Galen NSG 3450 Final Exam 3 | Nursing Practice –
Mental Health (2026) Actual Q&A PDF
1. Which defense mechanism is most characteristic of a client with borderline
personality disorder who views staff as either perfect or worthless?
A) Intellectualization
B) Projection
C) Reaction formation
D) Splitting
Correct Answer: Splitting
Rationale: Splitting is a hallmark defense mechanism in borderline personality disorder
where individuals categorize people as all good or all bad. This behavior often leads to
conflict and manipulation among staff members on the unit. The nurse must recognize
this to maintain a consistent team approach and prevent the client's attempts to divide
the staff.
2. What is the primary goal of nursing interventions for a client with antisocial
personality disorder?
A) Set clear, consistent limits on manipulative behavior
B) Encourage the client to express deep-seated emotions
C) Promote dependence on the nursing staff for decision-making
D) Allow the client to lead group therapy sessions
Correct Answer: Set clear, consistent limits on manipulative behavior
Rationale: Individuals with antisocial personality disorder often disregard the rights of
others and use manipulation to achieve their own goals. Setting firm and consistent
limits is the most effective nursing strategy to manage these behaviors and maintain unit
safety. This approach helps the client understand boundaries and reduces exploitative
interactions.
3. A child is prescribed methylphenidate for ADHD. Which side effect should the
nurse instruct the parents to monitor?
A) Insomnia and weight loss
B) Excessive sleepiness and lethargy
C) Increased appetite and weight gain
,D) Bradypnea and hypotension
Correct Answer: Insomnia and weight loss
Rationale: Methylphenidate is a central nervous system stimulant that can cause
insomnia, decreased appetite, and weight loss. Parents should administer the
medication in the morning to prevent sleep disturbances and monitor the child's growth.
Excessive sleepiness, increased appetite, and hypotension are not typical side effects.
4. Which physical finding should the nurse prioritize when assessing a client with
anorexia nervosa?
A) Hypertension
B) Tachycardia
C) Hyperthermia
D) Bradycardia
Correct Answer: Bradycardia
Rationale: Anorexia nervosa often leads to physiological adaptations to starvation, such
as bradycardia and hypotension. These changes occur as the body attempts to conserve
energy and can lead to life-threatening cardiac arrhythmias. Monitoring vital signs is
critical for early detection of medical instability in eating disorder patients.
5. A nurse is assessing an older adult client for delirium. Which characteristic
distinguishes delirium from dementia?
A) Gradual onset of symptoms over several years
B) Permanent and irreversible cognitive decline
C) Sudden onset with fluctuating levels of consciousness
D) Normal level of attention and alertness
Correct Answer: Sudden onset with fluctuating levels of consciousness
Rationale: Delirium is characterized by a rapid, acute onset of confusion and
fluctuations in consciousness throughout the day. Unlike dementia, which is progressive
and chronic, delirium is often secondary to an underlying medical condition like a UTI or
electrolyte imbalance. Identifying the root cause of delirium is essential for reversal and
patient safety.
6. Which statement made by a patient demonstrates acceptance of the criteria
required for hospice care?
A) "I want my family to be with me."
,B) "There is no cure for my illness. I have accepted that."
C) "It's important to me that I die in my own home."
D) "I don't want my family to bear the burden of caring for me."
Correct Answer: "There is no cure for my illness. I have accepted that."
Rationale: Acceptance of hospice care requires the patient to understand that their
illness is terminal and that curative treatment is no longer the goal. The statement
"There is no cure for my illness. I have accepted that" reflects this understanding. The
other statements express preferences about care but do not demonstrate acceptance of
the terminal nature of the illness.
7. Which statement made by a widow demonstrates that her grief work has been
effective? Select all that apply.
A) "I can remember how much my deceased husband loved chocolate chip ice cream."
B) "Painting is my new passion, and I really enjoy learning the various strokes."
C) "Jim could be very stubborn when he thought he was right."
D) "I don't know why he had to die."
E) "I just can't believe he's gone."
Correct Answer: "I can remember how much my deceased husband loved chocolate
chip ice cream."
Rationale: Effective grief work is demonstrated by the ability to remember the deceased
realistically, including both positive and negative qualities, and to reinvest in new
activities and relationships. Statements A, B, and C reflect healthy adaptation.
Statements D and E indicate ongoing denial and unresolved grief.
