NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
NUR 253 Exam 1 Mental Health (2026/2027)
Galen College of Nursing | Mental Health Nursing
This comprehensive exam contains 100 multiple-choice questions spanning the eight core domains of NUR
253 Exam 1 (Mental Health Nursing), calibrated to the 2026/2027 academic cycle at Galen College of Nursing.
Each question is labeled with a competency tag (e.g., Therapeutic Communication – Reflection) and a
cognitive level (Recall, Application, Analysis) so that you can target review efficiently. The cognitive
distribution is approximately 30% recall, 50% application, and 20% analysis, mirroring the structure of a
foundational mental health nursing exam. Approximately 70% of items are scenario-based and 30% test direct
recall of theorists, concepts, and legal criteria. Each rationale doubles as study content: it explains why the correct
answer is correct and why each distractor is wrong, including theoretical foundations, therapeutic communication
principles, legal obligations, and standards of practice. Use this document as a self-assessment, then return to the
rationales for targeted study.
How to use this exam:
1. Answer all 100 questions before consulting the rationales to simulate exam conditions.
2. After completing, review rationales for items you missed; pay attention to the therapeutic communication
principle, theorist attribution, legal obligation, or standard of practice flagged in the rationale.
3. Watch for commonly confused pairs: psychoanalytic vs. humanistic, behavioral vs. cognitive,
transference vs. countertransference, and Peplau's relationship phases.
4. Each section heading below lists the competencies covered for targeted review.
Section 1: Foundations of Psychiatric-Mental Health Nursing
History, Trends, & Core Concepts (Q1–Q14)
Competencies covered: Deinstitutionalization; Community Mental Health Movement; Moral Treatment (Dix);
Peplau's Role; Telehealth & Integrated Care; Stigma Reduction; Mental Health Parity (MHPAEA);
Multidisciplinary Team; Levels of Care; Case Management.
Q1. [Foundations – Deinstitutionalization] Cognitive: Recall
The movement that began in the 1960s to transfer patients from large psychiatric institutions to
community-based settings is known as:
A. The Community Mental Health Movement
B. Deinstitutionalization [CORRECT]
C. The Moral Treatment Movement
D. The Mental Hygiene Movement
Correct Answer: B
Rationale: Deinstitutionalization refers to the policy shift that began in the 1960s (catalyzed by the discovery of
antipsychotic medications like chlorpromazine and the 1963 Community Mental Health Act) of moving patients out of
large state psychiatric hospitals into community-based care. While the Community Mental Health Movement (A) is
Page 1
,NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
closely related and overlapped historically, deinstitutionalization specifically refers to the depopulation of asylums.
The Moral Treatment Movement (C) was a 19th-century reform; the Mental Hygiene Movement (D) was an
early-20th-century effort by Clifford Beers. Distinguishing these historical movements is foundational content for
NUR 253.
Q2. [Foundations – Community Mental Health Act] Cognitive: Recall
The 1963 legislation signed by President John F. Kennedy that established Community Mental
Health Centers (CMHCs) and accelerated deinstitutionalization was the:
A. Social Security Act amendments of 1965
B. Americans with Disabilities Act of 1990
C. Mental Retardation Facilities and Community Mental Health Centers Construction Act
[CORRECT]
D. Mental Health Systems Act of 1980
Correct Answer: C
Rationale: The Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963
(PL-88-164), signed by President Kennedy, provided federal funding to build community mental health centers and is
considered the legislative cornerstone of deinstitutionalization. The other Acts address different issues: Social Security
amendments (A) created Medicare/Medicaid; the ADA (B) prohibited disability discrimination; the Mental Health
Systems Act (D) came later (1980) and was largely defunded under President Reagan.
