Galen NSG 3450 Exam 1 | Nursing Practice – Mental Health
(2026) Actual Q&A PDF
1. A nursing student is reviewing the history of mental health care. Which event had the
greatest impact on deinstitutionalization in the United States?
A) Development of electroconvulsive therapy (ECT)
B) Publication of "The Snake Pit"
C) Passage of the Community Mental Health Centers Act of 1963
D) Discovery of lithium for bipolar disorder
Correct Answer: Passage of the Community Mental Health Centers Act of 1963
Rationale: The Community Mental Health Centers Act (signed by President Kennedy) provided
federal funding for community-based care, leading to the closure of large state hospitals and the
shift toward community integration. ECT was developed earlier and is a treatment modality, not
a driver of deinstitutionalization. The book highlighted poor conditions but did not legislate
change. Lithium treats symptoms but did not close hospitals.
2. A nurse is using the biopsychosocial model to assess a client with major depression. Which
factor represents the "bio" component?
A) Recent job loss
B) Low self-esteem
C) Family history of depression
D) Lack of social support
Correct Answer: Family history of depression
,Rationale: The biological component includes genetics, neurochemistry, and medical conditions.
Recent job loss and lack of social support are social/environmental factors. Low self-esteem is a
psychological factor.
3. According to Maslow's Hierarchy of Needs, which patient behavior should the nurse address
first?
A) The patient states, "I feel so alone and isolated from my family."
B) The patient refuses to participate in group therapy, stating, "I'm not good enough for them."
C) The patient is restless and reports not sleeping or eating for two days.
D) The patient expresses a desire to write a book about their life experiences.
Correct Answer: The patient is restless and reports not sleeping or eating for two days.
Rationale: Physiological needs (food, water, sleep, oxygenation) form the base of Maslow's
pyramid and must be addressed before higher-level needs (safety, love/belonging, esteem, self-
actualization) can be met.
4. A patient tells the nurse, "You remind me of my mother. I always feel so safe when you're
here." The nurse recognizes this statement as an example of which phenomenon?
A) Countertransference
B) Reality testing
C) Transference
D) Behavioral modification
Correct Answer: Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings felt toward a
significant person in their past (like a parent) onto the healthcare professional in the present.
Countertransference is the healthcare provider's emotional reaction to the patient.
,5. A client tells the nurse, "I'm worthless and I should just die." Which nursing response
demonstrates therapeutic communication and safety?
A) "You shouldn't say things like that."
B) "Why do you feel worthless?"
C) "You have so much to live for."
D) "You sound very hopeless. Have you thought about hurting yourself?"
Correct Answer: "You sound very hopeless. Have you thought about hurting yourself?"
Rationale: This response validates the client's feeling (hopelessness) AND performs a direct
suicide risk assessment, which is the priority. False reassurance and blocking are
nontherapeutic, and asking "why" can put a client on the defensive.
6. A client with schizophrenia tells the nurse, "The FBI is poisoning my food." What is the most
therapeutic response?
A) "That's not true. The FBI doesn't care about you."
B) "I understand you believe that. It must be frightening. Here in the hospital, your food is safe."
C) "Let's talk about something else."
D) "Why do you think the FBI would want to poison you?"
Correct Answer: "I understand you believe that. It must be frightening. Here in the hospital,
your food is safe."
Rationale: This response acknowledges the client's feelings (validates the emotion) without
reinforcing the delusion, while also providing reality orientation and a sense of safety.
, 7. A psychiatric nurse is working with a patient who has difficulty trusting others. Based on
Erikson's stages of psychosocial development, which stage was most likely not successfully
mastered?
A) Initiative vs. Guilt
B) Trust vs. Mistrust
C) Autonomy vs. Shame and Doubt
D) Industry vs. Inferiority
Correct Answer: Trust vs. Mistrust
Rationale: The crisis of infancy (birth to 18 months) is Trust vs. Mistrust. Successful mastery
leads to a sense of trust and safety; failure results in mistrust and fear.
8. A couple celebrating 10 years of marriage and reporting they "don't give up" on each other is
in which Erikson stage?
A) Intimacy vs. Isolation
B) Generativity vs. Stagnation
C) Identity vs. Role Confusion
D) Trust vs. Mistrust
Correct Answer: Intimacy vs. Isolation
Rationale: Young adulthood (approximately 19-40 years) is associated with Erikson's stage of
Intimacy vs. Isolation, where the primary task is to form close, committed relationships.
9. According to the QSEN competencies, which action best demonstrates "Patient-Centered
Care"?
