,NUR 256 Exam 3 | Concepts of Mental Health Nursing
(2026) Q&A | Galen College
1. A client who survived a mass shooting reports recurring nightmares and avoids
crowded places. Which condition should the nurse suspect?
A) Adjustment disorder
B) Post - traumatic stress disorder
C) Acute stress disorder
D) Generalized anxiety disorder
Correct Answer: Post - traumatic stress disorder
Rationale: PTSD is diagnosed when symptoms such as re - experiencing, avoidance,
and hyperarousal persist for more than one month after a traumatic event.
Adjustment disorder involves non - traumatic stressors, acute stress disorder lasts
from three days to one month, a nd generalized anxiety disorder is not tied to a
specific trauma.
2. What is the primary distinguishing feature between acute stress disorder and
post - traumatic stress disorder?
A) The severity of the traumatic event
B) The duration of symptoms
C) The presence of dissociation
D) The type of avoidance behaviors
Correct Answer: The duration of symptoms
Rationale: Acute stress disorder is diagnosed when symptoms last from three days
to one month after trauma, while PTSD requires symptoms to persist beyond one
month. The severity of the event, presence of dissociation, and type of avoidance do
not distinguish the tw o diagnoses.
,3. A client with PTSD reports feeling detached from others and unable to experience
positive emotions. Which symptom cluster does this represent?
A) Re - experiencing
B) Avoidance
C) Negative alterations in cognitions and mood
D) Hyperarousal
Correct Answer: Negative alterations in cognitions and mood
Rationale: Negative alterations in cognitions and mood include persistent negative
beliefs, distorted blame, detachment from others, and inability to experience
positive emotions. Re - experiencing involves flashbacks and nightmares. Avoidance
involves avoiding trauma - related stimuli. Hyperarousal involves irritability and
hypervigilance.
4. During a trauma - informed interview, a client suddenly stares blankly and speaks
in a childlike voice. Which phenomenon is the nurse most likely observing?
A) Flashback
B) Dissociative identity switch
C) Depersonalization episode
D) Maladaptive daydreaming
Correct Answer: Dissociative identity switch
Rationale: Sudden changes in voice, demeanor, and memory gaps in a client with
severe trauma history suggest a dissociative identity switch. The nurse's priority is
maintaining a calm, safe presence without confrontation. Flashbacks involve
sensory re - experiencing, depersonalization involves feeling detached from one's
body, and maladaptive daydreaming is not trauma - related.
5. Which nursing action is the priority during a dissociative episode?
A) Confront the client about the behavior
B) Leave the room to reduce stimulation
, C) Ensure safety and remain calm while the episode resolves
D) Administer a PRN anxiolytic immediately
Correct Answer: Ensure safety and remain calm while the episode resolves
Rationale: During a dissociative episode, the priority is maintaining a calm, safe
presence and ensuring the client does not harm themselves. Confrontation can
escalate distress. Leaving the room is unsafe. Medication may be used if ordered,
but safety and calm pres ence are the first interventions.
6. A client with dissociative amnesia is unable to recall personal information related
to a stressful event. Which nursing intervention is most appropriate?
A) Confront the client with the forgotten information
B) Create a safe environment and use grounding techniques
C) Encourage the client to recall the event as quickly as possible
D) Administer a memory - enhancing medication
Correct Answer: Create a safe environment and use grounding techniques
Rationale: For dissociative amnesia, the priority is creating a safe environment and
using grounding techniques to help the client stay oriented to the present.
Confrontation and pressuring the client to recall the event can increase distress.
Memory - enhancing medic ations are not standard treatment.
7. Which statement by a client with somatic symptom disorder indicates a need for
further teaching?
A) "I know stress can make my pain worse."
B) "My pain is real even if tests are normal."
C) "I should focus on my symptoms to figure out what's wrong."
D) "Relaxation techniques might help me feel better."
