NUR 256/ NUR256 Exam 4 –
Concepts of Mental Health
Nursing Guide | Galen (Latest
2026/ 2027 Update) 100%
Verified Questions & Answers |
Grade A
=======================================================================
=
========
PART A – MULTIPLE CHOICE (Q1-60)
========================================================================
========
* *Q1 (Crisis intervention – definition of crisis):**
A crisis is BEST defined as:
A) A chronic mental illness that requires long-term psychiatric hospitalization
B) A temporary state of psychological disequilibrium in which an individual's usual coping
mechanisms are overwhelmed by a perceived threat
C) A permanent personality change resulting from traumatic life events
D) A medical emergency requiring immediate pharmacological intervention
* *[CORRECT]** B
*Rationale: A crisis is defined as a temporary state of psychological disequilibrium where an
individual's usual coping mechanisms are overwhelmed by a perceived threat, according to
Roberts' crisis intervention model. Option A is incorrect because crisis is temporary, not chronic.
Option C is incorrect because crisis does not cause permanent personality changes. Option D is
incorrect because while some crises may require medication, the definition of crisis is
psychological, not medical.*
* *Q2 (Crisis intervention – phases of crisis):**
According to Roberts' Seven-Stage Crisis Intervention Model, which of the following is the
FIRST step?
, ) Establish rapport and develop a therapeutic relationship
A
B) Conduct a comprehensive biopsychosocial assessment
C) Identify precipitating events and major problems
D) Explore feelings and emotions
* *[CORRECT]** A
*Rationale: Roberts' Seven-Stage Crisis Intervention Model begins with Stage 1: Plan and
conduct a crisis and biopsychosocial assessment, which includes establishing rapport and
developing a therapeutic relationship. Option B is part of the assessment but rapport comes
first. Option C is Stage 2. Option D is Stage 3. Clinical pearl: Without rapport, the patient will not
engage in the assessment or intervention process.*
* *Q3 (Crisis intervention – Roberts' model):**
In Roberts' Seven-Stage Crisis Intervention Model, Stage 4 involves:
A) Exploring alternatives and partializing problems
B) Restoring cognitive functioning through implementation of an action plan
C) Conducting a lethality assessment
D) Making appropriate referrals
* *[CORRECT]** A
*Rationale: Stage 4 of Roberts' model involves exploring feelings and emotions, exploring
alternatives, and partializing problems. Option B describes Stage 5 (restoring cognitive
functioning). Option C is part of Stage 1 assessment. Option D is Stage 7. Clinical pearl:
Partializing problems helps the patient feel less overwhelmed by breaking the crisis into
manageable components.*
* *Q4 (Disaster mental health – psychological first aid):**
Which of the following is a CORE action of Psychological First Aid (PFA) according to the
NCTSN/NCPTSD model?
A) Conducting formal psychological debriefing immediately after a disaster
B) Contact and engagement, safety and comfort, stabilization, information gathering, practical
assistance, connection with social supports, and information on coping
C) Administering psychotropic medications to all disaster survivors
D) Requiring survivors to discuss their traumatic experiences in group settings
* *[CORRECT]** B
*Rationale: The eight core actions of PFA are: contact and engagement, safety and comfort,
stabilization, information gathering, practical assistance, connection with social supports,
information on coping, and linkage with collaborative services. Option A is incorrect because
formal debriefing is no longer recommended. Option C is incorrect because medication is not a
core PFA action. Option D is incorrect because forcing disclosure can cause re-traumatization.*
* *Q5 (Disaster mental health – CISD):**
Regarding Critical Incident Stress Debriefing (CISD), the nurse understands that:
, ) CISD should be conducted within 24-72 hours after a critical incident for all exposed
A
individuals
B) CISD is universally recommended as the gold standard for disaster mental health response
C) Current evidence suggests CISD may cause harm for some individuals and should not be
mandatory
D) CISD replaces the need for ongoing mental health services after a disaster
* *[CORRECT]** C
*Rationale: Current evidence, including Cochrane reviews and APA guidelines, suggests that
mandatory CISD may cause harm for some individuals and is not universally recommended.
