrionic personality disorder are dramatic, attention-seeking,
and emotionally labile. Setting firm, consistent limits on manipulative behavior is
,essential. Focusing on objective facts helps prevent the client from using emotional
manipulation to gain attention or avoid responsibility.
7. A nurse is providing education to a client starting phenelzine (Nardil). Which
food item should the nurse instruct the client to avoid?
A) Milk and cheese.
B) Avocados and bananas.
C) Aged cheese and red wine.
D) Leafy green vegetables.
Correct Answer: C
Explanation: Phenelzine is an MAOI. A diet low in tyramine is required. Aged cheeses,
cured meats, red wine, and fermented foods are high in tyramine. Avocados and
bananas are moderate but less of a concern than aged cheese and red wine. Ingesting
tyramine can cause a hypertensive crisis.
8. A client is diagnosed with antisocial personality disorder. Which behavioral
manifestation is most characteristic of this disorder?
A) Extreme emotionality and attention-seeking.
B) Lack of empathy and disregard for the rights of others.
C) Submissive and clinging behavior.
D) Perfectionism and rigidity.
Correct Answer: B
Explanation: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others. Lack of empathy, deceitfulness, and
impulsivity are core traits. Option A describes histrionic, C describes dependent, and D
describes obsessive-compulsive personality disorder.
9. During a therapeutic group session, a client monopolizes the conversation.
Which is the most appropriate action by the nurse?
A) Ignore the behavior to avoid confrontation.
B) Allow the client to continue to express themselves.
C) Thank the client for their input and ask others to share.
D) Tell the client they are being rude.
Correct Answer: C
Explanation: This action uses therapeutic technique of redirecting the group. It
validates the monopolizing client's contribution while allowing others to participate. This
maintains the group's purpose and sets a boundary without being punitive or
dismissive.
10. The nurse is assessing a client’s level of consciousness. The client is drowsy,
falls asleep when not stimulated, and is easily aroused. Which level of
, consciousness does this describe?
A) Alert.
B) Lethargic.
C) Stuporous.
D) Comatose.
Correct Answer: B
Explanation: Lethargy is a state of drowsiness or apathy where the client can be
aroused with moderate stimuli. Stupor requires vigorous stimuli, and coma involves no
response. The key here is "easily aroused," which distinguishes lethargy from stupor.
11. A client on the psychiatric unit is observed pacing back and forth, talking
rapidly, and unable to sit still. The nurse documents this behavior as:
A) Apathy.
B) Akathisia.
C) Dystonia.
D) Tardive dyskinesia.
Correct Answer: B
Explanation: Akathisia is a common extrapyramidal side effect of antipsychotic
medications, characterized by a subjective feeling of restlessness and objective pacing
or fidgeting. Dystonia is muscle spasms, and tardive dyskinesia involves involuntary
movements of the tongue, face, and jaw.
12. A client tells the nurse, "I have decided to stop taking my antipsychotic
medication because it makes me feel like a zombie." Which is the nurse's best
response?
A) "You cannot just stop taking your medication."
B) "I understand. Let’s talk to the doctor about changing it."
C) "That is a common side effect, but you need to take it."
D) "You are feeling frustrated. Let's discuss these side effects."
Correct Answer: D
Explanation: This response acknowledges the client's feelings (frustration/being a
zombie) and opens the door for a collaborative discussion about managing side effects.
It respects the client's autonomy while addressing a serious medication adherence issue,
which is more therapeutic than being dismissive or authoritarian.
13. The nurse is using cognitive-behavioral therapy (CBT) techniques with a client.
Which statement reflects the underlying principle of CBT?
A) "Past experiences are the root of all current problems."
B) "Our thoughts influence our feelings and behaviors."
C) "Unconscious drives are the primary motivators."
D) "Behavior is learned and can be unlearned."
College of Nursing
NUR 253 Exam 1: Foundations of Mental Health Nursing
1. A client with a history of schizophrenia is admitted to the psychiatric unit. The
nurse notes the client is exhibiting echolalia. Which of the following best describes
this symptom?
A) Repeating the words of others.
B) Making up new words.
C) Stopping speech in the middle of a sentence.
D) Speaking in a monotone voice.
Correct Answer: A
Explanation: Echolalia is the pathological repetition of another's words, often seen in
schizophrenia. It is a form of disorganized speech. Option B is neologism, C is thought
blocking, and D is a flat affect.
2. A nurse is caring for a client who is experiencing a panic attack. Which of the
following interventions should the nurse implement first?
A) Encourage the client to talk about feelings.
B) Administer prescribed PRN lorazepam.
C) Remain with the client and speak in a calm, brief manner.
D) Place the client in a quiet room alone.
Correct Answer: C
Explanation: The priority during a panic attack is to provide safety and reduce stimuli.
Remaining with the client provides a sense of security. Calm, brief directions (like "sit
down" or "breathe with me") help the client focus. Medication is important but not the
first step; leaving the client alone can increase fear.
3. The nurse is assessing a client’s risk for suicide. Which question is most
appropriate for the nurse to ask first?
A) "Do you feel like hurting yourself?"
B) "Have you thought about how you would kill yourself?"
C) "Do you have a plan to commit suicide?"
D) "Have you ever attempted suicide before?"
