NUR 253 Mental Health Nursing Exams 1–4
Practice Questions and Answers PDF 2026/2027 |
Galen College of Nursing Study Guide
• This practice guide contains 200 multiple-choice questions modeled after the NUR
253 Mental Health Nursing Exams 1–4 at Galen College of Nursing, covering all
major exam topics to help you prepare thoroughly for your assessments.
• Use this material by attempting each question independently before checking the
highlighted correct answer and EXPERT RATIONALE below it — this active recall
method significantly boosts retention and exam performance.
MENTAL HEALTH NURSING — NUR 253 EXAMS 1–4 PRACTICE QUESTIONS |
GALEN COLLEGE OF NURSING | 2026/2027
1. A nurse is caring for a patient experiencing a panic attack. Which
intervention should the nurse prioritize?
A. Leave the patient alone to calm down
B. Encourage the patient to discuss the cause of anxiety
C. Stay with the patient and speak in a calm, reassuring voice
D. Administer antipsychotic medication immediately
E. Instruct the patient to perform vigorous physical activity
Correct Answer: C. Stay with the patient and speak in a calm, reassuring
voice EXPERT RATIONALE: During a panic attack, the patient needs immediate
presence and reassurance. Leaving the patient alone increases fear. Discussing causes is
not therapeutic during acute anxiety. Antipsychotics are not indicated for panic attacks.
2. Which neurotransmitter is most associated with anxiety disorders?
A. Dopamine
B. Serotonin
,C. Acetylcholine
D. GABA (gamma-aminobutyric acid)
E. Norepinephrine
Correct Answer: D. GABA (gamma-aminobutyric acid) EXPERT
RATIONALE: GABA is the primary inhibitory neurotransmitter. Low GABA activity is linked
to increased neuronal excitability, contributing to anxiety. Benzodiazepines work by
enhancing GABA activity.
3. A patient with schizophrenia tells the nurse, "The TV is sending me special
messages." This is an example of:
A. Hallucination
B. Delusion of grandeur
C. Delusion of reference
D. Thought broadcasting
E. Loose associations
Correct Answer: C. Delusion of reference EXPERT RATIONALE: A delusion of
reference is a false belief that external events or objects have special personal
significance. The patient falsely believes the TV is sending personal messages directed at
them.
4. Which of the following is a negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
E. Agitation
, Correct Answer: C. Flat affect EXPERT RATIONALE: Negative symptoms of
schizophrenia include flat affect, alogia, avolition, anhedonia, and asociality.
Hallucinations and delusions are positive symptoms. Flat affect reflects a reduction in
emotional expression.
5. A nurse is assessing a patient who reports hearing voices telling them to
harm themselves. What is the nurse's priority action?
A. Document the finding and continue assessment
B. Notify the family immediately
C. Ensure patient safety and initiate suicide precautions
D. Administer an antipsychotic PRN medication
E. Encourage the patient to ignore the voices
Correct Answer: C. Ensure patient safety and initiate suicide precautions
EXPERT RATIONALE: Safety is always the priority in nursing care. Command
hallucinations directing self-harm require immediate safety measures including 1:1
observation, removal of harmful objects, and notifying the treatment team.
6. Which therapeutic communication technique is the nurse using when they
say, "You mentioned feeling hopeless. Can you tell me more about that?"
A. Giving advice
B. Exploring
C. Summarizing
D. Offering self
E. Clarifying
Correct Answer: B. Exploring EXPERT RATIONALE: Exploring encourages the
patient to elaborate on a specific topic. The nurse invites the patient to share more
details about their feelings, deepening the therapeutic conversation.
, 7. A patient is prescribed lithium for bipolar disorder. Which lab value must
the nurse monitor closely?
A. Blood glucose
B. Serum lithium level
C. Liver enzymes
D. White blood cell count
E. Serum potassium
Correct Answer: B. Serum lithium level EXPERT RATIONALE: Lithium has a
narrow therapeutic index (0.6–1.2 mEq/L). Levels above 1.5 mEq/L indicate toxicity.
Regular monitoring is essential to ensure therapeutic effectiveness and prevent life-
threatening toxicity.
8. A patient with depression states, "Nothing will ever get better. I might as
well be dead." What is the nurse's best response?
A. "Don't say that — things will improve."
B. "Have you spoken to your doctor about this?"
C. "It sounds like you're having thoughts of suicide. Can you tell me more?"
D. "You have so much to live for."
E. "Let me get your family so they can cheer you up."
Correct Answer: C. "It sounds like you're having thoughts of suicide. Can
you tell me more?" EXPERT RATIONALE: The nurse should directly and calmly
address suicidal ideation to assess risk. Dismissing or deflecting the comment is non-
therapeutic. Direct questioning about suicide does not plant the idea and is the safest
clinical response.
