NUR 253 — MENTAL HEALTH NURSING A+
VERIFIED
NUR 253 Exams 1 – 4 | Mental Health | Galen College of Nursing
2026/2027
| Therapeutic | Application – Pass Guaranteed – A+ Graded
200 4 200
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS ABOUT THIS ASSESSMENT
This four-exam bundle assesses psychiatric-mental health nursing
Exam 1: Foundations of Mental Health Nursing across the lifespan. Domain coverage spans foundations of
Communication, MSE, ethics, milieu, defense mechanisms, anxiety therapeutic practice, mood and anxiety spectrum disorders,
levels
psychotic and personality conditions, and substance use, eating
Exam 2: Mood, Anxiety, and Trauma-Related Disorders disorders, and crisis intervention. Each item targets application
MDD, bipolar, GAD, panic, PTSD, OCD, phobias, acute stress
and analysis-level reasoning consistent with the NCLEX test plan
and AACN essentials for baccalaureate psychiatric nursing.
Exam 3: Psychotic and Personality Disorders
Schizophrenia, schizoaffective, BPD, antisocial, narcissistic,
dissociative
Exam 4: Substance Use, Eating, and Crisis Disorders BLOOM'S LEVEL Application/Analysis
Alcohol, opioids, stimulants, anorexia, bulimia, suicide, crisis, IPV
STUVIA ACTUAL EXAM
PASSING SCORE: 80% FORMAT: MCQ
LEVEL: Intermediate QUESTIONS: 200
,NUR 253 — MENTAL HEALTH NURSING 80% PASS
Section 1 — Exam 1: Foundations of Mental Health Nursing
Therapeutic communication, assessment, ethics, milieu, and the nursing process | Questions 1–50
1. A nursing student is caring for a withdrawn adult with major depression. Which behavior best demonstrates active
listening?
CONCEPT: Therapeutic Communication — Active Listening
A. Leaning slightly forward and maintaining appropriate eye contact while the patient speaks
B. Asking several closed questions to keep the interview focused
C. Documenting observations while the patient describes feelings
D. Sharing a personal story about sadness to build rapport
Rationale: Correct answer: A. Active listening uses attentive posture, eye contact, and presence to convey acceptance. Note-taking
or excessive closed questions interfere with rapport, and self-disclosure shifts focus from the patient.
2. Which statement by the nurse is an open-ended question appropriate for an initial psychiatric interview?
CONCEPT: Therapeutic Communication — Open-Ended Question
A. “Did you sleep well last night?”
B. “How have you been coping since the layoff?”
C. “Are you feeling sad today?”
D. “Do you take your medications every day?”
Rationale: Correct answer: B. Open-ended questions cannot be answered with yes/no and encourage elaboration. Option C invites
narrative. The others are closed-ended and limit therapeutic exploration.
3. A patient says, “I just feel like everything is falling apart.” Which nurse response best exemplifies the technique of
reflection?
CONCEPT: Therapeutic Communication — Reflection
A. “You should try to focus on the positive things.”
B. “Why do you think everything is falling apart?”
C. “It sounds like you’re feeling overwhelmed right now.”
D. “Tell me exactly what fell apart today.”
Rationale: Correct answer: C. Reflection mirrors the patient’s expressed feeling, validating emotion and encouraging further
disclosure. “Why” questions are non-therapeutic, and reassurance dismisses the feeling.
4. During an interview, a patient becomes tearful and pauses after describing a recent loss. What is the nurse’s most
therapeutic response?
CONCEPT: Therapeutic Communication — Silence
A. Quickly offer a tissue and change the subject
B. Prompt the patient to describe funeral details
C. Tell the patient that crying will help the healing
D. Maintain quiet presence and allow the silence to continue
Rationale: Correct answer: D. Therapeutic silence gives the patient space to process emotion and conveys acceptance. Changing
topics or rushing to fill the silence invalidates the experience.
