NUR 253 Exam 1: Concepts of Mental Health Nursing -
Galen College of Nursing Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is sitting with a client who is crying after receiving a diagnosis of a terminal illness. Which action
by the nurse demonstrates the therapeutic technique of ‘offering self’?
A. Leaving the room to give the client privacy to express emotions.
B. Asking the client to explain why they are feeling so upset.
C. Telling the client that everything will be alright eventually.
D. Staying with the client and sitting in silence for a period of time.
Correct Answer: D
Rationale: Offering self is a technique where the nurse makes their presence available to the client. This
shows interest and a desire to understand the client’s experience without making demands. Sitting in
silence provides support without forcing the client to talk before they are ready. It is a non-verbal way of
communicating that the nurse is there for the patient. Unlike ‘why’ questions, this approach fosters a safe
environment for the expression of feelings.
2. A client is admitted to the psychiatric unit involuntarily because they are a danger to themselves. Which
right does this client still retain despite the involuntary status?
A. The right to leave the hospital at any time against medical advice.
B. The right to share a room with a person of their choosing.
C. The right to possess dangerous items in their personal locker.
D. The right to refuse psychotropic medications unless an emergency exists.
Correct Answer: D
,Rationale: Involuntary admission does not automatically result in the loss of the right to refuse
treatment. Patients retain the right to refuse medication except in emergency situations where they are
an immediate threat to self or others. Informed consent is still required for most procedures and
medications in the psychiatric setting. The nurse must document the refusal and notify the treatment
team while maintaining a safe environment. This protection ensures that civil liberties are maintained
even during psychiatric crises.
3. During a mental status examination (MSE), the nurse asks the client to explain the meaning of the phrase
‘don’t cry over spilled milk.’ What is the nurse assessing?
A. Memory
B. Orientation
C. Abstract thinking
D. Attention span
Correct Answer: C
Rationale: Abstract thinking is the ability to interpret information that is not literal, such as proverbs or
metaphors. If a client interprets the phrase literally by talking about actual milk, it indicates concrete
thinking. This assessment helps the nurse understand the client’s cognitive processing and intellectual
functioning. Concrete thinking is often seen in conditions like schizophrenia or organic brain disorders.
Evaluating this component is a standard part of a comprehensive mental status exam.
4. Which ethical principle is the nurse following when they ensure that resources and care are distributed
fairly among all clients on the unit?
A. Veracity
B. Justice
,C. Autonomy
D. Fidelity
Correct Answer: B
Rationale: Justice refers to the duty to treat all individuals fairly and equally regardless of their
background. In nursing, this means providing the same standard of care to every patient regardless of
their diagnosis or behavior. Veracity involves telling the truth, while autonomy respects the patient’s
right to choose. Fidelity relates to being faithful to commitments and promises made to the patient.
Practicing justice ensures that no single patient receives preferential treatment over others in the clinical
setting.
5. A client tells the nurse, ‘I don’t think I can handle this anymore. I have a plan to end it all tonight.’ What is
the nurse’s priority action?
A. Document the statement in the medical record for the next shift.
B. Encourage the client to go to their room and rest for a while.
C. Initiate one-on-one constant observation for the client’s safety.
D. Administer an as-needed (PRN) anti-anxiety medication immediately.
Correct Answer: C
Rationale: Safety is the highest priority in mental health nursing when a client expresses active suicidal
ideation with a plan. One-on-one observation ensures that the client is never left alone and the nurse can
intervene immediately if self-harm is attempted. Documentation is necessary but comes after the
immediate physical safety of the client is secured. Encouraging rest or isolation is dangerous because it
provides the client the opportunity to act on their plan. Protecting the client from harm is the
fundamental responsibility of the psychiatric nurse.
, 6. The nurse is using therapeutic communication with a client and says, ‘You say you’re feeling angry, but
you’re smiling.’ Which technique is the nurse utilizing?
A. Confronting
B. Exploring
C. Restating
D. Giving recognition
Correct Answer: A
Rationale: Confronting involves pointing out discrepancies in the client’s behavior, verbalizations, or
non-verbal cues. This technique is used to help the client recognize inconsistencies in their own
communication. It should be done in a non-judgmental and supportive manner to facilitate self-
awareness. Restating would simply involve repeating the client’s words back to them. By highlighting the
mismatch between emotion and expression, the nurse encourages deeper exploration of the client’s true
feelings.
7. Which phase of the nurse-client relationship involves establishing boundaries, identifying client needs,
and setting goals?
A. Orientation phase
B. Working phase
C. Pre-interaction phase
D. Termination phase
Correct Answer: A
Rationale: The orientation phase is the initial meeting where the nurse and client get to know each
other. During this phase, the nurse sets the contract, establishes rapport, and identifies the reason for
Galen College of Nursing Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is sitting with a client who is crying after receiving a diagnosis of a terminal illness. Which action
by the nurse demonstrates the therapeutic technique of ‘offering self’?