Q3. [Foundations – Current Trends (Telehealth)] Cognitive: Application
A psychiatric-mental health nurse in rural Kentucky provides weekly cognitive-behavioral therapy
sessions to a client with depression via secure video conferencing. This model of care best
exemplifies:
A. Integrated care
B. Telepsychiatry / telehealth mental health services [CORRECT]
C. Deinstitutionalization
D. Case management
Correct Answer: B
Rationale: Telepsychiatry (a subset of telehealth) delivers psychiatric and mental health services via secure video
conferencing, expanding access to clients in rural or underserved areas. Integrated care (A) refers to behavioral health
embedded within primary care. Deinstitutionalization (C) is the historical shift from hospitals to communities. Case
management (D) coordinates services across providers but does not require video conferencing.
Q4. [Foundations – Integrated Care] Cognitive: Application
A primary care clinic embeds a psychiatric-mental health nurse practitioner in the same office as
family physicians so that clients with depression, anxiety, or substance use can receive behavioral
health services during their medical visit. This model is:
A. Integrated behavioral health care [CORRECT]
B. Inpatient psychiatric care
C. Partial hospitalization
D. Residential treatment
Page 2
,NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
Correct Answer: A
Rationale: Integrated behavioral health care co-locates and coordinates physical and behavioral health services, often
in primary care. It improves access, reduces stigma, and addresses the high comorbidity of physical and mental illness.
Inpatient psychiatric care (B) is acute hospitalization; partial hospitalization (C) is structured day programs; residential
treatment (D) is 24-hour non-hospital care. Recognizing care models is foundational NUR 253 content.
Q5. [Foundations – Stigma Reduction] Cognitive: Application
A nurse educator teaches staff to use person-first language such as "a person with schizophrenia"
rather than "a schizophrenic." The primary goal of this practice is to:
A. Improve diagnostic accuracy
B. Reduce stigma by separating the person from the diagnosis [CORRECT]
C. Shorten documentation time
D. Increase admissions
Correct Answer: B
Rationale: Person-first language ("a person with schizophrenia") separates identity from diagnosis, reducing stigma
and promoting recovery-oriented care. Saying "a schizophrenic" defines the person by their illness. Stigma reduction is
a current priority in mental health nursing. The other options are unrelated consequences of language choice.
Q6. [Foundations – Historical Figures] Cognitive: Recall
Which 19th-century reformer advocated humane treatment of people with mental illness and is
credited with the Moral Treatment Movement in the United States, including her work at the
Worcester State Hospital?
A. Dorothea Dix [CORRECT]
B. Clifford Beers
C. Sigmund Freud
D. Hildegard Peplau
Correct Answer: A
Rationale: Dorothea Dix (1802–1887) was the 19th-century reformer who advocated for humane treatment of people
with mental illness and was instrumental in establishing state psychiatric hospitals across the U.S. Clifford Beers (B)
authored "A Mind That Found Itself" (1908) and founded the Mental Hygiene Movement. Freud (C) developed
psychoanalysis. Peplau (D) developed the nurse-client relationship model in the 20th century.
Q7. [Foundations – Role of the PMH Nurse] Cognitive: Recall
Hildegard Peplau is recognized in psychiatric-mental health nursing for her contribution to:
A. Developing the first antipsychotic medication
B. Establishing the therapeutic nurse-client relationship as the foundation of psychiatric nursing
practice [CORRECT]
C. Founding the National Alliance on Mental Illness (NAMI)
D. Authoring the Diagnostic and Statistical Manual
Correct Answer: B
Rationale: Hildegard Peplau, often called the mother of psychiatric nursing, published "Interpersonal Relations in
Nursing" in 1952 and established the nurse-client relationship as the foundation of psychiatric nursing practice.
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, NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
Antipsychotic medications (A) were developed by pharmacologists (e.g., Laborit, Delay, Deniker); NAMI (C) was
founded by family members; the DSM (D) is published by the American Psychiatric Association.
Q8. [Foundations – Multidisciplinary Team] Cognitive: Application
A client is admitted to an inpatient psychiatric unit with severe depression and suicidal ideation.
Which team member is primarily responsible for prescribing and managing psychotropic
medications?
