NU 160 Exam 4 | Mental Health Concepts
Nursing Practice Exam (2026/2027) - Galen College
(1) A client with schizophrenia is experiencing auditory hallucinations and tells the nurse,
'The voices are telling me I am evil.' Which is the best nursing response?
A. 'I don't hear the voices, but I believe they are real to you.'
B. 'You know those voices are just your imagination.'
C. 'What are the voices saying to you exactly?'
D. 'Try to ignore the voices and focus on this puzzle.'
CORRECT ANSWER: A
Rationale: Acknowledging the client's experience without validating the hallucination is therapeutic. It builds
trust while maintaining reality.
(2) A nurse is caring for a client with schizophrenia who is taking clozapine. Which lab
result should the nurse monitor most closely?
A. Serum glucose
B. White blood cell count
C. Liver function tests
D. Platelet count
CORRECT ANSWER: B
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), which can be fatal. Frequent
monitoring is mandatory.
(3) A client with borderline personality disorder (BPD) tells Nurse A that they are the only
'good' nurse on the unit, while complaining about Nurse B. This is an example of which
defense mechanism?
A. Projection
B. Rationalization
C. Splitting
D. Displacement
CORRECT ANSWER: C
Rationale: Splitting is common in BPD, where people or things are viewed as all good or all bad, with no
middle ground.
,(4) Which intervention is the priority for a client with Antisocial Personality Disorder who is
manipulating other clients?
A. Assigning a peer mentor.
B. Setting clear, consistent limits and consequences.
C. Providing 1:1 emotional support.
D. Ignoring the behavior to avoid reinforcement.
CORRECT ANSWER: B
Rationale: Consistent limit-setting is crucial for antisocial personality disorder to prevent manipulation and
maintain safety.
(5) A client is admitted for Anorexia Nervosa with a BMI of 15. What is the priority nursing
diagnosis?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Chronic low self-esteem
D. Social isolation
CORRECT ANSWER: B
Rationale: Physiological stability and nutrition are the priority in anorexia, as severe malnutrition can lead to
organ failure and death.
(6) A nurse notes Russell's sign on a client. Which condition does this indicate?
A. Anorexia Nervosa
B. Bulimia Nervosa
C. Binge Eating Disorder
D. Pica
CORRECT ANSWER: B
Rationale: Russell's sign (calluses on knuckles) is caused by repeated self-induced vomiting and is a clinical
sign of Bulimia Nervosa.
(7) An elderly client with Alzheimer's disease becomes increasingly agitated and confused
in the late afternoon. This is known as:
A. Delirium
B. Sundowning
C. Agnosia
D. Aphasia
CORRECT ANSWER: B
Rationale: Sundowning is a phenomenon in dementia where confusion and agitation worsen in the evening
hours.
,(8) Which is the primary difference between delirium and dementia?
A. Delirium is progressive; dementia is acute.
B. Delirium is reversible; dementia is irreversible.
C. Dementia affects consciousness; delirium affects memory.
D. Delirium is long-term; dementia is short-term.
CORRECT ANSWER: B
Rationale: Delirium has an acute onset and is usually reversible once the underlying cause (e.g., infection,
medication) is treated.
(9) A child with ADHD is prescribed methylphenidate. What should the nurse include in the
teaching?
A. Administer the medication before bedtime.
B. Monitor the child's height and weight regularly.
C. Expect an increase in appetite.
D. Double the dose if a day is missed.
CORRECT ANSWER: B
Rationale: Stimulants like methylphenidate can cause growth suppression and decreased appetite in children.
(10) Which client should be assigned the highest priority for assessment in the mental
health clinic?
A. A client who stopped taking their antidepressant 2 days ago.
B. A client with a plan and means for suicide.
C. A client complaining of insomnia.
D. A client experiencing mild anxiety after a breakup.
CORRECT ANSWER: B
Rationale: Suicidal ideation with a plan and access to means represents an immediate threat to life and is the
top priority.
