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HESI CAT EXAM 2023 | HESI Computerized Adaptive Testing (CAT) Test Bank With Rationales A nurse is counseling the spouse of a client who has a history of alcohol abuse. What does the nurse explain is the main reason for drinking alcohol in people with a long history of alcohol abuse? 1 They ar...

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  • 19 januari 2024
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HESI CAT EXAM 2023 | HESI Computerized Adaptive
Testing (CAT) Test Bank With Rationales
A nurse is counseling the spouse of a client who has a history of alcohol abuse.
What does the nurse explain is the main reason for drinking alcohol in people with a
long history of alcohol abuse?
1
They are dependent on it.
2
They lack the motivation to stop.
3
They use it for coping.
4
They enjoy the associated socialization. Correct Ans:- 1
Alcohol causes both physical and psychological dependence; the individual needs
the alcohol to function. Alcoholism is a disorder that entails physical and
psychological dependence. Because alcohol is so physiologically addictive, the
client's body craves the alcohol, so most clients lack the motivation to stop because
they will go into withdrawal. Clients who abuse alcohol have numbed their ability to
utilize other coping mechanisms, so alcohol is used as an excuse for coping. People
with alcoholism usually drink alone or feel alone in a crowd; socialization is not the
prime reason for their drinking.

How do adolescents establish family identity during psychosocial development?
Select all that apply.
1
By acting independently to make his or her own decisions
2
By evaluating his or her own health with a feeling of well-being
3
By fostering his or her own development within a balanced family structure
4
By building close peer relationships to achieve acceptance in the society
5
By achieving marked physical changes Correct Ans:- 13
An adolescent establishes family identity by acting independently for taking
important decisions about self. They also need to foster their development along
with maintaining a balanced family structure. Health identity is associated with the
evaluation of one's own health with a feeling of well-being. By building close peer
relationships, an adolescent develops a sense of belonging, approval, and the
opportunity to learn acceptable behavior. These actions establish an adolescent's
group identity. The sound and healthy growth of the adolescent, with marked
physical changes, helps to build an adolescent's sexual identity.

A clinic nurse observes a 2-year-old client sitting alone, rocking and staring at a
small, shiny top that she is spinning. Later the father relates his concerns, stating,
"She pushes me away. She doesn't speak, and she only shows feelings when I take
her top away. Is it something I've done?" What is the most therapeutic initial
response by the nurse?

,1
Asking the father about his relationship with his wife
2
Asking the father how he held the child when she was an infant
3
Telling the father that it is nothing he has done and sharing the nurse's
observations of the child
4
Telling the father not to be concerned and stressing that the child will outgrow this
developmental phase Correct Ans:- 3
The nurse provides support in a nonjudgmental way by sharing information and
observations about the child. This child exhibits symptoms of autism, which is not
attributable to the actions of the parents. Asking the father about his relationship
with his wife or how he held the child when she was an infant indirectly indicates
that the parent may be at fault; it negates the father's need for support and
increases his sense of guilt. Telling the father not to be concerned and stressing
that the child will outgrow this developmental phase is false reassurance that does
not provide support; the father recognizes that something is wrong.

What is most appropriate for a nurse to say when interviewing a newly admitted
depressed client whose thoughts are focused on feelings of worthlessness and
failure?
1
"Tell me how you feel about yourself."
2
"Tell me what has been bothering you."
3
"Why do you feel so bad about yourself?"
4
"What can we do to help you while you're here?" Correct Ans:- 1
Because major depression is a result of the client's feelings of self-rejection, it is
important for the nurse to have the client initially identify these feelings before
developing a plan of care. Later discussion should be focused on other topics to
prevent reinforcement of negative thoughts and feelings. "Tell me what has been
bothering you" is asking the client to draw a conclusion; the client may be unable to
do so at this time. Also, depression may be related not to external events but
instead to a client's psychobiology. Asking why does not let a client explore
feelings; it usually elicits an "I don't know" response. "What can we do to help you
while you're here?" is beyond the scope of the client's abilities at this time.

