NUR 253 EXAM 4 MENTAL HEALTH 2026–
2027 | Galen College of Nursing | Practice
Questions & Correct Answers | Complete
Exam Review PDF
NUR 253 EXAM 4 MENTAL HEALTH 2026–2027 | Galen College of Nursing |
Practice Questions & Correct Answers
DOCUMENT OVERVIEW
• This comprehensive practice exam contains multiple-choice questions designed to
strengthen your mental health nursing knowledge and prepare you for clinical
exams covering major psychiatric disorders, therapeutic interventions,
psychopharmacology, and evidence-based nursing care.
• Study this material by working through questions systematically, reviewing
rationales carefully for both correct and incorrect answers, and using it to identify
knowledge gaps in specific mental health domains before your actual examination.
QUESTIONS 1–25: ANXIETY DISORDERS
1) A 28-year-old client with generalized anxiety disorder reports persistent
worry about work, finances, and health for the past eight months. Which
assessment finding would the nurse expect to identify?
A) Client has not experienced any physical symptoms of anxiety
B) Client reports symptoms that are intermittent and manageable without
intervention
C) Client demonstrates difficulty concentrating and reports muscle tension
D) Client's anxiety is limited to specific social situations only
E) Client has experienced anxiety for less than one month
CORRECT ANSWER: C) Client demonstrates difficulty concentrating and
reports muscle tension
,RATIONALE: Generalized anxiety disorder (GAD) is characterized by persistent
worry lasting at least six months and includes cognitive symptoms (difficulty
concentrating, racing thoughts, poor memory) and physical symptoms (muscle
tension, restlessness, fatigue, sleep disturbances). This client meets the temporal
criteria (eight months) and presents with classic symptoms. Options A and B are
incorrect because GAD involves persistent, pervasive symptoms. Option D
describes social anxiety disorder specifically. Option E contradicts the timeline given
in the question.
2) A client with panic disorder describes experiencing sudden onset of chest
pain, heart palpitations, shortness of breath, and a feeling of impending
doom. The client is convinced they are having a heart attack. What is the
nurse's priority intervention?
A) Reassure the client that panic attacks are not dangerous and cannot cause death
B) Assist the client to slow breathing through diaphragmatic breathing techniques
while remaining with them
C) Immediately discharge the client after vital signs are stable
D) Tell the client the symptoms are "all in their head"
E) Administer oxygen immediately without assessment
CORRECT ANSWER: B) Assist the client to slow breathing through
diaphragmatic breathing techniques while remaining with them
RATIONALE: During a panic attack, the nurse's priority is to reduce anxiety through
grounding and breathing techniques while providing a calm, supportive presence.
Diaphragmatic breathing helps counteract hyperventilation and reduces physical
symptoms. Option A, though true, is dismissive and ineffective during acute panic.
Option D is judgmental and harmful. Option C is premature without full
assessment. Option E is unnecessary and not evidence-based without clinical
indication.
,3) A client with social anxiety disorder declines to attend a family gathering,
stating, "Everyone will judge me, and I'll embarrass myself." Which
therapeutic response demonstrates cognitive-behavioral principles?
A) "You're right, you should probably stay home then"
B) "Let's examine the evidence for and against this thought. What specific evidence
do you have that people will judge you?"
C) "Your family loves you, so nobody will judge you"
D) "Social anxiety is just shyness; you'll outgrow it"
E) "You need to force yourself to go to overcome this fear"
CORRECT ANSWER: B) "Let's examine the evidence for and against this
thought. What specific evidence do you have that people will judge you?"
RATIONALE: Cognitive-behavioral therapy (CBT) focuses on identifying and
challenging distorted thoughts by examining evidence. This response helps the
client reality-test their catastrophic thinking. Option A enables avoidance. Option C
dismisses the client's real distress. Option D minimizes the disorder. Option E may
increase anxiety without proper therapeutic support and coping skills.
4) A 35-year-old client with agoraphobia has not left their home in three
months due to fear of having a panic attack in public. Which nursing diagnosis
is most appropriate?
A) Ineffective airway clearance related to anxiety
B) Impaired physical mobility related to neuromuscular impairment
C) Social isolation related to fear of panic attacks in public places
D) Acute pain related to anxiety
E) Disturbed sleep pattern related to poor sleep hygiene
CORRECT ANSWER: C) Social isolation related to fear of panic attacks in public
places
, RATIONALE: Agoraphobia involves anxiety about situations where escape is
difficult or embarrassing, leading to avoidance and social withdrawal. "Social
isolation" directly addresses the client's withdrawn behavior and its etiology. Option
A is not appropriate for anxiety. Option B relates to physical, not psychological,
causes of immobility. Option D does not address the primary problem. Option E
may be secondary but is not the primary nursing diagnosis.
5) Which medication is first-line treatment for generalized anxiety disorder?
A) Alprazolam (Xanax)
B) Buspirone (Buspar)
C) Sertraline (Zoloft)
D) Diphenhydramine (Benadryl)
E) Propranolol (Inderal)
CORRECT ANSWER: C) Sertraline (Zoloft)
RATIONALE: SSRIs like sertraline are first-line medications for GAD because they
are effective, have favorable side effect profiles, and low abuse potential.
Benzodiazepines (alprazolam) are second-line due to dependence risk and
tolerance. Buspiron is an azapirone alternative. Antihistamines and beta-blockers
address specific symptoms but are not primary treatments.
6) A client taking an SSRI for anxiety disorder reports sexual dysfunction and
weight gain. What is an appropriate nursing action?
