Galen NSG 3450 Exam 2 | Nursing Practice – Mental Health
(2026) Actual Q&A PDF
1. A nurse is preparing to assess a patient's spiritual beliefs. Which question is most appropriate
for the initial spiritual assessment?
A) "What is your religious affiliation?"
B) "What role does spirituality play in your daily life?"
C) "Do you attend church regularly?"
D) "Would you like to speak with a chaplain?"
Correct Answer: "What role does spirituality play in your daily life?"
Rationale: This open-ended question invites the patient to describe the personal significance of
spirituality, which is the initial focus of a spiritual assessment. Asking about religious affiliation
or church attendance is more structured and may not capture the full scope of spiritual beliefs,
while offering a chaplain assumes a need before it is assessed.
2. A nursing student asks the nurse what the goal of the orientation phase of the nurse-patient
relationship is. What is the best response by the nurse?
A) "To explore self-perceptions and promote change."
B) "To establish trust and formulate a contract."
C) "To evaluate goal attainment and plan for discharge."
D) "To gather information from the patient's family."
Correct Answer: "To establish trust and formulate a contract."
Rationale: The orientation (introductory) phase of the nurse-patient relationship focuses on
establishing trust, setting goals, and defining the parameters of the relationship. Exploring self-
,perceptions and promoting change occur in the working phase, and evaluating goal attainment
occurs in the termination phase.
3. A patient with a history of childhood trauma tells the nurse, "You remind me of my mother. I
feel so safe when you are here." The nurse recognizes this statement as which phenomenon?
A) Countertransference
B) Transference
C) Reality testing
D) Therapeutic alliance
Correct Answer: Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings and attitudes
from a significant person in their past onto the nurse. Countertransference is the nurse's
emotional reaction to the patient. Reality testing distinguishes internal from external reality,
and the therapeutic alliance is the collaborative relationship between nurse and patient.
4. Which nursing intervention is most appropriate to establish trust with a patient who is
experiencing concrete thinking?
A) Using complex medical terminology to explain procedures
B) Being consistent in adhering to unit guidelines and policies
C) Sharing personal experiences to build rapport
D) Using idioms and metaphors to explain concepts
Correct Answer: Being consistent in adhering to unit guidelines and policies
Rationale: For patients with concrete thinking, consistency and predictability are essential to
build trust. Using complex language or idioms can confuse the patient, and sharing personal
,experiences is not a primary trust-building strategy. Clear, consistent communication and follow-
through on promises are key.
5. A nurse is caring for a patient who is exhibiting signs of moderate anxiety. Which assessment
finding is most consistent with this level of anxiety?
A) Mild muscle tension and occasional stomach-ache
B) Anxious most of the day with changes in sleep and appetite
C) Chest tightness, sensory overload, and inability to focus
D) Panic attacks, inability to function, and obsessive thoughts
Correct Answer: Anxious most of the day with changes in sleep and appetite
Rationale: Moderate anxiety is characterized by anxiety most of the day, changes in sleep and
appetite, difficulty concentrating, avoidance behaviors, headaches, and fatigue. Mild anxiety
involves muscle tension and stomach-ache. Severe anxiety involves chest tightness and sensory
overload, while panic-level anxiety involves panic attacks and obsessive thoughts.
6. A patient experiencing a severe anxiety attack reports feeling breathless and having chest
tightness. What is the nurse's priority action?
A) Administer a PRN benzodiazepine immediately
B) Leave the patient alone to calm down
C) Stay with the patient and use calming techniques
D) Encourage the patient to hyperventilate to release tension
Correct Answer: Stay with the patient and use calming techniques
Rationale: During a severe anxiety attack, the nurse's priority is to remain with the patient,
provide reassurance, and use calming techniques such as deep breathing exercises. Leaving the
, patient alone can increase anxiety, and medication may be used but is not the immediate
priority.
7. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement
by the patient indicates a correct understanding of this medication?
A) "I can take this medication as needed for anxiety attacks."
B) "I will feel the effects of this medication immediately."
C) "This medication may take several weeks to become effective."
D) "I should avoid drinking grapefruit juice while taking this medication."
Correct Answer: "This medication may take several weeks to become effective."
Rationale: Buspirone is a non-benzodiazepine anxiolytic that takes several weeks (typically 2-4
weeks) to reach therapeutic effect. It is not a PRN medication for acute anxiety. Grapefruit juice
interactions are more commonly associated with benzodiazepines and other medications.
8. Which statement is an example of a therapeutic communication technique?
A) "Why did you do that?"
B) "Tell me more about how you are feeling."
C) "You will be fine."
D) "I know exactly how you feel."
Correct Answer: "Tell me more about how you are feeling."
Rationale: This statement uses an open-ended question to encourage the patient to express
their feelings, which is a therapeutic communication technique. Asking "why" can make the
patient defensive, false reassurance ("You will be fine") and assuming you know how the patient
feels ("I know exactly how you feel") are nontherapeutic.
