,NUR253/NUR 253 Mental Health Nursing Exam 4 |
Galen College of Nursing | 2026/2027 Edition (PDF)
1. The nurse is providing support to the family of a client who died suddenly. A family member states, "I
keep thinking about all the things I should have said." The nurse recognizes this as which type of grief
response?
A) Anticipatory grief
B) Complicated grief
C) Disenfranchised grief
D) Normal bereavement
Correct Answer: Normal bereavement
Rationale: This statement reflects a normal bereavement response involving reflection and regrets,
which are common in the early stages of grief. Anticipatory grief occurs before a death, complicated
grief is prolonged and disabling, and disenfranchised grief is not socially recognized.
2. The nurse is caring for a client who is in the acute phase of grief after the loss of a child. Which
nursing intervention is most appropriate?
A) Encourage the client to be strong for surviving family members
B) Suggest that the client avoid discussing the child to prevent upset
C) Provide a quiet, supportive presence and allow the client to express feelings
D) Tell the client that time heals all wounds
Correct Answer: Provide a quiet, supportive presence and allow the client to express feelings
Rationale: The most therapeutic intervention is to provide a supportive presence and allow the client to
express their feelings without judgment. Offering platitudes or encouraging avoidance is not helpful and
can invalidate the client's experience.
3. The nurse is educating a client with generalized anxiety disorder about cognitive-behavioral therapy
(CBT). Which statement best describes the goal of CBT?
,A) "CBT will uncover the unconscious conflicts from your childhood."
B) "CBT helps you identify and change irrational thoughts that cause anxiety."
C) "CBT uses medication to reduce your physical symptoms of anxiety."
D) "CBT is a technique to relax your muscles during a panic attack."
Correct Answer: "CBT helps you identify and change irrational thoughts that cause anxiety."
Rationale: CBT focuses on the connection between thoughts, feelings, and behaviors. The goal is to
identify and modify maladaptive thought patterns that contribute to anxiety. It is not primarily focused
on unconscious conflicts, medication, or muscle relaxation alone.
4. A client with borderline personality disorder is engaging in splitting behavior, praising one nurse and
criticizing another. Which nursing intervention is most appropriate?
A) Allow the client to choose their preferred nurse
B) Ensure all staff members communicate consistently and use the same approach
C) Avoid discussing the client's behavior with other staff
D) Give the client different rules depending on the staff member
Correct Answer: Ensure all staff members communicate consistently and use the same approach
Rationale: Consistent communication and a unified approach among staff are essential to manage
splitting. Allowing the client to choose staff, avoiding communication, or giving different rules reinforces
splitting and is not therapeutic.
5. The nurse is planning care for a client with antisocial personality disorder who is being discharged to a
halfway house. Which intervention is most likely to promote successful community living?
A) Allow the client to set all their own rules without supervision
B) Establish clear, consistent limits with immediate consequences for rule violations
C) Use a permissive approach to build trust
D) Confront the client daily about past criminal behavior
, Correct Answer: Establish clear, consistent limits with immediate consequences for rule violations
Rationale: Clients with antisocial personality disorder respond best to firm, consistent limits with clear
consequences. Permissiveness is often exploited, and confrontation about past behavior is not
therapeutic.
6. A client with narcissistic personality disorder is being treated. Which statement by the client indicates
progress?
A) "I realize that I may not always be right about everything."
B) "I am better than everyone else, and I deserve special treatment."
C) "I don't need to listen to other people's opinions."
D) "I am the most important person in any situation."
Correct Answer: "I realize that I may not always be right about everything."
Rationale: Grandiosity and lack of empathy are core features of narcissistic personality disorder.
Acknowledging that one may not always be right indicates some insight and progress. The other
statements reflect continued grandiosity.
7. The nurse is caring for a client with avoidant personality disorder. Which statement by the client
indicates a goal has been met?
A) "I attended group therapy today and spoke once."
B) "I avoided the group therapy session today."
C) "I don't need to talk to anyone."
D) "I only feel comfortable talking to my nurse."
Correct Answer: "I attended group therapy today and spoke once."
Rationale: Attending group therapy and participating, even minimally, indicates progress for a client with
avoidant personality disorder. Avoidance and isolation are maladaptive behaviors, and only talking to
one person does not indicate broad progress.