5. A patient states, “Sometimes my head gets all mixed up and I can’t think straight.” Which response uses clarification?
CONCEPT: Therapeutic Communication — Clarification
A. “Are you saying you have trouble concentrating?”
B. “I understand what you mean.”
C. “Tell me more about being mixed up.”
D. “That sounds scary.”
Rationale: Correct answer: A. Clarification restates the patient’s words as a focused question to verify meaning. Option C is too
broad, option D jumps to interpretation, and option A assumes understanding without verification.
STUVIA ACTUAL EXAM Page 2
,NUR 253 — MENTAL HEALTH NURSING 80% PASS
6. A patient with schizophrenia says, “The government planted a chip in my tooth.” What is the most therapeutic initial
response?
CONCEPT: Therapeutic Communication — Validation
A. “That’s not true; you’re experiencing delusions.”
B. “I don’t see a chip, but I can tell this feels real to you.”
C. “Why would the government do that?”
D. “Let’s have the dentist remove it.”
Rationale: Correct answer: B. Validation acknowledges the patient’s emotional reality without confirming the delusion. Directly
contradicting, rationalizing, or colluding are non-therapeutic.
7. Near the close of a 30-minute session, the nurse reviews the patient’s main concerns and agreed plans. This technique is
best described as:
CONCEPT: Therapeutic Communication — Summarizing
A. Focusing
B. Confrontation
C. Summarizing
D. Interpreting
Rationale: Correct answer: C. Summarizing pulls together key points discussed during a session, reinforces mutual understanding,
and signals transition. Focusing narrows on one theme; confrontation challenges inconsistency.
8. Which nurse statement represents the non-therapeutic technique of giving false reassurance?
CONCEPT: Therapeutic Communication — Non-Therapeutic Phrases
A. “You sound frightened about tomorrow’s procedure.”
B. “What concerns you most about tomorrow?”
C. “Many patients feel anxious before this procedure.”
D. “Don’t worry — everything will be fine, I promise.”
Rationale: Correct answer: D. False reassurance dismisses the patient’s concern with a guarantee the nurse cannot ensure. The
other options encourage expression of feeling or normalize appropriately.
9. When documenting appearance and behavior in the MSE, which observation is most appropriate?
CONCEPT: Mental Status Examination — Appearance & Behavior
A. “Disheveled, pacing the room with wringing hands, poor eye contact.”
B. “Patient appears depressed and uncooperative.”
C. “Patient seems to have borderline traits.”
D. “Patient probably has not bathed in days.”
Rationale: Correct answer: A. MSE observations are objective and descriptive, not inferential. Option B reports specific
observable findings; the others introduce conclusions without supporting data.
10. A patient gives lengthy, rambling answers that include many loosely related details but never returns to the original
question. This finding is best documented as:
CONCEPT: Mental Status Examination — Thought Process
A. Flight of ideas
B. Circumstantiality
C. Neologism
D. Tangentiality
Rationale: Correct answer: B. Circumstantiality includes excessive unnecessary detail but eventually returns to the point.
Tangentiality never returns; flight of ideas is rapid topic-shifting seen in mania.
11. A patient describes a fixed, false belief that neighbors are entering the apartment at night despite evidence to the
contrary. This is best categorized as:
CONCEPT: Mental Status Examination — Thought Content
A. Illusion
B. Hallucination
STUVIA ACTUAL EXAM Page 3
, NUR 253 — MENTAL HEALTH NURSING 80% PASS
C. Delusion of persecution
D. Ideas of reference
Rationale: Correct answer: C. A delusion is a fixed false belief held despite evidence. Persecutory type involves being harmed. An
illusion is a misinterpretation of real stimuli; hallucinations are perceptual.
12. A patient reports hearing voices when no one is present. The nurse documents this as:
CONCEPT: Mental Status Examination — Perception
A. Delusion
B. Illusion
C. Tactile hallucination
D. Auditory hallucination
Rationale: Correct answer: D. Hallucinations are sensory perceptions without external stimuli. Auditory is most common in
psychotic disorders. Delusions are beliefs; illusions misinterpret real stimuli.