Option A describes the traditional timing but ignores current evidence. Option B is incorrect as
CISD is no longer considered a gold standard. Option D is incorrect because CISD does not
replace ongoing services. Clinical pearl: PFA has largely replaced CISD as the preferred
immediate intervention.*
* *Q6 (Suicide prevention – risk assessment):**
When using the Columbia Suicide Severity Rating Scale (C-SSRS), which of the following
indicates the HIGHEST level of risk?
A) Passive suicidal ideation without a plan
B) Active suicidal ideation with a specific plan but no intent
C) Active suicidal ideation with specific plan, intent, and access to means
D) History of previous suicide attempt with no current ideation
* *[CORRECT]** C
*Rationale: The C-SSRS assesses severity along a continuum, with active ideation, specific
plan, intent, and access to means representing the highest risk category. Option A represents
lower risk. Option B has a plan but lacks intent. Option D indicates historical risk but no current
acute risk. Clinical pearl: Always assess means restriction when intent and plan are present.*
* *Q7 (Suicide prevention – SAFE-T):**
The SAFE-T (Suicide Assessment Five-Step Evaluation and Triage) model includes all of the
following EXCEPT:
A) Identify risk factors
B) Identify protective factors
C) Conduct a full MMSE (Mini-Mental State Examination)
D) Determine risk level and appropriate interventions
* *[CORRECT]** C
*Rationale: The SAFE-T model includes: Step 1 – Identify risk factors, Step 2 – Identify
protective factors, Step 3 – Conduct an inquiry about suicidal thoughts/behaviors, Step 4 –
Determine risk level, and Step 5 – Document and develop a treatment plan. A full MMSE is not
part of the SAFE-T protocol. Options A, B, and D are all components of SAFE-T.*
**Q8 (Suicide prevention – protective factors):**
, hich of the following is a PROTECTIVE factor against suicide?
W
A) Access to lethal means
B) Strong therapeutic alliance with mental health providers
C) History of multiple suicide attempts
D) Chronic substance use disorder
* *[CORRECT]** B
*Rationale: Strong therapeutic alliance is a well-established protective factor against suicide.
Option A is a risk factor. Option C is a significant risk factor. Option D increases suicide risk.
Clinical pearl: Protective factors include social support, religious/spiritual beliefs, children in the
home, and effective mental health treatment.*
* *Q9 (Suicide prevention – safety planning):**
The Safety Planning Intervention (SPI) developed by Stanley and Brown includes how many
steps?
A) 3 steps
B) 5 steps
C) 6 steps
D) 8 steps
* *[CORRECT]** C
*Rationale: The Safety Planning Intervention includes 6 steps: (1) Warning signs recognition, (2)
Internal coping strategies, (3) Social distraction and social support, (4) Family members or
friends who may offer help, (5) Professionals and agencies to contact during a crisis, and (6)
Making the environment safe (means restriction). Clinical pearl: SPI is collaborative and written
in the patient's own words.*
* *Q10 (Suicide prevention – means restriction):**
A 22-year-old patient with major depressive disorder and active suicidal ideation is being
discharged. The nurse's PRIORITY intervention regarding means restriction is to:
A) Ask the patient to sign a no-suicide contract
B) Collaborate with the patient and family to remove or secure lethal means, especially firearms
and medications
C) Schedule weekly outpatient therapy appointments
D) Provide a list of crisis hotline numbers
* *[CORRECT]** B
*Rationale: Means restriction is the most evidence-based intervention for reducing suicide risk,
particularly removing or securing firearms and medications. No-suicide contracts (Option A) are
not evidence-based and may provide false security. Options C and D are important but
secondary to immediate safety. Clinical pearl: Firearms are the most common method of
completed suicide in the US.*
**Q11 (Suicide prevention – postvention):**
Concepts of Mental Health
Nursing Guide | Galen (Latest
2026/ 2027 Update) 100%
Verified Questions & Answers |
Grade A
=======================================================================
=
========
PART A – MULTIPLE CHOICE (Q1-60)
========================================================================
========
* *Q1 (Crisis intervention – definition of crisis):**
A crisis is BEST defined as:
A) A chronic mental illness that requires long-term psychiatric hospitalization
B) A temporary state of psychological disequilibrium in which an individual's usual coping
mechanisms are overwhelmed by a perceived threat
C) A permanent personality change resulting from traumatic life events
D) A medical emergency requiring immediate pharmacological intervention
* *[CORRECT]** B
*Rationale: A crisis is defined as a temporary state of psychological disequilibrium where an
individual's usual coping mechanisms are overwhelmed by a perceived threat, according to
Roberts' crisis intervention model. Option A is incorrect because crisis is temporary, not chronic.
