Galen NUR 256 Exam 2 2026
Galen NUR 256 Exam 2 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales NCLEX Style
Exam Blueprint Summary
✅ Therapeutic Communication
✅ Anxiety Disorders
✅ Panic Disorder
✅ Obsessive-Compulsive Disorder (OCD)
✅ Post-Traumatic Stress Disorder (PTSD)
✅ Major Depressive Disorder
✅ Bipolar Disorders
✅ Schizophrenia Spectrum Disorders
✅ Personality Disorders
✅ Suicide Risk Assessment & Prevention
✅ Crisis Intervention
✅ Defense Mechanisms
✅ Psychopharmacology (SSRIs, MAOIs, Lithium, Antipsychotics, Mood Stabilizers)
✅ Extrapyramidal Symptoms (EPS)
✅ Neuroleptic Malignant Syndrome (NMS)
✅ Serotonin Syndrome
✅ Clozapine Monitoring
✅ Lithium Toxicity
✅ Delegation & Prioritization
✅ NGN Clinical Judgment (Bow-Tie, SATA, Matrix, and Unfolding Case Studies)
Question 1
A nurse is assessing a client admitted with generalized anxiety disorder (GAD). Which
assessment finding requires the highest priority intervention?
, Galen NUR 256 Exam 2 2026
A. Reports difficulty sleeping for the past month
B. States, "I worry about everything."
C. Has a heart rate of 132 beats/min with chest tightness and severe shortness of breath
D. Reports muscle tension and headaches
✅ Correct Answer: C
Rationale:
The priority is to rule out a life-threatening medical condition. Severe tachycardia, chest
tightness, and dyspnea may represent a panic attack but could also indicate myocardial ischemia
or another cardiopulmonary emergency. ABCs take priority before psychiatric interventions.
Question 2
A client tells the nurse, "The voices tell me I'm worthless." Which response is most therapeutic?
A. "Those voices aren't real."
B. "What are the voices saying to you?"
C. "Ignore them."
D. "You shouldn't listen to hallucinations."
✅ Correct Answer: B
Rationale:
Assessing the content of hallucinations helps determine whether they are command
hallucinations or pose a safety risk. Validating the client's experience without reinforcing the
hallucination promotes therapeutic communication.
Question 3 (SATA)
Which findings are consistent with major depressive disorder?
Select all that apply.
A. Feelings of worthlessness
B. Decreased appetite
C. Inflated self-esteem
D. Psychomotor retardation
E. Decreased need for sleep
✅ Correct Answers: A, B, D
, Galen NUR 256 Exam 2 2026
Rationale:
Depression commonly includes:
Worthlessness
Appetite changes
Psychomotor slowing
Inflated self-esteem and decreased need for sleep are associated with mania.
Question 4
A nurse is caring for a client experiencing a panic attack. What is the priority nursing
intervention?
A. Teach relaxation techniques.
B. Encourage group therapy.
C. Stay with the client and speak calmly.
D. Discuss the source of anxiety.
✅ Correct Answer: C
Rationale:
During a panic attack, clients cannot process complex information. Remaining with the client
and providing calm reassurance reduces anxiety and promotes safety.
Question 5
Which client is at greatest risk for suicide?
A. Recently diagnosed with diabetes
B. Newly divorced with supportive friends
C. Recently discharged after a suicide attempt
D. Elderly client with controlled hypertension
✅ Correct Answer: C
Rationale:
The strongest predictor of suicide is a previous suicide attempt, particularly within weeks
following hospital discharge.
, Galen NUR 256 Exam 2 2026
Question 6
A client with schizophrenia states, "The FBI implanted a chip in my brain." Which response is
most appropriate?
A. "You're mistaken."
B. "Tell me more about that."
C. "That must be frightening for you."
D. "There are no chips in your brain."
✅ Correct Answer: C
Rationale:
Acknowledge the client's feelings without validating or challenging the delusion.
Question 7 (NGN Case Study)
A client with bipolar I disorder has slept only 2 hours in the past 3 days. The client is pacing,
talking rapidly, and attempting to organize activities for the entire unit.
Which nursing actions are appropriate?
Select all that apply.
A. Offer high-calorie finger foods.
B. Encourage participation in competitive games.
C. Reduce environmental stimulation.
D. Set consistent behavioral limits.
E. Allow unlimited visitors.
✅ Correct Answers: A, C, D
Rationale:
Manic clients require:
Frequent high-calorie snacks
Low-stimulation environments
Clear, consistent limits
Competitive activities and excessive visitors increase stimulation.
