,NSG3450/NSG 3450 Exam 2 | Nursing Practice – Mental
Health | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is assessing a client who is experiencing occasional sadness due to the recent death of a
beloved pet. The client's appetite remains good, sleep is uninterrupted, and they are able to go to work
and socialize. How should the nurse document this finding?
A) The client is experiencing clinical depression.
B) The client may be at risk for a mental disorder.
C) This is a normal response to loss, not a mental illness.
D) The client should be referred to a psychiatrist.
Correct Answer: This is a normal response to loss, not a mental illness.
Rationale: This client is demonstrating a normal grief response to a significant loss. Mental health is not
simply the absence of sadness; it is the ability to function in daily life despite emotional pain. This client's
daily functioning is intact, which indicates resilience, not pathology.
2. At what point should the nurse determine that a client is at risk for developing a mental disorder?
A) When the client experiences feelings of sadness.
B) When the client's behavior becomes culturally deviant.
C) When the client experiences difficulty at work AND in relationships.
D) When a family member has a diagnosed mental illness.
Correct Answer: When the client experiences difficulty at work AND in relationships.
Rationale: A mental disorder is diagnosed when an individual's behavior, thoughts, or emotions cause
clinically significant distress or impairment in social, occupational, or other important areas of
functioning. Difficulty in multiple domains suggests a risk for a mental disorder.
,3. Which statement made by the nurse demonstrates the best understanding of nonverbal
communication?
A) "The patient's verbal and nonverbal communication is often different."
B) "When my patient responds to my question, I check for congruence between verbal and nonverbal
communication to help validate the response."
C) "If a patient is silent, it means they are being resistant."
D) "Nonverbal communication is less important than what the patient says."
Correct Answer: "When my patient responds to my question, I check for congruence between verbal
and nonverbal communication to help validate the response."
Rationale: Assessing congruence between verbal and nonverbal messages is essential for accurate
interpretation. When there is a mismatch, the nurse should gently explore the discrepancy to
understand the patient's true feelings.
4. What is incongruous communication?
A) Communication that is clear and consistent
B) Communication that contains conflicting messages by the speaker
C) Communication that is overly aggressive
D) Communication that avoids the main issue
Correct Answer: Communication that contains conflicting messages by the speaker
Rationale: Incongruous communication occurs when there is a mismatch between verbal and nonverbal
messages. For example, a patient may say "I'm fine" while crying or clenching their fists. The nurse
should gently explore the discrepancy.
5. An adolescent asks a nurse conducting an assessment interview, "Why should I tell you anything?
You'll just tell my parents whatever you find out." Which response by the nurse is appropriate?
A) "You're right to be concerned, but I have to tell your parents everything."
B) "What you say about feelings is private, but some things, like suicidal thinking, must be reported to
the treatment team."
, C) "I promise I won't tell your parents anything."
D) "Your parents have a right to know everything you tell me."
Correct Answer: "What you say about feelings is private, but some things, like suicidal thinking, must be
reported to the treatment team."
Rationale: This response is honest about the limits of confidentiality while respecting the adolescent's
need for privacy. It establishes trust by clarifying what information will be shared and under what
circumstances.
6. According to the phases of the therapeutic relationship, which phase involves the nurse and patient
working together to achieve mutually agreed-upon goals?
A) Pre-interaction phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: The working phase is when the nurse and patient collaborate to achieve therapeutic goals,
with the patient actively participating in problem-solving. The orientation phase establishes trust, and
the termination phase concludes the relationship.
7. A nurse is caring for a patient who is in the pre-interaction phase of the therapeutic relationship.
Which nursing action is most appropriate?
A) Reviewing the patient's chart and available information
B) Establishing trust and setting boundaries
C) Exploring the patient's feelings
D) Terminating the relationship
Correct Answer: Reviewing the patient's chart and available information
Health | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is assessing a client who is experiencing occasional sadness due to the recent death of a
beloved pet. The client's appetite remains good, sleep is uninterrupted, and they are able to go to work
and socialize. How should the nurse document this finding?
A) The client is experiencing clinical depression.
B) The client may be at risk for a mental disorder.
C) This is a normal response to loss, not a mental illness.
D) The client should be referred to a psychiatrist.
Correct Answer: This is a normal response to loss, not a mental illness.
Rationale: This client is demonstrating a normal grief response to a significant loss. Mental health is not
simply the absence of sadness; it is the ability to function in daily life despite emotional pain. This client's
daily functioning is intact, which indicates resilience, not pathology.
2. At what point should the nurse determine that a client is at risk for developing a mental disorder?
A) When the client experiences feelings of sadness.
B) When the client's behavior becomes culturally deviant.
C) When the client experiences difficulty at work AND in relationships.
D) When a family member has a diagnosed mental illness.
Correct Answer: When the client experiences difficulty at work AND in relationships.
Rationale: A mental disorder is diagnosed when an individual's behavior, thoughts, or emotions cause
clinically significant distress or impairment in social, occupational, or other important areas of
functioning. Difficulty in multiple domains suggests a risk for a mental disorder.
,3. Which statement made by the nurse demonstrates the best understanding of nonverbal
communication?
A) "The patient's verbal and nonverbal communication is often different."
B) "When my patient responds to my question, I check for congruence between verbal and nonverbal
communication to help validate the response."
C) "If a patient is silent, it means they are being resistant."
D) "Nonverbal communication is less important than what the patient says."
Correct Answer: "When my patient responds to my question, I check for congruence between verbal
and nonverbal communication to help validate the response."
Rationale: Assessing congruence between verbal and nonverbal messages is essential for accurate
interpretation. When there is a mismatch, the nurse should gently explore the discrepancy to
understand the patient's true feelings.
4. What is incongruous communication?
A) Communication that is clear and consistent
B) Communication that contains conflicting messages by the speaker
C) Communication that is overly aggressive
D) Communication that avoids the main issue
Correct Answer: Communication that contains conflicting messages by the speaker
Rationale: Incongruous communication occurs when there is a mismatch between verbal and nonverbal
messages. For example, a patient may say "I'm fine" while crying or clenching their fists. The nurse
should gently explore the discrepancy.
5. An adolescent asks a nurse conducting an assessment interview, "Why should I tell you anything?
You'll just tell my parents whatever you find out." Which response by the nurse is appropriate?
A) "You're right to be concerned, but I have to tell your parents everything."
B) "What you say about feelings is private, but some things, like suicidal thinking, must be reported to
the treatment team."
, C) "I promise I won't tell your parents anything."
D) "Your parents have a right to know everything you tell me."
Correct Answer: "What you say about feelings is private, but some things, like suicidal thinking, must be
reported to the treatment team."
Rationale: This response is honest about the limits of confidentiality while respecting the adolescent's
need for privacy. It establishes trust by clarifying what information will be shared and under what
circumstances.
6. According to the phases of the therapeutic relationship, which phase involves the nurse and patient
working together to achieve mutually agreed-upon goals?
A) Pre-interaction phase
B) Orientation phase
C) Working phase
D) Termination phase
Correct Answer: Working phase
Rationale: The working phase is when the nurse and patient collaborate to achieve therapeutic goals,
with the patient actively participating in problem-solving. The orientation phase establishes trust, and
the termination phase concludes the relationship.
7. A nurse is caring for a patient who is in the pre-interaction phase of the therapeutic relationship.
Which nursing action is most appropriate?
A) Reviewing the patient's chart and available information
B) Establishing trust and setting boundaries
C) Exploring the patient's feelings
D) Terminating the relationship
Correct Answer: Reviewing the patient's chart and available information