8. Which factor has the greatest influence on the hospice nurse's ability to provide
respectful professional care?
A) Acceptance that death is a natural part of life
B) Possession of excellent caregiving nursing skills
C) The existence of a healthy, well-balanced personal life
D) The desire to work with both the patient and the family
Correct Answer: The existence of a healthy, well-balanced personal life
Rationale: A hospice nurse's ability to provide respectful professional care is most
influenced by having a healthy, well-balanced personal life. This enables the nurse to
maintain emotional boundaries, cope with the cumulative grief of working with dying
, patients, and prevent burnout. While skills and acceptance are important, personal
well-being is foundational.
9. Which intrinsic factor plays into the medical model's focus on the prolongation of
life?
A) Healthcare workers do not want their patients to die
B) Medicare is a fee-for-service model
C) Palliative care is expensive to administer
D) Keeping people alive as long as possible is the ethical thing to do
Correct Answer: Keeping people alive as long as possible is the ethical thing to do
Rationale: The intrinsic factor that plays into the medical model's focus on prolongation
of life is the belief that keeping people alive as long as possible is the ethical thing to do.
This value is deeply ingrained in Western medicine. Other factors such as
reimbursement models are extrinsic rather than intrinsic.
10. A patient with terminal breast cancer becomes upset when the nurse brings up
hospice care. Which response by the nurse is most appropriate?
A) "Hospice is a model of healthcare that emphasizes quality of life for you and your
family."
B) "Hospice means the end of curative treatments and pain management."
C) "Hospice is a multidisciplinary team providing curative and therapeutic treatment."
D) "Hospice is an aggressive medical plan to end suffering and hasten death."
Correct Answer: "Hospice is a model of healthcare that emphasizes quality of life for you
and your family."
Rationale: Hospice care emphasizes quality of life, comfort, and dignity for patients with
terminal illnesses and their families. It does not hasten death or end all treatments;
rather, it shifts the focus from curative to comfort care. The nurse should provide
accurate information to alleviate the patient's fears.
11. A terminally ill patient's family members are unaware of her end-of-life wishes.
What is the best action for the nurse?
A) Discuss durable power of attorney
B) Organize a family meeting with the patient's permission to discuss her goals and
wishes
C) Have a family meeting without the patient so as not to upset her
Mental Health (2026) Actual Q&A PDF
1. Which defense mechanism is most characteristic of a client with borderline
personality disorder who views staff as either perfect or worthless?
A) Intellectualization
B) Projection
C) Reaction formation
D) Splitting
Correct Answer: Splitting
Rationale: Splitting is a hallmark defense mechanism in borderline personality disorder
where individuals categorize people as all good or all bad. This behavior often leads to
conflict and manipulation among staff members on the unit. The nurse must recognize
this to maintain a consistent team approach and prevent the client's attempts to divide
the staff.
2. What is the primary goal of nursing interventions for a client with antisocial
personality disorder?
A) Set clear, consistent limits on manipulative behavior
B) Encourage the client to express deep-seated emotions
C) Promote dependence on the nursing staff for decision-making
D) Allow the client to lead group therapy sessions
Correct Answer: Set clear, consistent limits on manipulative behavior
Rationale: Individuals with antisocial personality disorder often disregard the rights of
others and use manipulation to achieve their own goals. Setting firm and consistent
limits is the most effective nursing strategy to manage these behaviors and maintain unit
safety. This approach helps the client understand boundaries and reduces exploitative
interactions.
3. A child is prescribed methylphenidate for ADHD. Which side effect should the
nurse instruct the parents to monitor?
A) Insomnia and weight loss
B) Excessive sleepiness and lethargy
C) Increased appetite and weight gain
,D) Bradypnea and hypotension
Correct Answer: Insomnia and weight loss
Rationale: Methylphenidate is a central nervous system stimulant that can cause
insomnia, decreased appetite, and weight loss. Parents should administer the
medication in the morning to prevent sleep disturbances and monitor the child's growth.
Excessive sleepiness, increased appetite, and hypotension are not typical side effects.
4. Which physical finding should the nurse prioritize when assessing a client with
anorexia nervosa?
A) Hypertension
B) Tachycardia
C) Hyperthermia
D) Bradycardia
Correct Answer: Bradycardia
Rationale: Anorexia nervosa often leads to physiological adaptations to starvation, such
as bradycardia and hypotension. These changes occur as the body attempts to conserve
energy and can lead to life-threatening cardiac arrhythmias. Monitoring vital signs is
critical for early detection of medical instability in eating disorder patients.
