MENTAL HEALTH NURSING
Practice Examination
NUR 253 – Comprehensive Review
Covers Exams 1–4 Content Areas
Academic Year
IMPORTANT NOTICE
This document is an original practice resource created for educational study purposes only. It is
not affiliated with, endorsed by, or copied from any specific institution or examination. These
questions are designed to reinforce general mental health nursing concepts and should be used as a
supplementary study tool alongside your coursework and textbooks.
Total Questions: 80 | Includes Rationales
,EXAM 1: FOUNDATIONS OF MENTAL HEALTH NURSING
1. A nurse is caring for a client who states, "I don't need my medication anymore; I feel fine."
Which response by the nurse demonstrates therapeutic communication?
A. "You need to take your medication or you'll get sick again."
B. "Tell me more about how you're feeling now compared to before."
C. "Your doctor knows what's best for you, so just follow the orders."
D. "If you don't take your meds, we'll have to keep you here longer."
Rationale: Therapeutic communication involves open-ended questions that encourage the client to express feelings
and thoughts. Option B invites the client to explore their experience without judgment or coercion.
2. Which of the following is the primary goal of the assessment phase in the nursing process
for mental health?
A. To diagnose the client's psychiatric disorder
B. To establish a therapeutic relationship and gather comprehensive data
C. To implement interventions immediately upon admission
D. To evaluate the effectiveness of previous treatments
Rationale: Assessment focuses on data collection and relationship building. Diagnosis is a medical function;
implementation and evaluation occur in later phases.
3. A client with schizophrenia tells the nurse that the television is sending secret messages.
The nurse recognizes this as:
A. A delusion of grandeur
B. An idea of reference
C. A hallucination
D. A loosening of associations
Rationale: An idea of reference is the belief that neutral events or objects have personal meaning or significance. A
delusion of grandeur involves inflated self-importance; hallucinations are sensory perceptions without external stimuli.
4. The nurse is using the DSM-5-TR to classify a client's symptoms. The DSM-5-TR primarily
provides:
A. Nursing diagnoses and interventions
B. Etiological explanations for mental disorders
C. Standardized diagnostic criteria and classification
D. Treatment protocols and medication guidelines
Rationale: The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders) provides standardized criteria for
diagnosing mental disorders. It does not include nursing diagnoses (NANDA) or treatment protocols.
, 5. Which behavior by a nurse best demonstrates the concept of "unconditional positive
regard" in a therapeutic relationship?
A. Setting clear boundaries with the client
B. Accepting the client without judgment regardless of behavior
C. Providing honest feedback about the client's actions
D. Maintaining professional distance at all times
Rationale: Unconditional positive regard, a concept from Carl Rogers, means accepting the client as a person of worth
regardless of their behaviors or choices, while still maintaining professional boundaries.
6. A client is admitted with a diagnosis of major depressive disorder. The nurse notes the
client has not eaten in 2 days and refuses to get out of bed. What is the priority nursing
intervention?
A. Encourage the client to participate in group therapy
B. Assess for suicidal ideation and ensure safety
C. Administer antidepressant medication as ordered
D. Provide a high-calorie diet and fluid replacement
Rationale: Safety is always the priority in mental health nursing. A client with major depression who is withdrawn and
not eating is at high risk for self-harm; suicidal ideation must be assessed immediately.
7. The nurse is caring for a client who is experiencing a panic attack. Which intervention is
most appropriate?
A. Leave the client alone to calm down independently
B. Speak in a calm, slow voice and guide the client to breathe slowly
C. Tell the client there is nothing to be afraid of
D. Restrain the client to prevent injury
Rationale: During a panic attack, the nurse should remain calm, use a soothing tone, and guide slow breathing.
Leaving the client alone or minimizing their fear is not therapeutic; restraints are inappropriate unless there is imminent
danger.
8. Which neurotransmitter is most commonly associated with the pathophysiology of
depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Rationale: Serotonin deficiency is strongly linked to depression. SSRIs (selective serotonin reuptake inhibitors) work
by increasing serotonin availability in the synapse.
