NUR 256 Mental Health Nursing Exam 4 Study Guide … 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 256 Mental Health Nursing Exam 4 Study Guide (2026)
UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 256 Mental Health Nursing Exam 4 Study Guide … 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A nurse is assessing a client for delirium. Which clinical characteristic most clearly
distinguishes delirium from dementia?
A. The client experiences a progressive decline in cognitive function.
B. The symptoms develop rapidly over a short period of time.
C. The client exhibits frequent periods of confabulation.
D. The client has difficulty recognizing familiar objects (agnosia).
Answer: B
Rationale: Delirium is characterized by a rapid onset of symptoms (hours to days), whereas dementia
involves a slow, progressive decline in cognitive function over months or years. Clear understanding of
this concept improves both test performance and everyday clinical judgment. Practice applying it to
short case scenarios to lock the idea in place. Understanding this helps the nurse notice early warning
signs and act before the problem gets worse. Early action often prevents bigger complications for the
client.
2. A client with a long history of chronic alcohol use disorder is admitted. The nurse notes
ataxia, confusion, and nystagmus. Which deficiency does the nurse suspect?
A. Vitamin B12 (Cobalamin)
B. Vitamin B1 (Thiamine)
C. Vitamin B6 (Pyridoxine)
D. Vitamin C (Ascorbic Acid)
Answer: B
Rationale: Wernicke-Korsakoff syndrome is caused by a deficiency in Thiamine (Vitamin B1),
common in chronic alcoholism, and presents with the triad of confusion, ataxia, and ocular
abnormalities. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. In practice, this guides the nurse to
set priorities and protect the client from harm. Safety, nutrition, and clear communication are frequent
priorities.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 256 Mental Health Nursing Exam 4 Study Guide … 2026/2027 • Verified • Assured Grade A+
3. A client diagnosed with Anorexia Nervosa has a BMI of 15 and is being admitted for
stabilization. What is the priority nursing intervention during the first week of refeeding?
A. Assessing for Lanugo and cold intolerance.
B. Encouraging the client to engage in aerobic exercise.
C. Monitoring serum phosphorus, potassium, and magnesium levels.
D. Implementing a strict 2,500 calorie per day diet immediately.
Answer: C
Rationale: Refeeding syndrome is a potentially fatal shift in fluids and electrolytes (especially
phosphorus) that occurs in malnourished patients; monitoring these levels is the priority safety
intervention. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities. This knowledge supports safe care and
helps the nurse teach the client and family clearly and simply. Clear teaching improves cooperation
and reduces anxiety.
4. A nurse is caring for a client with Borderline Personality Disorder. The client tells the
nurse, ‘You are the only one who cares, the night nurse is incompetent and cruel.’ This is an
example of:
A. Projection
B. Splitting
C. Rationalization
D. Reaction Formation
Answer: B
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder where
individuals view people or situations as either ‘all good’ or ‘all bad,’ unable to integrate positive and
negative qualities. Knowing the reason behind the correct answer makes it easier to rule out the wrong
options quickly. Look for the choice that protects the client and matches the priority need. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 256 Mental Health Nursing Exam 4 Study Guide (2026)
UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 256 Mental Health Nursing Exam 4 Study Guide … 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A nurse is assessing a client for delirium. Which clinical characteristic most clearly
distinguishes delirium from dementia?
A. The client experiences a progressive decline in cognitive function.
B. The symptoms develop rapidly over a short period of time.
C. The client exhibits frequent periods of confabulation.
D. The client has difficulty recognizing familiar objects (agnosia).
Answer: B
Rationale: Delirium is characterized by a rapid onset of symptoms (hours to days), whereas dementia
involves a slow, progressive decline in cognitive function over months or years. Clear understanding of
this concept improves both test performance and everyday clinical judgment. Practice applying it to
short case scenarios to lock the idea in place. Understanding this helps the nurse notice early warning
signs and act before the problem gets worse. Early action often prevents bigger complications for the
client.
2. A client with a long history of chronic alcohol use disorder is admitted. The nurse notes
ataxia, confusion, and nystagmus. Which deficiency does the nurse suspect?
A. Vitamin B12 (Cobalamin)
B. Vitamin B1 (Thiamine)
C. Vitamin B6 (Pyridoxine)
D. Vitamin C (Ascorbic Acid)
Answer: B
Rationale: Wernicke-Korsakoff syndrome is caused by a deficiency in Thiamine (Vitamin B1),
common in chronic alcoholism, and presents with the triad of confusion, ataxia, and ocular
abnormalities. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. In practice, this guides the nurse to
set priorities and protect the client from harm. Safety, nutrition, and clear communication are frequent
priorities.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 256 Mental Health Nursing Exam 4 Study Guide … 2026/2027 • Verified • Assured Grade A+
3. A client diagnosed with Anorexia Nervosa has a BMI of 15 and is being admitted for
stabilization. What is the priority nursing intervention during the first week of refeeding?
A. Assessing for Lanugo and cold intolerance.
B. Encouraging the client to engage in aerobic exercise.
C. Monitoring serum phosphorus, potassium, and magnesium levels.
D. Implementing a strict 2,500 calorie per day diet immediately.
Answer: C
Rationale: Refeeding syndrome is a potentially fatal shift in fluids and electrolytes (especially
phosphorus) that occurs in malnourished patients; monitoring these levels is the priority safety
intervention. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities. This knowledge supports safe care and
helps the nurse teach the client and family clearly and simply. Clear teaching improves cooperation
and reduces anxiety.
4. A nurse is caring for a client with Borderline Personality Disorder. The client tells the
nurse, ‘You are the only one who cares, the night nurse is incompetent and cruel.’ This is an
example of:
A. Projection
B. Splitting
C. Rationalization
D. Reaction Formation
Answer: B
Rationale: Splitting is a common defense mechanism in Borderline Personality Disorder where
individuals view people or situations as either ‘all good’ or ‘all bad,’ unable to integrate positive and
negative qualities. Knowing the reason behind the correct answer makes it easier to rule out the wrong
options quickly. Look for the choice that protects the client and matches the priority need. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now.
Exam (Elaborations) • Detailed Rationales Page 3