A. Psychiatric-mental health registered nurse
B. Psychiatric social worker
C. Psychiatrist or psychiatric-mental health nurse practitioner [CORRECT]
D. Occupational therapist
Correct Answer: C
Rationale: Prescriptive authority for psychotropic medications rests with the psychiatrist (MD/DO) or
psychiatric-mental health nurse practitioner (PMHNP), depending on state scope of practice. The PMH RN (A)
administers and monitors medications but does not prescribe. Social workers (B) provide psychotherapy and case
management. Occupational therapists (D) focus on activities of daily living and vocational skills.
Q9. [Foundations – Standards of Practice] Cognitive: Recall
The American Nurses Association (ANA) Scope and Standards of Psychiatric-Mental Health
Nursing Practice are organized around which framework?
A. The medical model of diagnosis
B. The nursing process (assessment, diagnosis, outcomes identification, planning, implementation,
evaluation) [CORRECT]
C. Freud's psychosexual stages
D. Maslow's hierarchy of needs
Correct Answer: B
Rationale: The ANA Scope and Standards of Psychiatric-Mental Health Nursing Practice are structured around the
nursing process — assessment, diagnosis, outcomes identification, planning, implementation, and evaluation.
Standards 1–6 focus on the nursing process; Standards 7–16 address professional performance (ethics, education,
evidence-based practice, quality, etc.). The medical model (A), Freud (C), and Maslow (D) are related concepts but
not the framework for the standards.
Q10. [Foundations – Evidence-Based Practice] Cognitive: Application
A PMH RN on an inpatient unit notices that a particular unit-based intervention reduces seclusion
and restraint use. The RN collects data, presents at a staff meeting, and changes the unit protocol.
This activity best represents:
A. Quality improvement and evidence-based practice [CORRECT]
B. Boundary violation
C. Countertransference
D. Non-therapeutic communication
Correct Answer: A
Page 4
NUR 253 Exam 1 Mental Health (2026/2027)
Galen College of Nursing | Mental Health Nursing
This comprehensive exam contains 100 multiple-choice questions spanning the eight core domains of NUR
253 Exam 1 (Mental Health Nursing), calibrated to the 2026/2027 academic cycle at Galen College of Nursing.
Each question is labeled with a competency tag (e.g., Therapeutic Communication – Reflection) and a
cognitive level (Recall, Application, Analysis) so that you can target review efficiently. The cognitive
distribution is approximately 30% recall, 50% application, and 20% analysis, mirroring the structure of a
foundational mental health nursing exam. Approximately 70% of items are scenario-based and 30% test direct
recall of theorists, concepts, and legal criteria. Each rationale doubles as study content: it explains why the correct
answer is correct and why each distractor is wrong, including theoretical foundations, therapeutic communication
principles, legal obligations, and standards of practice. Use this document as a self-assessment, then return to the
rationales for targeted study.
How to use this exam:
1. Answer all 100 questions before consulting the rationales to simulate exam conditions.
2. After completing, review rationales for items you missed; pay attention to the therapeutic communication
principle, theorist attribution, legal obligation, or standard of practice flagged in the rationale.
3. Watch for commonly confused pairs: psychoanalytic vs. humanistic, behavioral vs. cognitive,
transference vs. countertransference, and Peplau's relationship phases.
4. Each section heading below lists the competencies covered for targeted review.
Section 1: Foundations of Psychiatric-Mental Health Nursing
History, Trends, & Core Concepts (Q1–Q14)
Competencies covered: Deinstitutionalization; Community Mental Health Movement; Moral Treatment (Dix);
Peplau's Role; Telehealth & Integrated Care; Stigma Reduction; Mental Health Parity (MHPAEA);
Multidisciplinary Team; Levels of Care; Case Management.
