NUR 253 Exam 4 Mental Health Nursing
NUR 253 EXAM BANK- Galen College of Nursing
Updated Questions & Answers With Rationale
A+ GRADED| BRAND NEW RELEASE!
This comprehensive 250-question practice exam is designed to prepare nursing students
for NUR 253 Exam 4 in Mental Health Nursing. The exam focuses on grief, loss, end-of-
life care, therapeutic communication, crisis intervention, and major psychiatric disorders.
It includes questions in a test-bank format with correct answers and short, high-yield
rationales to reinforce clinical judgment and NCLEX-style critical thinking.
DOMAINS
1. Grief, Loss, and End-of-Life Care
2. Therapeutic Communication & Nurse-Client Relationship
3. Anxiety, OCD, and Trauma-Related Disorders
4. Mood Disorders & Suicide Risk
5. Psychotic Disorders & Antipsychotic Medications
6. Personality Disorders & Maladaptive Coping
7. Substance Use & Addictive Disorders
8. Eating Disorders & Somatic Symptoms
9. Crisis Intervention & Milieu Management
10. Psychopharmacology & Medication Safety
SECTION 1: GRIEF, LOSS, AND END-OF-LIFE CARE
1. The nurse is providing support to the family of a recently deceased client. A
family member states, “My father took me fishing all the time. He can’t physically
take me anymore, but he will be watching over me. I really miss him, “The nurse
recognizes the family member is experiencing
A. Mourning
B. Anticipatory grief
,C. Disenfranchised grief
D. Bereavement
Correct Answer: D. Bereavement
Expert rationale: Bereavement is the state/condition of having experienced a loss
through death. Anticipatory grief occurs before the death. Disenfranchised grief is
grief that is not socially recognized/validated. Mourning is the outward/behavioral
expression of grief (rituals, funerals), which isn’t specifically described here.
2. The nurse educator is providing an in—service to nursing staff on a unit that has
recently experienced and increase in client deaths. The nurse educator knows that a
priority recommendation for nurses who are struggling to cope with all the loss is
A. Creating sustainable practice of self-care and balance
B. Working additional shifts to provide support for each other
C. Volunteering on days off to stay busy and make a positive difference
D. Temporarily transferring to another unit with fewer terminal diagnosis
Correct Answer: A. Creating sustainable practice of self-care and balance
Expert rationale: Healthy coping with repeated loss in clinical settings requires
ongoing, sustainable self-care (sleep, boundaries, debriefing, support). Options B
and C increase workload and risk burnout/compassion fatigue. Option D may be
appropriate in select cases, but it’s not the priority universal recommendation
compared with building durable coping and balance.
3. The nurse is caring for a client whose spouse of 52 years suddenly died. Which
of the following statements by the nurse is most therapeutic.
A. “Your loved on is no longer in pain: you should be happy for that.”
,B. “You can be grateful for the time you had together”
C. “Your loved one was very special and will not be replaceable”
D. “I know how you feel: I have had many family members pass away”
Correct Answer: C. “Your loved one was very special and will not be replaceable”
Expert rationale: This response validates the significance of the relationship and
acknowledges the uniqueness of the loss. A and B can sound like
minimizing/redirecting (“should be happy,” “be grateful”). D shifts focus to the nurse
and uses “I know how you feel,” which is generally non-therapeutic.
4. The nurse is caring for a client who is dying and in severe pain. Which of the
following interventions should the nurse consider as the priority?
A. Teach the client the end stages of grief.
B. Enhance the client’s quality of life.
C. Encourage the client to speak to a grief counselor.
D. Support the clients family in grieving.
Correct Answer: B. Enhance the client’s quality of life.
Expert rationale: In end-of-life care—especially with severe pain—the priority is
comfort and quality of life (effective pain management, symptom control). Teaching
grief stages and counseling may help later, but uncontrolled pain is an immediate
priority.
5. A nurse is assessing a client who is experiencing prolonged grief disorder. Which
of the following findings should the nurse expect?
A. The client has been experiencing intense grief for 6 months.
, B. The client has returned to work and social activities.
C. The client reports feeling guilty about laughing.
D. The client has not accepted the death for over 12 months.
Correct Answer: D. The client has not accepted the death for over 12 months.
Expert rationale: Prolonged grief disorder is diagnosed when intense grief persists
for more than 12 months in adults (6 months in children) and impairs daily
functioning. Option A is not long enough. Option B indicates healthy adaptation.
Option C is a normal grief reaction.
6. A hospice nurse is caring for a client who is actively dying. The nurse notes that
the client has Cheyne-Stokes respirations and mottling of the extremities. What is
the priority nursing action?
A. Administer oxygen via nasal cannula.
B. Reposition the client for comfort.
C. Notify the family that death is imminent.
D. Suction the client's airway.
Correct Answer: C. Notify the family that death is imminent.
Expert rationale: Cheyne-Stokes respirations and mottling are signs of imminent
death. The priority is to prepare the family and allow them time to say goodbye.
Oxygen and suctioning may cause unnecessary distress. Repositioning is important
but secondary to family notification.
7. A nurse is providing postmortem care. Which of the following actions should the
nurse take first?