(11) A client with schizophrenia is experiencing auditory hallucinations and tells the nurse,
'The voices are telling me I am evil.' Which is the best nursing response?
A. 'I don't hear the voices, but I believe they are real to you.'
B. 'You know those voices are just your imagination.'
C. 'What are the voices saying to you exactly?'
D. 'Try to ignore the voices and focus on this puzzle.'
CORRECT ANSWER: A
Rationale: Acknowledging the client's experience without validating the hallucination is therapeutic. It builds
trust while maintaining reality.
, (12) A nurse is caring for a client with schizophrenia who is taking clozapine. Which lab
result should the nurse monitor most closely?
A. Serum glucose
B. White blood cell count
C. Liver function tests
D. Platelet count
CORRECT ANSWER: B
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), which can be fatal. Frequent
monitoring is mandatory.
(13) A client with borderline personality disorder (BPD) tells Nurse A that they are the only
'good' nurse on the unit, while complaining about Nurse B. This is an example of which
defense mechanism?
A. Projection
B. Rationalization
C. Splitting
D. Displacement
CORRECT ANSWER: C
Rationale: Splitting is common in BPD, where people or things are viewed as all good or all bad, with no
middle ground.
(14) Which intervention is the priority for a client with Antisocial Personality Disorder who
is manipulating other clients?
A. Assigning a peer mentor.
B. Setting clear, consistent limits and consequences.
C. Providing 1:1 emotional support.
D. Ignoring the behavior to avoid reinforcement.
CORRECT ANSWER: B
Rationale: Consistent limit-setting is crucial for antisocial personality disorder to prevent manipulation and
maintain safety.
(15) A client is admitted for Anorexia Nervosa with a BMI of 15. What is the priority nursing
diagnosis?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Chronic low self-esteem
D. Social isolation
CORRECT ANSWER: B
Rationale: Physiological stability and nutrition are the priority in anorexia, as severe malnutrition can lead to
organ failure and death.
Nursing Practice Exam (2026/2027) - Galen College
(1) A client with schizophrenia is experiencing auditory hallucinations and tells the nurse,
'The voices are telling me I am evil.' Which is the best nursing response?
A. 'I don't hear the voices, but I believe they are real to you.'
B. 'You know those voices are just your imagination.'
C. 'What are the voices saying to you exactly?'
D. 'Try to ignore the voices and focus on this puzzle.'
CORRECT ANSWER: A
Rationale: Acknowledging the client's experience without validating the hallucination is therapeutic. It builds
trust while maintaining reality.
(2) A nurse is caring for a client with schizophrenia who is taking clozapine. Which lab
result should the nurse monitor most closely?
A. Serum glucose
B. White blood cell count
C. Liver function tests
D. Platelet count
CORRECT ANSWER: B
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), which can be fatal. Frequent
monitoring is mandatory.
(3) A client with borderline personality disorder (BPD) tells Nurse A that they are the only
'good' nurse on the unit, while complaining about Nurse B. This is an example of which
defense mechanism?
A. Projection
B. Rationalization
C. Splitting
D. Displacement
CORRECT ANSWER: C
Rationale: Splitting is common in BPD, where people or things are viewed as all good or all bad, with no
middle ground.
,(4) Which intervention is the priority for a client with Antisocial Personality Disorder who is
manipulating other clients?
A. Assigning a peer mentor.
B. Setting clear, consistent limits and consequences.
C. Providing 1:1 emotional support.
D. Ignoring the behavior to avoid reinforcement.
CORRECT ANSWER: B
Rationale: Consistent limit-setting is crucial for antisocial personality disorder to prevent manipulation and
maintain safety.
(5) A client is admitted for Anorexia Nervosa with a BMI of 15. What is the priority nursing
diagnosis?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Chronic low self-esteem
D. Social isolation
CORRECT ANSWER: B
Rationale: Physiological stability and nutrition are the priority in anorexia, as severe malnutrition can lead to
organ failure and death.
