Galen NUR 256 midterm exam 2026
Galen NUR 256 Midterm Exam 2026
Edition 100 Advanced Questions with
Answers and Detailed Rationales NCLEX
Style
Coverage:
✔ Psychiatric assessment
✔ Therapeutic communication
✔ Anxiety disorders
✔ Depression & suicide precautions
✔ Bipolar disorder
✔ Schizophrenia
✔ Crisis intervention
✔ Psychopharmacology
✔ Legal/ethical issues
✔ Delegation
✔ NGN clinical judgment scenarios
Question 1
A nurse is caring for a client diagnosed with major depressive disorder who states,
"Everyone would be better off without me." What is the nurse's priority action?
A. Encourage participation in group therapy.
B. Ask the client whether they have thoughts of suicide.
C. Explain that treatment is effective.
D. Notify the family immediately.
, Galen NUR 256 midterm exam 2026
✅ Correct Answer: B
Rationale
The client's statement suggests possible suicidal ideation. The priority is to perform a
direct suicide assessment. Asking about suicide does not increase the risk and helps
determine the appropriate level of intervention.
Question 2
A client experiencing a panic attack is hyperventilating and trembling. Which
intervention should the nurse implement first?
A. Teach relaxation exercises.
B. Stay with the client and speak calmly.
C. Ask about recent stressors.
D. Encourage journaling.
✅ Correct Answer: B
Rationale
During a panic attack, the priority is to remain with the client, reduce environmental
stimulation, and provide reassurance until anxiety decreases.
Question 3 (SATA)
Which findings are characteristic of schizophrenia?
Select all that apply.
A. Auditory hallucinations
B. Delusions
C. Flat affect
, Galen NUR 256 midterm exam 2026
D. Loose associations
E. Euphoric mood
✅ Correct Answers: A, B, C, D
Rationale
Positive symptoms include hallucinations, delusions, and disorganized thinking (loose
associations). Flat affect is a negative symptom. Euphoria is more consistent with
mania.
Question 4
A client taking lithium reports vomiting, coarse tremors, and confusion. Which action is
most appropriate?
A. Administer the next dose with food.
B. Encourage caffeine intake.
C. Hold the medication and notify the provider.
D. Reassure the client these effects are expected.
✅ Correct Answer: C
Rationale
These findings are consistent with lithium toxicity and require immediate intervention.
Question 5
Which client should the nurse assess first?
A. Client requesting sleeping medication
B. Client hearing voices telling them to hurt themselves
, Galen NUR 256 midterm exam 2026
C. Client refusing breakfast
D. Client crying after a family visit
✅ Correct Answer: B
Rationale
Command hallucinations directing self-harm indicate immediate safety concerns and
require priority assessment.
Question 6
A client says, "The FBI implanted a chip in my brain." What is the nurse's best response?
A. "That isn't true."
B. "Tell me more about your experience."
C. "Why do you think that happened?"
D. "I'll call the FBI."
✅ Correct Answer: B
Rationale
The nurse acknowledges the client's experience without validating the delusion or
arguing about reality.
Question 7
Which defense mechanism is demonstrated when a student who fails an exam blames
the instructor?
A. Projection
B. Rationalization
Galen NUR 256 Midterm Exam 2026
Edition 100 Advanced Questions with
Answers and Detailed Rationales NCLEX
Style
Coverage:
✔ Psychiatric assessment
✔ Therapeutic communication
✔ Anxiety disorders
✔ Depression & suicide precautions
✔ Bipolar disorder
✔ Schizophrenia
✔ Crisis intervention
✔ Psychopharmacology
✔ Legal/ethical issues
✔ Delegation
✔ NGN clinical judgment scenarios
Question 1
A nurse is caring for a client diagnosed with major depressive disorder who states,
"Everyone would be better off without me." What is the nurse's priority action?
A. Encourage participation in group therapy.
B. Ask the client whether they have thoughts of suicide.
C. Explain that treatment is effective.
D. Notify the family immediately.
, Galen NUR 256 midterm exam 2026
✅ Correct Answer: B
Rationale
The client's statement suggests possible suicidal ideation. The priority is to perform a
direct suicide assessment. Asking about suicide does not increase the risk and helps
determine the appropriate level of intervention.
Question 2
A client experiencing a panic attack is hyperventilating and trembling. Which
intervention should the nurse implement first?
A. Teach relaxation exercises.
B. Stay with the client and speak calmly.
C. Ask about recent stressors.
D. Encourage journaling.
✅ Correct Answer: B
Rationale
During a panic attack, the priority is to remain with the client, reduce environmental
stimulation, and provide reassurance until anxiety decreases.
Question 3 (SATA)
Which findings are characteristic of schizophrenia?
Select all that apply.
A. Auditory hallucinations
B. Delusions
C. Flat affect
, Galen NUR 256 midterm exam 2026
D. Loose associations
E. Euphoric mood
✅ Correct Answers: A, B, C, D
Rationale
Positive symptoms include hallucinations, delusions, and disorganized thinking (loose
associations). Flat affect is a negative symptom. Euphoria is more consistent with
mania.
Question 4
A client taking lithium reports vomiting, coarse tremors, and confusion. Which action is
most appropriate?
A. Administer the next dose with food.
B. Encourage caffeine intake.
C. Hold the medication and notify the provider.
D. Reassure the client these effects are expected.
✅ Correct Answer: C
Rationale
These findings are consistent with lithium toxicity and require immediate intervention.
Question 5
Which client should the nurse assess first?
A. Client requesting sleeping medication
B. Client hearing voices telling them to hurt themselves
, Galen NUR 256 midterm exam 2026
C. Client refusing breakfast
D. Client crying after a family visit
✅ Correct Answer: B
Rationale
Command hallucinations directing self-harm indicate immediate safety concerns and
require priority assessment.
Question 6
A client says, "The FBI implanted a chip in my brain." What is the nurse's best response?
A. "That isn't true."
B. "Tell me more about your experience."
C. "Why do you think that happened?"
D. "I'll call the FBI."
✅ Correct Answer: B
Rationale
The nurse acknowledges the client's experience without validating the delusion or
arguing about reality.
Question 7
Which defense mechanism is demonstrated when a student who fails an exam blames
the instructor?
A. Projection
B. Rationalization
