NUR 256 final Exam Mental Health
Nursing (2026) PDF | Galen College of
Nursing Questions and Ansẉers with
Expert-Verified Explanation
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
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Question 1
A nurse is caring for a client with major depressive disorder who has been
prescribed fluoxetine. Which statement by the client indicates a need for further
teaching?
A) "I should take this medication in the morning to prevent insomnia."
B) "It might take 4 to 6 weeks before I feel the full benefit."
C) "If I have a headache, I can take ibuprofen without any problem."
D) "I will report any worsening of suicidal thoughts to my provider."
Correct Answer: C
Expert Explanation: Fluoxetine is a selective serotonin reuptake inhibitor
(SSRI). SSRIs increase serotonin levels, and combining them with NSAIDs like
ibuprofen raises the risk of gastrointestinal bleeding due to platelet inhibition.
Clients should be advised to use acetaminophen instead unless otherwise
directed by a provider. Option A is correct because fluoxetine can cause
activation and insomnia, so morning dosing is recommended. Option B is
accurate—full therapeutic effect often takes several weeks. Option D reflects
proper safety monitoring because SSRIs may increase suicidality in the first few
weeks, especially in young adults. The incorrect statement (C) poses a safety
risk; therefore, it indicates need for further teaching. Galen emphasizes
medication adherence and adverse effect recognition as key components of
safe mental health nursing.
Question 2
A client with schizophrenia tells the nurse, "The FBI is using my neighbor's TV
to send poison gas into my apartment." What is the nurse’s best response?
A) "That doesn’t make sense. Why would the FBI target you?"
B) "I don’t hear the voices, but I understand you believe this is real."
C) "Let’s install a carbon monoxide detector to be safe."
,D) "You need to stop watching TV if it upsets you."
Correct Answer: B
Expert Explanation: This client is experiencing a paranoid delusion—a fixed
false belief. The therapeutic response is to acknowledge the client’s experience
without reinforcing the delusion or arguing. Option B validates the client’s
emotional reality (“I understand you believe this”) while grounding the
interaction in the nurse’s shared reality (“I don’t hear the voices”). Arguing (A)
damages trust and increases anxiety. Option C colludes with the delusion,
potentially worsening paranoia. Option D dismisses the client’s distress. Galen
teaches that de-escalation and reality orientation without confrontation are
essential for psychotic disorders. The goal is to preserve self-esteem and
redirect to safe, neutral topics.
Question 3
A nurse on a psychiatric unit hears a client say, "I’m going to kill myself tonight
after shift change." What action should the nurse take first?
A) Ask the client, "Do you have a specific plan?"
B) Place the client on one-to-one observation.
C) Notify the charge nurse and physician.
D) Remove all sharp objects from the client’s room.
Correct Answer: A
Expert Explanation: The priority nursing action for any suicidal statement is
to assess the immediate risk by asking about plan, means, and intent. Without
knowing if the client has a specific, lethal plan (e.g., pills hidden, weapon),
interventions may be insufficient. Option A directly assesses lethality. After
assessment, the nurse would then implement safety measures (B and D) and
notify the treatment team (C). However, assessment precedes action according
to the nursing process. Galen’s mental health curriculum stresses that suicide
risk assessment is a core competency—never assume the client is just seeking
attention. Even if the client denies a plan, any suicidal ideation requires
immediate intervention and notification.
Question 4
Which medication is most commonly associated with the side effect of
agranulocytosis?
A) Lithium carbonate
B) Clozapine
, C) Haloperidol
D) Fluoxetine
Correct Answer: B
Expert Explanation: Clozapine, an atypical antipsychotic used for treatment-
resistant schizophrenia, carries a black box warning for agranulocytosis—a
potentially fatal drop in neutrophils leading to severe infection risk. Clients
must have regular absolute neutrophil count (ANC) monitoring through the
REMS program. Lithium (A) is associated with nephrogenic diabetes insipidus
and thyroid dysfunction, not agranulocytosis. Haloperidol (C) can cause
extrapyramidal symptoms and tardive dyskinesia. Fluoxetine (D) may cause
serotonin syndrome or hyponatremia in older adults. Galen emphasizes that
nurses must educate clients on signs of infection (fever, sore throat) and ensure
lab compliance for those on clozapine.
Question 5
A client with bipolar I disorder is in the acute manic phase and has not slept for
three days. He is pacing, shouting, and making sexual comments to staff. What
is the priority nursing diagnosis?
A) Risk for injury related to poor judgment and hyperactivity
B) Impaired social interaction related to manic behavior
C) Disturbed thought process related to biochemical imbalance
D) Self-care deficit related to psychomotor agitation
Correct Answer: A
Expert Explanation: During acute mania, the client’s hyperactivity, poor
impulse control, and lack of sleep create high risk for physical exhaustion,
dehydration, falls, and injury to self or others. Safety is always the priority in
psychiatric nursing. While B, C, and D are also valid, they are secondary to the
immediate physiological and environmental risk. The manic client may also
have grandiose delusions leading to dangerous actions (e.g., trying to fly).
Interventions include providing a low-stimulation environment, offering fluids
and high-calorie finger foods, and administering prescribed mood stabilizers
(e.g., lithium, valproate) or antipsychotics. Galen teaches that unmet safety
needs override all other concerns in Maslow’s hierarchy.