A) Using the latest evidence-based guideline to treat a patient's depression
(2026) Actual Q&A PDF
1. A nursing student is reviewing the history of mental health care. Which event had the
greatest impact on deinstitutionalization in the United States?
A) Development of electroconvulsive therapy (ECT)
B) Publication of "The Snake Pit"
C) Passage of the Community Mental Health Centers Act of 1963
D) Discovery of lithium for bipolar disorder
Correct Answer: Passage of the Community Mental Health Centers Act of 1963
Rationale: The Community Mental Health Centers Act (signed by President Kennedy) provided
federal funding for community-based care, leading to the closure of large state hospitals and the
shift toward community integration. ECT was developed earlier and is a treatment modality, not
a driver of deinstitutionalization. The book highlighted poor conditions but did not legislate
change. Lithium treats symptoms but did not close hospitals.
2. A nurse is using the biopsychosocial model to assess a client with major depression. Which
factor represents the "bio" component?
A) Recent job loss
B) Low self-esteem
C) Family history of depression
D) Lack of social support
Correct Answer: Family history of depression
,Rationale: The biological component includes genetics, neurochemistry, and medical conditions.
Recent job loss and lack of social support are social/environmental factors. Low self-esteem is a
psychological factor.
3. According to Maslow's Hierarchy of Needs, which patient behavior should the nurse address
first?
A) The patient states, "I feel so alone and isolated from my family."
B) The patient refuses to participate in group therapy, stating, "I'm not good enough for them."
C) The patient is restless and reports not sleeping or eating for two days.
D) The patient expresses a desire to write a book about their life experiences.
Correct Answer: The patient is restless and reports not sleeping or eating for two days.
Rationale: Physiological needs (food, water, sleep, oxygenation) form the base of Maslow's
pyramid and must be addressed before higher-level needs (safety, love/belonging, esteem, self-
actualization) can be met.
4. A patient tells the nurse, "You remind me of my mother. I always feel so safe when you're
here." The nurse recognizes this statement as an example of which phenomenon?
A) Countertransference
B) Reality testing
C) Transference
D) Behavioral modification
Correct Answer: Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings felt toward a
significant person in their past (like a parent) onto the healthcare professional in the present.
Countertransference is the healthcare provider's emotional reaction to the patient.
,5. A client tells the nurse, "I'm worthless and I should just die." Which nursing response
demonstrates therapeutic communication and safety?
A) "You shouldn't say things like that."
B) "Why do you feel worthless?"
C) "You have so much to live for."
D) "You sound very hopeless. Have you thought about hurting yourself?"
Correct Answer: "You sound very hopeless. Have you thought about hurting yourself?"
Rationale: This response validates the client's feeling (hopelessness) AND performs a direct
suicide risk assessment, which is the priority. False reassurance and blocking are
nontherapeutic, and asking "why" can put a client on the defensive.
6. A client with schizophrenia tells the nurse, "The FBI is poisoning my food." What is the most
therapeutic response?
A) "That's not true. The FBI doesn't care about you."
B) "I understand you believe that. It must be frightening. Here in the hospital, your food is safe."
C) "Let's talk about something else."
D) "Why do you think the FBI would want to poison you?"
Correct Answer: "I understand you believe that. It must be frightening. Here in the hospital,
your food is safe."
Rationale: This response acknowledges the client's feelings (validates the emotion) without
reinforcing the delusion, while also providing reality orientation and a sense of safety.
, 7. A psychiatric nurse is working with a patient who has difficulty trusting others. Based on
Erikson's stages of psychosocial development, which stage was most likely not successfully
mastered?
A) Initiative vs. Guilt
B) Trust vs. Mistrust
C) Autonomy vs. Shame and Doubt
D) Industry vs. Inferiority
Correct Answer: Trust vs. Mistrust
Rationale: The crisis of infancy (birth to 18 months) is Trust vs. Mistrust. Successful mastery
leads to a sense of trust and safety; failure results in mistrust and fear.
8. A couple celebrating 10 years of marriage and reporting they "don't give up" on each other is
in which Erikson stage?
A) Intimacy vs. Isolation
B) Generativity vs. Stagnation
C) Identity vs. Role Confusion
D) Trust vs. Mistrust
Correct Answer: Intimacy vs. Isolation
Rationale: Young adulthood (approximately 19-40 years) is associated with Erikson's stage of
Intimacy vs. Isolation, where the primary task is to form close, committed relationships.
9. According to the QSEN competencies, which action best demonstrates "Patient-Centered
Care"?
A) Using the latest evidence-based guideline to treat a patient's depression
