,Galen NSG 3450 Exam 2 | Nursing Practice –
Mental Health (2026) Actual Q&A PDF
1. A patient with borderline personality disorder tells the nurse, "You are the
only one who cares. The other nurses are mean." The nurse identifies this
behavior as:
A) Transference
B) Countertransference
C) Splitting
D) Projection
Correct Answer: Splitting
Rationale: Splitting is a primitive defense mechanism common in borderline
personality disorder, where individuals view others as all good or all bad. The
patient idealizes one nurse while devaluing others, which can disrupt team
dynamics and must be managed with consistent limit setting.
2. During a group therapy session, a patient becomes restless and asks to leave.
The nurse notes the patient's heart rate is 100 bpm and palms are sweaty. This
physiological response is characteristic of which anxiety level?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Severe anxiety
,Rationale: Severe anxiety manifests with sympathetic nervous system
activation—tachycardia, diaphoresis, and restlessness—while perceptual field is
greatly reduced. Panic-level anxiety would involve disorganized behavior and
inability to communicate. Recognition guides appropriate intervention.
3. A patient with major depressive disorder says, "I don't enjoy anything
anymore." The nurse documents this statement as:
A) Anhedonia
B) Avolition
C) Alogia
D) Anergia
Correct Answer: Anhedonia
Rationale: Anhedonia is the loss of interest or pleasure in previously enjoyable
activities, a core symptom of depression. Avolition is lack of motivation, alogia
is poverty of speech, and anergia is lack of energy. Accurate terminology aids
diagnosis and treatment planning.
4. A nurse is leading a therapy group and makes all decisions without input from
members. This leadership style is:
A) Democratic
B) Autocratic
C) Laissez-faire
D) Transformational
, Correct Answer: Autocratic
Rationale: Autocratic leaders control the group and make unilateral decisions,
often resulting in productivity but low member satisfaction. Democratic leaders
share decision-making; laissez-faire provides minimal guidance;
transformational inspires change. Different styles suit different group phases.
5. A patient with schizophrenia is started on clozapine. Which laboratory test
must be monitored regularly due to the risk of agranulocytosis?
A) Serum lithium level
B) Absolute neutrophil count (ANC)
C) Thyroid-stimulating hormone
D) Liver function tests
Correct Answer: Absolute neutrophil count (ANC)
Rationale: Clozapine can cause life-threatening agranulocytosis. Regular ANC
monitoring is mandatory to detect early declines. If ANC drops below threshold,
the drug must be discontinued. Other tests monitor different medications or
aspects of health but are not specific to clozapine.
6. A patient is admitted for alcohol detoxification. The nurse administers
lorazepam as ordered based on a CIWA-Ar score of 18. The primary purpose of
this medication is to:
A) Prevent delirium tremens and reduce withdrawal symptoms
B) Treat underlying depression
C) Induce aversion to alcohol
Mental Health (2026) Actual Q&A PDF
1. A patient with borderline personality disorder tells the nurse, "You are the
only one who cares. The other nurses are mean." The nurse identifies this
behavior as:
A) Transference
B) Countertransference
C) Splitting
D) Projection
Correct Answer: Splitting
Rationale: Splitting is a primitive defense mechanism common in borderline
personality disorder, where individuals view others as all good or all bad. The
patient idealizes one nurse while devaluing others, which can disrupt team
dynamics and must be managed with consistent limit setting.
2. During a group therapy session, a patient becomes restless and asks to leave.
The nurse notes the patient's heart rate is 100 bpm and palms are sweaty. This
physiological response is characteristic of which anxiety level?
A) Mild anxiety
B) Moderate anxiety
C) Severe anxiety
D) Panic-level anxiety
Correct Answer: Severe anxiety
,Rationale: Severe anxiety manifests with sympathetic nervous system
activation—tachycardia, diaphoresis, and restlessness—while perceptual field is
greatly reduced. Panic-level anxiety would involve disorganized behavior and
inability to communicate. Recognition guides appropriate intervention.
3. A patient with major depressive disorder says, "I don't enjoy anything
anymore." The nurse documents this statement as:
A) Anhedonia
B) Avolition
C) Alogia
D) Anergia
Correct Answer: Anhedonia
Rationale: Anhedonia is the loss of interest or pleasure in previously enjoyable
activities, a core symptom of depression. Avolition is lack of motivation, alogia
is poverty of speech, and anergia is lack of energy. Accurate terminology aids
diagnosis and treatment planning.
4. A nurse is leading a therapy group and makes all decisions without input from
members. This leadership style is:
A) Democratic
B) Autocratic
C) Laissez-faire
D) Transformational
, Correct Answer: Autocratic
Rationale: Autocratic leaders control the group and make unilateral decisions,
often resulting in productivity but low member satisfaction. Democratic leaders
share decision-making; laissez-faire provides minimal guidance;
transformational inspires change. Different styles suit different group phases.
5. A patient with schizophrenia is started on clozapine. Which laboratory test
must be monitored regularly due to the risk of agranulocytosis?
A) Serum lithium level
B) Absolute neutrophil count (ANC)
C) Thyroid-stimulating hormone
D) Liver function tests
Correct Answer: Absolute neutrophil count (ANC)
Rationale: Clozapine can cause life-threatening agranulocytosis. Regular ANC
monitoring is mandatory to detect early declines. If ANC drops below threshold,
the drug must be discontinued. Other tests monitor different medications or
aspects of health but are not specific to clozapine.
6. A patient is admitted for alcohol detoxification. The nurse administers
lorazepam as ordered based on a CIWA-Ar score of 18. The primary purpose of
this medication is to:
A) Prevent delirium tremens and reduce withdrawal symptoms
B) Treat underlying depression
C) Induce aversion to alcohol
