NUR 253 Exam 2: Mental Health Nursing Concepts |
2026/2027 Edition | 150 Verified Questions
NUR 253 Exam 2 Mental Health Nursing Concepts 2026-2027 QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation resource for NUR 253 Exam 2 covers essential mental health
nursing concepts, including therapeutic communication, psychopharmacology, and crisis intervention.
With 150 verified questions and answers, it provides a thorough review of key topics such as mood
disorders, anxiety disorders, and schizophrenia. Designed to align with the Galen College of Nursing
curriculum, this document ensures students are well-prepared for the exam. Each question includes
detailed rationales to reinforce learning and critical thinking.
Key Features:
Therapeutic communication techniques and the nurse-patient relationship
Psychopharmacology: antidepressants, antipsychotics, mood stabilizers, and anxiolytics
Mood disorders: major depressive disorder, bipolar disorder, and suicide assessment
Anxiety disorders: generalized anxiety, panic disorder, PTSD, and OCD
Schizophrenia spectrum disorders: positive and negative symptoms, antipsychotic management
Crisis intervention, trauma-informed care, and legal/ethical considerations
Updates for 2026:
- Updated to reflect 2026-2027 Galen College of Nursing curriculum changes
- Incorporated latest DSM-5-TR diagnostic criteria for mental health disorders
- Enhanced rationales with evidence-based practice guidelines from APA and ANA
- Added new questions on telehealth in mental health nursing
- Revised medication tables to include newest FDA-approved psychotropic drugs
Abstract:
This document serves as a definitive study guide for NUR 253 Exam 2, focusing on mental health nursing concepts
as taught at Galen College of Nursing. It comprises 150 verified questions and answers, each accompanied by
thorough rationales that explain the correct and incorrect options. The content spans therapeutic communication,
psychopharmacology, and the nursing management of major psychiatric disorders, including mood, anxiety,
psychotic, and personality disorders. Special emphasis is placed on suicide risk assessment, crisis intervention,
and legal/ethical frameworks such as HIPAA and involuntary commitment. The material is organized by content
area with corresponding question ranges and weightings, allowing students to target their study efforts effectively.
Updated for the 2026-2027 academic year, this resource aligns with the latest DSM-5-TR criteria and
evidence-based nursing practices. It is designed to promote critical thinking and clinical judgment, essential for
success on the exam and in professional practice.
Keywords:
mental health nursing, NUR 253, Galen College of Nursing, therapeutic communication, psychopharmacology,
mood disorders, anxiety disorders, schizophrenia
Answer Format:
Each question is presented with four answer options, followed by the correct answer and a detailed rationale
explaining why it is correct. Incorrect options are also addressed with explanations to clarify common
misconceptions. Rationales incorporate nursing process, pharmacology, and evidence-based guidelines.
Compliance Checklist:
Aligned with Galen College of Nursing NUR 253 course objectives
Page 1
, Based on DSM-5-TR diagnostic criteria and APA practice guidelines
Includes legal and ethical standards (HIPAA, informed consent, mandatory reporting)
Covers QSEN competencies: patient-centered care, safety, and teamwork
Updated for 2026-2027 academic year with current psychopharmacology
Verified by subject matter experts for accuracy and relevance
Content Area Overview:
Content Area Questions Key Topics Weight
Therapeutic Communication & 1-25 Active listening, empathy, boundaries, 17%
Nurse-Patient Relationship phases of therapeutic relationship,
communication barriers
Psychopharmacology 26-55 Antidepressants, antipsychotics, mood 20%
stabilizers, anxiolytics, side effects, patient
education
Mood Disorders & Suicide 56-80 Major depressive disorder, bipolar disorder, 17%
suicide risk assessment, safety planning
Anxiety, OCD, & 81-105 Generalized anxiety, panic disorder, PTSD, 17%
Trauma-Related Disorders OCD, phobias, relaxation techniques
Schizophrenia Spectrum & 106-130 Positive/negative symptoms, antipsychotic 17%
Psychotic Disorders management, extrapyramidal side effects,
nursing interventions
Crisis Intervention, 131-150 Crisis theory, de-escalation, involuntary 12%
Legal/Ethical Issues & Other commitment, HIPAA, personality disorders,
Disorders eating disorders
Page 2
,Q1. A patient diagnosed with borderline personality disorder has a history of self-harm and frequently
presents to the emergency department with suicidal ideation. The nursing team is concerned about splitting
behavior. Which nursing intervention best addresses this dynamic?
