NUR 253 Mental Health Exam 1 Review(2026) PDF |
Practice Questions & Rationales | Galen
NUR 253 EXAM 1
15 TOUGHEST & MOST-TESTED CASE-BASED QUESTIONS
1. Therapeutic Communication – Best Response
A 30-year-old patient hospitalized for major depressive disorder says,
"I feel like a burden to everyone. Nothing I do matters anymore."
Which nurse response is most therapeutic?
A. “Your family wouldn’t feel that way if you tried harder.”
B. “Why do you feel like a burden?”
,C. “It sounds like you’re feeling very hopeless. Tell me more about that.”
D. “Many people with depression feel this way.”
✅ Correct Answer: C
Rationale:
Acknowledges feelings and invites expression. Avoid “why” questions, minimizing, or generalizing.
2. Suicide Risk – Priority Recognition
A patient with depression has been withdrawn all week. Today the patient appears calm, requests to
shower alone, and gives personal belongings to another patient.
What is the priority nursing concern?
A. Improved coping
B. Noncompliance with treatment
C. Imminent suicide risk
D. Boundary-setting issues
✅ Correct Answer: C
Rationale:
Sudden calm + giving away possessions = high suicide risk.
3. Suicide Precautions – Nursing Action
A patient expresses suicidal ideation with a plan but no immediate means.
Which nursing intervention is most important?
A. Encourage journaling
B. Establish a safety contract
C. Initiate ordered 1:1 observation
D. Allow family to visit continuously
✅ Correct Answer: C
Rationale:
Observation and environmental safety override all other interventions.
4. Anxiety Levels – Identification
A patient is trembling, unable to focus, breathing rapidly, and repeatedly says, “I can’t think—I need to
get out!”
Which level of anxiety is present?
, A. Mild
B. Moderate
C. Severe
D. Panic
✅ Correct Answer: D
Rationale:
Panic anxiety causes loss of control and inability to process information.
5. Panic Attack – Priority Intervention
During a panic attack, a patient is hyperventilating and crying.
What should the nurse do first?
A. Teach deep-breathing exercises
B. Ask about the trigger
C. Stay with the patient and speak calmly
D. Administer PRN medication
✅ Correct Answer: C
Rationale:
Safety and presence come first. Teaching and questioning are ineffective during panic.
6. Defense Mechanisms – Identification
A patient diagnosed with substance use disorder states,
"I only drink socially—everyone does."
Which defense mechanism is being used?
A. Projection
B. Denial
C. Rationalization
D. Suppression
✅ Correct Answer: B
Rationale:
Denial = refusal to acknowledge reality.
7. Hallucinations – Therapeutic Response
Practice Questions & Rationales | Galen
NUR 253 EXAM 1
15 TOUGHEST & MOST-TESTED CASE-BASED QUESTIONS
1. Therapeutic Communication – Best Response
A 30-year-old patient hospitalized for major depressive disorder says,
"I feel like a burden to everyone. Nothing I do matters anymore."
Which nurse response is most therapeutic?
A. “Your family wouldn’t feel that way if you tried harder.”
B. “Why do you feel like a burden?”
,C. “It sounds like you’re feeling very hopeless. Tell me more about that.”
D. “Many people with depression feel this way.”
✅ Correct Answer: C
Rationale:
Acknowledges feelings and invites expression. Avoid “why” questions, minimizing, or generalizing.
2. Suicide Risk – Priority Recognition
A patient with depression has been withdrawn all week. Today the patient appears calm, requests to
shower alone, and gives personal belongings to another patient.
What is the priority nursing concern?
A. Improved coping
B. Noncompliance with treatment
C. Imminent suicide risk
D. Boundary-setting issues
✅ Correct Answer: C
Rationale:
Sudden calm + giving away possessions = high suicide risk.
3. Suicide Precautions – Nursing Action
A patient expresses suicidal ideation with a plan but no immediate means.
Which nursing intervention is most important?
A. Encourage journaling
B. Establish a safety contract
C. Initiate ordered 1:1 observation
D. Allow family to visit continuously
✅ Correct Answer: C
Rationale:
Observation and environmental safety override all other interventions.
4. Anxiety Levels – Identification
A patient is trembling, unable to focus, breathing rapidly, and repeatedly says, “I can’t think—I need to
get out!”
Which level of anxiety is present?
, A. Mild
B. Moderate
C. Severe
D. Panic
✅ Correct Answer: D
Rationale:
Panic anxiety causes loss of control and inability to process information.
5. Panic Attack – Priority Intervention
During a panic attack, a patient is hyperventilating and crying.
What should the nurse do first?
A. Teach deep-breathing exercises
B. Ask about the trigger
C. Stay with the patient and speak calmly
D. Administer PRN medication
✅ Correct Answer: C
Rationale:
Safety and presence come first. Teaching and questioning are ineffective during panic.
6. Defense Mechanisms – Identification
A patient diagnosed with substance use disorder states,
"I only drink socially—everyone does."
Which defense mechanism is being used?
A. Projection
B. Denial
C. Rationalization
D. Suppression
✅ Correct Answer: B
Rationale:
Denial = refusal to acknowledge reality.
7. Hallucinations – Therapeutic Response
