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NUR 253 Exam 4 Mental Health (2026/2027) | Galen
College of Nursing + Rated Practice Questions,
Answers & Rationales
Question 1
A nurse is caring for a client whose spouse died unexpectedly two weeks ago. During the
assessment, the client cries while discussing the loss and states, “I still cannot believe this
happened, but I know I need to figure out how to move forward.” Which concept best describes
the state of having experienced a loss through death?
A. Mourning
B. Bereavement
C. Anticipatory grief
D. Disenfranchised grief
Answer: B. Bereavement
Explanation: Bereavement refers to the state of having experienced the death of someone
significant. Mourning refers to the outward expression of grief that may be influenced by cultural
practices. Anticipatory grief occurs before an expected loss, while disenfranchised grief involves
a loss that may not be openly recognized or socially supported.
, Question 2
A client with a terminal illness tells the nurse, “I am angry that this is happening to me. None of
this is fair.” The client has previously acknowledged the diagnosis but now expresses significant
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frustration and anger. Which stage of the Kübler-Ross model is most consistent with this
response?
A. Denial
B. Anger
C. Bargaining
D. Acceptance
Answer: B. Anger
Explanation: Anger is one of the commonly described responses in the Kübler-Ross model of
grief. The client recognizes the reality of the illness but expresses frustration, resentment, or
unfairness. The stages are not necessarily experienced in a fixed order, and individuals may
move back and forth between responses.
Question 3
A client receiving hospice care says, “I don't want to talk about dying anymore. I just want to be
comfortable and spend time with my family.” Which nursing intervention is most appropriate?
A. Encourage the client to discuss the five stages of grief
B. Focus on comfort, symptom management, and the client's goals
C. Explain that discussing death will help the client achieve acceptance
D. Encourage aggressive treatment to prolong life as long as possible
, Answer: B. Focus on comfort, symptom management, and the client's goals
Explanation: Hospice care emphasizes comfort and quality of life for clients approaching the
end of life. Nursing care should be individualized according to the client's goals and preferences
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and should address pain, dyspnea, anxiety, psychosocial needs, and family support rather than
focusing solely on prolonging life.
Question 4
A client says to the nurse, “I don't know how I am going to get through this. I feel completely
overwhelmed.” Which response demonstrates therapeutic communication?
A. “Everything will work out eventually.”
B. “You need to stay positive.”
C. “Tell me more about what feels overwhelming right now.”
D. “Other people have experienced much worse situations.”
Answer: C. “Tell me more about what feels overwhelming right now.”
Explanation: An open-ended response encourages the client to elaborate and allows the nurse to
assess emotional needs more thoroughly. Statements that offer false reassurance, minimize the
client's feelings, or compare the client's experience with someone else's are generally
nontherapeutic.
Question 5
A client tells the nurse, “I am so angry at my father that sometimes I wish he would disappear.”
The nurse recognizes that additional assessment is necessary. Which response is most appropriate
initially?
, A. “You should not have those kinds of thoughts.”
B. “Are you thinking about harming your father?”
C. “Your father probably knows that you are upset.”
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D. “Try to focus on the positive aspects of your relationship.”
Answer: B. “Are you thinking about harming your father?”
Explanation: When a client expresses a potentially violent thought, the nurse should directly
assess for intent, plan, means, and access to the potential target. Asking directly about violence
does not cause a person to become violent; instead, it supports accurate risk assessment and
safety planning.
Question 6
A hospitalized client with alcohol use disorder has been abstinent for approximately 12 hours and
is becoming increasingly anxious and tremulous. The nurse notes diaphoresis, tachycardia, and
agitation. Which intervention is the priority?
A. Place the client in a stimulating group therapy environment
B. Assess the severity of withdrawal and initiate prescribed withdrawal management
C. Encourage the client to sleep without further assessment
D. Administer an opioid antagonist
Answer: B. Assess the severity of withdrawal and initiate prescribed withdrawal
management
Explanation: Alcohol withdrawal can progress to severe complications, including seizures and
delirium tremens. Nurses should monitor withdrawal severity using an appropriate assessment
NUR 253 Exam 4 Mental Health (2026/2027) | Galen
College of Nursing + Rated Practice Questions,
Answers & Rationales
Question 1
A nurse is caring for a client whose spouse died unexpectedly two weeks ago. During the
assessment, the client cries while discussing the loss and states, “I still cannot believe this
happened, but I know I need to figure out how to move forward.” Which concept best describes
the state of having experienced a loss through death?
