Galen College of Nursing NUR 253 Exam 1 (pdf) | 2026/2027 | Mental
Health Q&A | Mental Health Nursing
1. A client tells the nurse, "I feel like I'm losing my mind." Which response by
the nurse is the most therapeutic initially?
A) "Don't worry, you're not losing your mind."
B) "Why do you feel that way?"
C) "Tell me more about what you are feeling."
D) "You should try to relax and not think about it."
Correct Answer: "Tell me more about what you are feeling."
Rationale: This open-ended statement encourages the client to elaborate on
their feelings, demonstrating empathy and active listening. It avoids
dismissing the client's feelings ("Don't worry"), asking a closed "why"
question that can feel accusatory, or giving unsolicited advice.
2. According to Peplau's model of the nurse-patient relationship, which phase
involves the nurse and patient working together to resolve the patient's
problems?
A) Orientation phase
B) Working phase
C) Termination phase
D) Pre-interaction phase
Correct Answer: Working phase
Rationale: The working phase is the stage where the nurse and patient
actively collaborate on problem-solving and achieving the goals established
in the orientation phase. The orientation phase involves establishing trust
and setting goals.
,3. A nurse is caring for a client who is using the defense mechanism of
projection. Which behavior would the nurse most likely observe?
A) Blaming others for their own shortcomings
B) Returning to an earlier developmental stage
C) Making excuses for unacceptable behavior
D) Refusing to acknowledge a painful reality
Correct Answer: Blaming others for their own shortcomings
Rationale: Projection involves attributing one's own unacceptable thoughts,
feelings, or impulses to another person. This allows the individual to deny
their own feelings by placing them onto others.
4. A patient who is an alcoholic states, "I only drink a little bit on the
weekends. It's not a problem." This is an example of which defense
mechanism?
A) Repression
B) Rationalization
C) Denial
D) Suppression
Correct Answer: Denial
Rationale: Denial is the refusal to acknowledge the reality of a situation or
the existence of a problem. By stating their drinking is not a problem, the
patient is actively denying the reality of their alcohol use disorder.
,5. A nurse is caring for a client with a diagnosis of schizophrenia. Which
neurotransmitter is most commonly associated with this disorder when
present in excess?
A) Serotonin
B) Norepinephrine
C) Dopamine
D) GABA
Correct Answer: Dopamine
Rationale: The dopamine hypothesis suggests that an excess of dopamine,
particularly in the mesolimbic pathway, is a key factor in the development of
schizophrenia. Too much dopamine is associated with psychosis, while too
little is linked to Parkinson's disease.
6. A client is prescribed a monoamine oxidase inhibitor (MAOI). Which
statement by the client indicates a correct understanding of the dietary
restrictions?
A) "I will avoid eating aged cheeses and cured meats."
B) "I should avoid all foods containing tyramine."
C) "I can eat anything I want as long as I take my medication with food."
D) "I need to increase my intake of protein while on this medication."
Correct Answer: "I will avoid eating aged cheeses and cured meats."
Rationale: MAOIs interact with tyramine, which can cause a hypertensive
crisis. Aged cheeses, cured meats, and fermented foods are high in tyramine
and must be avoided to prevent dangerously high blood pressure.
, 7. The nurse is assessing a client's level of consciousness. According to
Maslow's Hierarchy of Needs, which level must be met first before higher-
level needs can be addressed?
A) Self-esteem
B) Love and belonging
C) Safety and security
D) Physiological needs
Correct Answer: Physiological needs
Rationale: Maslow's hierarchy of needs is a pyramid with basic physiological
needs (e.g., breathing, food, water, shelter) at the base. These fundamental
needs must be addressed first before a person can focus on safety, love, or
self-esteem.
8. A client reports using guided imagery to help manage their anxiety. The
nurse recognizes this as an example of which type of stress-reduction
technique?
A) Biofeedback
B) Cognitive reframing
C) Relaxation technique
D) Physical exercise
Correct Answer: Relaxation technique
Rationale: Guided imagery is a relaxation technique where the client focuses
on pleasant mental images to replace negative or stressful feelings. It is a
form of cognitive-behavioral therapy used to reduce anxiety.