A. Assign the same nurse to the patient each shift to build consistency.
B. Encourage the patient to choose their preferred nurse daily.
C. Implement a team-based approach with consistent limit-setting across all staff.
D. Allow the patient to verbalize frustrations about staff to the charge nurse only.
Correct Answer: C. Implement a team-based approach with consistent limit-setting across all staff.
Rationale: Splitting is a defense mechanism where the patient idealizes one staff member and devalues another. A
team-based approach with consistent expectations and limits prevents manipulation and promotes therapeutic
boundaries. Assigning the same nurse may reinforce dependency, while allowing choices can exacerbate splitting.
Why Wrong:
A - Assigning the same nurse may foster dependency and does not address splitting across the team.
B - Allowing the patient to choose a preferred nurse can reinforce idealization and devaluation patterns.
D - Limiting expression to one staff member does not prevent splitting and may isolate the patient's concerns.
Reference: Townsend, M.C. (2020). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 9th Ed., Ch. 22
Q2. A patient with a history of trauma is admitted after a suicide attempt. The nurse notices the patient
becomes hypervigilant and withdrawn when a male staff member enters the room. Which approach best
demonstrates trauma-informed care?
A. Explain to the patient that the male staff member is there to help and they need to cooperate.
B. Ask the patient if they would prefer a female nurse and document the preference.
C. Proceed with care as usual, as the patient's reaction is likely due to their illness.
D. Request that the male staff member avoid the patient's room to prevent triggering.
Correct Answer: B. Ask the patient if they would prefer a female nurse and document the preference.
Rationale: Trauma-informed care emphasizes safety, choice, and collaboration. Offering a female nurse respects
the patient's autonomy and reduces re-traumatization. Forcing interaction or ignoring triggers can exacerbate
distress. Avoiding the patient entirely may not be practical and can reinforce avoidance behaviors.
Why Wrong:
A - This approach dismisses the patient's fear and may increase distress, violating trauma-informed principles.
C - Ignoring the trigger fails to address the trauma response and may worsen the patient's condition.
D - While well-intentioned, completely avoiding male staff is not always feasible and may reinforce
avoidance rather than coping.
Reference: Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Trauma-Informed
Care in Behavioral Health Services.
Q3. A patient receiving clozapine for treatment-resistant schizophrenia develops a fever of 38.9°C, sore
throat, and malaise. The nurse should prioritize which action?
A. Administer acetaminophen and encourage fluids.
B. Hold the next dose of clozapine and obtain a stat complete blood count (CBC).
C. Increase the clozapine dose to control psychotic symptoms.
D. Reassure the patient that these are common side effects that will subside.
Correct Answer: B. Hold the next dose of clozapine and obtain a stat complete blood count (CBC).
Rationale: Clozapine can cause agranulocytosis, a life-threatening drop in white blood cells. Fever and sore throat
are early signs; immediate CBC is essential. Holding the dose reduces risk until results are known. Acetaminophen
treats symptoms but does not address the underlying neutropenia.
Why Wrong:
A - Symptom management without investigation delays diagnosis of agranulocytosis.
Page 3
, C - Increasing clozapine could worsen agranulocytosis if present.
D - Reassurance without action is dangerous; these symptoms warrant urgent evaluation.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 16
Q4. A patient with major depressive disorder has been on fluoxetine 20 mg daily for 6 weeks with minimal
improvement. The patient reports feeling 'no different' and is becoming hopeless. Which nursing action is
most appropriate?
A. Increase the dose to 40 mg as per standing protocol.
B. Encourage the patient to continue the medication as it can take up to 8 weeks.
C. Document the lack of response and notify the provider for possible medication change.
D. Switch to a different SSRI immediately.
Correct Answer: C. Document the lack of response and notify the provider for possible medication change.
Rationale: After 6 weeks of therapeutic dosing, lack of response warrants reevaluation. While some
antidepressants require 8 weeks, the patient's hopelessness increases suicide risk. The nurse should advocate for a
medication review. Increasing dose without order is beyond nursing scope; immediate switching without assessment
is premature.