A. Mourning
B. Bereavement
C. Anticipatory grief
D. Disenfranchised grief
Answer: B. Bereavement
Explanation: Bereavement refers to the state of having experienced the death of someone
significant. Mourning refers to the outward expression of grief that may be influenced by cultural
practices. Anticipatory grief occurs before an expected loss, while disenfranchised grief involves
a loss that may not be openly recognized or socially supported.
, Question 2
A client with a terminal illness tells the nurse, “I am angry that this is happening to me. None of
this is fair.” The client has previously acknowledged the diagnosis but now expresses significant
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frustration and anger. Which stage of the Kübler-Ross model is most consistent with this
response?
A. Denial
B. Anger
C. Bargaining
D. Acceptance
Answer: B. Anger
Explanation: Anger is one of the commonly described responses in the Kübler-Ross model of
grief. The client recognizes the reality of the illness but expresses frustration, resentment, or
unfairness. The stages are not necessarily experienced in a fixed order, and individuals may
move back and forth between responses.
Question 3
A client receiving hospice care says, “I don't want to talk about dying anymore. I just want to be
comfortable and spend time with my family.” Which nursing intervention is most appropriate?
A. Encourage the client to discuss the five stages of grief
B. Focus on comfort, symptom management, and the client's goals
C. Explain that discussing death will help the client achieve acceptance
D. Encourage aggressive treatment to prolong life as long as possible
, Answer: B. Focus on comfort, symptom management, and the client's goals
Explanation: Hospice care emphasizes comfort and quality of life for clients approaching the
end of life. Nursing care should be individualized according to the client's goals and preferences
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and should address pain, dyspnea, anxiety, psychosocial needs, and family support rather than
focusing solely on prolonging life.
Question 4
A client says to the nurse, “I don't know how I am going to get through this. I feel completely
overwhelmed.” Which response demonstrates therapeutic communication?
A. “Everything will work out eventually.”
B. “You need to stay positive.”
C. “Tell me more about what feels overwhelming right now.”
D. “Other people have experienced much worse situations.”
Answer: C. “Tell me more about what feels overwhelming right now.”
Explanation: An open-ended response encourages the client to elaborate and allows the nurse to
assess emotional needs more thoroughly. Statements that offer false reassurance, minimize the
client's feelings, or compare the client's experience with someone else's are generally
nontherapeutic.
Question 5
A client tells the nurse, “I am so angry at my father that sometimes I wish he would disappear.”
The nurse recognizes that additional assessment is necessary. Which response is most appropriate
initially?
, A. “You should not have those kinds of thoughts.”
B. “Are you thinking about harming your father?”
C. “Your father probably knows that you are upset.”
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D. “Try to focus on the positive aspects of your relationship.”
Answer: B. “Are you thinking about harming your father?”
Explanation: When a client expresses a potentially violent thought, the nurse should directly
assess for intent, plan, means, and access to the potential target. Asking directly about violence
does not cause a person to become violent; instead, it supports accurate risk assessment and
safety planning.
Question 6
A hospitalized client with alcohol use disorder has been abstinent for approximately 12 hours and
is becoming increasingly anxious and tremulous. The nurse notes diaphoresis, tachycardia, and
agitation. Which intervention is the priority?
A. Place the client in a stimulating group therapy environment
B. Assess the severity of withdrawal and initiate prescribed withdrawal management
C. Encourage the client to sleep without further assessment
D. Administer an opioid antagonist
Answer: B. Assess the severity of withdrawal and initiate prescribed withdrawal
management
Explanation: Alcohol withdrawal can progress to severe complications, including seizures and
delirium tremens. Nurses should monitor withdrawal severity using an appropriate assessment