A client is admitted to the mental health unit with the diagnosis of major depressive
disorder. Which statement alerts the nurse to the possibility of a suicide attempt?
1
"I don't feel too good today."
2
"I feel much better; today is a lovely day."
3
"I feel a little better, but it probably won't last."
4
"I'm really tired today, so I'll take things a little slower." Correct Ans:- 2

,A rapid mood upswing and psychomotor change may signal that the client has
made a decision and has developed a plan for suicide. "I don't feel too good today";
"I feel a little better, but it probably won't last"; and "I'm really tired today, so I'll
take things a little slower" are all typical of the depressed client; none of these
statements signals a change in mood.

During a group discussion it is learned that a group member hid suicidal urges and
committed suicide several days ago. What should the nurse leading the group be
prepared to manage?
1
Guilt of the co-leaders for failing to anticipate and prevent the suicide
2
Guilt of group members because they could not prevent another's suicide
3
Lack of concern over the suicide expressed by several of the members in the group
4
Fear by some members that their own suicidal urges may go unnoticed and that
they may go unprotected Correct Ans:- 4
Ambivalence about life and death, plus the introspection commonly found in clients
with emotional problems, can lead to increased anxiety and fear among the group
members. These feelings must be handled within the support and supervisory
systems for the staff; the group members are the primary concern. Guilt that the
group's leaders or members might feel because they could not prevent another's
suicide will probably be a secondary concern of the group leader. Lack of concern
over the suicide expressed by several of the members in the group is not a primary
concern, but this should be explored later to determine the reason for such
apparent indifference, which may be a mask to cover true feelings.

Which screening report will help the nurse determine skeletal growth in a child?
1
Electroencephalogram reports
2
Radiographs of the hand and wrist
3
Magnetic resonance imaging (MRI)
4
Denver Developmental Screening Test Correct Ans:- 2
Skeletal growth in a child can be determined from the ossification centers. At 5 to 6
months of age, the capitate and hamate bones in the wrist are the earliest centers.
Therefore radiographs of the hand and wrist will help determine skeletal growth in
the child. Electroencephalogram reports will help assess a child's brain activity. MRI
is used to scan the internal structures of a client. The Denver Developmental
Screening Test is used to understand developmental issues of a child.

A client describes his delusions in minute detail to the nurse. How should the nurse
respond?
1
Changing the topic to reality-based events
2
Continuing to discuss the delusion with the client

, 3
Getting the client involved in a social project with peers
4
Disputing the perceptions with the use of logical thinking Correct Ans:- 1
Decreasing time spent on delusions prevents reinforcement of psychotic thinking.
Discussing reality-based events improves contact with reality. Encouraging
discussion will give validity to the delusion. The client will have difficulty getting
involved in a social activity; the activity will not stop the delusion. Challenging the
client may increase anxiety.

A nurse working on a mental health unit is caring for several clients who are at risk
for suicide. Which client is at the greatest risk for successful suicide?
1
Young adult who is acutely psychotic
2
Adolescent who was recently sexually abused
3
Older single man just found to have pancreatic cancer
4
Middle-age woman experiencing dysfunctional grieving Correct Ans:- 3
Older single men with chronic health problems are at the highest risk of suicide.
This is because men have fewer social supports than women do. (Men are less
social then women in general.) Less social support at times of stress can increase
the risk of suicide. Also, chronic health problems can lead to learned helplessness,
which can lead to depression. People who are acutely psychotic as a group are at
higher risk for suicide, but they do not have the suicide rate of older single adult
men with chronic health problems. An adolescent who was recently sexually
abused, although severely traumatized, does not have the risk of suicide of an older
single man with chronic health problems. Dysfunctional grieving is prolonged
grieving that is characterized by greater disability and dysfunctional patterns of
behavior. Although people with complicated dysfunctional grieving may be at risk
for self-directed violence, they do not have the suicide risk of older single men with
chronic health problems.

Which stages would the nurse explain that a toddler goes through, according to
Freud's theory? Select all that apply.
1
Oral
2
Anal
3
Phallic
4
Genital
5
Latency Correct Ans:- 12
According to Freud's theory, a toddler goes through the oral and anal stages. The
phallic stage is seen in children between the ages of 3 to 6 years. The genital stage
is seen during puberty through adulthood. The latency stage is seen in children
ages 6 to 12 years of age.

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