NUR 253 Exam 4: Concepts of Mental Health Nursing -
Galen College of Nursing
1. A client is experiencing a crisis following the unexpected loss of their job. Which type of crisis is this client
experiencing?
A. Situational crisis
B. Maturational crisis
C. Adventitious crisis
D. Internal crisis
Correct Answer: A
Rationale: A situational crisis arises from external sources that are often unanticipated, such as a job loss
or death of a loved one. Maturational crises are related to developmental milestones like marriage or
retirement. Adventitious crises result from natural disasters or crimes of violence. Understanding the
type of crisis helps the nurse tailor specific intervention strategies. The nurse must assess the client’s
perception of the event to provide effective care.
2. When assessing a client for suicide risk, which of the following methods is considered most lethal?
A. Overdosing on aspirin
B. Cutting wrists
C. Inhaling natural gas
D. Using a firearm
Correct Answer: D
Rationale: A firearm is considered a highly lethal method because it allows for little to no time for
intervention once the action is taken. High-lethality methods also include hanging and jumping from high
,places. Lower-lethality methods include wrist cutting or ingesting pills where discovery is possible.
Assessing the lethality of a plan is a critical component of a comprehensive suicide risk assessment. The
nurse must prioritize safety based on the severity of the client’s intended method.
3. During the orientation phase of the nurse-patient relationship, what is the primary focus?
A. Evaluating progress toward goals
B. Promoting the client’s problem-solving skills
C. Establishing rapport and a contract
D. Discussing the nurse’s personal experiences
Correct Answer: C
Rationale: The orientation phase is the initial meeting where trust and rapport are built between the
nurse and the client. During this time, the nurse establishes the parameters of the relationship, including
the time and place of meetings. This phase involves defining the roles and responsibilities of both parties
to ensure professional boundaries. It is also when the termination date is first discussed to manage
expectations. Establishing a formal or informal contract is essential for setting the therapeutic
foundation.
4. A nurse is caring for a client who is in the third phase of a crisis. What is the characteristic of this phase?
A. The client uses trial-and-error to solve the problem.
B. The client’s tension escalates to a state of severe anxiety or panic.
C. The client experiences panic and internal discomfort.
D. The client experiences a rise in tension that triggers a defense response.
Correct Answer: B
, Rationale: Phase 3 of a crisis occurs when trial-and-error attempts fail and tension escalates to severe
anxiety or panic levels. During this phase, the individual may resort to withdrawal or flight to cope with
the overwhelming stress. The nurse should observe for signs of compromise in the client’s ability to
function. This phase often precedes the final phase of total breakdown if resolution is not found. Prompt
intervention is necessary to prevent further emotional deterioration.
5. Which statement by the nurse demonstrates the therapeutic communication technique of ‘restating’?
A. ‘I will stay here with you for a while.’
B. ‘Tell me more about your family.’
C. ‘You say that you are feeling overwhelmed by your work.’
D. ‘I think you should try to sleep now.’
Correct Answer: C
Rationale: Restating involves repeating the main idea expressed by the client to confirm understanding.
This technique allows the client to know they are being heard and provides an opportunity for
clarification. It differs from reflecting, which focuses more on the emotional content of the message.
Restating should be used sparingly to avoid appearing repetitive or insincere. It is an effective tool for
validating the client’s experience during a crisis.
6. A client with a history of depression tells the nurse, ‘I don’t see any point in living anymore.’ What is the
nurse’s priority action?
A. Document the statement and check back in an hour.
B. Tell the client that everything will be okay.
C. Ask the client, ‘Do you have a specific plan to harm yourself?’
D. Remind the client of their family and support system.
Galen College of Nursing
1. A client is experiencing a crisis following the unexpected loss of their job. Which type of crisis is this client
experiencing?
A. Situational crisis
B. Maturational crisis
C. Adventitious crisis
D. Internal crisis
Correct Answer: A
Rationale: A situational crisis arises from external sources that are often unanticipated, such as a job loss
or death of a loved one. Maturational crises are related to developmental milestones like marriage or
retirement. Adventitious crises result from natural disasters or crimes of violence. Understanding the
type of crisis helps the nurse tailor specific intervention strategies. The nurse must assess the client’s
perception of the event to provide effective care.
2. When assessing a client for suicide risk, which of the following methods is considered most lethal?
A. Overdosing on aspirin
B. Cutting wrists
C. Inhaling natural gas
D. Using a firearm
Correct Answer: D
Rationale: A firearm is considered a highly lethal method because it allows for little to no time for
intervention once the action is taken. High-lethality methods also include hanging and jumping from high
,places. Lower-lethality methods include wrist cutting or ingesting pills where discovery is possible.
Assessing the lethality of a plan is a critical component of a comprehensive suicide risk assessment. The
nurse must prioritize safety based on the severity of the client’s intended method.
3. During the orientation phase of the nurse-patient relationship, what is the primary focus?
A. Evaluating progress toward goals
B. Promoting the client’s problem-solving skills
C. Establishing rapport and a contract
D. Discussing the nurse’s personal experiences
Correct Answer: C
Rationale: The orientation phase is the initial meeting where trust and rapport are built between the
nurse and the client. During this time, the nurse establishes the parameters of the relationship, including
the time and place of meetings. This phase involves defining the roles and responsibilities of both parties
to ensure professional boundaries. It is also when the termination date is first discussed to manage
expectations. Establishing a formal or informal contract is essential for setting the therapeutic
foundation.
4. A nurse is caring for a client who is in the third phase of a crisis. What is the characteristic of this phase?
A. The client uses trial-and-error to solve the problem.
B. The client’s tension escalates to a state of severe anxiety or panic.
C. The client experiences panic and internal discomfort.
D. The client experiences a rise in tension that triggers a defense response.
Correct Answer: B
, Rationale: Phase 3 of a crisis occurs when trial-and-error attempts fail and tension escalates to severe
anxiety or panic levels. During this phase, the individual may resort to withdrawal or flight to cope with
the overwhelming stress. The nurse should observe for signs of compromise in the client’s ability to
function. This phase often precedes the final phase of total breakdown if resolution is not found. Prompt
intervention is necessary to prevent further emotional deterioration.
5. Which statement by the nurse demonstrates the therapeutic communication technique of ‘restating’?
A. ‘I will stay here with you for a while.’
B. ‘Tell me more about your family.’
C. ‘You say that you are feeling overwhelmed by your work.’
D. ‘I think you should try to sleep now.’
Correct Answer: C
Rationale: Restating involves repeating the main idea expressed by the client to confirm understanding.
This technique allows the client to know they are being heard and provides an opportunity for
clarification. It differs from reflecting, which focuses more on the emotional content of the message.
Restating should be used sparingly to avoid appearing repetitive or insincere. It is an effective tool for
validating the client’s experience during a crisis.
6. A client with a history of depression tells the nurse, ‘I don’t see any point in living anymore.’ What is the
nurse’s priority action?
A. Document the statement and check back in an hour.
B. Tell the client that everything will be okay.
C. Ask the client, ‘Do you have a specific plan to harm yourself?’
D. Remind the client of their family and support system.
