Galen NUR 256 Final exam 2026
Galen NUR 256 Final Exam 2026 Edition
100 Advanced Questions with Answers
and Detailed Rationales NCLEX Style
Covered topics:
Major depressive disorder
Bipolar disorder
Schizophrenia
PTSD
Anxiety disorders
OCD
Personality disorders
Substance use disorders
Suicide/violence prevention
Psychiatric medications
Adverse effects and emergencies
Therapeutic communication
NGN clinical judgment principles
Part 1: Questions 1–25
(Mental Health Nursing — Clinical Judgment, Safety, Pharmacology, Therapeutic
Communication)
Question 1
A nurse is caring for a client admitted with major depressive disorder who states, “My
family would be better off without me.” Which action should the nurse take first?
A. Encourage the client to discuss positive memories with family
B. Ask the client directly whether they have a plan to harm themselves
C. Notify the healthcare provider immediately
D. Place the client in a group therapy session
, Galen NUR 256 Final exam 2026
Answer: B
Rationale:
The priority is suicide risk assessment. Asking directly about suicidal thoughts, intent,
and plan does not increase risk and provides essential safety information. The nurse
must determine immediacy of danger before other interventions.
A: Not appropriate before assessing safety.
C: May be needed after assessment if risk is identified.
D: Group therapy is unsafe if the client is actively suicidal.
Question 2
A client with schizophrenia says, “The voices are telling me that I am evil and should
die.” Which response by the nurse is best?
A. “The voices are not real. You should ignore them.”
B. “Why do you think the voices want you to die?”
C. “I understand you hear voices, but I do not hear them. Are they telling you to harm
yourself?”
D. “You need to focus on something else.”
Answer: C
Rationale:
The nurse acknowledges the client’s experience without validating the hallucination.
Safety assessment for command hallucinations is the priority.
A: Dismisses the client’s feelings.
B: Explores content but misses immediate safety.
D: Does not assess risk.
Question 3 — SATA
A nurse is teaching a client taking an SSRI antidepressant. Which instructions should
the nurse include?
Select all that apply.
, Galen NUR 256 Final exam 2026
A. Therapeutic effects may take several weeks to occur
B. Stop the medication once mood improves
C. Report worsening depression or suicidal thoughts
D. Avoid abrupt discontinuation
E. Take extra doses if a dose is missed
Answers: A, C, D
Rationale:
SSRIs typically require 2–6 weeks for full therapeutic effect. Clients must report suicidal
thoughts, especially early in treatment. Abrupt stopping can cause discontinuation
syndrome.
B: Incorrect—medication should continue as prescribed.
E: Incorrect—double dosing can cause adverse effects.
Question 4
A client experiencing acute mania is pacing rapidly, talking loudly, and refusing meals.
Which intervention should the nurse implement first?
A. Provide detailed explanations about treatment
B. Reduce environmental stimulation
C. Encourage participation in recreational activities
D. Ask the client to identify triggers
Answer: B
Rationale:
Clients experiencing mania have difficulty processing information. Reducing stimuli
decreases agitation and promotes safety.
Question 5
A nurse is caring for a client with anorexia nervosa. Which finding requires immediate
intervention?
, Galen NUR 256 Final exam 2026
A. Client reports fear of gaining weight
B. Client has a BMI of 17
C. Client’s potassium level is 2.8 mEq/L
D. Client exercises after meals
Answer: C
Rationale:
Severe hypokalemia places the client at risk for life-threatening cardiac dysrhythmias.
Question 6
A client says, “I don’t want to talk about my trauma because nobody understands.”
Which therapeutic response is best?
A. “You need to talk about it to heal.”
B. “Tell me everything that happened.”
C. “It sounds like discussing this feels difficult. We can talk when you are ready.”
D. “Your feelings are common among trauma survivors.”
Answer: C
Rationale:
This response demonstrates empathy and respects the client’s readiness while
maintaining therapeutic presence.
Question 7
A client receiving lithium therapy reports diarrhea, vomiting, and severe tremors.
Which action should the nurse take?