Galen NUR 256 Exam 2 2026 Edition 100
Advanced Questions with Answers and
Detailed Rationales NCLEX Style
Exam Blueprint Summary
✅ Therapeutic Communication
✅ Anxiety Disorders
✅ Panic Disorder
✅ Obsessive-Compulsive Disorder (OCD)
✅ Post-Traumatic Stress Disorder (PTSD)
✅ Major Depressive Disorder
✅ Bipolar Disorders
✅ Schizophrenia Spectrum Disorders
✅ Personality Disorders
✅ Suicide Risk Assessment & Prevention
✅ Crisis Intervention
✅ Defense Mechanisms
✅ Psychopharmacology (SSRIs, MAOIs, Lithium, Antipsychotics, Mood Stabilizers)
✅ Extrapyramidal Symptoms (EPS)
✅ Neuroleptic Malignant Syndrome (NMS)
✅ Serotonin Syndrome
✅ Clozapine Monitoring
✅ Lithium Toxicity
✅ Delegation & Prioritization
✅ NGN Clinical Judgment (Bow-Tie, SATA, Matrix, and Unfolding Case Studies)
Question 1
A nurse is assessing a client admitted with generalized anxiety disorder (GAD). Which
assessment finding requires the highest priority intervention?
, Galen NUR 256 Exam 2 2026
A. Reports difficulty sleeping for the past month
B. States, "I worry about everything."
C. Has a heart rate of 132 beats/min with chest tightness and severe shortness of breath
D. Reports muscle tension and headaches
✅ Correct Answer: C
Rationale:
The priority is to rule out a life-threatening medical condition. Severe tachycardia, chest
tightness, and dyspnea may represent a panic attack but could also indicate myocardial ischemia
or another cardiopulmonary emergency. ABCs take priority before psychiatric interventions.
Question 2
A client tells the nurse, "The voices tell me I'm worthless." Which response is most therapeutic?
A. "Those voices aren't real."
B. "What are the voices saying to you?"
C. "Ignore them."
D. "You shouldn't listen to hallucinations."
✅ Correct Answer: B
Rationale:
Assessing the content of hallucinations helps determine whether they are command
hallucinations or pose a safety risk. Validating the client's experience without reinforcing the
hallucination promotes therapeutic communication.
Question 3 (SATA)
Which findings are consistent with major depressive disorder?
Select all that apply.
A. Feelings of worthlessness
B. Decreased appetite
C. Inflated self-esteem
D. Psychomotor retardation
E. Decreased need for sleep
✅ Correct Answers: A, B, D
, Galen NUR 256 Exam 2 2026
Rationale:
Depression commonly includes:
Worthlessness
Appetite changes
Psychomotor slowing
Inflated self-esteem and decreased need for sleep are associated with mania.
Question 4
A nurse is caring for a client experiencing a panic attack. What is the priority nursing
intervention?
A. Teach relaxation techniques.
B. Encourage group therapy.
C. Stay with the client and speak calmly.
D. Discuss the source of anxiety.
✅ Correct Answer: C
Rationale:
During a panic attack, clients cannot process complex information. Remaining with the client
and providing calm reassurance reduces anxiety and promotes safety.
Question 5
Which client is at greatest risk for suicide?
A. Recently diagnosed with diabetes
B. Newly divorced with supportive friends
C. Recently discharged after a suicide attempt
D. Elderly client with controlled hypertension
✅ Correct Answer: C
Rationale:
The strongest predictor of suicide is a previous suicide attempt, particularly within weeks
following hospital discharge.
, Galen NUR 256 Exam 2 2026
Question 6
A client with schizophrenia states, "The FBI implanted a chip in my brain." Which response is
most appropriate?
A. "You're mistaken."
B. "Tell me more about that."
C. "That must be frightening for you."
D. "There are no chips in your brain."
✅ Correct Answer: C
Rationale:
Acknowledge the client's feelings without validating or challenging the delusion.
Question 7 (NGN Case Study)
A client with bipolar I disorder has slept only 2 hours in the past 3 days. The client is pacing,
talking rapidly, and attempting to organize activities for the entire unit.
Which nursing actions are appropriate?
Select all that apply.
A. Offer high-calorie finger foods.
B. Encourage participation in competitive games.
C. Reduce environmental stimulation.
D. Set consistent behavioral limits.
E. Allow unlimited visitors.
✅ Correct Answers: A, C, D
Rationale:
Manic clients require:
Frequent high-calorie snacks
Low-stimulation environments
Clear, consistent limits
Competitive activities and excessive visitors increase stimulation.