Why Wrong:
A - Dose adjustments must be prescribed by the provider; nurses cannot independently increase doses.
B - Waiting longer may increase suicide risk; the patient's hopelessness is a red flag.
D - Switching abruptly without provider order is unsafe and not within nursing scope.
Reference: American Psychiatric Association. (2010). Practice Guideline for the Treatment of Patients With Major
Depressive Disorder, 3rd Ed.
Q5. During a group therapy session, a patient with antisocial personality disorder becomes agitated when
confronted about manipulative behavior. The patient states, 'You're all against me, just like everyone else.'
Which therapeutic response by the nurse is most effective?
A. 'I can see you're upset. Let's take a break and talk privately.'
B. 'Your behavior is disruptive. You need to control yourself or leave the group.'
C. 'It sounds like you feel misunderstood. Can you tell us more about that?'
D. 'We are not against you. We are here to help you.'
Correct Answer: A. 'I can see you're upset. Let's take a break and talk privately.'
Rationale: Removing the patient from the group de-escalates the situation and prevents reinforcement of
manipulative behavior. Private discussion allows exploration without audience. Confrontation in group may
escalate; validating feelings without addressing manipulation may be seen as weakness. Direct contradiction may
provoke argument.
Why Wrong:
B - Publicly challenging the patient may escalate agitation and damage therapeutic rapport.
C - Encouraging elaboration of paranoid ideation in group may reinforce distortion and disrupt therapy.
D - Defensiveness ('we are not against you') may be perceived as insincere and fuel conflict.
Reference: Townsend, M.C. (2020). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 9th Ed., Ch. 22
Q6. A patient with bipolar I disorder is admitted in acute mania. The patient has not slept for 3 days, is
talking rapidly, and has grandiose delusions about being a prophet. Which nursing intervention should be
prioritized?
A. Encourage the patient to journal their thoughts to process them.
B. Provide a structured environment with minimal stimuli and frequent rest periods.
C. Engage the patient in a debate to challenge delusional beliefs.
D. Allow the patient to ambulate freely to expend excess energy.
Page 4
2026/2027 Edition | 150 Verified Questions
NUR 253 Exam 2 Mental Health Nursing Concepts 2026-2027 QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation resource for NUR 253 Exam 2 covers essential mental health
nursing concepts, including therapeutic communication, psychopharmacology, and crisis intervention.
With 150 verified questions and answers, it provides a thorough review of key topics such as mood
disorders, anxiety disorders, and schizophrenia. Designed to align with the Galen College of Nursing
curriculum, this document ensures students are well-prepared for the exam. Each question includes
detailed rationales to reinforce learning and critical thinking.
Key Features:
Therapeutic communication techniques and the nurse-patient relationship
Psychopharmacology: antidepressants, antipsychotics, mood stabilizers, and anxiolytics
Mood disorders: major depressive disorder, bipolar disorder, and suicide assessment
Anxiety disorders: generalized anxiety, panic disorder, PTSD, and OCD
Schizophrenia spectrum disorders: positive and negative symptoms, antipsychotic management
Crisis intervention, trauma-informed care, and legal/ethical considerations
Updates for 2026:
- Updated to reflect 2026-2027 Galen College of Nursing curriculum changes
- Incorporated latest DSM-5-TR diagnostic criteria for mental health disorders
- Enhanced rationales with evidence-based practice guidelines from APA and ANA
- Added new questions on telehealth in mental health nursing
- Revised medication tables to include newest FDA-approved psychotropic drugs
Abstract:
This document serves as a definitive study guide for NUR 253 Exam 2, focusing on mental health nursing concepts
as taught at Galen College of Nursing. It comprises 150 verified questions and answers, each accompanied by
thorough rationales that explain the correct and incorrect options. The content spans therapeutic communication,
psychopharmacology, and the nursing management of major psychiatric disorders, including mood, anxiety,
psychotic, and personality disorders. Special emphasis is placed on suicide risk assessment, crisis intervention,
and legal/ethical frameworks such as HIPAA and involuntary commitment. The material is organized by content
area with corresponding question ranges and weightings, allowing students to target their study efforts effectively.