5. A nurse is assessing an older adult client for delirium. Which characteristic
distinguishes delirium from dementia?
A) Gradual onset of symptoms over several years
B) Permanent and irreversible cognitive decline
C) Sudden onset with fluctuating levels of consciousness
D) Normal level of attention and alertness
Correct Answer: Sudden onset with fluctuating levels of consciousness
Rationale: Delirium is characterized by a rapid, acute onset of confusion and
fluctuations in consciousness throughout the day. Unlike dementia, which is progressive
and chronic, delirium is often secondary to an underlying medical condition like a UTI or
electrolyte imbalance. Identifying the root cause of delirium is essential for reversal and
patient safety.
6. Which statement made by a patient demonstrates acceptance of the criteria
required for hospice care?
A) "I want my family to be with me."
,B) "There is no cure for my illness. I have accepted that."
C) "It's important to me that I die in my own home."
D) "I don't want my family to bear the burden of caring for me."
Correct Answer: "There is no cure for my illness. I have accepted that."
Rationale: Acceptance of hospice care requires the patient to understand that their
illness is terminal and that curative treatment is no longer the goal. The statement
"There is no cure for my illness. I have accepted that" reflects this understanding. The
other statements express preferences about care but do not demonstrate acceptance of
the terminal nature of the illness.
7. Which statement made by a widow demonstrates that her grief work has been
effective? Select all that apply.
A) "I can remember how much my deceased husband loved chocolate chip ice cream."
B) "Painting is my new passion, and I really enjoy learning the various strokes."
C) "Jim could be very stubborn when he thought he was right."
D) "I don't know why he had to die."
E) "I just can't believe he's gone."
Correct Answer: "I can remember how much my deceased husband loved chocolate
chip ice cream."
Rationale: Effective grief work is demonstrated by the ability to remember the deceased
realistically, including both positive and negative qualities, and to reinvest in new
activities and relationships. Statements A, B, and C reflect healthy adaptation.
Statements D and E indicate ongoing denial and unresolved grief.
8. Which factor has the greatest influence on the hospice nurse's ability to provide
respectful professional care?
A) Acceptance that death is a natural part of life
B) Possession of excellent caregiving nursing skills
C) The existence of a healthy, well-balanced personal life
D) The desire to work with both the patient and the family
Correct Answer: The existence of a healthy, well-balanced personal life
Rationale: A hospice nurse's ability to provide respectful professional care is most
influenced by having a healthy, well-balanced personal life. This enables the nurse to
maintain emotional boundaries, cope with the cumulative grief of working with dying
, patients, and prevent burnout. While skills and acceptance are important, personal
well-being is foundational.
9. Which intrinsic factor plays into the medical model's focus on the prolongation of
life?
A) Healthcare workers do not want their patients to die
B) Medicare is a fee-for-service model
C) Palliative care is expensive to administer
D) Keeping people alive as long as possible is the ethical thing to do
Correct Answer: Keeping people alive as long as possible is the ethical thing to do
Rationale: The intrinsic factor that plays into the medical model's focus on prolongation
of life is the belief that keeping people alive as long as possible is the ethical thing to do.
This value is deeply ingrained in Western medicine. Other factors such as
reimbursement models are extrinsic rather than intrinsic.
10. A patient with terminal breast cancer becomes upset when the nurse brings up
hospice care. Which response by the nurse is most appropriate?
A) "Hospice is a model of healthcare that emphasizes quality of life for you and your
family."
B) "Hospice means the end of curative treatments and pain management."
C) "Hospice is a multidisciplinary team providing curative and therapeutic treatment."
D) "Hospice is an aggressive medical plan to end suffering and hasten death."
Correct Answer: "Hospice is a model of healthcare that emphasizes quality of life for you
and your family."
Rationale: Hospice care emphasizes quality of life, comfort, and dignity for patients with
terminal illnesses and their families. It does not hasten death or end all treatments;
rather, it shifts the focus from curative to comfort care. The nurse should provide
accurate information to alleviate the patient's fears.
11. A terminally ill patient's family members are unaware of her end-of-life wishes.
What is the best action for the nurse?
A) Discuss durable power of attorney
B) Organize a family meeting with the patient's permission to discuss her goals and
wishes
C) Have a family meeting without the patient so as not to upset her
