NUR 256 Mental Health Exam 4 Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section A: Grief, Loss, & End-of-Life Care (8 Questions)
Q1: A 68-year-old woman whose husband died 3 months ago tells the nurse, "I keep
expecting him to walk through the door. I can't believe he's really gone." Which
Kübler-Ross stage of grief is being demonstrated?
A. Anger
B. Bargaining
C. Denial [CORRECT]
D. Acceptance
Correct Answer: C
Rationale: Denial involves refusing to accept the reality of the loss; the patient's disbelief
reflects this stage. Anger (A) involves blame or hostility. Bargaining (B) involves "if only"
negotiations. Acceptance (D) involves coming to terms with the loss.
Q2: A 45-year-old man presents 2 weeks after his mother's death with insomnia, poor
appetite, guilt about not being present when she died, and difficulty concentrating.
Which assessment finding best differentiates normal grief from major depressive
disorder?
A. The presence of insomnia and poor appetite
B. The acute onset of symptoms after a loss
C. Guilt focused on actions related to the deceased rather than global self-worth
[CORRECT]
D. The presence of suicidal ideation
Correct Answer: C
Rationale: In normal grief, guilt is typically focused on the deceased or specific events,
whereas MDD involves global feelings of worthlessness and self-loathing. Insomnia (A),
acute onset (B), and suicidal ideation (D) can occur in both conditions.
,Q3: A family caregiver of a patient with terminal pancreatic cancer states, "I find myself
crying when I look at old photos, even though she's still here. I feel like I'm already
mourning." Which term best describes this experience?
A. Complicated grief
B. Anticipatory grief [CORRECT]
C. Disenfranchised grief
D. Delayed grief
Correct Answer: B
Rationale: Anticipatory grief occurs before the actual loss, common in terminal illness
when caregivers mourn the anticipated death. Complicated grief (A) is prolonged and
debilitating after the loss. Disenfranchised grief (C) is socially unrecognized. Delayed
grief (D) is postponed.
Q4: A hospice nurse is caring for a patient with end-stage COPD. The patient states, "I
just want to be comfortable and spend time with my family at home." Which hospice
philosophy principle is most relevant?
A. Cure the underlying disease
B. Prolong life at all costs
C. Provide comfort, dignity, and quality of life [CORRECT]
D. Transfer to acute care for aggressive treatment
Correct Answer: C
Rationale: Hospice philosophy emphasizes palliation, comfort, dignity, and quality of life
rather than cure (A) or prolongation (B). Transfer to acute care (D) contradicts hospice
goals when the patient desires comfort at home.
Q5: A bereaved client tells the nurse, "I need to find a way to live without my partner
while still honoring our memories." According to Worden's four tasks of mourning, which
task is the client working on?
A. Accept the reality of the loss
B. Process the pain of grief
C. Adjust to a world without the deceased
D. Find an enduring connection while embarking on a new life [CORRECT]
Correct Answer: D
Rationale: Worden's fourth task involves maintaining a connection to the deceased
while moving forward. Accepting reality (A) is Task 1. Processing pain (B) is Task 2.
Adjusting to the world (C) is Task 3.
, Q6: A nurse is communicating with a recently widowed patient. The patient says, "I don't
know how I'm going to manage the finances." Which is the most therapeutic nursing
response?
A. "Don't worry, everything will work out."
B. "You should hire a financial advisor immediately."
C. "It sounds overwhelming to think about finances while you're grieving. Tell me more
about your concerns." [CORRECT]
D. "At least you have your children to help you."
Correct Answer: C
Rationale: Therapeutic communication uses active listening, validation, and open-ended
questions. A dismisses feelings. B gives premature advice. D minimizes grief with "at
least." C validates the emotional experience and encourages expression.
Q7: A family member of a dying patient asks the nurse, "How long do you think my
father has?" Which is the most appropriate nursing response?
A. "I can't say for sure, but I can tell you that his condition is declining. Let's focus on
keeping him comfortable and supporting your family." [CORRECT]
B. "He will probably die within the next 24 hours."
C. "You should ask the doctor; nurses don't predict death."
D. "It could be weeks or months; nobody really knows."
Correct Answer: A
Rationale: Nurses should provide honest but compassionate responses without giving
exact timeframes, while redirecting to comfort and family support. B is too specific and
potentially inaccurate. C deflects responsibility. D may give false hope or unnecessary
distress.
Q8: A patient lost her child 18 months ago and continues to have intense yearning,
preoccupation with the death, difficulty accepting the loss, and social isolation. She
reports feeling "stuck" and unable to move forward. Which condition should the nurse
suspect?