(6) A nurse notes Russell's sign on a client. Which condition does this indicate?
A. Anorexia Nervosa
B. Bulimia Nervosa
C. Binge Eating Disorder
D. Pica
CORRECT ANSWER: B
Rationale: Russell's sign (calluses on knuckles) is caused by repeated self-induced vomiting and is a clinical
sign of Bulimia Nervosa.
(7) An elderly client with Alzheimer's disease becomes increasingly agitated and confused
in the late afternoon. This is known as:
A. Delirium
B. Sundowning
C. Agnosia
D. Aphasia
CORRECT ANSWER: B
Rationale: Sundowning is a phenomenon in dementia where confusion and agitation worsen in the evening
hours.
,(8) Which is the primary difference between delirium and dementia?
A. Delirium is progressive; dementia is acute.
B. Delirium is reversible; dementia is irreversible.
C. Dementia affects consciousness; delirium affects memory.
D. Delirium is long-term; dementia is short-term.
CORRECT ANSWER: B
Rationale: Delirium has an acute onset and is usually reversible once the underlying cause (e.g., infection,
medication) is treated.
(9) A child with ADHD is prescribed methylphenidate. What should the nurse include in the
teaching?
A. Administer the medication before bedtime.
B. Monitor the child's height and weight regularly.
C. Expect an increase in appetite.
D. Double the dose if a day is missed.
CORRECT ANSWER: B
Rationale: Stimulants like methylphenidate can cause growth suppression and decreased appetite in children.
(10) Which client should be assigned the highest priority for assessment in the mental
health clinic?
A. A client who stopped taking their antidepressant 2 days ago.
B. A client with a plan and means for suicide.
C. A client complaining of insomnia.
D. A client experiencing mild anxiety after a breakup.
CORRECT ANSWER: B
Rationale: Suicidal ideation with a plan and access to means represents an immediate threat to life and is the
top priority.
(11) A client with schizophrenia is experiencing auditory hallucinations and tells the nurse,
'The voices are telling me I am evil.' Which is the best nursing response?
A. 'I don't hear the voices, but I believe they are real to you.'
B. 'You know those voices are just your imagination.'
C. 'What are the voices saying to you exactly?'
D. 'Try to ignore the voices and focus on this puzzle.'
CORRECT ANSWER: A
Rationale: Acknowledging the client's experience without validating the hallucination is therapeutic. It builds
trust while maintaining reality.
, (12) A nurse is caring for a client with schizophrenia who is taking clozapine. Which lab
result should the nurse monitor most closely?
A. Serum glucose
B. White blood cell count
C. Liver function tests
D. Platelet count
CORRECT ANSWER: B
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), which can be fatal. Frequent
monitoring is mandatory.
(13) A client with borderline personality disorder (BPD) tells Nurse A that they are the only
'good' nurse on the unit, while complaining about Nurse B. This is an example of which
defense mechanism?
A. Projection
B. Rationalization
C. Splitting
D. Displacement
CORRECT ANSWER: C
Rationale: Splitting is common in BPD, where people or things are viewed as all good or all bad, with no
middle ground.
(14) Which intervention is the priority for a client with Antisocial Personality Disorder who
is manipulating other clients?
A. Assigning a peer mentor.
B. Setting clear, consistent limits and consequences.
C. Providing 1:1 emotional support.
D. Ignoring the behavior to avoid reinforcement.
CORRECT ANSWER: B
Rationale: Consistent limit-setting is crucial for antisocial personality disorder to prevent manipulation and
maintain safety.
(15) A client is admitted for Anorexia Nervosa with a BMI of 15. What is the priority nursing
diagnosis?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Chronic low self-esteem
D. Social isolation
CORRECT ANSWER: B
Rationale: Physiological stability and nutrition are the priority in anorexia, as severe malnutrition can lead to
organ failure and death.