Health Q&A | Mental Health Nursing
1. A client tells the nurse, "I feel like I'm losing my mind." Which response by
the nurse is the most therapeutic initially?
A) "Don't worry, you're not losing your mind."
B) "Why do you feel that way?"
C) "Tell me more about what you are feeling."
D) "You should try to relax and not think about it."
Correct Answer: "Tell me more about what you are feeling."
Rationale: This open-ended statement encourages the client to elaborate on
their feelings, demonstrating empathy and active listening. It avoids
dismissing the client's feelings ("Don't worry"), asking a closed "why"
question that can feel accusatory, or giving unsolicited advice.
2. According to Peplau's model of the nurse-patient relationship, which phase
involves the nurse and patient working together to resolve the patient's
problems?
A) Orientation phase
B) Working phase
C) Termination phase
D) Pre-interaction phase
Correct Answer: Working phase
Rationale: The working phase is the stage where the nurse and patient
actively collaborate on problem-solving and achieving the goals established
in the orientation phase. The orientation phase involves establishing trust
and setting goals.
,3. A nurse is caring for a client who is using the defense mechanism of
projection. Which behavior would the nurse most likely observe?
A) Blaming others for their own shortcomings
B) Returning to an earlier developmental stage
C) Making excuses for unacceptable behavior
D) Refusing to acknowledge a painful reality
Correct Answer: Blaming others for their own shortcomings
Rationale: Projection involves attributing one's own unacceptable thoughts,
feelings, or impulses to another person. This allows the individual to deny
their own feelings by placing them onto others.
4. A patient who is an alcoholic states, "I only drink a little bit on the
weekends. It's not a problem." This is an example of which defense
mechanism?
A) Repression
B) Rationalization
C) Denial
D) Suppression
Correct Answer: Denial
Rationale: Denial is the refusal to acknowledge the reality of a situation or
the existence of a problem. By stating their drinking is not a problem, the
patient is actively denying the reality of their alcohol use disorder.
,5. A nurse is caring for a client with a diagnosis of schizophrenia. Which
neurotransmitter is most commonly associated with this disorder when
present in excess?
A) Serotonin
B) Norepinephrine
C) Dopamine
D) GABA
Correct Answer: Dopamine
Rationale: The dopamine hypothesis suggests that an excess of dopamine,
particularly in the mesolimbic pathway, is a key factor in the development of
schizophrenia. Too much dopamine is associated with psychosis, while too
little is linked to Parkinson's disease.
6. A client is prescribed a monoamine oxidase inhibitor (MAOI). Which
statement by the client indicates a correct understanding of the dietary
restrictions?
A) "I will avoid eating aged cheeses and cured meats."
B) "I should avoid all foods containing tyramine."
C) "I can eat anything I want as long as I take my medication with food."
D) "I need to increase my intake of protein while on this medication."
Correct Answer: "I will avoid eating aged cheeses and cured meats."
Rationale: MAOIs interact with tyramine, which can cause a hypertensive
crisis. Aged cheeses, cured meats, and fermented foods are high in tyramine
and must be avoided to prevent dangerously high blood pressure.
, 7. The nurse is assessing a client's level of consciousness. According to
Maslow's Hierarchy of Needs, which level must be met first before higher-
level needs can be addressed?
A) Self-esteem
B) Love and belonging
C) Safety and security
D) Physiological needs
Correct Answer: Physiological needs
Rationale: Maslow's hierarchy of needs is a pyramid with basic physiological
needs (e.g., breathing, food, water, shelter) at the base. These fundamental
needs must be addressed first before a person can focus on safety, love, or
self-esteem.
8. A client reports using guided imagery to help manage their anxiety. The
nurse recognizes this as an example of which type of stress-reduction
technique?
A) Biofeedback
B) Cognitive reframing
C) Relaxation technique
D) Physical exercise
Correct Answer: Relaxation technique
Rationale: Guided imagery is a relaxation technique where the client focuses
on pleasant mental images to replace negative or stressful feelings. It is a
form of cognitive-behavioral therapy used to reduce anxiety.