A. Leaving the room to give the client privacy to express emotions.
B. Asking the client to explain why they are feeling so upset.
C. Telling the client that everything will be alright eventually.
D. Staying with the client and sitting in silence for a period of time.
Correct Answer: D
Rationale: Offering self is a technique where the nurse makes their presence available to the client. This
shows interest and a desire to understand the client’s experience without making demands. Sitting in
silence provides support without forcing the client to talk before they are ready. It is a non-verbal way of
communicating that the nurse is there for the patient. Unlike ‘why’ questions, this approach fosters a safe
environment for the expression of feelings.
2. A client is admitted to the psychiatric unit involuntarily because they are a danger to themselves. Which
right does this client still retain despite the involuntary status?
A. The right to leave the hospital at any time against medical advice.
B. The right to share a room with a person of their choosing.
C. The right to possess dangerous items in their personal locker.
D. The right to refuse psychotropic medications unless an emergency exists.
Correct Answer: D
,Rationale: Involuntary admission does not automatically result in the loss of the right to refuse
treatment. Patients retain the right to refuse medication except in emergency situations where they are
an immediate threat to self or others. Informed consent is still required for most procedures and
medications in the psychiatric setting. The nurse must document the refusal and notify the treatment
team while maintaining a safe environment. This protection ensures that civil liberties are maintained
even during psychiatric crises.
3. During a mental status examination (MSE), the nurse asks the client to explain the meaning of the phrase
‘don’t cry over spilled milk.’ What is the nurse assessing?
A. Memory
B. Orientation
C. Abstract thinking
D. Attention span
Correct Answer: C
Rationale: Abstract thinking is the ability to interpret information that is not literal, such as proverbs or
metaphors. If a client interprets the phrase literally by talking about actual milk, it indicates concrete
thinking. This assessment helps the nurse understand the client’s cognitive processing and intellectual
functioning. Concrete thinking is often seen in conditions like schizophrenia or organic brain disorders.
Evaluating this component is a standard part of a comprehensive mental status exam.
4. Which ethical principle is the nurse following when they ensure that resources and care are distributed
fairly among all clients on the unit?
A. Veracity
B. Justice
,C. Autonomy
D. Fidelity
Correct Answer: B
Rationale: Justice refers to the duty to treat all individuals fairly and equally regardless of their
background. In nursing, this means providing the same standard of care to every patient regardless of
their diagnosis or behavior. Veracity involves telling the truth, while autonomy respects the patient’s
right to choose. Fidelity relates to being faithful to commitments and promises made to the patient.
Practicing justice ensures that no single patient receives preferential treatment over others in the clinical
setting.
5. A client tells the nurse, ‘I don’t think I can handle this anymore. I have a plan to end it all tonight.’ What is
the nurse’s priority action?
A. Document the statement in the medical record for the next shift.
B. Encourage the client to go to their room and rest for a while.
C. Initiate one-on-one constant observation for the client’s safety.
D. Administer an as-needed (PRN) anti-anxiety medication immediately.
Correct Answer: C
Rationale: Safety is the highest priority in mental health nursing when a client expresses active suicidal
ideation with a plan. One-on-one observation ensures that the client is never left alone and the nurse can
intervene immediately if self-harm is attempted. Documentation is necessary but comes after the
immediate physical safety of the client is secured. Encouraging rest or isolation is dangerous because it
provides the client the opportunity to act on their plan. Protecting the client from harm is the
fundamental responsibility of the psychiatric nurse.
, 6. The nurse is using therapeutic communication with a client and says, ‘You say you’re feeling angry, but
you’re smiling.’ Which technique is the nurse utilizing?
A. Confronting
B. Exploring
C. Restating
D. Giving recognition
Correct Answer: A
Rationale: Confronting involves pointing out discrepancies in the client’s behavior, verbalizations, or
non-verbal cues. This technique is used to help the client recognize inconsistencies in their own
communication. It should be done in a non-judgmental and supportive manner to facilitate self-
awareness. Restating would simply involve repeating the client’s words back to them. By highlighting the
mismatch between emotion and expression, the nurse encourages deeper exploration of the client’s true
feelings.
7. Which phase of the nurse-client relationship involves establishing boundaries, identifying client needs,
and setting goals?
A. Orientation phase
B. Working phase
C. Pre-interaction phase
D. Termination phase
Correct Answer: A
Rationale: The orientation phase is the initial meeting where the nurse and client get to know each
other. During this phase, the nurse sets the contract, establishes rapport, and identifies the reason for