Practice Questions and Answers PDF 2026/2027 |
Galen College of Nursing Study Guide
• This practice guide contains 200 multiple-choice questions modeled after the NUR
253 Mental Health Nursing Exams 1–4 at Galen College of Nursing, covering all
major exam topics to help you prepare thoroughly for your assessments.
• Use this material by attempting each question independently before checking the
highlighted correct answer and EXPERT RATIONALE below it — this active recall
method significantly boosts retention and exam performance.
MENTAL HEALTH NURSING — NUR 253 EXAMS 1–4 PRACTICE QUESTIONS |
GALEN COLLEGE OF NURSING | 2026/2027
1. A nurse is caring for a patient experiencing a panic attack. Which
intervention should the nurse prioritize?
A. Leave the patient alone to calm down
B. Encourage the patient to discuss the cause of anxiety
C. Stay with the patient and speak in a calm, reassuring voice
D. Administer antipsychotic medication immediately
E. Instruct the patient to perform vigorous physical activity
Correct Answer: C. Stay with the patient and speak in a calm, reassuring
voice EXPERT RATIONALE: During a panic attack, the patient needs immediate
presence and reassurance. Leaving the patient alone increases fear. Discussing causes is
not therapeutic during acute anxiety. Antipsychotics are not indicated for panic attacks.
2. Which neurotransmitter is most associated with anxiety disorders?
A. Dopamine
B. Serotonin
,C. Acetylcholine
D. GABA (gamma-aminobutyric acid)
E. Norepinephrine
Correct Answer: D. GABA (gamma-aminobutyric acid) EXPERT
RATIONALE: GABA is the primary inhibitory neurotransmitter. Low GABA activity is linked
to increased neuronal excitability, contributing to anxiety. Benzodiazepines work by
enhancing GABA activity.
3. A patient with schizophrenia tells the nurse, "The TV is sending me special
messages." This is an example of:
A. Hallucination
B. Delusion of grandeur
C. Delusion of reference
D. Thought broadcasting
E. Loose associations
Correct Answer: C. Delusion of reference EXPERT RATIONALE: A delusion of
reference is a false belief that external events or objects have special personal
significance. The patient falsely believes the TV is sending personal messages directed at
them.
4. Which of the following is a negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Flat affect
D. Disorganized speech
E. Agitation
, Correct Answer: C. Flat affect EXPERT RATIONALE: Negative symptoms of
schizophrenia include flat affect, alogia, avolition, anhedonia, and asociality.
Hallucinations and delusions are positive symptoms. Flat affect reflects a reduction in
emotional expression.
5. A nurse is assessing a patient who reports hearing voices telling them to
harm themselves. What is the nurse's priority action?
A. Document the finding and continue assessment
B. Notify the family immediately
C. Ensure patient safety and initiate suicide precautions
D. Administer an antipsychotic PRN medication
E. Encourage the patient to ignore the voices
Correct Answer: C. Ensure patient safety and initiate suicide precautions
EXPERT RATIONALE: Safety is always the priority in nursing care. Command
hallucinations directing self-harm require immediate safety measures including 1:1
observation, removal of harmful objects, and notifying the treatment team.
6. Which therapeutic communication technique is the nurse using when they
say, "You mentioned feeling hopeless. Can you tell me more about that?"
A. Giving advice
B. Exploring
C. Summarizing
D. Offering self
E. Clarifying
Correct Answer: B. Exploring EXPERT RATIONALE: Exploring encourages the
patient to elaborate on a specific topic. The nurse invites the patient to share more
details about their feelings, deepening the therapeutic conversation.
, 7. A patient is prescribed lithium for bipolar disorder. Which lab value must
the nurse monitor closely?
A. Blood glucose
B. Serum lithium level
C. Liver enzymes
D. White blood cell count
E. Serum potassium
Correct Answer: B. Serum lithium level EXPERT RATIONALE: Lithium has a
narrow therapeutic index (0.6–1.2 mEq/L). Levels above 1.5 mEq/L indicate toxicity.
Regular monitoring is essential to ensure therapeutic effectiveness and prevent life-
threatening toxicity.
8. A patient with depression states, "Nothing will ever get better. I might as
well be dead." What is the nurse's best response?
A. "Don't say that — things will improve."
B. "Have you spoken to your doctor about this?"
C. "It sounds like you're having thoughts of suicide. Can you tell me more?"
D. "You have so much to live for."
E. "Let me get your family so they can cheer you up."
Correct Answer: C. "It sounds like you're having thoughts of suicide. Can
you tell me more?" EXPERT RATIONALE: The nurse should directly and calmly
address suicidal ideation to assess risk. Dismissing or deflecting the comment is non-
therapeutic. Direct questioning about suicide does not plant the idea and is the safest
clinical response.