Practice Examination
NUR 253 – Comprehensive Review
Covers Exams 1–4 Content Areas
Academic Year
IMPORTANT NOTICE
This document is an original practice resource created for educational study purposes only. It is
not affiliated with, endorsed by, or copied from any specific institution or examination. These
questions are designed to reinforce general mental health nursing concepts and should be used as a
supplementary study tool alongside your coursework and textbooks.
Total Questions: 80 | Includes Rationales
,EXAM 1: FOUNDATIONS OF MENTAL HEALTH NURSING
1. A nurse is caring for a client who states, "I don't need my medication anymore; I feel fine."
Which response by the nurse demonstrates therapeutic communication?
A. "You need to take your medication or you'll get sick again."
B. "Tell me more about how you're feeling now compared to before."
C. "Your doctor knows what's best for you, so just follow the orders."
D. "If you don't take your meds, we'll have to keep you here longer."
Rationale: Therapeutic communication involves open-ended questions that encourage the client to express feelings
and thoughts. Option B invites the client to explore their experience without judgment or coercion.
2. Which of the following is the primary goal of the assessment phase in the nursing process
for mental health?
A. To diagnose the client's psychiatric disorder
B. To establish a therapeutic relationship and gather comprehensive data
C. To implement interventions immediately upon admission
D. To evaluate the effectiveness of previous treatments
Rationale: Assessment focuses on data collection and relationship building. Diagnosis is a medical function;
implementation and evaluation occur in later phases.
3. A client with schizophrenia tells the nurse that the television is sending secret messages.
The nurse recognizes this as:
A. A delusion of grandeur
B. An idea of reference
C. A hallucination
D. A loosening of associations
Rationale: An idea of reference is the belief that neutral events or objects have personal meaning or significance. A
delusion of grandeur involves inflated self-importance; hallucinations are sensory perceptions without external stimuli.
4. The nurse is using the DSM-5-TR to classify a client's symptoms. The DSM-5-TR primarily
provides:
A. Nursing diagnoses and interventions
B. Etiological explanations for mental disorders
C. Standardized diagnostic criteria and classification
D. Treatment protocols and medication guidelines
Rationale: The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders) provides standardized criteria for
diagnosing mental disorders. It does not include nursing diagnoses (NANDA) or treatment protocols.
, 5. Which behavior by a nurse best demonstrates the concept of "unconditional positive
regard" in a therapeutic relationship?
A. Setting clear boundaries with the client
B. Accepting the client without judgment regardless of behavior
C. Providing honest feedback about the client's actions
D. Maintaining professional distance at all times
Rationale: Unconditional positive regard, a concept from Carl Rogers, means accepting the client as a person of worth
regardless of their behaviors or choices, while still maintaining professional boundaries.
6. A client is admitted with a diagnosis of major depressive disorder. The nurse notes the
client has not eaten in 2 days and refuses to get out of bed. What is the priority nursing
intervention?
A. Encourage the client to participate in group therapy
B. Assess for suicidal ideation and ensure safety
C. Administer antidepressant medication as ordered
D. Provide a high-calorie diet and fluid replacement
Rationale: Safety is always the priority in mental health nursing. A client with major depression who is withdrawn and
not eating is at high risk for self-harm; suicidal ideation must be assessed immediately.
7. The nurse is caring for a client who is experiencing a panic attack. Which intervention is
most appropriate?
A. Leave the client alone to calm down independently
B. Speak in a calm, slow voice and guide the client to breathe slowly
C. Tell the client there is nothing to be afraid of
D. Restrain the client to prevent injury
Rationale: During a panic attack, the nurse should remain calm, use a soothing tone, and guide slow breathing.
Leaving the client alone or minimizing their fear is not therapeutic; restraints are inappropriate unless there is imminent
danger.
8. Which neurotransmitter is most commonly associated with the pathophysiology of
depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Rationale: Serotonin deficiency is strongly linked to depression. SSRIs (selective serotonin reuptake inhibitors) work
by increasing serotonin availability in the synapse.