Correct Answer: "I should focus on my symptoms to figure out what's wrong."
(2026) Q&A | Galen College
1. A client who survived a mass shooting reports recurring nightmares and avoids
crowded places. Which condition should the nurse suspect?
A) Adjustment disorder
B) Post - traumatic stress disorder
C) Acute stress disorder
D) Generalized anxiety disorder
Correct Answer: Post - traumatic stress disorder
Rationale: PTSD is diagnosed when symptoms such as re - experiencing, avoidance,
and hyperarousal persist for more than one month after a traumatic event.
Adjustment disorder involves non - traumatic stressors, acute stress disorder lasts
from three days to one month, a nd generalized anxiety disorder is not tied to a
specific trauma.
2. What is the primary distinguishing feature between acute stress disorder and
post - traumatic stress disorder?
A) The severity of the traumatic event
B) The duration of symptoms
C) The presence of dissociation
D) The type of avoidance behaviors
Correct Answer: The duration of symptoms
Rationale: Acute stress disorder is diagnosed when symptoms last from three days
to one month after trauma, while PTSD requires symptoms to persist beyond one
month. The severity of the event, presence of dissociation, and type of avoidance do
not distinguish the tw o diagnoses.
,3. A client with PTSD reports feeling detached from others and unable to experience
positive emotions. Which symptom cluster does this represent?
A) Re - experiencing
B) Avoidance
C) Negative alterations in cognitions and mood
D) Hyperarousal
Correct Answer: Negative alterations in cognitions and mood
Rationale: Negative alterations in cognitions and mood include persistent negative
beliefs, distorted blame, detachment from others, and inability to experience
positive emotions. Re - experiencing involves flashbacks and nightmares. Avoidance
involves avoiding trauma - related stimuli. Hyperarousal involves irritability and
hypervigilance.
4. During a trauma - informed interview, a client suddenly stares blankly and speaks
in a childlike voice. Which phenomenon is the nurse most likely observing?
A) Flashback
B) Dissociative identity switch
C) Depersonalization episode
D) Maladaptive daydreaming
Correct Answer: Dissociative identity switch
Rationale: Sudden changes in voice, demeanor, and memory gaps in a client with
severe trauma history suggest a dissociative identity switch. The nurse's priority is
maintaining a calm, safe presence without confrontation. Flashbacks involve
sensory re - experiencing, depersonalization involves feeling detached from one's
body, and maladaptive daydreaming is not trauma - related.
5. Which nursing action is the priority during a dissociative episode?
A) Confront the client about the behavior
B) Leave the room to reduce stimulation
, C) Ensure safety and remain calm while the episode resolves
D) Administer a PRN anxiolytic immediately
Correct Answer: Ensure safety and remain calm while the episode resolves
Rationale: During a dissociative episode, the priority is maintaining a calm, safe
presence and ensuring the client does not harm themselves. Confrontation can
escalate distress. Leaving the room is unsafe. Medication may be used if ordered,
but safety and calm pres ence are the first interventions.
6. A client with dissociative amnesia is unable to recall personal information related
to a stressful event. Which nursing intervention is most appropriate?
A) Confront the client with the forgotten information
B) Create a safe environment and use grounding techniques
C) Encourage the client to recall the event as quickly as possible
D) Administer a memory - enhancing medication
Correct Answer: Create a safe environment and use grounding techniques
Rationale: For dissociative amnesia, the priority is creating a safe environment and
using grounding techniques to help the client stay oriented to the present.
Confrontation and pressuring the client to recall the event can increase distress.
Memory - enhancing medic ations are not standard treatment.
7. Which statement by a client with somatic symptom disorder indicates a need for
further teaching?
A) "I know stress can make my pain worse."
B) "My pain is real even if tests are normal."
C) "I should focus on my symptoms to figure out what's wrong."
D) "Relaxation techniques might help me feel better."
Correct Answer: "I should focus on my symptoms to figure out what's wrong."
