NUR 253 Exam 2: Concepts of Mental Health Nursing -
Galen College of Nursing Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is caring for a client experiencing a severe panic attack. Which of the following nursing
interventions is the priority?
A. Instruct the client to practice deep breathing exercises.
B. Stay with the client and remain quiet and calm.
C. Encourage the client to discuss the cause of the panic.
D. Administer an as-needed dose of a stimulant medication.
Correct Answer: B
Rationale: During a severe panic attack, the nurse’s presence provides a sense of safety and security to
the client. The nurse should remain with the client to ensure their immediate physical safety. Using a
calm and quiet voice helps to lower the environmental stimuli that may worsen anxiety. Instruction on
complex techniques should be avoided as the client cannot process information during this level of
anxiety. The goal is to reduce the immediate physiological and psychological distress of the panic state.
2. A client with Bipolar I disorder is in the manic phase and is moving rapidly around the unit. Which of the
following snacks is most appropriate for this client?
A. A bowl of hot chicken noodle soup
B. An apple and a turkey sandwich wrap
C. A cup of yogurt with a spoon
D. Spaghetti and meatballs with a side salad
Correct Answer: B
,Rationale: Clients in a manic state are often too hyperactive to sit down for a full, structured meal.
Providing high-calorie finger foods allows the client to eat while on the move and maintain necessary
nutrition. An apple and a wrap are easy to carry and require no utensils, making them ideal for this phase.
The nurse must prioritize caloric intake to prevent physical exhaustion and weight loss during mania.
This intervention supports the client’s physiological needs while accommodating their current behavioral
symptoms.
3. A client is prescribed Lithium Carbonate for the management of Bipolar Disorder. Which laboratory value
should the nurse report to the provider immediately?
A. Serum lithium level of 0.8 mEq/L
B. Serum lithium level of 1.2 mEq/L
C. Serum sodium level of 128 mEq/L
D. White blood cell count of 8,000/mm3
Correct Answer: C
Rationale: Lithium is a salt and is handled by the kidneys in a manner similar to sodium. Low sodium
levels, such as 128 mEq/L, can lead to lithium retention and increased risk of toxicity. The therapeutic
range for lithium is generally between 0.6 and 1.2 mEq/L, so those values are normal. Hyponatremia is a
critical finding because it directly affects how the body excretes this specific medication. The nurse must
monitor electrolyte balance closely to ensure the client remains within a safe therapeutic window.
4. A nurse is assessing a client with Borderline Personality Disorder. Which of the following behaviors
should the nurse expect?
A. Extreme perfectionism and preoccupation with order
B. Lack of remorse for hurting others and law-breaking
, C. Emotional instability and splitting of staff members
D. Social withdrawal due to a fear of being criticized
Correct Answer: C
Rationale: Borderline Personality Disorder is characterized by instability in interpersonal relationships
and self-image. Splitting is a common defense mechanism where the client views others as all good or all
bad. This behavior often leads to conflict within the healthcare team if not managed with consistent
boundaries. Clients with this disorder also experience intense moods and a significant fear of
abandonment. Understanding these patterns allows the nurse to implement a structured and consistent
care plan.
5. A client has been taking Fluoxetine (an SSRI) for three weeks. Which statement by the client indicates a
need for further teaching?
A. I might feel a bit drowsy or have some dry mouth at first.
B. I will stop taking the medication immediately if I feel better.
C. It may take another week or two to feel the full effect of the drug.
D. I should call my doctor if I have thoughts about hurting myself.
Correct Answer: B
Rationale: Antidepressants like Fluoxetine should never be stopped abruptly because it can lead to
discontinuation syndrome. Clients must be taught that these medications require several weeks to reach
full therapeutic effectiveness in the body. Stopping the medication once symptoms improve can lead to a
rapid relapse of the depressive disorder. The nurse should emphasize the importance of tapering the
dose under medical supervision if a change is needed. Sustained adherence is critical for the long-term
management of mood disorders.