Updated for the 2026-2027 academic year, this resource aligns with the latest DSM-5-TR criteria and
evidence-based nursing practices. It is designed to promote critical thinking and clinical judgment, essential for
success on the exam and in professional practice.
Keywords:
mental health nursing, NUR 253, Galen College of Nursing, therapeutic communication, psychopharmacology,
mood disorders, anxiety disorders, schizophrenia
Answer Format:
Each question is presented with four answer options, followed by the correct answer and a detailed rationale
explaining why it is correct. Incorrect options are also addressed with explanations to clarify common
misconceptions. Rationales incorporate nursing process, pharmacology, and evidence-based guidelines.
Compliance Checklist:
Aligned with Galen College of Nursing NUR 253 course objectives
Page 1
, Based on DSM-5-TR diagnostic criteria and APA practice guidelines
Includes legal and ethical standards (HIPAA, informed consent, mandatory reporting)
Covers QSEN competencies: patient-centered care, safety, and teamwork
Updated for 2026-2027 academic year with current psychopharmacology
Verified by subject matter experts for accuracy and relevance
Content Area Overview:
Content Area Questions Key Topics Weight
Therapeutic Communication & 1-25 Active listening, empathy, boundaries, 17%
Nurse-Patient Relationship phases of therapeutic relationship,
communication barriers
Psychopharmacology 26-55 Antidepressants, antipsychotics, mood 20%
stabilizers, anxiolytics, side effects, patient
education
Mood Disorders & Suicide 56-80 Major depressive disorder, bipolar disorder, 17%
suicide risk assessment, safety planning
Anxiety, OCD, & 81-105 Generalized anxiety, panic disorder, PTSD, 17%
Trauma-Related Disorders OCD, phobias, relaxation techniques
Schizophrenia Spectrum & 106-130 Positive/negative symptoms, antipsychotic 17%
Psychotic Disorders management, extrapyramidal side effects,
nursing interventions
Crisis Intervention, 131-150 Crisis theory, de-escalation, involuntary 12%
Legal/Ethical Issues & Other commitment, HIPAA, personality disorders,
Disorders eating disorders
Page 2
,Q1. A patient diagnosed with borderline personality disorder has a history of self-harm and frequently
presents to the emergency department with suicidal ideation. The nursing team is concerned about splitting
behavior. Which nursing intervention best addresses this dynamic?
A. Assign the same nurse to the patient each shift to build consistency.
B. Encourage the patient to choose their preferred nurse daily.
C. Implement a team-based approach with consistent limit-setting across all staff.
D. Allow the patient to verbalize frustrations about staff to the charge nurse only.
Correct Answer: C. Implement a team-based approach with consistent limit-setting across all staff.
Rationale: Splitting is a defense mechanism where the patient idealizes one staff member and devalues another. A
team-based approach with consistent expectations and limits prevents manipulation and promotes therapeutic
boundaries. Assigning the same nurse may reinforce dependency, while allowing choices can exacerbate splitting.
Why Wrong:
A - Assigning the same nurse may foster dependency and does not address splitting across the team.
B - Allowing the patient to choose a preferred nurse can reinforce idealization and devaluation patterns.
D - Limiting expression to one staff member does not prevent splitting and may isolate the patient's concerns.
Reference: Townsend, M.C. (2020). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 9th Ed., Ch. 22
Q2. A patient with a history of trauma is admitted after a suicide attempt. The nurse notices the patient
becomes hypervigilant and withdrawn when a male staff member enters the room. Which approach best
demonstrates trauma-informed care?
A. Explain to the patient that the male staff member is there to help and they need to cooperate.
B. Ask the patient if they would prefer a female nurse and document the preference.
C. Proceed with care as usual, as the patient's reaction is likely due to their illness.
D. Request that the male staff member avoid the patient's room to prevent triggering.
Correct Answer: B. Ask the patient if they would prefer a female nurse and document the preference.
Rationale: Trauma-informed care emphasizes safety, choice, and collaboration. Offering a female nurse respects
the patient's autonomy and reduces re-traumatization. Forcing interaction or ignoring triggers can exacerbate
distress. Avoiding the patient entirely may not be practical and can reinforce avoidance behaviors.
Why Wrong:
A - This approach dismisses the patient's fear and may increase distress, violating trauma-informed principles.
