NUR 253 Exam 3 Mental Health Galen
College ACTUAL EXAM 2026/2027 |
Galen NUR 253 Mental Health | Verified
Q&A | Pass Guaranteed - A+ Graded
Section 1: Therapeutic Communication & Nurse-Client Relationship (10 Questions)
Q1: A 24-year-old client with borderline personality disorder looks at the nurse and says, "You're the
only nurse who understands me. The other nurses are terrible." Which is the best therapeutic response
by the nurse?
A. "I'm glad you trust me, but you need to get along with the other nurses too."
B. "That's not fair to the other nurses. They work just as hard as I do."
C. "Tell me more about what makes you feel understood here. [CORRECT]"
D. "Why do you think the other nurses don't understand you?"
Correct Answer: C
Rationale: C is correct because open-ended responses encourage the client to explore feelings without
reinforcing splitting (a defense mechanism common in BPD where people are viewed as all-good or all-
bad). The nurse maintains professional boundaries while fostering therapeutic dialogue. A is incorrect
because it prematurely confronts the splitting behavior without exploring the underlying need for
connection. B is incorrect because it defends the staff, which is nontherapeutic and escalates conflict. D
is incorrect because "why" questions can sound accusatory and put the client on the defensive.
(Varcarolis' Mental Health Nursing, Ch. 9 – Therapeutic Communication)
Q2: During a group therapy session, a client with schizophrenia states, "The government put
microphones in my teeth to record my thoughts." Which response demonstrates the best understanding
of therapeutic communication with psychotic clients?
A. "There are no microphones in your teeth. That's impossible."
B. "That must be frightening for you. Can you tell me more about what you're experiencing? [CORRECT]"
,C. "Have you talked to your doctor about these thoughts?"
D. "You know that's not true, right?"
Correct Answer: B
Rationale: B is correct because acknowledging the client's feelings without arguing about the reality of
the delusion maintains trust and reduces anxiety. Challenging delusions increases defensiveness and
damages the therapeutic alliance. A is incorrect because directly confronting delusions is nontherapeutic
and can increase agitation. C is incorrect because it deflects from the present moment and the client's
expressed distress. D is incorrect because it invalidates the client's experience and is confrontational.
(Varcarolis' Mental Health Nursing, Ch. 12 – Schizophrenia)
Q3: A nurse is caring for a client who recently lost a child. The client states, "I don't want to talk about it.
I just need to stay busy." The nurse recognizes this as which defense mechanism?
A. Sublimation
B. Denial
C. Rationalization
D. Suppression [CORRECT]
Correct Answer: D
Rationale: D is correct because suppression is a conscious, deliberate pushing away of painful thoughts
and feelings—"I don't want to talk about it" indicates awareness and conscious avoidance. A is incorrect
because subimation involves channeling unacceptable impulses into socially acceptable activities (e.g.,
running to release anger). B is incorrect because denial is unconscious refusal to acknowledge reality;
this client is aware of the loss but chooses not to discuss it. C is incorrect because rationalization
involves making excuses to justify behavior or feelings. (Varcarolis' Mental Health Nursing, Ch. 3 –
Defense Mechanisms)
Q4: A client with major depressive disorder tells the nurse, "My family would be better off without me."
The nurse notices the client has been giving away personal belongings. Which nursing action is the
priority?