Galen College of Nursing Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is caring for a client experiencing a severe panic attack. Which of the following nursing
interventions is the priority?
A. Instruct the client to practice deep breathing exercises.
B. Stay with the client and remain quiet and calm.
C. Encourage the client to discuss the cause of the panic.
D. Administer an as-needed dose of a stimulant medication.
Correct Answer: B
Rationale: During a severe panic attack, the nurse’s presence provides a sense of safety and security to
the client. The nurse should remain with the client to ensure their immediate physical safety. Using a
calm and quiet voice helps to lower the environmental stimuli that may worsen anxiety. Instruction on
complex techniques should be avoided as the client cannot process information during this level of
anxiety. The goal is to reduce the immediate physiological and psychological distress of the panic state.
2. A client with Bipolar I disorder is in the manic phase and is moving rapidly around the unit. Which of the
following snacks is most appropriate for this client?
A. A bowl of hot chicken noodle soup
B. An apple and a turkey sandwich wrap
C. A cup of yogurt with a spoon
D. Spaghetti and meatballs with a side salad
Correct Answer: B
,Rationale: Clients in a manic state are often too hyperactive to sit down for a full, structured meal.
Providing high-calorie finger foods allows the client to eat while on the move and maintain necessary
nutrition. An apple and a wrap are easy to carry and require no utensils, making them ideal for this phase.
The nurse must prioritize caloric intake to prevent physical exhaustion and weight loss during mania.
This intervention supports the client’s physiological needs while accommodating their current behavioral
symptoms.
3. A client is prescribed Lithium Carbonate for the management of Bipolar Disorder. Which laboratory value
should the nurse report to the provider immediately?
A. Serum lithium level of 0.8 mEq/L
B. Serum lithium level of 1.2 mEq/L
C. Serum sodium level of 128 mEq/L
D. White blood cell count of 8,000/mm3
Correct Answer: C
Rationale: Lithium is a salt and is handled by the kidneys in a manner similar to sodium. Low sodium
levels, such as 128 mEq/L, can lead to lithium retention and increased risk of toxicity. The therapeutic
range for lithium is generally between 0.6 and 1.2 mEq/L, so those values are normal. Hyponatremia is a
critical finding because it directly affects how the body excretes this specific medication. The nurse must
monitor electrolyte balance closely to ensure the client remains within a safe therapeutic window.
4. A nurse is assessing a client with Borderline Personality Disorder. Which of the following behaviors
should the nurse expect?
A. Extreme perfectionism and preoccupation with order
B. Lack of remorse for hurting others and law-breaking
, C. Emotional instability and splitting of staff members
D. Social withdrawal due to a fear of being criticized
Correct Answer: C
Rationale: Borderline Personality Disorder is characterized by instability in interpersonal relationships
and self-image. Splitting is a common defense mechanism where the client views others as all good or all
bad. This behavior often leads to conflict within the healthcare team if not managed with consistent
boundaries. Clients with this disorder also experience intense moods and a significant fear of
abandonment. Understanding these patterns allows the nurse to implement a structured and consistent
care plan.
5. A client has been taking Fluoxetine (an SSRI) for three weeks. Which statement by the client indicates a
need for further teaching?
A. I might feel a bit drowsy or have some dry mouth at first.
B. I will stop taking the medication immediately if I feel better.
C. It may take another week or two to feel the full effect of the drug.
D. I should call my doctor if I have thoughts about hurting myself.
Correct Answer: B
Rationale: Antidepressants like Fluoxetine should never be stopped abruptly because it can lead to
discontinuation syndrome. Clients must be taught that these medications require several weeks to reach
full therapeutic effectiveness in the body. Stopping the medication once symptoms improve can lead to a
rapid relapse of the depressive disorder. The nurse should emphasize the importance of tapering the
dose under medical supervision if a change is needed. Sustained adherence is critical for the long-term
management of mood disorders.