A. Normal grief
B. Major depressive disorder
C. Prolonged grief disorder (complicated grief) [CORRECT]
D. Adjustment disorder
Correct Answer: C
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section A: Grief, Loss, & End-of-Life Care (8 Questions)
Q1: A 68-year-old woman whose husband died 3 months ago tells the nurse, "I keep
expecting him to walk through the door. I can't believe he's really gone." Which
Kübler-Ross stage of grief is being demonstrated?
A. Anger
B. Bargaining
C. Denial [CORRECT]
D. Acceptance
Correct Answer: C
Rationale: Denial involves refusing to accept the reality of the loss; the patient's disbelief
reflects this stage. Anger (A) involves blame or hostility. Bargaining (B) involves "if only"
negotiations. Acceptance (D) involves coming to terms with the loss.
Q2: A 45-year-old man presents 2 weeks after his mother's death with insomnia, poor
appetite, guilt about not being present when she died, and difficulty concentrating.
Which assessment finding best differentiates normal grief from major depressive
disorder?
A. The presence of insomnia and poor appetite
B. The acute onset of symptoms after a loss
C. Guilt focused on actions related to the deceased rather than global self-worth
[CORRECT]
D. The presence of suicidal ideation
Correct Answer: C
Rationale: In normal grief, guilt is typically focused on the deceased or specific events,
whereas MDD involves global feelings of worthlessness and self-loathing. Insomnia (A),
acute onset (B), and suicidal ideation (D) can occur in both conditions.
,Q3: A family caregiver of a patient with terminal pancreatic cancer states, "I find myself
crying when I look at old photos, even though she's still here. I feel like I'm already
mourning." Which term best describes this experience?
A. Complicated grief
B. Anticipatory grief [CORRECT]
C. Disenfranchised grief
D. Delayed grief
Correct Answer: B
Rationale: Anticipatory grief occurs before the actual loss, common in terminal illness
when caregivers mourn the anticipated death. Complicated grief (A) is prolonged and
debilitating after the loss. Disenfranchised grief (C) is socially unrecognized. Delayed
grief (D) is postponed.
Q4: A hospice nurse is caring for a patient with end-stage COPD. The patient states, "I
just want to be comfortable and spend time with my family at home." Which hospice
philosophy principle is most relevant?
A. Cure the underlying disease
B. Prolong life at all costs
C. Provide comfort, dignity, and quality of life [CORRECT]
D. Transfer to acute care for aggressive treatment
Correct Answer: C
Rationale: Hospice philosophy emphasizes palliation, comfort, dignity, and quality of life
rather than cure (A) or prolongation (B). Transfer to acute care (D) contradicts hospice
goals when the patient desires comfort at home.
Q5: A bereaved client tells the nurse, "I need to find a way to live without my partner
while still honoring our memories." According to Worden's four tasks of mourning, which
task is the client working on?
A. Accept the reality of the loss
B. Process the pain of grief
C. Adjust to a world without the deceased
D. Find an enduring connection while embarking on a new life [CORRECT]
Correct Answer: D
Rationale: Worden's fourth task involves maintaining a connection to the deceased
while moving forward. Accepting reality (A) is Task 1. Processing pain (B) is Task 2.
Adjusting to the world (C) is Task 3.
, Q6: A nurse is communicating with a recently widowed patient. The patient says, "I don't
know how I'm going to manage the finances." Which is the most therapeutic nursing
response?
A. "Don't worry, everything will work out."
B. "You should hire a financial advisor immediately."
C. "It sounds overwhelming to think about finances while you're grieving. Tell me more
about your concerns." [CORRECT]
D. "At least you have your children to help you."
Correct Answer: C
Rationale: Therapeutic communication uses active listening, validation, and open-ended
questions. A dismisses feelings. B gives premature advice. D minimizes grief with "at
least." C validates the emotional experience and encourages expression.
Q7: A family member of a dying patient asks the nurse, "How long do you think my
father has?" Which is the most appropriate nursing response?
A. "I can't say for sure, but I can tell you that his condition is declining. Let's focus on
keeping him comfortable and supporting your family." [CORRECT]
B. "He will probably die within the next 24 hours."
C. "You should ask the doctor; nurses don't predict death."
D. "It could be weeks or months; nobody really knows."
Correct Answer: A
Rationale: Nurses should provide honest but compassionate responses without giving
exact timeframes, while redirecting to comfort and family support. B is too specific and
potentially inaccurate. C deflects responsibility. D may give false hope or unnecessary
distress.
Q8: A patient lost her child 18 months ago and continues to have intense yearning,
preoccupation with the death, difficulty accepting the loss, and social isolation. She
reports feeling "stuck" and unable to move forward. Which condition should the nurse
suspect?
A. Normal grief
B. Major depressive disorder
C. Prolonged grief disorder (complicated grief) [CORRECT]
D. Adjustment disorder
Correct Answer: C