13. A patient with schizophrenia states, “I don’t need medication — there’s nothing wrong with me.” How should the nurse
characterize the patient’s insight?
CONCEPT: Mental Status Examination — Insight & Judgment
A. Poor insight
B. Good insight
C. Fair insight
D. Excellent judgment
Rationale: Correct answer: A. Denial of illness and refusal of treatment indicate poor insight. Insight reflects awareness that
symptoms reflect a disorder requiring treatment.
14. A patient correctly states their name, the current location, and the year, but cannot name the month or day of the week.
The nurse documents orientation as:
CONCEPT: Mental Status Examination — Orientation
A. Oriented x3
B. Oriented x2
C. Oriented x1
D. Disoriented x4
Rationale: Correct answer: B. Orientation is documented person, place, time. Correctly identifying self and place but missing
day/month/time equals oriented x2.
15. A patient with new-onset panic is hyperventilating, cannot follow directions, and reports terror. According to Peplau, this
corresponds to which anxiety level?
CONCEPT: Anxiety Levels — Peplau’s Framework
A. Mild
B. Moderate
C. Panic
D. Severe
Rationale: Correct answer: C. Panic-level anxiety immobilizes the person, distorts perception, and prevents effective
communication. The patient cannot problem-solve or process directions.
16. Which patient behavior best exemplifies problem-focused coping?
CONCEPT: Coping Mechanisms — Problem-Focused
A. Watching television to avoid thinking about a recent diagnosis
B. Telling family the diagnosis is “no big deal”
C. Sleeping through meals to escape stress
D. Asking the nurse to explain the treatment plan step by step
Rationale: Correct answer: D. Problem-focused coping directly addresses the stressor through information-seeking or action. The
other options reflect avoidant or emotion-focused coping.
STUVIA ACTUAL EXAM Page 4
VERIFIED
NUR 253 Exams 1 – 4 | Mental Health | Galen College of Nursing
2026/2027
| Therapeutic | Application – Pass Guaranteed – A+ Graded
200 4 200
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS ABOUT THIS ASSESSMENT
This four-exam bundle assesses psychiatric-mental health nursing
Exam 1: Foundations of Mental Health Nursing across the lifespan. Domain coverage spans foundations of
Communication, MSE, ethics, milieu, defense mechanisms, anxiety therapeutic practice, mood and anxiety spectrum disorders,
levels
psychotic and personality conditions, and substance use, eating
Exam 2: Mood, Anxiety, and Trauma-Related Disorders disorders, and crisis intervention. Each item targets application
MDD, bipolar, GAD, panic, PTSD, OCD, phobias, acute stress
and analysis-level reasoning consistent with the NCLEX test plan
and AACN essentials for baccalaureate psychiatric nursing.
Exam 3: Psychotic and Personality Disorders
Schizophrenia, schizoaffective, BPD, antisocial, narcissistic,
dissociative
Exam 4: Substance Use, Eating, and Crisis Disorders BLOOM'S LEVEL Application/Analysis
Alcohol, opioids, stimulants, anorexia, bulimia, suicide, crisis, IPV
STUVIA ACTUAL EXAM
PASSING SCORE: 80% FORMAT: MCQ
LEVEL: Intermediate QUESTIONS: 200
,NUR 253 — MENTAL HEALTH NURSING 80% PASS
Section 1 — Exam 1: Foundations of Mental Health Nursing
Therapeutic communication, assessment, ethics, milieu, and the nursing process | Questions 1–50
1. A nursing student is caring for a withdrawn adult with major depression. Which behavior best demonstrates active
listening?