Galen College of Nursing | 2026/2027 Edition (PDF)
1. The nurse is providing support to the family of a client who died suddenly. A family member states, "I
keep thinking about all the things I should have said." The nurse recognizes this as which type of grief
response?
A) Anticipatory grief
B) Complicated grief
C) Disenfranchised grief
D) Normal bereavement
Correct Answer: Normal bereavement
Rationale: This statement reflects a normal bereavement response involving reflection and regrets,
which are common in the early stages of grief. Anticipatory grief occurs before a death, complicated
grief is prolonged and disabling, and disenfranchised grief is not socially recognized.
2. The nurse is caring for a client who is in the acute phase of grief after the loss of a child. Which
nursing intervention is most appropriate?
A) Encourage the client to be strong for surviving family members
B) Suggest that the client avoid discussing the child to prevent upset
C) Provide a quiet, supportive presence and allow the client to express feelings
D) Tell the client that time heals all wounds
Correct Answer: Provide a quiet, supportive presence and allow the client to express feelings
Rationale: The most therapeutic intervention is to provide a supportive presence and allow the client to
express their feelings without judgment. Offering platitudes or encouraging avoidance is not helpful and
can invalidate the client's experience.
3. The nurse is educating a client with generalized anxiety disorder about cognitive-behavioral therapy
(CBT). Which statement best describes the goal of CBT?
,A) "CBT will uncover the unconscious conflicts from your childhood."
B) "CBT helps you identify and change irrational thoughts that cause anxiety."
C) "CBT uses medication to reduce your physical symptoms of anxiety."
D) "CBT is a technique to relax your muscles during a panic attack."
Correct Answer: "CBT helps you identify and change irrational thoughts that cause anxiety."
Rationale: CBT focuses on the connection between thoughts, feelings, and behaviors. The goal is to
identify and modify maladaptive thought patterns that contribute to anxiety. It is not primarily focused
on unconscious conflicts, medication, or muscle relaxation alone.
4. A client with borderline personality disorder is engaging in splitting behavior, praising one nurse and
criticizing another. Which nursing intervention is most appropriate?
A) Allow the client to choose their preferred nurse
B) Ensure all staff members communicate consistently and use the same approach
C) Avoid discussing the client's behavior with other staff
D) Give the client different rules depending on the staff member
Correct Answer: Ensure all staff members communicate consistently and use the same approach
Rationale: Consistent communication and a unified approach among staff are essential to manage
splitting. Allowing the client to choose staff, avoiding communication, or giving different rules reinforces
splitting and is not therapeutic.
5. The nurse is planning care for a client with antisocial personality disorder who is being discharged to a
halfway house. Which intervention is most likely to promote successful community living?
A) Allow the client to set all their own rules without supervision
B) Establish clear, consistent limits with immediate consequences for rule violations
C) Use a permissive approach to build trust
D) Confront the client daily about past criminal behavior
, Correct Answer: Establish clear, consistent limits with immediate consequences for rule violations
Rationale: Clients with antisocial personality disorder respond best to firm, consistent limits with clear
consequences. Permissiveness is often exploited, and confrontation about past behavior is not
therapeutic.
6. A client with narcissistic personality disorder is being treated. Which statement by the client indicates
progress?
A) "I realize that I may not always be right about everything."
B) "I am better than everyone else, and I deserve special treatment."
C) "I don't need to listen to other people's opinions."
D) "I am the most important person in any situation."
Correct Answer: "I realize that I may not always be right about everything."
Rationale: Grandiosity and lack of empathy are core features of narcissistic personality disorder.
Acknowledging that one may not always be right indicates some insight and progress. The other
statements reflect continued grandiosity.
7. The nurse is caring for a client with avoidant personality disorder. Which statement by the client
indicates a goal has been met?
A) "I attended group therapy today and spoke once."
B) "I avoided the group therapy session today."
C) "I don't need to talk to anyone."
D) "I only feel comfortable talking to my nurse."
Correct Answer: "I attended group therapy today and spoke once."
Rationale: Attending group therapy and participating, even minimally, indicates progress for a client with
avoidant personality disorder. Avoidance and isolation are maladaptive behaviors, and only talking to
one person does not indicate broad progress.