C - Ignoring the trigger fails to address the trauma response and may worsen the patient's condition.
D - While well-intentioned, completely avoiding male staff is not always feasible and may reinforce
avoidance rather than coping.
Reference: Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Trauma-Informed
Care in Behavioral Health Services.
Q3. A patient receiving clozapine for treatment-resistant schizophrenia develops a fever of 38.9°C, sore
throat, and malaise. The nurse should prioritize which action?
A. Administer acetaminophen and encourage fluids.
B. Hold the next dose of clozapine and obtain a stat complete blood count (CBC).
C. Increase the clozapine dose to control psychotic symptoms.
D. Reassure the patient that these are common side effects that will subside.
Correct Answer: B. Hold the next dose of clozapine and obtain a stat complete blood count (CBC).
Rationale: Clozapine can cause agranulocytosis, a life-threatening drop in white blood cells. Fever and sore throat
are early signs; immediate CBC is essential. Holding the dose reduces risk until results are known. Acetaminophen
treats symptoms but does not address the underlying neutropenia.
Why Wrong:
A - Symptom management without investigation delays diagnosis of agranulocytosis.
Page 3
, C - Increasing clozapine could worsen agranulocytosis if present.
D - Reassurance without action is dangerous; these symptoms warrant urgent evaluation.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 16
Q4. A patient with major depressive disorder has been on fluoxetine 20 mg daily for 6 weeks with minimal
improvement. The patient reports feeling 'no different' and is becoming hopeless. Which nursing action is
most appropriate?
A. Increase the dose to 40 mg as per standing protocol.
B. Encourage the patient to continue the medication as it can take up to 8 weeks.
C. Document the lack of response and notify the provider for possible medication change.
D. Switch to a different SSRI immediately.
Correct Answer: C. Document the lack of response and notify the provider for possible medication change.
Rationale: After 6 weeks of therapeutic dosing, lack of response warrants reevaluation. While some
antidepressants require 8 weeks, the patient's hopelessness increases suicide risk. The nurse should advocate for a
medication review. Increasing dose without order is beyond nursing scope; immediate switching without assessment
is premature.
Why Wrong:
A - Dose adjustments must be prescribed by the provider; nurses cannot independently increase doses.
B - Waiting longer may increase suicide risk; the patient's hopelessness is a red flag.
D - Switching abruptly without provider order is unsafe and not within nursing scope.
Reference: American Psychiatric Association. (2010). Practice Guideline for the Treatment of Patients With Major
Depressive Disorder, 3rd Ed.
Q5. During a group therapy session, a patient with antisocial personality disorder becomes agitated when
confronted about manipulative behavior. The patient states, 'You're all against me, just like everyone else.'
Which therapeutic response by the nurse is most effective?
A. 'I can see you're upset. Let's take a break and talk privately.'
B. 'Your behavior is disruptive. You need to control yourself or leave the group.'
C. 'It sounds like you feel misunderstood. Can you tell us more about that?'
D. 'We are not against you. We are here to help you.'
Correct Answer: A. 'I can see you're upset. Let's take a break and talk privately.'
Rationale: Removing the patient from the group de-escalates the situation and prevents reinforcement of
manipulative behavior. Private discussion allows exploration without audience. Confrontation in group may
escalate; validating feelings without addressing manipulation may be seen as weakness. Direct contradiction may
provoke argument.
Why Wrong:
B - Publicly challenging the patient may escalate agitation and damage therapeutic rapport.
C - Encouraging elaboration of paranoid ideation in group may reinforce distortion and disrupt therapy.
D - Defensiveness ('we are not against you') may be perceived as insincere and fuel conflict.
Reference: Townsend, M.C. (2020). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based
Practice, 9th Ed., Ch. 22
Q6. A patient with bipolar I disorder is admitted in acute mania. The patient has not slept for 3 days, is
talking rapidly, and has grandiose delusions about being a prophet. Which nursing intervention should be
prioritized?
A. Encourage the patient to journal their thoughts to process them.
B. Provide a structured environment with minimal stimuli and frequent rest periods.
C. Engage the patient in a debate to challenge delusional beliefs.
D. Allow the patient to ambulate freely to expend excess energy.
Page 4