Option C is incorrect because crisis does not cause permanent personality changes. Option D is
incorrect because while some crises may require medication, the definition of crisis is
psychological, not medical.*
* *Q2 (Crisis intervention – phases of crisis):**
According to Roberts' Seven-Stage Crisis Intervention Model, which of the following is the
FIRST step?
, ) Establish rapport and develop a therapeutic relationship
A
B) Conduct a comprehensive biopsychosocial assessment
C) Identify precipitating events and major problems
D) Explore feelings and emotions
* *[CORRECT]** A
*Rationale: Roberts' Seven-Stage Crisis Intervention Model begins with Stage 1: Plan and
conduct a crisis and biopsychosocial assessment, which includes establishing rapport and
developing a therapeutic relationship. Option B is part of the assessment but rapport comes
first. Option C is Stage 2. Option D is Stage 3. Clinical pearl: Without rapport, the patient will not
engage in the assessment or intervention process.*
* *Q3 (Crisis intervention – Roberts' model):**
In Roberts' Seven-Stage Crisis Intervention Model, Stage 4 involves:
A) Exploring alternatives and partializing problems
B) Restoring cognitive functioning through implementation of an action plan
C) Conducting a lethality assessment
D) Making appropriate referrals
* *[CORRECT]** A
*Rationale: Stage 4 of Roberts' model involves exploring feelings and emotions, exploring
alternatives, and partializing problems. Option B describes Stage 5 (restoring cognitive
functioning). Option C is part of Stage 1 assessment. Option D is Stage 7. Clinical pearl:
Partializing problems helps the patient feel less overwhelmed by breaking the crisis into
manageable components.*
* *Q4 (Disaster mental health – psychological first aid):**
Which of the following is a CORE action of Psychological First Aid (PFA) according to the
NCTSN/NCPTSD model?
A) Conducting formal psychological debriefing immediately after a disaster
B) Contact and engagement, safety and comfort, stabilization, information gathering, practical
assistance, connection with social supports, and information on coping
C) Administering psychotropic medications to all disaster survivors
D) Requiring survivors to discuss their traumatic experiences in group settings
* *[CORRECT]** B
*Rationale: The eight core actions of PFA are: contact and engagement, safety and comfort,
stabilization, information gathering, practical assistance, connection with social supports,
information on coping, and linkage with collaborative services. Option A is incorrect because
formal debriefing is no longer recommended. Option C is incorrect because medication is not a
core PFA action. Option D is incorrect because forcing disclosure can cause re-traumatization.*
* *Q5 (Disaster mental health – CISD):**
Regarding Critical Incident Stress Debriefing (CISD), the nurse understands that:
, ) CISD should be conducted within 24-72 hours after a critical incident for all exposed
A
individuals
B) CISD is universally recommended as the gold standard for disaster mental health response
C) Current evidence suggests CISD may cause harm for some individuals and should not be
mandatory
D) CISD replaces the need for ongoing mental health services after a disaster
* *[CORRECT]** C
*Rationale: Current evidence, including Cochrane reviews and APA guidelines, suggests that
mandatory CISD may cause harm for some individuals and is not universally recommended.