A) Instruct the client to stop the medication immediately
B) Inform the client these side effects are permanent and unavoidable
C) Assess if the side effects are affecting medication adherence and discuss options
with the provider
D) Tell the client that these side effects indicate the medication is not working
2027 | Galen College of Nursing | Practice
Questions & Correct Answers | Complete
Exam Review PDF
NUR 253 EXAM 4 MENTAL HEALTH 2026–2027 | Galen College of Nursing |
Practice Questions & Correct Answers
DOCUMENT OVERVIEW
• This comprehensive practice exam contains multiple-choice questions designed to
strengthen your mental health nursing knowledge and prepare you for clinical
exams covering major psychiatric disorders, therapeutic interventions,
psychopharmacology, and evidence-based nursing care.
• Study this material by working through questions systematically, reviewing
rationales carefully for both correct and incorrect answers, and using it to identify
knowledge gaps in specific mental health domains before your actual examination.
QUESTIONS 1–25: ANXIETY DISORDERS
1) A 28-year-old client with generalized anxiety disorder reports persistent
worry about work, finances, and health for the past eight months. Which
assessment finding would the nurse expect to identify?
A) Client has not experienced any physical symptoms of anxiety
B) Client reports symptoms that are intermittent and manageable without
intervention
C) Client demonstrates difficulty concentrating and reports muscle tension
D) Client's anxiety is limited to specific social situations only
E) Client has experienced anxiety for less than one month
CORRECT ANSWER: C) Client demonstrates difficulty concentrating and
reports muscle tension
,RATIONALE: Generalized anxiety disorder (GAD) is characterized by persistent
worry lasting at least six months and includes cognitive symptoms (difficulty
concentrating, racing thoughts, poor memory) and physical symptoms (muscle
tension, restlessness, fatigue, sleep disturbances). This client meets the temporal
criteria (eight months) and presents with classic symptoms. Options A and B are
incorrect because GAD involves persistent, pervasive symptoms. Option D
describes social anxiety disorder specifically. Option E contradicts the timeline given
in the question.
2) A client with panic disorder describes experiencing sudden onset of chest
pain, heart palpitations, shortness of breath, and a feeling of impending
doom. The client is convinced they are having a heart attack. What is the
nurse's priority intervention?
A) Reassure the client that panic attacks are not dangerous and cannot cause death
B) Assist the client to slow breathing through diaphragmatic breathing techniques
while remaining with them
C) Immediately discharge the client after vital signs are stable
D) Tell the client the symptoms are "all in their head"
E) Administer oxygen immediately without assessment
CORRECT ANSWER: B) Assist the client to slow breathing through
diaphragmatic breathing techniques while remaining with them
RATIONALE: During a panic attack, the nurse's priority is to reduce anxiety through
grounding and breathing techniques while providing a calm, supportive presence.
Diaphragmatic breathing helps counteract hyperventilation and reduces physical
symptoms. Option A, though true, is dismissive and ineffective during acute panic.
Option D is judgmental and harmful. Option C is premature without full
assessment. Option E is unnecessary and not evidence-based without clinical
indication.
,3) A client with social anxiety disorder declines to attend a family gathering,
stating, "Everyone will judge me, and I'll embarrass myself." Which
therapeutic response demonstrates cognitive-behavioral principles?
A) "You're right, you should probably stay home then"
B) "Let's examine the evidence for and against this thought. What specific evidence
do you have that people will judge you?"
C) "Your family loves you, so nobody will judge you"
D) "Social anxiety is just shyness; you'll outgrow it"
E) "You need to force yourself to go to overcome this fear"
CORRECT ANSWER: B) "Let's examine the evidence for and against this
thought. What specific evidence do you have that people will judge you?"
RATIONALE: Cognitive-behavioral therapy (CBT) focuses on identifying and
challenging distorted thoughts by examining evidence. This response helps the
client reality-test their catastrophic thinking. Option A enables avoidance. Option C
dismisses the client's real distress. Option D minimizes the disorder. Option E may
increase anxiety without proper therapeutic support and coping skills.
4) A 35-year-old client with agoraphobia has not left their home in three
months due to fear of having a panic attack in public. Which nursing diagnosis
is most appropriate?
A) Ineffective airway clearance related to anxiety
B) Impaired physical mobility related to neuromuscular impairment
C) Social isolation related to fear of panic attacks in public places
D) Acute pain related to anxiety
E) Disturbed sleep pattern related to poor sleep hygiene
CORRECT ANSWER: C) Social isolation related to fear of panic attacks in public
places
, RATIONALE: Agoraphobia involves anxiety about situations where escape is
difficult or embarrassing, leading to avoidance and social withdrawal. "Social
isolation" directly addresses the client's withdrawn behavior and its etiology. Option
A is not appropriate for anxiety. Option B relates to physical, not psychological,
causes of immobility. Option D does not address the primary problem. Option E
may be secondary but is not the primary nursing diagnosis.
5) Which medication is first-line treatment for generalized anxiety disorder?
A) Alprazolam (Xanax)
B) Buspirone (Buspar)
C) Sertraline (Zoloft)
D) Diphenhydramine (Benadryl)
E) Propranolol (Inderal)
CORRECT ANSWER: C) Sertraline (Zoloft)
RATIONALE: SSRIs like sertraline are first-line medications for GAD because they
are effective, have favorable side effect profiles, and low abuse potential.
Benzodiazepines (alprazolam) are second-line due to dependence risk and
tolerance. Buspiron is an azapirone alternative. Antihistamines and beta-blockers
address specific symptoms but are not primary treatments.
6) A client taking an SSRI for anxiety disorder reports sexual dysfunction and
weight gain. What is an appropriate nursing action?
A) Instruct the client to stop the medication immediately
B) Inform the client these side effects are permanent and unavoidable
C) Assess if the side effects are affecting medication adherence and discuss options
with the provider
D) Tell the client that these side effects indicate the medication is not working