Q1. [Foundations – Deinstitutionalization] Cognitive: Recall
The movement that began in the 1960s to transfer patients from large psychiatric institutions to
community-based settings is known as:
A. The Community Mental Health Movement
B. Deinstitutionalization [CORRECT]
C. The Moral Treatment Movement
D. The Mental Hygiene Movement
Correct Answer: B
Rationale: Deinstitutionalization refers to the policy shift that began in the 1960s (catalyzed by the discovery of
antipsychotic medications like chlorpromazine and the 1963 Community Mental Health Act) of moving patients out of
large state psychiatric hospitals into community-based care. While the Community Mental Health Movement (A) is
Page 1
,NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
closely related and overlapped historically, deinstitutionalization specifically refers to the depopulation of asylums.
The Moral Treatment Movement (C) was a 19th-century reform; the Mental Hygiene Movement (D) was an
early-20th-century effort by Clifford Beers. Distinguishing these historical movements is foundational content for
NUR 253.
Q2. [Foundations – Community Mental Health Act] Cognitive: Recall
The 1963 legislation signed by President John F. Kennedy that established Community Mental
Health Centers (CMHCs) and accelerated deinstitutionalization was the:
A. Social Security Act amendments of 1965
B. Americans with Disabilities Act of 1990
C. Mental Retardation Facilities and Community Mental Health Centers Construction Act
[CORRECT]
D. Mental Health Systems Act of 1980
Correct Answer: C
Rationale: The Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963
(PL-88-164), signed by President Kennedy, provided federal funding to build community mental health centers and is
considered the legislative cornerstone of deinstitutionalization. The other Acts address different issues: Social Security
amendments (A) created Medicare/Medicaid; the ADA (B) prohibited disability discrimination; the Mental Health
Systems Act (D) came later (1980) and was largely defunded under President Reagan.
Q3. [Foundations – Current Trends (Telehealth)] Cognitive: Application
A psychiatric-mental health nurse in rural Kentucky provides weekly cognitive-behavioral therapy
sessions to a client with depression via secure video conferencing. This model of care best
exemplifies:
A. Integrated care
B. Telepsychiatry / telehealth mental health services [CORRECT]
C. Deinstitutionalization
D. Case management
Correct Answer: B
Rationale: Telepsychiatry (a subset of telehealth) delivers psychiatric and mental health services via secure video
conferencing, expanding access to clients in rural or underserved areas. Integrated care (A) refers to behavioral health
embedded within primary care. Deinstitutionalization (C) is the historical shift from hospitals to communities. Case
management (D) coordinates services across providers but does not require video conferencing.
Q4. [Foundations – Integrated Care] Cognitive: Application
A primary care clinic embeds a psychiatric-mental health nurse practitioner in the same office as
family physicians so that clients with depression, anxiety, or substance use can receive behavioral
health services during their medical visit. This model is:
A. Integrated behavioral health care [CORRECT]
B. Inpatient psychiatric care
C. Partial hospitalization
D. Residential treatment
Page 2
,NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
Correct Answer: A
Rationale: Integrated behavioral health care co-locates and coordinates physical and behavioral health services, often
in primary care. It improves access, reduces stigma, and addresses the high comorbidity of physical and mental illness.
Inpatient psychiatric care (B) is acute hospitalization; partial hospitalization (C) is structured day programs; residential
treatment (D) is 24-hour non-hospital care. Recognizing care models is foundational NUR 253 content.
Q5. [Foundations – Stigma Reduction] Cognitive: Application
A nurse educator teaches staff to use person-first language such as "a person with schizophrenia"
rather than "a schizophrenic." The primary goal of this practice is to:
A. Improve diagnostic accuracy
B. Reduce stigma by separating the person from the diagnosis [CORRECT]
C. Shorten documentation time
D. Increase admissions
Correct Answer: B
Rationale: Person-first language ("a person with schizophrenia") separates identity from diagnosis, reducing stigma
and promoting recovery-oriented care. Saying "a schizophrenic" defines the person by their illness. Stigma reduction is
a current priority in mental health nursing. The other options are unrelated consequences of language choice.