(2026) Actual Q&A PDF
1. A nurse is preparing to assess a patient's spiritual beliefs. Which question is most appropriate
for the initial spiritual assessment?
A) "What is your religious affiliation?"
B) "What role does spirituality play in your daily life?"
C) "Do you attend church regularly?"
D) "Would you like to speak with a chaplain?"
Correct Answer: "What role does spirituality play in your daily life?"
Rationale: This open-ended question invites the patient to describe the personal significance of
spirituality, which is the initial focus of a spiritual assessment. Asking about religious affiliation
or church attendance is more structured and may not capture the full scope of spiritual beliefs,
while offering a chaplain assumes a need before it is assessed.
2. A nursing student asks the nurse what the goal of the orientation phase of the nurse-patient
relationship is. What is the best response by the nurse?
A) "To explore self-perceptions and promote change."
B) "To establish trust and formulate a contract."
C) "To evaluate goal attainment and plan for discharge."
D) "To gather information from the patient's family."
Correct Answer: "To establish trust and formulate a contract."
Rationale: The orientation (introductory) phase of the nurse-patient relationship focuses on
establishing trust, setting goals, and defining the parameters of the relationship. Exploring self-
,perceptions and promoting change occur in the working phase, and evaluating goal attainment
occurs in the termination phase.
3. A patient with a history of childhood trauma tells the nurse, "You remind me of my mother. I
feel so safe when you are here." The nurse recognizes this statement as which phenomenon?
A) Countertransference
B) Transference
C) Reality testing
D) Therapeutic alliance
Correct Answer: Transference
Rationale: Transference occurs when a patient unconsciously redirects feelings and attitudes
from a significant person in their past onto the nurse. Countertransference is the nurse's
emotional reaction to the patient. Reality testing distinguishes internal from external reality,
and the therapeutic alliance is the collaborative relationship between nurse and patient.
4. Which nursing intervention is most appropriate to establish trust with a patient who is
experiencing concrete thinking?
A) Using complex medical terminology to explain procedures
B) Being consistent in adhering to unit guidelines and policies
C) Sharing personal experiences to build rapport
D) Using idioms and metaphors to explain concepts
Correct Answer: Being consistent in adhering to unit guidelines and policies
Rationale: For patients with concrete thinking, consistency and predictability are essential to
build trust. Using complex language or idioms can confuse the patient, and sharing personal
,experiences is not a primary trust-building strategy. Clear, consistent communication and follow-
through on promises are key.
5. A nurse is caring for a patient who is exhibiting signs of moderate anxiety. Which assessment
finding is most consistent with this level of anxiety?
A) Mild muscle tension and occasional stomach-ache
B) Anxious most of the day with changes in sleep and appetite
C) Chest tightness, sensory overload, and inability to focus
D) Panic attacks, inability to function, and obsessive thoughts
Correct Answer: Anxious most of the day with changes in sleep and appetite
Rationale: Moderate anxiety is characterized by anxiety most of the day, changes in sleep and
appetite, difficulty concentrating, avoidance behaviors, headaches, and fatigue. Mild anxiety
involves muscle tension and stomach-ache. Severe anxiety involves chest tightness and sensory
overload, while panic-level anxiety involves panic attacks and obsessive thoughts.
6. A patient experiencing a severe anxiety attack reports feeling breathless and having chest
tightness. What is the nurse's priority action?
A) Administer a PRN benzodiazepine immediately
B) Leave the patient alone to calm down
C) Stay with the patient and use calming techniques
D) Encourage the patient to hyperventilate to release tension
Correct Answer: Stay with the patient and use calming techniques
Rationale: During a severe anxiety attack, the nurse's priority is to remain with the patient,
provide reassurance, and use calming techniques such as deep breathing exercises. Leaving the
, patient alone can increase anxiety, and medication may be used but is not the immediate
priority.
7. A patient with generalized anxiety disorder (GAD) is prescribed buspirone. Which statement
by the patient indicates a correct understanding of this medication?
A) "I can take this medication as needed for anxiety attacks."
B) "I will feel the effects of this medication immediately."
C) "This medication may take several weeks to become effective."
D) "I should avoid drinking grapefruit juice while taking this medication."
Correct Answer: "This medication may take several weeks to become effective."
Rationale: Buspirone is a non-benzodiazepine anxiolytic that takes several weeks (typically 2-4
weeks) to reach therapeutic effect. It is not a PRN medication for acute anxiety. Grapefruit juice
interactions are more commonly associated with benzodiazepines and other medications.
8. Which statement is an example of a therapeutic communication technique?
A) "Why did you do that?"
B) "Tell me more about how you are feeling."
C) "You will be fine."
D) "I know exactly how you feel."
Correct Answer: "Tell me more about how you are feeling."
Rationale: This statement uses an open-ended question to encourage the patient to express
their feelings, which is a therapeutic communication technique. Asking "why" can make the
patient defensive, false reassurance ("You will be fine") and assuming you know how the patient
feels ("I know exactly how you feel") are nontherapeutic.