CONCEPT: Therapeutic Communication — Active Listening
A. Leaning slightly forward and maintaining appropriate eye contact while the patient speaks
B. Asking several closed questions to keep the interview focused
C. Documenting observations while the patient describes feelings
D. Sharing a personal story about sadness to build rapport
Rationale: Correct answer: A. Active listening uses attentive posture, eye contact, and presence to convey acceptance. Note-taking
or excessive closed questions interfere with rapport, and self-disclosure shifts focus from the patient.
2. Which statement by the nurse is an open-ended question appropriate for an initial psychiatric interview?
CONCEPT: Therapeutic Communication — Open-Ended Question
A. “Did you sleep well last night?”
B. “How have you been coping since the layoff?”
C. “Are you feeling sad today?”
D. “Do you take your medications every day?”
Rationale: Correct answer: B. Open-ended questions cannot be answered with yes/no and encourage elaboration. Option C invites
narrative. The others are closed-ended and limit therapeutic exploration.
3. A patient says, “I just feel like everything is falling apart.” Which nurse response best exemplifies the technique of
reflection?
CONCEPT: Therapeutic Communication — Reflection
A. “You should try to focus on the positive things.”
B. “Why do you think everything is falling apart?”
C. “It sounds like you’re feeling overwhelmed right now.”
D. “Tell me exactly what fell apart today.”
Rationale: Correct answer: C. Reflection mirrors the patient’s expressed feeling, validating emotion and encouraging further
disclosure. “Why” questions are non-therapeutic, and reassurance dismisses the feeling.
4. During an interview, a patient becomes tearful and pauses after describing a recent loss. What is the nurse’s most
therapeutic response?
CONCEPT: Therapeutic Communication — Silence
A. Quickly offer a tissue and change the subject
B. Prompt the patient to describe funeral details
C. Tell the patient that crying will help the healing
D. Maintain quiet presence and allow the silence to continue
Rationale: Correct answer: D. Therapeutic silence gives the patient space to process emotion and conveys acceptance. Changing
topics or rushing to fill the silence invalidates the experience.
5. A patient states, “Sometimes my head gets all mixed up and I can’t think straight.” Which response uses clarification?
CONCEPT: Therapeutic Communication — Clarification
A. “Are you saying you have trouble concentrating?”
B. “I understand what you mean.”
C. “Tell me more about being mixed up.”
D. “That sounds scary.”
Rationale: Correct answer: A. Clarification restates the patient’s words as a focused question to verify meaning. Option C is too
broad, option D jumps to interpretation, and option A assumes understanding without verification.
STUVIA ACTUAL EXAM Page 2
,NUR 253 — MENTAL HEALTH NURSING 80% PASS
6. A patient with schizophrenia says, “The government planted a chip in my tooth.” What is the most therapeutic initial
response?
CONCEPT: Therapeutic Communication — Validation
A. “That’s not true; you’re experiencing delusions.”
B. “I don’t see a chip, but I can tell this feels real to you.”
C. “Why would the government do that?”
D. “Let’s have the dentist remove it.”
Rationale: Correct answer: B. Validation acknowledges the patient’s emotional reality without confirming the delusion. Directly
contradicting, rationalizing, or colluding are non-therapeutic.
7. Near the close of a 30-minute session, the nurse reviews the patient’s main concerns and agreed plans. This technique is
best described as:
CONCEPT: Therapeutic Communication — Summarizing
A. Focusing
B. Confrontation
C. Summarizing
D. Interpreting
Rationale: Correct answer: C. Summarizing pulls together key points discussed during a session, reinforces mutual understanding,
and signals transition. Focusing narrows on one theme; confrontation challenges inconsistency.
8. Which nurse statement represents the non-therapeutic technique of giving false reassurance?
CONCEPT: Therapeutic Communication — Non-Therapeutic Phrases
A. “You sound frightened about tomorrow’s procedure.”
B. “What concerns you most about tomorrow?”
C. “Many patients feel anxious before this procedure.”
D. “Don’t worry — everything will be fine, I promise.”
Rationale: Correct answer: D. False reassurance dismisses the patient’s concern with a guarantee the nurse cannot ensure. The
other options encourage expression of feeling or normalize appropriately.