,Correct Answer: A
Explanation: The nurse should first assess for suicidal ideation with a direct, non-
judgmental question. While assessing the plan (B), means (C), and history (D) are crucial,
the initial screening is to determine if the client is having thoughts of self-harm. Asking
about it does not plant the idea.
4. A client diagnosed with major depressive disorder states, "I am a terrible person
and everyone would be better off without me." Which is the nurse's best
response?
A) "That is a very negative way to think."
B) "You have so much to live for."
C) "It sounds like you are feeling hopeless right now."
D) "I don't think that's true at all."
Correct Answer: C
Explanation: This response uses therapeutic communication by reflecting the client's
feeling of hopelessness, which validates the emotion. Options A and D are judgmental
and dismissive. Option B is a cliché and offers false reassurance, which does not help the
client explore their feelings.
5. A client is admitted involuntarily to a psychiatric unit. Which of the following
rights is the client legally guaranteed?
A) The right to refuse all medication.
B) The right to vote.
C) The right to have a telephone call within 24 hours.
D) The right to leave the unit at any time.
Correct Answer: C
Explanation: Involuntary commitment means the client is held against their will for
safety reasons, but they retain most civil rights, including the right to communicate with
others. They cannot leave the unit freely (D). They can refuse some medications but not
all if a court order is in place (A). Voting rights depend on state laws but are generally
retained.
6. The nurse is planning care for a client with histrionic personality disorder. Which
communication style is most likely to be effective?
A) Direct, matter-of-fact, and avoiding power struggles.
B) Gentle, empathetic, and focused on feelings.
C) Firm, consistent, and focused on objective facts.
D) Highly structured, rigid, and formal.
Correct Answer: C
Explanation: Clients with histrionic personality disorder are dramatic, attention-seeking,
and emotionally labile. Setting firm, consistent limits on manipulative behavior is
,essential. Focusing on objective facts helps prevent the client from using emotional
manipulation to gain attention or avoid responsibility.
7. A nurse is providing education to a client starting phenelzine (Nardil). Which
food item should the nurse instruct the client to avoid?
A) Milk and cheese.
B) Avocados and bananas.
C) Aged cheese and red wine.
D) Leafy green vegetables.
Correct Answer: C
Explanation: Phenelzine is an MAOI. A diet low in tyramine is required. Aged cheeses,
cured meats, red wine, and fermented foods are high in tyramine. Avocados and
bananas are moderate but less of a concern than aged cheese and red wine. Ingesting
tyramine can cause a hypertensive crisis.
8. A client is diagnosed with antisocial personality disorder. Which behavioral
manifestation is most characteristic of this disorder?
A) Extreme emotionality and attention-seeking.
B) Lack of empathy and disregard for the rights of others.
C) Submissive and clinging behavior.
D) Perfectionism and rigidity.
Correct Answer: B
Explanation: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others. Lack of empathy, deceitfulness, and
impulsivity are core traits. Option A describes histrionic, C describes dependent, and D
describes obsessive-compulsive personality disorder.
9. During a therapeutic group session, a client monopolizes the conversation.
Which is the most appropriate action by the nurse?
A) Ignore the behavior to avoid confrontation.
B) Allow the client to continue to express themselves.
C) Thank the client for their input and ask others to share.
D) Tell the client they are being rude.
Correct Answer: C
Explanation: This action uses therapeutic technique of redirecting the group. It
validates the monopolizing client's contribution while allowing others to participate. This
maintains the group's purpose and sets a boundary without being punitive or
dismissive.
10. The nurse is assessing a client’s level of consciousness. The client is drowsy,
falls asleep when not stimulated, and is easily aroused. Which level of
, consciousness does this describe?
A) Alert.
B) Lethargic.
C) Stuporous.
D) Comatose.
Correct Answer: B
Explanation: Lethargy is a state of drowsiness or apathy where the client can be
aroused with moderate stimuli. Stupor requires vigorous stimuli, and coma involves no
response. The key here is "easily aroused," which distinguishes lethargy from stupor.
11. A client on the psychiatric unit is observed pacing back and forth, talking
rapidly, and unable to sit still. The nurse documents this behavior as:
A) Apathy.
B) Akathisia.
C) Dystonia.
D) Tardive dyskinesia.
Correct Answer: B
Explanation: Akathisia is a common extrapyramidal side effect of antipsychotic
medications, characterized by a subjective feeling of restlessness and objective pacing
or fidgeting. Dystonia is muscle spasms, and tardive dyskinesia involves involuntary
movements of the tongue, face, and jaw.
12. A client tells the nurse, "I have decided to stop taking my antipsychotic
medication because it makes me feel like a zombie." Which is the nurse's best
response?
A) "You cannot just stop taking your medication."
B) "I understand. Let’s talk to the doctor about changing it."
C) "That is a common side effect, but you need to take it."
D) "You are feeling frustrated. Let's discuss these side effects."
Correct Answer: D
Explanation: This response acknowledges the client's feelings (frustration/being a
zombie) and opens the door for a collaborative discussion about managing side effects.
It respects the client's autonomy while addressing a serious medication adherence issue,
which is more therapeutic than being dismissive or authoritarian.
13. The nurse is using cognitive-behavioral therapy (CBT) techniques with a client.
Which statement reflects the underlying principle of CBT?
A) "Past experiences are the root of all current problems."
B) "Our thoughts influence our feelings and behaviors."
C) "Unconscious drives are the primary motivators."
D) "Behavior is learned and can be unlearned."
