HESI FUNDAMENTAL REAL EXAM the purpose of therapeutic interaction - ANSWER-to allow the client to autonomy to make choices when appropriate. keep statements value-free, advice fr...
hesi fundamental real exam 2022 202 hesi fundamental re hesi fundamental real exam 2022 202 al exam 2022 202 hesi fundament hesi fundamental real exam 2022 2023 al real exam 2022
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HESI FUNDAMENTAL REAL EXAM 2022-
2023
the purpose of therapeutic interaction - ANSWER-to allow the client to autonomy to make choices when
appropriate. keep statements value-free, advice free, and reassurance-free
what action should the nurse take in a psychiatric situation when the client describes a physical
problem? - ANSWER-assess. example: if a client has schizophrenia complains of chest pain take their
blood pressure
nausea is a common complaint after ECT - ANSWER-vomiting by an unconscious can lead to aspiration.
maintain a paten airway
common physiological responses to anxiety - ANSWER-increased heart rate, and blood pressure, rapid
shallow respirations, dry mouth, tight feeling in throat, tremors, muscle twitching, anorexia, urinary
frequency, palmar sweating
nurse-client anxiety - ANSWER-anxiety is contagious, nurse needs to asses on anxiety level and remain
calm. it helps gain control, decrease anxiety, and increase feelings of security
desensitization - ANSWER-is the nursing intervention for phobia disorders. --assess client to recognize
the factors associated with feared stimuli.
-teach and practice with client alternative coping strategies
-expose client to feared stimuli
-provide positive reinforcement
,the nurse should place an anxious client where there are reduced environmental stimuli - ANSWER-quiet
area of the unit away from the nurse's station
the best time for interaction with a client is at the completion of the performed ritual - ANSWER-the
client's anxiety is lowest at this time and its an optimal time for learning
compulsive acts are used in response to anxiety, which may or may not be related to the obsession. its
the nurse's responsibility help alleviate anxiety - ANSWER-its the nurse's responsibility help alleviate
anxiety, interfering will increase the anxiety
as long as the client's acts are free of violence: nurse should.... - ANSWER--actively listen to the clients
obsessive themes
-acknowledge the effects that ritualistic acts have on the client
-demonstrate empathy
-avoid being judgmental
ford clients with PTSD, the nurse should.... - ANSWER--actively listen to client's stories of experiences
surrounding the traumatic event
-assess suicide risk
-assist client to develop objectivity about the event and problem solve regarding possible means of
controlling anxiety related to the event
-encourage group therapy with other clients who have experienced the same traumatic event
be aware of your own feelings when dealing with this somatoform clients. - ANSWER-the pain is real to
the person experiencing it
theses disorders cannot be explained medically, it results from internal conflict. the nurse should... -
ANSWER--acknowledge the symptom or complaint
-reaffirm that diagnostic test results reveal no organic pathology
,-determine the secondary gains acquired by the client
avoid giving clients with dissociative disorders too much information about past events at one time -
ANSWER-the various types of amnestic that accompany dissociative disorders provide protection from
pain and too much to soon can cause decompensation
personality disorders are long standing behavioral traits that are maladaptive responses to anxiety and
that cause difficulty in relating to and working with other individuals - ANSWER-persons with personality
disorders are usually comfortable with their disorders and believe that they are right and the world is
wrong and have little motivation
people with anorexia gain pleasure from providing others with food and watching them eat - ANSWER-
these behaviors reinforce their perception of self-control. don not allow these clients to plan or prepare
food for unit-based activities
individuals with Bulimia often use syrup of ipecac to induce vomiting. if ipecac is not vomited and is
absorbed, cardiotoxicity may occur and cause conduction disturbances, cardiac dysrhythmias, fatal
myocarditis, and circulatory failure - ANSWER-because heart failure is not usually seen in this age group,
it is often overlooked. assess for edema and listen to breath sounds
physical assessment and nutritional support are a priority, the physiological implication are great.
nursing interventions should increase self-esteem and develop a positive body image. - ANSWER-family
therapy is most effective because issues of control are common in these (eating disorders.) therapy is
usually long term
the most important s/s of depression are a depressed mood with a loss of interest in the pleasures in life
- ANSWER-the client has a sustained loss
s/s of depression - ANSWER--significant change in appetite
-insomnia
-fatigue or lack of energy
, -feelings of hopelessness
-loss of ability to concentrate
-preoccupation with death or suicide
depressed clients have difficulty hearing and accepting compliments because of their lowered self-
concept - ANSWER-comment on signs of improvement by noting behavior
the nurse knows depressed clients are improving when they - ANSWER-begin to take an interest in their
appearance or begin to perform self-care activities
the nurse should suspect an imminent suicide attempt if a depressed client becomes "better" -
ANSWER-be aware a happy affect may signify the the client feels relieved that a plan has been made and
is prepared for the suicide attempt
when dealing with a depressed client the nurse should assist with personal hygiene tasks and encourage
the client to initiate grooming activities even when they dont feel like doing so - ANSWER-this helps to
promote self-esteem and a sense of control
nursing intervention for depressed client - ANSWER-sit quietly with the client, offering your support with
your presence
side effects of antianxiety drugs - ANSWER-sedation, drowsiness
s/e of antidepressants drugs - ANSWER-anticholinergic effects, postural hypotension
s/e MAO inhibitors - ANSWER-hypertensive crisis
lithium requires renal function assessment and monitoring - ANSWER-phenothiazines cause EPS (tardic
dyskinesia can be permanent)
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