NUR 253 MENTAL HEALTH EXAMS 2 (GALEN)
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains
- Psychiatric Assessment and Diagnostic Formulation
- Therapeutic Communication and Nurse-Patient Relationship
- Psychopharmacology and Biological Interventions
- Crisis Intervention and Suicide Prevention
- Legal, Ethical, and Regulatory Standards in Psychiatric Nursing
- Management of Acute and Chronic Mental Health Disorders
- Substance Use Disorders and Co-Occurring Conditions
- Psychosocial Rehabilitation and Recovery-Oriented Care
- Trauma-Informed Care and Abuse/Maltreatment
- Group and Family Therapy Modalities
Introduction
This comprehensive examination is designed to evaluate the essential
competencies required for safe, effective, and compassionate
psychiatric-mental health nursing practice. The assessment
encompasses foundational theoretical knowledge,
psychopharmacological principles, and complex clinical decision-making
skills necessary for the care of individuals, families, and groups across
diverse mental health settings. The multiple-choice format integrates
scenario-based questions that reflect real-world clinical situations,
emphasizing critical thinking, ethical reasoning, therapeutic
communication, and adherence to legal and regulatory frameworks.
Successful completion of this examination demonstrates readiness to
apply evidence-based interventions, manage psychiatric emergencies,
,and support recovery-oriented care in alignment with professional
nursing standards.
SECTION ONE: QUESTIONS 1 – 100
1. A client diagnosed with major depressive disorder has been taking
fluoxetine 20 mg daily for six weeks and reports no improvement in
symptoms. Which action should the psychiatric nurse take first?
A. Increase the dose to 40 mg daily per protocol.
B. Discontinue fluoxetine and switch to another antidepressant.
C. Assess for medication adherence and side effects.
D. Recommend a referral for electroconvulsive therapy.
C
RATIONALE: The first action is to assess for adherence and side
effects, as many clients may not take the medication as prescribed or
may be experiencing side effects that impact efficacy. Six weeks is still
within the early therapeutic window, and abrupt changes or referral
without assessment are premature.
2. A client with borderline personality disorder frequently calls the
crisis line multiple times per night demanding to speak with the same
nurse. Which boundary intervention is most appropriate?
A. Allow the client to call anytime as it builds trust.
B. Block the client's phone number to prevent dependency.
C. Establish a structured contract regarding call times and duration.
D. Transfer the client to a different nurse each time.
, C
RATIONALE: Clients with borderline personality disorder often
struggle with boundaries, and a structured contract helps maintain
clear expectations and consistency, which is therapeutic while
preventing splitting and dependency.
3. A client prescribed haloperidol for schizophrenia presents with
muscle rigidity, fever, and altered mental status. Which condition
should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Extrapyramidal symptoms
D. Tardive dyskinesia
B
RATIONALE: The triad of muscle rigidity, hyperthermia, and altered
mental status in a client taking haloperidol is classic for neuroleptic
malignant syndrome, a life-threatening adverse reaction requiring
immediate medical intervention.
4. A nurse is assessing a client with post-traumatic stress disorder who
reports recurrent nightmares and hypervigilance. Which nursing
diagnosis takes priority?
A. Disturbed sleep pattern
B. Risk for injury related to hypervigilance
C. Anxiety related to traumatic memories
D. Social isolation
, B
RATIONALE: Risk for injury is the priority because hypervigilance
and startle response can lead to accidental harm to self or others,
making safety the most immediate concern.
5. A client with anorexia nervosa refuses to eat and states, "I am too
fat." Which response by the nurse is most therapeutic?
A. "You are dangerously underweight and need to eat."
B. "I can see you are distressed. Let's sit and talk about your feelings."
C. "If you don't eat, we will have to place a feeding tube."
D. "Your perception of your body is incorrect."
B
RATIONALE: Acknowledging the client's distress and offering a non-
judgmental opportunity to discuss feelings is therapeutic, whereas
confronting the behavior or perceptions can increase resistance and
anxiety.
6. A client with bipolar disorder in a manic episode is pacing, talking
rapidly, and not sleeping. Which intervention should the nurse
implement first?
