NUR 253 Mental Health Nursing Concepts
Actual Exam Updated Questions & Answers (Verified A+ Guide)
Galen College of Nursing
Question 1
A patient diagnosed with schizophrenia says, "The CIA is putting poison in my food."
Which response by the nurse is MOST therapeutic?
A) "Why would the CIA want to poison you?"
B) "I don't see anyone poisoning your food. You are safe here."
C) "It must be frightening to think someone is trying to poison you."
D) "Let's skip lunch and just have some snacks from the vending machine."
**Answer : C) "It must be frightening to think someone is trying to poison you." **
**Rationale: ** This response uses the therapeutic technique of *reflecting feelings*. It
acknowledges the patient's emotional experience (fear) without validating the delusion
(the poison) or arguing with it. "Why" questions are non - therapeutic and demanding.
Arguing (" I don't see anyone") increases distrust. Changing the subject avoids the
issue.
---
,### Question 2
A patient with severe anxiety is pacing the hallway, breathing rapidly, and is unable to
focus on the nurse's questions. What is the nurse's PRIORITY intervention?
A) Teach the patient deep breathing relaxation techniques.
B) Ask the patient to explain what is making them anxious.
C) Move the patient to a quiet, low - stimulation environment and stay with them.
D) Administer a PRN benzodiazepine immediately.
**Answer : C) Move the patient to a quiet, low - stimulation environment and stay with
them. **
**Rationale: ** This patient is experiencing severe - to- panic level anxiety. At this level,
the patient cannot process complex instructions (like deep breathing) or Answer
"why" questions. The priority is to reduce environmental stimuli and provide a calm,
safe, non - threatening presence. Medication may be needed, but de - escalation and
environmental safety are the first nursing actions.
---
### Question 3
A nurse is caring for a patient admitted on an involuntary hold. The patient demands to
leave the hospital. Which nursing response is MOST appropriate?
A) "You cannot leave because the doctor hasn't discharged you yet."
B) "I understand you want to leave, but you are here because there are concerns about
your safety. Let's talk to your doctor about your options."
C) "If you try to leave, I will have to call security to restrain you."
D) "You are legally allowed to sign yourself out whenever you want, but I don't
recommend it."
, **Answer : B) "I understand you want to leave, but you are here because there are
concerns about your safety. Let's talk to your doctor about your options." **
**Rationale: ** Patients on involuntary holds have specific legal rights, but they cannot
just walk out. The nurse should acknowledge the patient's frustration, calmly state the
reality of the situation without arguing, and involve the treatment team. Threatening
securit y is non - therapeutic, and Option D is legally false for an involuntary hold.
---
### Question 4
A patient with a history of major depressive disorder says, "My family would be better
off if I were dead." What is the nurse's PRIORITY action?
A) Ask the pa tient if they have a specific plan to harm themselves.
B) Reassure the patient that things will get better soon.
C) Redirect the conversation to positive aspects of the patient's life.
D) Document the statement in the nurse's notes and continue the assessment later.
**Answer : A) Ask the patient if they have a specific plan to harm themselves. **
**Rationale: ** The patient has expressed passive suicidal ideation. The nursing priority
is to conduct an immediate, direct suicide risk assessment. This includes asking about
the presence of a plan, intent, means, and timeline. Reassuring the patient or
redirecting inv alidates their feelings and misses a critical safety assessment.
---
### Question 5
Which of the following is considered a "negative symptom" of schizophrenia?
A) Visual hallucinations
Actual Exam Updated Questions & Answers (Verified A+ Guide)
Galen College of Nursing
Question 1
A patient diagnosed with schizophrenia says, "The CIA is putting poison in my food."
Which response by the nurse is MOST therapeutic?
A) "Why would the CIA want to poison you?"
B) "I don't see anyone poisoning your food. You are safe here."
C) "It must be frightening to think someone is trying to poison you."
D) "Let's skip lunch and just have some snacks from the vending machine."
**Answer : C) "It must be frightening to think someone is trying to poison you." **
**Rationale: ** This response uses the therapeutic technique of *reflecting feelings*. It
acknowledges the patient's emotional experience (fear) without validating the delusion
(the poison) or arguing with it. "Why" questions are non - therapeutic and demanding.
Arguing (" I don't see anyone") increases distrust. Changing the subject avoids the
issue.
---
,### Question 2
A patient with severe anxiety is pacing the hallway, breathing rapidly, and is unable to
focus on the nurse's questions. What is the nurse's PRIORITY intervention?
A) Teach the patient deep breathing relaxation techniques.
B) Ask the patient to explain what is making them anxious.
C) Move the patient to a quiet, low - stimulation environment and stay with them.
D) Administer a PRN benzodiazepine immediately.
**Answer : C) Move the patient to a quiet, low - stimulation environment and stay with
them. **
**Rationale: ** This patient is experiencing severe - to- panic level anxiety. At this level,
the patient cannot process complex instructions (like deep breathing) or Answer
"why" questions. The priority is to reduce environmental stimuli and provide a calm,
safe, non - threatening presence. Medication may be needed, but de - escalation and
environmental safety are the first nursing actions.
---
### Question 3
A nurse is caring for a patient admitted on an involuntary hold. The patient demands to
leave the hospital. Which nursing response is MOST appropriate?
A) "You cannot leave because the doctor hasn't discharged you yet."
B) "I understand you want to leave, but you are here because there are concerns about
your safety. Let's talk to your doctor about your options."
C) "If you try to leave, I will have to call security to restrain you."
D) "You are legally allowed to sign yourself out whenever you want, but I don't
recommend it."
, **Answer : B) "I understand you want to leave, but you are here because there are
concerns about your safety. Let's talk to your doctor about your options." **
**Rationale: ** Patients on involuntary holds have specific legal rights, but they cannot
just walk out. The nurse should acknowledge the patient's frustration, calmly state the
reality of the situation without arguing, and involve the treatment team. Threatening
securit y is non - therapeutic, and Option D is legally false for an involuntary hold.
---
### Question 4
A patient with a history of major depressive disorder says, "My family would be better
off if I were dead." What is the nurse's PRIORITY action?
A) Ask the pa tient if they have a specific plan to harm themselves.
B) Reassure the patient that things will get better soon.
C) Redirect the conversation to positive aspects of the patient's life.
D) Document the statement in the nurse's notes and continue the assessment later.
**Answer : A) Ask the patient if they have a specific plan to harm themselves. **
**Rationale: ** The patient has expressed passive suicidal ideation. The nursing priority
is to conduct an immediate, direct suicide risk assessment. This includes asking about
the presence of a plan, intent, means, and timeline. Reassuring the patient or
redirecting inv alidates their feelings and misses a critical safety assessment.
---
### Question 5
Which of the following is considered a "negative symptom" of schizophrenia?
A) Visual hallucinations