Q6. [Foundations – Historical Figures] Cognitive: Recall
Which 19th-century reformer advocated humane treatment of people with mental illness and is
credited with the Moral Treatment Movement in the United States, including her work at the
Worcester State Hospital?
A. Dorothea Dix [CORRECT]
B. Clifford Beers
C. Sigmund Freud
D. Hildegard Peplau
Correct Answer: A
Rationale: Dorothea Dix (1802–1887) was the 19th-century reformer who advocated for humane treatment of people
with mental illness and was instrumental in establishing state psychiatric hospitals across the U.S. Clifford Beers (B)
authored "A Mind That Found Itself" (1908) and founded the Mental Hygiene Movement. Freud (C) developed
psychoanalysis. Peplau (D) developed the nurse-client relationship model in the 20th century.
Q7. [Foundations – Role of the PMH Nurse] Cognitive: Recall
Hildegard Peplau is recognized in psychiatric-mental health nursing for her contribution to:
A. Developing the first antipsychotic medication
B. Establishing the therapeutic nurse-client relationship as the foundation of psychiatric nursing
practice [CORRECT]
C. Founding the National Alliance on Mental Illness (NAMI)
D. Authoring the Diagnostic and Statistical Manual
Correct Answer: B
Rationale: Hildegard Peplau, often called the mother of psychiatric nursing, published "Interpersonal Relations in
Nursing" in 1952 and established the nurse-client relationship as the foundation of psychiatric nursing practice.
Page 3
, NUR 253 Exam 1 Mental Health (2026/2027) | Galen College of Nursing Mental Health Nursing
Antipsychotic medications (A) were developed by pharmacologists (e.g., Laborit, Delay, Deniker); NAMI (C) was
founded by family members; the DSM (D) is published by the American Psychiatric Association.
Q8. [Foundations – Multidisciplinary Team] Cognitive: Application
A client is admitted to an inpatient psychiatric unit with severe depression and suicidal ideation.
Which team member is primarily responsible for prescribing and managing psychotropic
medications?
A. Psychiatric-mental health registered nurse
B. Psychiatric social worker
C. Psychiatrist or psychiatric-mental health nurse practitioner [CORRECT]
D. Occupational therapist
Correct Answer: C
Rationale: Prescriptive authority for psychotropic medications rests with the psychiatrist (MD/DO) or
psychiatric-mental health nurse practitioner (PMHNP), depending on state scope of practice. The PMH RN (A)
administers and monitors medications but does not prescribe. Social workers (B) provide psychotherapy and case
management. Occupational therapists (D) focus on activities of daily living and vocational skills.
Q9. [Foundations – Standards of Practice] Cognitive: Recall
The American Nurses Association (ANA) Scope and Standards of Psychiatric-Mental Health
Nursing Practice are organized around which framework?
A. The medical model of diagnosis
B. The nursing process (assessment, diagnosis, outcomes identification, planning, implementation,
evaluation) [CORRECT]
C. Freud's psychosexual stages
D. Maslow's hierarchy of needs
Correct Answer: B
Rationale: The ANA Scope and Standards of Psychiatric-Mental Health Nursing Practice are structured around the
nursing process — assessment, diagnosis, outcomes identification, planning, implementation, and evaluation.
Standards 1–6 focus on the nursing process; Standards 7–16 address professional performance (ethics, education,
evidence-based practice, quality, etc.). The medical model (A), Freud (C), and Maslow (D) are related concepts but
not the framework for the standards.
Q10. [Foundations – Evidence-Based Practice] Cognitive: Application
A PMH RN on an inpatient unit notices that a particular unit-based intervention reduces seclusion
and restraint use. The RN collects data, presents at a staff meeting, and changes the unit protocol.
This activity best represents:
A. Quality improvement and evidence-based practice [CORRECT]
B. Boundary violation
C. Countertransference
D. Non-therapeutic communication
Correct Answer: A
Page 4
