GALEN COLLEGE OF NURSING
NU 160: Mental Health Concepts — Exam 3 Examination
2026/2027 Semester | Units 6, 7 & 8 Clinical Focus
Student Name: _______________________ Date: ________________________
Course: NU 160 Mental Health Concepts Total Questions: 50 Multiple Choice
Question 1. A nurse on the psychiatric inpatient unit is assessing a client with schizophrenia who states,
'I hear voices telling me to jump out the window right now.' How should the nurse prioritize and
document this clinical finding?
A) Document the finding as an illusion and leave the client alone to reduce environmental stimuli.
B) Recognize this as a command auditory hallucination and immediately assess if the client intends to act
on the voices.
C) Classify the statement as a depressive delusion and notify the healthcare provider at shift change.
D) Interpret this as a tactile hallucination and place the client in Level 3 seclusion.
✔ Correct Answer: Option B
Rationale: Auditory hallucinations are sensory perceptions occurring without external stimuli and represent
the most common type of hallucination in schizophrenia. When a client reports hearing voices, the nurse
must immediately assess whether the hallucinations are commanding in nature and whether the client plans
or intends to act on them to ensure safety.
Question 2. During a psychiatric mental status examination, a client with schizophrenia tells the nurse,
'The ipsy is not happy when the fulgari is green.' Which specific thought or speech disturbance is the
client demonstrating?
A) Neologisms
B) Echolalia
C) Clang associations
D) Flight of ideas
✔ Correct Answer: Option A
Rationale: Neologisms are words or expressions invented by the individual that have no standard meaning
to others (e.g., 'ipsy', 'fulgari'). Echolalia is the exact repetition of another person's words, clang associations
involve meaningless rhyming, and flight of ideas refers to rapid topic switching.
Galen College of Nursing — NU 160 Exam 3 Exam | Page 1
,Question 3. When asked by the nurse to interpret the proverb 'A stitch in time saves nine,' a client
diagnosed with schizophrenia states, 'It means you need to sew the holes in your clothes immediately.'
How should the nurse document this cognitive process?
A) Word salad
B) Concrete thinking
C) Loose associations
D) Thought broadcasting
✔ Correct Answer: Option B
Rationale: Concrete thinking is the inability to consider or understand abstract meanings; clients interpret
phrases or proverbs literally (e.g., interpreting 'a stitch in time saves nine' as literally sewing clothes). Testing
proverb interpretation is a standard method to assess for concrete thinking in psychotic disorders.
Question 4. A nurse enters the room of a client diagnosed with catatonic schizophrenia and observes
the client standing in a rigid, trance-like position. When the nurse attempts to move the client's arm to
take a blood pressure, the client's limb resists movement and remains fixed. Which motor alteration is
present?
A) Echopraxia
B) Akathisia
C) Posturing and waxy flexibility
D) Tardive dyskinesia
✔ Correct Answer: Option C
Rationale: Catatonia is characterized by a severe decrease in reaction to environmental stimuli. Posturing
involves maintaining a rigid, bizarre posture that resists efforts to move, while waxy flexibility is remaining in
a fixed position until moved by another person.
Question 5. A nursing student is studying the biological etiology and age of onset for Schizophrenia.
Which statement accurately reflects the epidemiological and neurochemical characteristics of this
disorder?
A) Schizophrenia has a rapid acute onset in early childhood and is caused by excess serotonin.
B) Schizophrenia presents with an insidious onset between late adolescence and mid-30s, linked to
increased dopamine activity.
C) Schizophrenia onset occurs equally in males and females between ages 45 and 55 with dopamine
deficiency.
D) Schizophrenia onset occurs primarily in older adults over age 65 due to severe thiamine depletion.
✔ Correct Answer: Option B
Rationale: Schizophrenia typically features an insidious (slow) onset between late adolescence and the mid-
30s. Etiological factors include genetic influences and increased dopamine neurochemical activity in the
Galen College of Nursing — NU 160 Exam 3 Exam | Page 2
, brain. Onset typically occurs earlier in males (18–25 years) than in females (25–30 years).