Option A describes the traditional timing but ignores current evidence. Option B is incorrect as
CISD is no longer considered a gold standard. Option D is incorrect because CISD does not
replace ongoing services. Clinical pearl: PFA has largely replaced CISD as the preferred
immediate intervention.*
* *Q6 (Suicide prevention – risk assessment):**
When using the Columbia Suicide Severity Rating Scale (C-SSRS), which of the following
indicates the HIGHEST level of risk?
A) Passive suicidal ideation without a plan
B) Active suicidal ideation with a specific plan but no intent
C) Active suicidal ideation with specific plan, intent, and access to means
D) History of previous suicide attempt with no current ideation
* *[CORRECT]** C
*Rationale: The C-SSRS assesses severity along a continuum, with active ideation, specific
plan, intent, and access to means representing the highest risk category. Option A represents
lower risk. Option B has a plan but lacks intent. Option D indicates historical risk but no current
acute risk. Clinical pearl: Always assess means restriction when intent and plan are present.*
* *Q7 (Suicide prevention – SAFE-T):**
The SAFE-T (Suicide Assessment Five-Step Evaluation and Triage) model includes all of the
following EXCEPT:
A) Identify risk factors
B) Identify protective factors
C) Conduct a full MMSE (Mini-Mental State Examination)
D) Determine risk level and appropriate interventions
* *[CORRECT]** C
*Rationale: The SAFE-T model includes: Step 1 – Identify risk factors, Step 2 – Identify
protective factors, Step 3 – Conduct an inquiry about suicidal thoughts/behaviors, Step 4 –
Determine risk level, and Step 5 – Document and develop a treatment plan. A full MMSE is not
part of the SAFE-T protocol. Options A, B, and D are all components of SAFE-T.*
**Q8 (Suicide prevention – protective factors):**
, hich of the following is a PROTECTIVE factor against suicide?
W
A) Access to lethal means
B) Strong therapeutic alliance with mental health providers
C) History of multiple suicide attempts
D) Chronic substance use disorder
* *[CORRECT]** B
*Rationale: Strong therapeutic alliance is a well-established protective factor against suicide.
Option A is a risk factor. Option C is a significant risk factor. Option D increases suicide risk.
Clinical pearl: Protective factors include social support, religious/spiritual beliefs, children in the
home, and effective mental health treatment.*
* *Q9 (Suicide prevention – safety planning):**
The Safety Planning Intervention (SPI) developed by Stanley and Brown includes how many
steps?
A) 3 steps
B) 5 steps
C) 6 steps
D) 8 steps
* *[CORRECT]** C
*Rationale: The Safety Planning Intervention includes 6 steps: (1) Warning signs recognition, (2)
Internal coping strategies, (3) Social distraction and social support, (4) Family members or
friends who may offer help, (5) Professionals and agencies to contact during a crisis, and (6)
Making the environment safe (means restriction). Clinical pearl: SPI is collaborative and written
in the patient's own words.*
* *Q10 (Suicide prevention – means restriction):**
A 22-year-old patient with major depressive disorder and active suicidal ideation is being
discharged. The nurse's PRIORITY intervention regarding means restriction is to:
A) Ask the patient to sign a no-suicide contract
B) Collaborate with the patient and family to remove or secure lethal means, especially firearms
and medications
C) Schedule weekly outpatient therapy appointments
D) Provide a list of crisis hotline numbers
* *[CORRECT]** B
*Rationale: Means restriction is the most evidence-based intervention for reducing suicide risk,
particularly removing or securing firearms and medications. No-suicide contracts (Option A) are
not evidence-based and may provide false security. Options C and D are important but
secondary to immediate safety. Clinical pearl: Firearms are the most common method of
completed suicide in the US.*
**Q11 (Suicide prevention – postvention):**
