NUR 253 Exam 2 – Galen Mental Health Nursing –
(2026/2o27) Actual Questions & Answers, 100%
Guarantee Pass
Section 1: Therapeutic Communication & Nurse-Patient Relationship
Q1. The nurse is assessing a patient's mental status. Which component of the
mental status examination (MSE) evaluates the patient's thought process?
A) Mood
B) Affect
C) Speech pattern and flow of ideas
D) Orientation
Answer: C) Speech pattern and flow of ideas
Rationale: Thought process is assessed through the patient's speech pattern, rate,
rhythm, and flow of ideas (e.g., tangential, circumstantial, loose associations).
Mood/affect relate to emotions; orientation relates to cognition.
Q2. A patient scheduled for surgery says, "I'm not worried at all about the
risks." The patient's partner tells the nurse the patient has been pacing and
unable to sleep. The nurse suspects the patient is using which defense
mechanism?
A) Denial
B) Reaction formation
C) Sublimation
D) Regression
Answer: B) Reaction formation
Rationale: Reaction formation is behaving in the opposite way of one's true
feelings. The patient is outwardly calm but internally anxious (pacing, insomnia).
Denial is refusing to acknowledge reality.
Q3. A patient experiencing panic-level anxiety is unable to sit still, has a rapid
pulse, and is hyperventilating. What is the nurse's priority intervention?
,A) Encourage the patient to talk about their feelings.
B) Provide a calm, quiet environment and use short, simple directions.
C) Begin deep relaxation exercises.
D) Administer PRN antianxiety medication and leave the patient alone.
Answer: B) Provide a calm, quiet environment and use short, simple directions.
Rationale: During panic-level anxiety, the patient cannot process complex
information. The priority is to provide a safe, quiet environment and use short,
concrete directions. The nurse must stay with the patient.
Q4. The nurse is documenting the termination phase of the nurse-patient
relationship. Which activity is expected?
A) Setting boundaries and building trust
B) Discussing progress and feelings about discharge
C) Completing the admission assessment
D) Developing the initial care plan
Answer: B) Discussing progress and feelings about discharge
Rationale: During termination, the nurse and patient review goals achieved,
discuss feelings about ending the relationship, and plan for discharge. Boundary
setting occurs in the orientation phase.
Q5. A nursing student asks why the nurse is careful about maintaining
professional boundaries. Which response is most accurate?
A) "Boundaries are optional and depend on the nurse's comfort level."
B) "Blurred boundaries can lead to the nurse meeting their own needs at the
patient's expense."
C) "Boundaries are only important in outpatient settings."
D) "Boundaries interfere with developing trust."
Answer: B) "Blurred boundaries can lead to the nurse meeting their own needs at
the patient's expense."
Rationale: Professional boundaries protect both the patient and the nurse. When
boundaries blur, the nurse may unconsciously use the patient to meet their own
emotional needs, compromising the therapeutic relationship.
,Q6. Which therapeutic communication technique is the nurse using when
saying, "You mentioned feeling sad. Tell me more about that."
A) Reflection
B) Exploring
C) Validation
D) Offering general leads
Answer: B) Exploring
Rationale: Exploring encourages the patient to elaborate on a topic. Reflection
repeats the patient's words; validation acknowledges feelings; offering general
leads gives a neutral invitation to continue.
Q7. The nurse tells a patient, "I notice you are clenching your fists and your
voice is raised." This is an example of:
A) Confrontation
B) Making an observation
C) Validation
D) Interpretation
Answer: B) Making an observation
Rationale: Making an observation draws attention to the patient's behavior in a
neutral, non-judgmental way, which can increase self-awareness.
Q8. Which statement by the nurse is an example of a non-therapeutic
communication block?
A) "Tell me what happened next."
B) "Why did you get so angry with your mother?"
C) "I understand this is difficult for you."
D) "Let's focus on what you can control."
Answer: B) "Why did you get so angry with your mother?"
Rationale: Asking "why" questions is non-therapeutic because it forces the
, patient to justify their feelings and can increase defensiveness. "Why" questions
are often perceived as accusatory.
Q9. A patient tells the nurse, "I think I'm going crazy." Which response by the
nurse is most therapeutic?
A) "You're not going crazy. Don't worry."
B) "What makes you feel like you're going crazy?"
C) "That's a common feeling. Let's talk to the doctor."
D) "Crazy is a strong word. You should say 'distressed.'"
Answer: B) "What makes you feel like you're going crazy?"
Rationale: This response uses clarification and exploring to understand the
patient's specific concerns. It validates the patient's experience without
dismissing it or giving false reassurance.
Q10. The nurse is working with a withdrawn, depressed patient. Which
approach is most therapeutic initially?
A) Initiating conversation about the patient's favorite hobbies.
B) Sitting quietly with the patient and allowing them to initiate conversation.
C) Encouraging the patient to join a group activity immediately.
D) Asking open-ended questions about their childhood.
Answer: B) Sitting quietly with the patient and allowing them to initiate
conversation.
Rationale: For a withdrawn patient, presence without pressure is therapeutic. The
nurse should respect the patient's need for silence while being available.
Section 2: Anxiety, Stress, & Coping (Q11–Q18)
Q11. Which of the following is consistent with moderate anxiety?