Question 6
Nursing (2026) PDF | Galen College of
Nursing Questions and Ansẉers with
Expert-Verified Explanation
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
Question 1
A nurse is caring for a client with major depressive disorder who has been
prescribed fluoxetine. Which statement by the client indicates a need for further
teaching?
A) "I should take this medication in the morning to prevent insomnia."
B) "It might take 4 to 6 weeks before I feel the full benefit."
C) "If I have a headache, I can take ibuprofen without any problem."
D) "I will report any worsening of suicidal thoughts to my provider."
Correct Answer: C
Expert Explanation: Fluoxetine is a selective serotonin reuptake inhibitor
(SSRI). SSRIs increase serotonin levels, and combining them with NSAIDs like
ibuprofen raises the risk of gastrointestinal bleeding due to platelet inhibition.
Clients should be advised to use acetaminophen instead unless otherwise
directed by a provider. Option A is correct because fluoxetine can cause
activation and insomnia, so morning dosing is recommended. Option B is
accurate—full therapeutic effect often takes several weeks. Option D reflects
proper safety monitoring because SSRIs may increase suicidality in the first few
weeks, especially in young adults. The incorrect statement (C) poses a safety
risk; therefore, it indicates need for further teaching. Galen emphasizes
medication adherence and adverse effect recognition as key components of
safe mental health nursing.
Question 2
A client with schizophrenia tells the nurse, "The FBI is using my neighbor's TV
to send poison gas into my apartment." What is the nurse’s best response?
A) "That doesn’t make sense. Why would the FBI target you?"
B) "I don’t hear the voices, but I understand you believe this is real."
C) "Let’s install a carbon monoxide detector to be safe."
,D) "You need to stop watching TV if it upsets you."
Correct Answer: B
Expert Explanation: This client is experiencing a paranoid delusion—a fixed
false belief. The therapeutic response is to acknowledge the client’s experience
without reinforcing the delusion or arguing. Option B validates the client’s
emotional reality (“I understand you believe this”) while grounding the
interaction in the nurse’s shared reality (“I don’t hear the voices”). Arguing (A)
damages trust and increases anxiety. Option C colludes with the delusion,
potentially worsening paranoia. Option D dismisses the client’s distress. Galen
teaches that de-escalation and reality orientation without confrontation are
essential for psychotic disorders. The goal is to preserve self-esteem and
redirect to safe, neutral topics.
Question 3
A nurse on a psychiatric unit hears a client say, "I’m going to kill myself tonight
after shift change." What action should the nurse take first?
A) Ask the client, "Do you have a specific plan?"
B) Place the client on one-to-one observation.
C) Notify the charge nurse and physician.
D) Remove all sharp objects from the client’s room.
Correct Answer: A
Expert Explanation: The priority nursing action for any suicidal statement is
to assess the immediate risk by asking about plan, means, and intent. Without
knowing if the client has a specific, lethal plan (e.g., pills hidden, weapon),
interventions may be insufficient. Option A directly assesses lethality. After
assessment, the nurse would then implement safety measures (B and D) and
notify the treatment team (C). However, assessment precedes action according
to the nursing process. Galen’s mental health curriculum stresses that suicide
risk assessment is a core competency—never assume the client is just seeking
attention. Even if the client denies a plan, any suicidal ideation requires
immediate intervention and notification.
Question 4
Which medication is most commonly associated with the side effect of
agranulocytosis?
A) Lithium carbonate
B) Clozapine
, C) Haloperidol
D) Fluoxetine
Correct Answer: B
Expert Explanation: Clozapine, an atypical antipsychotic used for treatment-
resistant schizophrenia, carries a black box warning for agranulocytosis—a
potentially fatal drop in neutrophils leading to severe infection risk. Clients
must have regular absolute neutrophil count (ANC) monitoring through the
REMS program. Lithium (A) is associated with nephrogenic diabetes insipidus
and thyroid dysfunction, not agranulocytosis. Haloperidol (C) can cause
extrapyramidal symptoms and tardive dyskinesia. Fluoxetine (D) may cause
serotonin syndrome or hyponatremia in older adults. Galen emphasizes that
nurses must educate clients on signs of infection (fever, sore throat) and ensure
lab compliance for those on clozapine.
Question 5
A client with bipolar I disorder is in the acute manic phase and has not slept for
three days. He is pacing, shouting, and making sexual comments to staff. What
is the priority nursing diagnosis?
A) Risk for injury related to poor judgment and hyperactivity
B) Impaired social interaction related to manic behavior
C) Disturbed thought process related to biochemical imbalance
D) Self-care deficit related to psychomotor agitation
Correct Answer: A
Expert Explanation: During acute mania, the client’s hyperactivity, poor
impulse control, and lack of sleep create high risk for physical exhaustion,
dehydration, falls, and injury to self or others. Safety is always the priority in
psychiatric nursing. While B, C, and D are also valid, they are secondary to the
immediate physiological and environmental risk. The manic client may also
have grandiose delusions leading to dangerous actions (e.g., trying to fly).
Interventions include providing a low-stimulation environment, offering fluids
and high-calorie finger foods, and administering prescribed mood stabilizers
(e.g., lithium, valproate) or antipsychotics. Galen teaches that unmet safety
needs override all other concerns in Maslow’s hierarchy.
Question 6