Question 6. A nurse is caring for a client with schizophrenia who demonstrates flat affect, apathy,
avolition, anhedonia, and alogia. How should the nurse categorize these symptoms and plan care?
A) Positive symptoms requiring immediate typical antipsychotics to lower serotonin.
B) Negative symptoms requiring nursing interventions based on physiological needs (Maslow's
hierarchy).
C) Acute extrapyramidal symptoms that require immediate IV anticholinergics.
D) Disorganized speech patterns that return to baseline within 24 hours.
✔ Correct Answer: Option B
Rationale: Negative symptoms (Type 2 schizophrenia) reflect a lack or loss of normal adaptive mechanisms
and include alogia (poverty of speech), anhedonia (inability to experience pleasure), apathy/flat affect,
avolition (lack of motivation), and anergia. Nursing interventions for negative symptoms focus heavily on
foundational physiological needs according to Maslow's hierarchy of needs.
Question 7. A client with chronic schizophrenia on an inpatient unit is observed drinking massive
quantities of water from sinks, water fountains, and shower heads. The nurse recognizes that the client
is at high risk for which life-threatening complication?
A) Delirium tremens
B) Water intoxication
C) Neuroleptic malignant syndrome
D) Wernicke-Korsakoff syndrome
✔ Correct Answer: Option B
Rationale: Water intoxication is a recognized complication in clients with schizophrenia. It is a psychosis-
induced metabolic state of severe fluid overload resulting from compulsive water drinking, which can cause
life-threatening hyponatremia and cerebral edema.
Question 8. A client is brought to the clinic after experiencing intense persecutory delusions and
auditory hallucinations that began 2 weeks ago following a severe life stressor. By week 3, the client's
symptoms completely resolve, and functioning returns to baseline. Which diagnosis is indicated?
A) Residual Schizophrenia
B) Schizophreniform Disorder
C) Brief Psychotic Disorder
D) Schizoaffective Disorder
✔ Correct Answer: Option C
Rationale: Brief Psychotic Disorder is characterized by a psychotic disturbance (delusions, hallucinations,
Galen College of Nursing — NU 160 Exam 3 Exam | Page 3
NU 160: Mental Health Concepts — Exam 3 Examination
2026/2027 Semester | Units 6, 7 & 8 Clinical Focus
Student Name: _______________________ Date: ________________________
Course: NU 160 Mental Health Concepts Total Questions: 50 Multiple Choice
Question 1. A nurse on the psychiatric inpatient unit is assessing a client with schizophrenia who states,
'I hear voices telling me to jump out the window right now.' How should the nurse prioritize and
document this clinical finding?
A) Document the finding as an illusion and leave the client alone to reduce environmental stimuli.
B) Recognize this as a command auditory hallucination and immediately assess if the client intends to act
on the voices.
C) Classify the statement as a depressive delusion and notify the healthcare provider at shift change.
D) Interpret this as a tactile hallucination and place the client in Level 3 seclusion.
✔ Correct Answer: Option B
Rationale: Auditory hallucinations are sensory perceptions occurring without external stimuli and represent
the most common type of hallucination in schizophrenia. When a client reports hearing voices, the nurse
must immediately assess whether the hallucinations are commanding in nature and whether the client plans
or intends to act on them to ensure safety.
Question 2. During a psychiatric mental status examination, a client with schizophrenia tells the nurse,
'The ipsy is not happy when the fulgari is green.' Which specific thought or speech disturbance is the
client demonstrating?
A) Neologisms
B) Echolalia
C) Clang associations
D) Flight of ideas
✔ Correct Answer: Option A
Rationale: Neologisms are words or expressions invented by the individual that have no standard meaning
to others (e.g., 'ipsy', 'fulgari'). Echolalia is the exact repetition of another person's words, clang associations
involve meaningless rhyming, and flight of ideas refers to rapid topic switching.
Galen College of Nursing — NU 160 Exam 3 Exam | Page 1
,Question 3. When asked by the nurse to interpret the proverb 'A stitch in time saves nine,' a client
diagnosed with schizophrenia states, 'It means you need to sew the holes in your clothes immediately.'
How should the nurse document this cognitive process?
