NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: SCHIZOPHRENIA AND PSYCHOTIC DISORDERS
Questions 1-25
Question 1
A client with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through a chip in my brain."
Which term best describes this statement?
A) Delusion of persecution
B) Delusion of grandeur
C) Thought insertion
D) Ideas of reference
Correct Answer: A
Rationale: Delusions of persecution involve the belief that one is being singled out for harm or harassment.
This client believes the FBI is monitoring him, which is a persecutory delusion. Delusions of grandeur involve
exaggerated beliefs of power or importance. Thought insertion is the belief that thoughts are being placed in
one's mind. Ideas of reference involve the belief that neutral events have special meaning.
Question 2
A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most
appropriate?
A) Tell the client the voices are not real
B) Encourage the client to ignore the voices
C) Acknowledge the client's experience and redirect to reality-based activities
D) Ask the client to describe what the voices are saying in detail
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
Correct Answer: C
Rationale: The nurse should acknowledge the client's experience without reinforcing the hallucination and
redirect to reality-based activities. Telling the client the voices are not real may increase defensiveness.
Encouraging the client to ignore the voices is unrealistic. Asking for detailed descriptions may reinforce the
hallucination.
Question 3
A client with schizophrenia is prescribed haloperidol (Haldol) . Which side effect requires immediate nursing
intervention?
A) Dry mouth
B) Drowsiness
C) Akathisia
D) Neuroleptic malignant syndrome (NMS)
Correct Answer: D
Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening side effect of antipsychotics
characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Dry mouth,
drowsiness, and akathisia are common but less serious side effects. NMS requires immediate medical
intervention.
Question 4
Which medication is most effective for treating the negative symptoms of schizophrenia?
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
A) Haloperidol (Haldol)
B) Fluphenazine (Prolixin)
C) Aripiprazole (Abilify)
D) Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Atypical antipsychotics like aripiprazole, clozapine, and olanzapine are more effective for negative
symptoms than typical antipsychotics. Haloperidol, fluphenazine, and chlorpromazine are typical
antipsychotics that are more effective for positive symptoms and have more extrapyramidal side effects.
Question 5
A client with schizophrenia has been prescribed clozapine (Clozaril) . Which laboratory test must be
monitored regularly?
A) Serum potassium
B) White blood cell count (WBC)
C) Liver function tests
D) Serum creatinine
Correct Answer: B
Rationale: Clozapine can cause agranulocytosis, a potentially fatal side effect. The WBC and absolute
neutrophil count (ANC) must be monitored regularly (weekly for the first 6 months, then biweekly). The
REMS program is required for clozapine prescribing.
Question 6
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
A client with schizophrenia is exhibiting echolalia. Which statement best describes this behavior?
A) Repeating the same word or phrase over and over
B) Imitating the words or phrases of others
C) Making up new words
D) Stopping speech in the middle of a sentence
Correct Answer: B
Rationale: Echolalia is the involuntary repetition of words or phrases spoken by others. Perseveration is
repeating the same word or phrase. Neologisms are made-up words. Thought blocking is stopping speech
mid-sentence.
Question 7
A client with schizophrenia is receiving antipsychotic medication. Which finding indicates the client is
experiencing tardive dyskinesia?
A) Tremors and rigidity
B) Involuntary movements of the tongue, face, and jaw
C) Muscle stiffness and fever
D) Restlessness and pacing
Correct Answer: B
Rationale: Tardive dyskinesia is characterized by involuntary, repetitive movements of the tongue, face, and
jaw (lip smacking, tongue protrusion). Tremors and rigidity are associated with parkinsonism. Muscle
stiffness and fever suggest NMS. Restlessness is akathisia.
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: SCHIZOPHRENIA AND PSYCHOTIC DISORDERS
Questions 1-25
Question 1
A client with schizophrenia tells the nurse, "The FBI is monitoring my thoughts through a chip in my brain."
Which term best describes this statement?
A) Delusion of persecution
B) Delusion of grandeur
C) Thought insertion
D) Ideas of reference
Correct Answer: A
Rationale: Delusions of persecution involve the belief that one is being singled out for harm or harassment.
This client believes the FBI is monitoring him, which is a persecutory delusion. Delusions of grandeur involve
exaggerated beliefs of power or importance. Thought insertion is the belief that thoughts are being placed in
one's mind. Ideas of reference involve the belief that neutral events have special meaning.
Question 2
A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most
appropriate?
A) Tell the client the voices are not real
B) Encourage the client to ignore the voices
C) Acknowledge the client's experience and redirect to reality-based activities
D) Ask the client to describe what the voices are saying in detail
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
Correct Answer: C
Rationale: The nurse should acknowledge the client's experience without reinforcing the hallucination and
redirect to reality-based activities. Telling the client the voices are not real may increase defensiveness.
Encouraging the client to ignore the voices is unrealistic. Asking for detailed descriptions may reinforce the
hallucination.
Question 3
A client with schizophrenia is prescribed haloperidol (Haldol) . Which side effect requires immediate nursing
intervention?
A) Dry mouth
B) Drowsiness
C) Akathisia
D) Neuroleptic malignant syndrome (NMS)
Correct Answer: D
Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening side effect of antipsychotics
characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Dry mouth,
drowsiness, and akathisia are common but less serious side effects. NMS requires immediate medical
intervention.
Question 4
Which medication is most effective for treating the negative symptoms of schizophrenia?
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
A) Haloperidol (Haldol)
B) Fluphenazine (Prolixin)
C) Aripiprazole (Abilify)
D) Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Atypical antipsychotics like aripiprazole, clozapine, and olanzapine are more effective for negative
symptoms than typical antipsychotics. Haloperidol, fluphenazine, and chlorpromazine are typical
antipsychotics that are more effective for positive symptoms and have more extrapyramidal side effects.
Question 5
A client with schizophrenia has been prescribed clozapine (Clozaril) . Which laboratory test must be
monitored regularly?
A) Serum potassium
B) White blood cell count (WBC)
C) Liver function tests
D) Serum creatinine
Correct Answer: B
Rationale: Clozapine can cause agranulocytosis, a potentially fatal side effect. The WBC and absolute
neutrophil count (ANC) must be monitored regularly (weekly for the first 6 months, then biweekly). The
REMS program is required for clozapine prescribing.
Question 6
, NUR 253 EXAM 4 MENTAL HEALTH ACTUAL EXAM 2026/2027 – GALEN
COLLEGE | EXPERT VERIFIED | 150 NGN-STYLE Q&A | MULTIPLE-CHOICE |
DETAILED RATIONALES | PASS GUARANTEED - A+ GRADED
A client with schizophrenia is exhibiting echolalia. Which statement best describes this behavior?
A) Repeating the same word or phrase over and over
B) Imitating the words or phrases of others
C) Making up new words
D) Stopping speech in the middle of a sentence
Correct Answer: B
Rationale: Echolalia is the involuntary repetition of words or phrases spoken by others. Perseveration is
repeating the same word or phrase. Neologisms are made-up words. Thought blocking is stopping speech
mid-sentence.
Question 7
A client with schizophrenia is receiving antipsychotic medication. Which finding indicates the client is
experiencing tardive dyskinesia?
A) Tremors and rigidity
B) Involuntary movements of the tongue, face, and jaw
C) Muscle stiffness and fever
D) Restlessness and pacing
Correct Answer: B
Rationale: Tardive dyskinesia is characterized by involuntary, repetitive movements of the tongue, face, and
jaw (lip smacking, tongue protrusion). Tremors and rigidity are associated with parkinsonism. Muscle
stiffness and fever suggest NMS. Restlessness is akathisia.