A. Encourage the client to participate in group therapy
B. Place the client on one-to-one observation [CORRECT]
C. Administer PRN antidepressant medication
D. Document the statement and continue monitoring
Correct Answer: B
Rationale: B is correct because giving away possessions combined with suicidal ideation indicates high
suicide risk requiring immediate safety intervention—one-to-one observation is the priority to prevent
self-harm. A is incorrect because group therapy is inappropriate when imminent safety risk exists. C is
, incorrect because antidepressants take weeks to work and do not address immediate safety. D is
incorrect because documentation alone is insufficient when a client presents active suicidal intent with
preparatory behaviors. (Varcarolis' Mental Health Nursing, Ch. 15 – Suicide Prevention)
Q5: A nurse finds herself feeling unusually angry and frustrated with a client who reminds her of her
estranged father. The nurse recognizes this as:
A. Transference
B. Countertransference [CORRECT]
C. Boundary violation
D. Therapeutic alliance breakdown
Correct Answer: B
Rationale: B is correct because countertransference occurs when the nurse unconsciously redirects
feelings about significant others onto the client. A is incorrect because transference is when the client
redirects feelings onto the nurse. C is incorrect because while countertransference can lead to boundary
violations, the phenomenon described is the emotional reaction itself, not yet an action. D is incorrect
because the therapeutic alliance may still be intact; this is the nurse's internal reaction requiring self-
awareness. (Varcarolis' Mental Health Nursing, Ch. 9 – Nurse-Client Relationship)
Q6: A client with bipolar disorder in the manic phase is pacing the hall, speaking loudly, and interrupting
other clients. Which nursing intervention is most appropriate?
A. Confront the client about respecting others' rights
B. Provide a quiet environment with reduced stimuli and offer a physical activity [CORRECT]
C. Place the client in seclusion immediately
D. Ignore the behavior to avoid reinforcing it
Correct Answer: B
Rationale: B is correct because reducing environmental stimuli and offering appropriate physical outlets
(e.g., walking, exercise) helps channel manic energy safely while preserving dignity. A is incorrect
because confrontation during mania can escalate agitation. C is incorrect because seclusion is a last
resort for imminent danger, not for loud or disruptive behavior. D is incorrect because ignoring
escalating behavior is unsafe and neglectful. (Varcarolis' Mental Health Nursing, Ch. 14 – Bipolar
Disorder)
Q7: During a therapeutic conversation, a client pauses and says, "I don't know... I guess I'm just tired."
The nurse notices the client is twisting a tissue in their hands. Which response best uses nonverbal cue
awareness?
College ACTUAL EXAM 2026/2027 |
Galen NUR 253 Mental Health | Verified
Q&A | Pass Guaranteed - A+ Graded
Section 1: Therapeutic Communication & Nurse-Client Relationship (10 Questions)
Q1: A 24-year-old client with borderline personality disorder looks at the nurse and says, "You're the
only nurse who understands me. The other nurses are terrible." Which is the best therapeutic response
by the nurse?
A. "I'm glad you trust me, but you need to get along with the other nurses too."
B. "That's not fair to the other nurses. They work just as hard as I do."
C. "Tell me more about what makes you feel understood here. [CORRECT]"
D. "Why do you think the other nurses don't understand you?"
Correct Answer: C
Rationale: C is correct because open-ended responses encourage the client to explore feelings without
reinforcing splitting (a defense mechanism common in BPD where people are viewed as all-good or all-
bad). The nurse maintains professional boundaries while fostering therapeutic dialogue. A is incorrect
because it prematurely confronts the splitting behavior without exploring the underlying need for
connection. B is incorrect because it defends the staff, which is nontherapeutic and escalates conflict. D
is incorrect because "why" questions can sound accusatory and put the client on the defensive.
(Varcarolis' Mental Health Nursing, Ch. 9 – Therapeutic Communication)
Q2: During a group therapy session, a client with schizophrenia states, "The government put
microphones in my teeth to record my thoughts." Which response demonstrates the best understanding
of therapeutic communication with psychotic clients?
A. "There are no microphones in your teeth. That's impossible."
B. "That must be frightening for you. Can you tell me more about what you're experiencing? [CORRECT]"
,C. "Have you talked to your doctor about these thoughts?"
D. "You know that's not true, right?"
Correct Answer: B
Rationale: B is correct because acknowledging the client's feelings without arguing about the reality of
the delusion maintains trust and reduces anxiety. Challenging delusions increases defensiveness and
damages the therapeutic alliance. A is incorrect because directly confronting delusions is nontherapeutic
and can increase agitation. C is incorrect because it deflects from the present moment and the client's
expressed distress. D is incorrect because it invalidates the client's experience and is confrontational.