A. Place the client in seclusion.
B. Administer lorazepam as ordered.
C. Provide a quiet, low-stimulation environment.
D. Encourage the client to exercise to expend energy.
C
RATIONALE: Reducing environmental stimuli is the least restrictive
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
- Psychiatric Assessment and Diagnostic Formulation
- Therapeutic Communication and Nurse-Patient Relationship
- Psychopharmacology and Biological Interventions
- Crisis Intervention and Suicide Prevention
- Legal, Ethical, and Regulatory Standards in Psychiatric Nursing
- Management of Acute and Chronic Mental Health Disorders
- Substance Use Disorders and Co-Occurring Conditions
- Psychosocial Rehabilitation and Recovery-Oriented Care
- Trauma-Informed Care and Abuse/Maltreatment
- Group and Family Therapy Modalities
Introduction
This comprehensive examination is designed to evaluate the essential
competencies required for safe, effective, and compassionate
psychiatric-mental health nursing practice. The assessment
encompasses foundational theoretical knowledge,
psychopharmacological principles, and complex clinical decision-making
skills necessary for the care of individuals, families, and groups across
diverse mental health settings. The multiple-choice format integrates
scenario-based questions that reflect real-world clinical situations,
emphasizing critical thinking, ethical reasoning, therapeutic
communication, and adherence to legal and regulatory frameworks.
Successful completion of this examination demonstrates readiness to
apply evidence-based interventions, manage psychiatric emergencies,
,and support recovery-oriented care in alignment with professional
nursing standards.
SECTION ONE: QUESTIONS 1 – 100
1. A client diagnosed with major depressive disorder has been taking
fluoxetine 20 mg daily for six weeks and reports no improvement in
symptoms. Which action should the psychiatric nurse take first?
A. Increase the dose to 40 mg daily per protocol.
B. Discontinue fluoxetine and switch to another antidepressant.
C. Assess for medication adherence and side effects.
D. Recommend a referral for electroconvulsive therapy.
C
RATIONALE: The first action is to assess for adherence and side
effects, as many clients may not take the medication as prescribed or
may be experiencing side effects that impact efficacy. Six weeks is still
within the early therapeutic window, and abrupt changes or referral
without assessment are premature.
2. A client with borderline personality disorder frequently calls the
crisis line multiple times per night demanding to speak with the same
nurse. Which boundary intervention is most appropriate?
A. Allow the client to call anytime as it builds trust.
B. Block the client's phone number to prevent dependency.
C. Establish a structured contract regarding call times and duration.
D. Transfer the client to a different nurse each time.
, C
RATIONALE: Clients with borderline personality disorder often
struggle with boundaries, and a structured contract helps maintain
clear expectations and consistency, which is therapeutic while
preventing splitting and dependency.
3. A client prescribed haloperidol for schizophrenia presents with
muscle rigidity, fever, and altered mental status. Which condition
should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Extrapyramidal symptoms
D. Tardive dyskinesia
B
RATIONALE: The triad of muscle rigidity, hyperthermia, and altered
mental status in a client taking haloperidol is classic for neuroleptic
malignant syndrome, a life-threatening adverse reaction requiring
immediate medical intervention.
4. A nurse is assessing a client with post-traumatic stress disorder who
reports recurrent nightmares and hypervigilance. Which nursing
diagnosis takes priority?
A. Disturbed sleep pattern
B. Risk for injury related to hypervigilance
C. Anxiety related to traumatic memories
D. Social isolation
, B
RATIONALE: Risk for injury is the priority because hypervigilance
and startle response can lead to accidental harm to self or others,
making safety the most immediate concern.
5. A client with anorexia nervosa refuses to eat and states, "I am too
fat." Which response by the nurse is most therapeutic?
A. "You are dangerously underweight and need to eat."
B. "I can see you are distressed. Let's sit and talk about your feelings."
C. "If you don't eat, we will have to place a feeding tube."
D. "Your perception of your body is incorrect."
B
RATIONALE: Acknowledging the client's distress and offering a non-
judgmental opportunity to discuss feelings is therapeutic, whereas
confronting the behavior or perceptions can increase resistance and
anxiety.
6. A client with bipolar disorder in a manic episode is pacing, talking
rapidly, and not sleeping. Which intervention should the nurse
implement first?
A. Place the client in seclusion.
B. Administer lorazepam as ordered.
C. Provide a quiet, low-stimulation environment.
D. Encourage the client to exercise to expend energy.
C
RATIONALE: Reducing environmental stimuli is the least restrictive