9. When documenting appearance and behavior in the MSE, which observation is most appropriate?
CONCEPT: Mental Status Examination — Appearance & Behavior
A. “Disheveled, pacing the room with wringing hands, poor eye contact.”
B. “Patient appears depressed and uncooperative.”
C. “Patient seems to have borderline traits.”
D. “Patient probably has not bathed in days.”
Rationale: Correct answer: A. MSE observations are objective and descriptive, not inferential. Option B reports specific
observable findings; the others introduce conclusions without supporting data.
10. A patient gives lengthy, rambling answers that include many loosely related details but never returns to the original
question. This finding is best documented as:
CONCEPT: Mental Status Examination — Thought Process
A. Flight of ideas
B. Circumstantiality
C. Neologism
D. Tangentiality
Rationale: Correct answer: B. Circumstantiality includes excessive unnecessary detail but eventually returns to the point.
Tangentiality never returns; flight of ideas is rapid topic-shifting seen in mania.
11. A patient describes a fixed, false belief that neighbors are entering the apartment at night despite evidence to the
contrary. This is best categorized as:
CONCEPT: Mental Status Examination — Thought Content
A. Illusion
B. Hallucination
STUVIA ACTUAL EXAM Page 3
, NUR 253 — MENTAL HEALTH NURSING 80% PASS
C. Delusion of persecution
D. Ideas of reference
Rationale: Correct answer: C. A delusion is a fixed false belief held despite evidence. Persecutory type involves being harmed. An
illusion is a misinterpretation of real stimuli; hallucinations are perceptual.
12. A patient reports hearing voices when no one is present. The nurse documents this as:
CONCEPT: Mental Status Examination — Perception
A. Delusion
B. Illusion
C. Tactile hallucination
D. Auditory hallucination
Rationale: Correct answer: D. Hallucinations are sensory perceptions without external stimuli. Auditory is most common in
psychotic disorders. Delusions are beliefs; illusions misinterpret real stimuli.
13. A patient with schizophrenia states, “I don’t need medication — there’s nothing wrong with me.” How should the nurse
characterize the patient’s insight?
CONCEPT: Mental Status Examination — Insight & Judgment
A. Poor insight
B. Good insight
C. Fair insight
D. Excellent judgment
Rationale: Correct answer: A. Denial of illness and refusal of treatment indicate poor insight. Insight reflects awareness that
symptoms reflect a disorder requiring treatment.
14. A patient correctly states their name, the current location, and the year, but cannot name the month or day of the week.
The nurse documents orientation as:
CONCEPT: Mental Status Examination — Orientation
A. Oriented x3
B. Oriented x2
C. Oriented x1
D. Disoriented x4
Rationale: Correct answer: B. Orientation is documented person, place, time. Correctly identifying self and place but missing
day/month/time equals oriented x2.
15. A patient with new-onset panic is hyperventilating, cannot follow directions, and reports terror. According to Peplau, this
corresponds to which anxiety level?
CONCEPT: Anxiety Levels — Peplau’s Framework
A. Mild
B. Moderate
C. Panic
D. Severe
Rationale: Correct answer: C. Panic-level anxiety immobilizes the person, distorts perception, and prevents effective
communication. The patient cannot problem-solve or process directions.
16. Which patient behavior best exemplifies problem-focused coping?
CONCEPT: Coping Mechanisms — Problem-Focused
A. Watching television to avoid thinking about a recent diagnosis
B. Telling family the diagnosis is “no big deal”
C. Sleeping through meals to escape stress
D. Asking the nurse to explain the treatment plan step by step
Rationale: Correct answer: D. Problem-focused coping directly addresses the stressor through information-seeking or action. The
other options reflect avoidant or emotion-focused coping.
STUVIA ACTUAL EXAM Page 4