(Varcarolis' Mental Health Nursing, Ch. 12 – Schizophrenia)
Q3: A nurse is caring for a client who recently lost a child. The client states, "I don't want to talk about it.
I just need to stay busy." The nurse recognizes this as which defense mechanism?
A. Sublimation
B. Denial
C. Rationalization
D. Suppression [CORRECT]
Correct Answer: D
Rationale: D is correct because suppression is a conscious, deliberate pushing away of painful thoughts
and feelings—"I don't want to talk about it" indicates awareness and conscious avoidance. A is incorrect
because subimation involves channeling unacceptable impulses into socially acceptable activities (e.g.,
running to release anger). B is incorrect because denial is unconscious refusal to acknowledge reality;
this client is aware of the loss but chooses not to discuss it. C is incorrect because rationalization
involves making excuses to justify behavior or feelings. (Varcarolis' Mental Health Nursing, Ch. 3 –
Defense Mechanisms)
Q4: A client with major depressive disorder tells the nurse, "My family would be better off without me."
The nurse notices the client has been giving away personal belongings. Which nursing action is the
priority?
A. Encourage the client to participate in group therapy
B. Place the client on one-to-one observation [CORRECT]
C. Administer PRN antidepressant medication
D. Document the statement and continue monitoring
Correct Answer: B
Rationale: B is correct because giving away possessions combined with suicidal ideation indicates high
suicide risk requiring immediate safety intervention—one-to-one observation is the priority to prevent
self-harm. A is incorrect because group therapy is inappropriate when imminent safety risk exists. C is
, incorrect because antidepressants take weeks to work and do not address immediate safety. D is
incorrect because documentation alone is insufficient when a client presents active suicidal intent with
preparatory behaviors. (Varcarolis' Mental Health Nursing, Ch. 15 – Suicide Prevention)
Q5: A nurse finds herself feeling unusually angry and frustrated with a client who reminds her of her
estranged father. The nurse recognizes this as:
A. Transference
B. Countertransference [CORRECT]
C. Boundary violation
D. Therapeutic alliance breakdown
Correct Answer: B
Rationale: B is correct because countertransference occurs when the nurse unconsciously redirects
feelings about significant others onto the client. A is incorrect because transference is when the client
redirects feelings onto the nurse. C is incorrect because while countertransference can lead to boundary
violations, the phenomenon described is the emotional reaction itself, not yet an action. D is incorrect
because the therapeutic alliance may still be intact; this is the nurse's internal reaction requiring self-
awareness. (Varcarolis' Mental Health Nursing, Ch. 9 – Nurse-Client Relationship)
Q6: A client with bipolar disorder in the manic phase is pacing the hall, speaking loudly, and interrupting
other clients. Which nursing intervention is most appropriate?
A. Confront the client about respecting others' rights
B. Provide a quiet environment with reduced stimuli and offer a physical activity [CORRECT]
C. Place the client in seclusion immediately
D. Ignore the behavior to avoid reinforcing it
Correct Answer: B
Rationale: B is correct because reducing environmental stimuli and offering appropriate physical outlets
(e.g., walking, exercise) helps channel manic energy safely while preserving dignity. A is incorrect
because confrontation during mania can escalate agitation. C is incorrect because seclusion is a last
resort for imminent danger, not for loud or disruptive behavior. D is incorrect because ignoring
escalating behavior is unsafe and neglectful. (Varcarolis' Mental Health Nursing, Ch. 14 – Bipolar
Disorder)
Q7: During a therapeutic conversation, a client pauses and says, "I don't know... I guess I'm just tired."
The nurse notices the client is twisting a tissue in their hands. Which response best uses nonverbal cue
awareness?