A) The patient is able to problem-solve effectively
B) The patient has a narrowed perceptual field and focuses on select details
C) The patient is completely unable to communicate
D) The patient demonstrates no observable signs of distress
(2026/2o27) Actual Questions & Answers, 100%
Guarantee Pass
Section 1: Therapeutic Communication & Nurse-Patient Relationship
Q1. The nurse is assessing a patient's mental status. Which component of the
mental status examination (MSE) evaluates the patient's thought process?
A) Mood
B) Affect
C) Speech pattern and flow of ideas
D) Orientation
Answer: C) Speech pattern and flow of ideas
Rationale: Thought process is assessed through the patient's speech pattern, rate,
rhythm, and flow of ideas (e.g., tangential, circumstantial, loose associations).
Mood/affect relate to emotions; orientation relates to cognition.
Q2. A patient scheduled for surgery says, "I'm not worried at all about the
risks." The patient's partner tells the nurse the patient has been pacing and
unable to sleep. The nurse suspects the patient is using which defense
mechanism?
A) Denial
B) Reaction formation
C) Sublimation
D) Regression
Answer: B) Reaction formation
Rationale: Reaction formation is behaving in the opposite way of one's true
feelings. The patient is outwardly calm but internally anxious (pacing, insomnia).
Denial is refusing to acknowledge reality.
Q3. A patient experiencing panic-level anxiety is unable to sit still, has a rapid
pulse, and is hyperventilating. What is the nurse's priority intervention?
,A) Encourage the patient to talk about their feelings.
B) Provide a calm, quiet environment and use short, simple directions.
C) Begin deep relaxation exercises.
D) Administer PRN antianxiety medication and leave the patient alone.
Answer: B) Provide a calm, quiet environment and use short, simple directions.
Rationale: During panic-level anxiety, the patient cannot process complex
information. The priority is to provide a safe, quiet environment and use short,
concrete directions. The nurse must stay with the patient.
Q4. The nurse is documenting the termination phase of the nurse-patient
relationship. Which activity is expected?
A) Setting boundaries and building trust
B) Discussing progress and feelings about discharge
C) Completing the admission assessment
D) Developing the initial care plan
Answer: B) Discussing progress and feelings about discharge
Rationale: During termination, the nurse and patient review goals achieved,
discuss feelings about ending the relationship, and plan for discharge. Boundary
setting occurs in the orientation phase.
Q5. A nursing student asks why the nurse is careful about maintaining
professional boundaries. Which response is most accurate?
A) "Boundaries are optional and depend on the nurse's comfort level."
B) "Blurred boundaries can lead to the nurse meeting their own needs at the
patient's expense."
C) "Boundaries are only important in outpatient settings."
D) "Boundaries interfere with developing trust."
Answer: B) "Blurred boundaries can lead to the nurse meeting their own needs at
the patient's expense."
Rationale: Professional boundaries protect both the patient and the nurse. When
boundaries blur, the nurse may unconsciously use the patient to meet their own
emotional needs, compromising the therapeutic relationship.
,Q6. Which therapeutic communication technique is the nurse using when
saying, "You mentioned feeling sad. Tell me more about that."
A) Reflection
B) Exploring
C) Validation
D) Offering general leads
Answer: B) Exploring
Rationale: Exploring encourages the patient to elaborate on a topic. Reflection
repeats the patient's words; validation acknowledges feelings; offering general
leads gives a neutral invitation to continue.
Q7. The nurse tells a patient, "I notice you are clenching your fists and your
voice is raised." This is an example of:
A) Confrontation
B) Making an observation
C) Validation
D) Interpretation
Answer: B) Making an observation
Rationale: Making an observation draws attention to the patient's behavior in a
neutral, non-judgmental way, which can increase self-awareness.
Q8. Which statement by the nurse is an example of a non-therapeutic
communication block?
A) "Tell me what happened next."
B) "Why did you get so angry with your mother?"
C) "I understand this is difficult for you."
D) "Let's focus on what you can control."
Answer: B) "Why did you get so angry with your mother?"
Rationale: Asking "why" questions is non-therapeutic because it forces the
, patient to justify their feelings and can increase defensiveness. "Why" questions
are often perceived as accusatory.
Q9. A patient tells the nurse, "I think I'm going crazy." Which response by the
nurse is most therapeutic?
A) "You're not going crazy. Don't worry."
B) "What makes you feel like you're going crazy?"
C) "That's a common feeling. Let's talk to the doctor."
D) "Crazy is a strong word. You should say 'distressed.'"
Answer: B) "What makes you feel like you're going crazy?"
Rationale: This response uses clarification and exploring to understand the
patient's specific concerns. It validates the patient's experience without
dismissing it or giving false reassurance.
Q10. The nurse is working with a withdrawn, depressed patient. Which
approach is most therapeutic initially?
A) Initiating conversation about the patient's favorite hobbies.
B) Sitting quietly with the patient and allowing them to initiate conversation.
C) Encouraging the patient to join a group activity immediately.
D) Asking open-ended questions about their childhood.
Answer: B) Sitting quietly with the patient and allowing them to initiate
conversation.
Rationale: For a withdrawn patient, presence without pressure is therapeutic. The
nurse should respect the patient's need for silence while being available.
Section 2: Anxiety, Stress, & Coping (Q11–Q18)
Q11. Which of the following is consistent with moderate anxiety?
A) The patient is able to problem-solve effectively
B) The patient has a narrowed perceptual field and focuses on select details
C) The patient is completely unable to communicate
D) The patient demonstrates no observable signs of distress