A. Administer the next dose with food
B. Hold the medication and notify the provider
C. Encourage increased caffeine intake
D. Reassure the client this is expected
Answer: B
Galen NUR 256 Final Exam 2026 Edition
100 Advanced Questions with Answers
and Detailed Rationales NCLEX Style
Covered topics:
Major depressive disorder
Bipolar disorder
Schizophrenia
PTSD
Anxiety disorders
OCD
Personality disorders
Substance use disorders
Suicide/violence prevention
Psychiatric medications
Adverse effects and emergencies
Therapeutic communication
NGN clinical judgment principles
Part 1: Questions 1–25
(Mental Health Nursing — Clinical Judgment, Safety, Pharmacology, Therapeutic
Communication)
Question 1
A nurse is caring for a client admitted with major depressive disorder who states, “My
family would be better off without me.” Which action should the nurse take first?
A. Encourage the client to discuss positive memories with family
B. Ask the client directly whether they have a plan to harm themselves
C. Notify the healthcare provider immediately
D. Place the client in a group therapy session
, Galen NUR 256 Final exam 2026
Answer: B
Rationale:
The priority is suicide risk assessment. Asking directly about suicidal thoughts, intent,
and plan does not increase risk and provides essential safety information. The nurse
must determine immediacy of danger before other interventions.
A: Not appropriate before assessing safety.
C: May be needed after assessment if risk is identified.
D: Group therapy is unsafe if the client is actively suicidal.
Question 2
A client with schizophrenia says, “The voices are telling me that I am evil and should
die.” Which response by the nurse is best?
A. “The voices are not real. You should ignore them.”
B. “Why do you think the voices want you to die?”
C. “I understand you hear voices, but I do not hear them. Are they telling you to harm
yourself?”
D. “You need to focus on something else.”
Answer: C
Rationale:
The nurse acknowledges the client’s experience without validating the hallucination.
Safety assessment for command hallucinations is the priority.
A: Dismisses the client’s feelings.
B: Explores content but misses immediate safety.
D: Does not assess risk.
Question 3 — SATA
A nurse is teaching a client taking an SSRI antidepressant. Which instructions should
the nurse include?
Select all that apply.
, Galen NUR 256 Final exam 2026
A. Therapeutic effects may take several weeks to occur
B. Stop the medication once mood improves
C. Report worsening depression or suicidal thoughts
D. Avoid abrupt discontinuation
E. Take extra doses if a dose is missed
Answers: A, C, D
Rationale:
SSRIs typically require 2–6 weeks for full therapeutic effect. Clients must report suicidal
thoughts, especially early in treatment. Abrupt stopping can cause discontinuation
syndrome.
B: Incorrect—medication should continue as prescribed.
E: Incorrect—double dosing can cause adverse effects.
Question 4
A client experiencing acute mania is pacing rapidly, talking loudly, and refusing meals.
Which intervention should the nurse implement first?
A. Provide detailed explanations about treatment
B. Reduce environmental stimulation
C. Encourage participation in recreational activities
D. Ask the client to identify triggers
Answer: B
Rationale:
Clients experiencing mania have difficulty processing information. Reducing stimuli
decreases agitation and promotes safety.
Question 5
A nurse is caring for a client with anorexia nervosa. Which finding requires immediate
intervention?
, Galen NUR 256 Final exam 2026
A. Client reports fear of gaining weight
B. Client has a BMI of 17
C. Client’s potassium level is 2.8 mEq/L
D. Client exercises after meals
Answer: C
Rationale:
Severe hypokalemia places the client at risk for life-threatening cardiac dysrhythmias.
Question 6
A client says, “I don’t want to talk about my trauma because nobody understands.”
Which therapeutic response is best?
A. “You need to talk about it to heal.”
B. “Tell me everything that happened.”
C. “It sounds like discussing this feels difficult. We can talk when you are ready.”
D. “Your feelings are common among trauma survivors.”
Answer: C
Rationale:
This response demonstrates empathy and respects the client’s readiness while
maintaining therapeutic presence.
Question 7
A client receiving lithium therapy reports diarrhea, vomiting, and severe tremors.
Which action should the nurse take?
A. Administer the next dose with food
B. Hold the medication and notify the provider
C. Encourage increased caffeine intake
D. Reassure the client this is expected
Answer: B