A) Word salad
B) Concrete thinking
C) Loose associations
D) Thought broadcasting
✔ Correct Answer: Option B
Rationale: Concrete thinking is the inability to consider or understand abstract meanings; clients interpret
phrases or proverbs literally (e.g., interpreting 'a stitch in time saves nine' as literally sewing clothes). Testing
proverb interpretation is a standard method to assess for concrete thinking in psychotic disorders.
Question 4. A nurse enters the room of a client diagnosed with catatonic schizophrenia and observes
the client standing in a rigid, trance-like position. When the nurse attempts to move the client's arm to
take a blood pressure, the client's limb resists movement and remains fixed. Which motor alteration is
present?
A) Echopraxia
B) Akathisia
C) Posturing and waxy flexibility
D) Tardive dyskinesia
✔ Correct Answer: Option C
Rationale: Catatonia is characterized by a severe decrease in reaction to environmental stimuli. Posturing
involves maintaining a rigid, bizarre posture that resists efforts to move, while waxy flexibility is remaining in
a fixed position until moved by another person.
Question 5. A nursing student is studying the biological etiology and age of onset for Schizophrenia.
Which statement accurately reflects the epidemiological and neurochemical characteristics of this
disorder?
A) Schizophrenia has a rapid acute onset in early childhood and is caused by excess serotonin.
B) Schizophrenia presents with an insidious onset between late adolescence and mid-30s, linked to
increased dopamine activity.
C) Schizophrenia onset occurs equally in males and females between ages 45 and 55 with dopamine
deficiency.
D) Schizophrenia onset occurs primarily in older adults over age 65 due to severe thiamine depletion.
✔ Correct Answer: Option B
Rationale: Schizophrenia typically features an insidious (slow) onset between late adolescence and the mid-
30s. Etiological factors include genetic influences and increased dopamine neurochemical activity in the
Galen College of Nursing — NU 160 Exam 3 Exam | Page 2
, brain. Onset typically occurs earlier in males (18–25 years) than in females (25–30 years).
Question 6. A nurse is caring for a client with schizophrenia who demonstrates flat affect, apathy,
avolition, anhedonia, and alogia. How should the nurse categorize these symptoms and plan care?
A) Positive symptoms requiring immediate typical antipsychotics to lower serotonin.
B) Negative symptoms requiring nursing interventions based on physiological needs (Maslow's
hierarchy).
C) Acute extrapyramidal symptoms that require immediate IV anticholinergics.
D) Disorganized speech patterns that return to baseline within 24 hours.
✔ Correct Answer: Option B
Rationale: Negative symptoms (Type 2 schizophrenia) reflect a lack or loss of normal adaptive mechanisms
and include alogia (poverty of speech), anhedonia (inability to experience pleasure), apathy/flat affect,
avolition (lack of motivation), and anergia. Nursing interventions for negative symptoms focus heavily on
foundational physiological needs according to Maslow's hierarchy of needs.
Question 7. A client with chronic schizophrenia on an inpatient unit is observed drinking massive
quantities of water from sinks, water fountains, and shower heads. The nurse recognizes that the client
is at high risk for which life-threatening complication?
A) Delirium tremens
B) Water intoxication
C) Neuroleptic malignant syndrome
D) Wernicke-Korsakoff syndrome
✔ Correct Answer: Option B
Rationale: Water intoxication is a recognized complication in clients with schizophrenia. It is a psychosis-
induced metabolic state of severe fluid overload resulting from compulsive water drinking, which can cause
life-threatening hyponatremia and cerebral edema.
Question 8. A client is brought to the clinic after experiencing intense persecutory delusions and
auditory hallucinations that began 2 weeks ago following a severe life stressor. By week 3, the client's
symptoms completely resolve, and functioning returns to baseline. Which diagnosis is indicated?
A) Residual Schizophrenia
B) Schizophreniform Disorder
C) Brief Psychotic Disorder
D) Schizoaffective Disorder
✔ Correct Answer: Option C
Rationale: Brief Psychotic Disorder is characterized by a psychotic disturbance (delusions, hallucinations,
Galen College of Nursing — NU 160 Exam 3 Exam | Page 3