A. Place the client in a supine position.
NUR 253 EXAM BANK- Galen College of Nursing
Updated Questions & Answers With Rationale
A+ GRADED| BRAND NEW RELEASE!
This comprehensive 250-question practice exam is designed to prepare nursing students
for NUR 253 Exam 4 in Mental Health Nursing. The exam focuses on grief, loss, end-of-
life care, therapeutic communication, crisis intervention, and major psychiatric disorders.
It includes questions in a test-bank format with correct answers and short, high-yield
rationales to reinforce clinical judgment and NCLEX-style critical thinking.
DOMAINS
1. Grief, Loss, and End-of-Life Care
2. Therapeutic Communication & Nurse-Client Relationship
3. Anxiety, OCD, and Trauma-Related Disorders
4. Mood Disorders & Suicide Risk
5. Psychotic Disorders & Antipsychotic Medications
6. Personality Disorders & Maladaptive Coping
7. Substance Use & Addictive Disorders
8. Eating Disorders & Somatic Symptoms
9. Crisis Intervention & Milieu Management
10. Psychopharmacology & Medication Safety
SECTION 1: GRIEF, LOSS, AND END-OF-LIFE CARE
1. The nurse is providing support to the family of a recently deceased client. A
family member states, “My father took me fishing all the time. He can’t physically
take me anymore, but he will be watching over me. I really miss him, “The nurse
recognizes the family member is experiencing
A. Mourning
B. Anticipatory grief
,C. Disenfranchised grief
D. Bereavement
Correct Answer: D. Bereavement
Expert rationale: Bereavement is the state/condition of having experienced a loss
through death. Anticipatory grief occurs before the death. Disenfranchised grief is
grief that is not socially recognized/validated. Mourning is the outward/behavioral
expression of grief (rituals, funerals), which isn’t specifically described here.
2. The nurse educator is providing an in—service to nursing staff on a unit that has
recently experienced and increase in client deaths. The nurse educator knows that a
priority recommendation for nurses who are struggling to cope with all the loss is
A. Creating sustainable practice of self-care and balance
B. Working additional shifts to provide support for each other
C. Volunteering on days off to stay busy and make a positive difference
D. Temporarily transferring to another unit with fewer terminal diagnosis
Correct Answer: A. Creating sustainable practice of self-care and balance
Expert rationale: Healthy coping with repeated loss in clinical settings requires
ongoing, sustainable self-care (sleep, boundaries, debriefing, support). Options B
and C increase workload and risk burnout/compassion fatigue. Option D may be
appropriate in select cases, but it’s not the priority universal recommendation
compared with building durable coping and balance.
3. The nurse is caring for a client whose spouse of 52 years suddenly died. Which
of the following statements by the nurse is most therapeutic.
A. “Your loved on is no longer in pain: you should be happy for that.”
,B. “You can be grateful for the time you had together”
C. “Your loved one was very special and will not be replaceable”
D. “I know how you feel: I have had many family members pass away”
Correct Answer: C. “Your loved one was very special and will not be replaceable”
Expert rationale: This response validates the significance of the relationship and
acknowledges the uniqueness of the loss. A and B can sound like
minimizing/redirecting (“should be happy,” “be grateful”). D shifts focus to the nurse
and uses “I know how you feel,” which is generally non-therapeutic.
4. The nurse is caring for a client who is dying and in severe pain. Which of the
following interventions should the nurse consider as the priority?
A. Teach the client the end stages of grief.
B. Enhance the client’s quality of life.
C. Encourage the client to speak to a grief counselor.
D. Support the clients family in grieving.
Correct Answer: B. Enhance the client’s quality of life.
Expert rationale: In end-of-life care—especially with severe pain—the priority is
comfort and quality of life (effective pain management, symptom control). Teaching
grief stages and counseling may help later, but uncontrolled pain is an immediate
priority.
5. A nurse is assessing a client who is experiencing prolonged grief disorder. Which
of the following findings should the nurse expect?
A. The client has been experiencing intense grief for 6 months.
, B. The client has returned to work and social activities.
C. The client reports feeling guilty about laughing.
D. The client has not accepted the death for over 12 months.
Correct Answer: D. The client has not accepted the death for over 12 months.
Expert rationale: Prolonged grief disorder is diagnosed when intense grief persists
for more than 12 months in adults (6 months in children) and impairs daily
functioning. Option A is not long enough. Option B indicates healthy adaptation.
Option C is a normal grief reaction.
6. A hospice nurse is caring for a client who is actively dying. The nurse notes that
the client has Cheyne-Stokes respirations and mottling of the extremities. What is
the priority nursing action?
A. Administer oxygen via nasal cannula.
B. Reposition the client for comfort.
C. Notify the family that death is imminent.
D. Suction the client's airway.
Correct Answer: C. Notify the family that death is imminent.
Expert rationale: Cheyne-Stokes respirations and mottling are signs of imminent
death. The priority is to prepare the family and allow them time to say goodbye.
Oxygen and suctioning may cause unnecessary distress. Repositioning is important
but secondary to family notification.
7. A nurse is providing postmortem care. Which of the following actions should the
nurse take first?
A. Place the client in a supine position.
