PSYCH HESI Questions and Answers (Latest Update 2021) The nurse is using the CAGE questionnaire as a screening tool for a client who is seeking help because his wife said he had a drinking problem . What information should the nurse explore in depth with the client based on this screening tool? A. ...
the nurse is using the cage questionnaire as a screening tool for a client who is seeking help because his wife said he had a drinking problem what information should the nurse explore in depth with
PSYCH HESI Questions and Answers (Latest Update 2021)
The nurse is using the CAGE questionnaire as a screening tool for a client who is seeking help
because his wife said he had a drinking problem. What information should the nurse explore in
depth with the client based on this screening tool?
A. Consumption, liver enzyme, gastrointestinal complaints and bleeding
B. Minimize drinking, frequently misses family events, guilt about drinking, amount of daily
intake
C. Cancer screening results, anger, gastritis, daily alcohol intake
D. Efforts to cut down, annoyance with questions, guilt, drinking as an "Eye-opener"
-----------D. Efforts to cut down, annoyance with questions, guilt, drinking as an "Eye-opener"
2. A client is admitted to the mental health unit and reports taking extra antianxiety medication
because, "I'm so stressed out. I just wanted to go sleep" the nurse should plan one-on- one
observation of the client based on which statement?
A) What should I do? Nothing seems to help."
B) I have been so tired lately and needed to sleep."
C) I really think that I don't need to be here."
D)I don't want to talk. Nothing matters anymore."
-----------D)I don't want to talk. Nothing matters anymore."
3. A male hospital employee is pushed out of the way by a female employee because of an
oncoming gurney. The pushed employee becomes very angry and swings at the female
employee. Both employees are referred for counseling with the staff psychiatric nurse. Which
factor in the pushed employee's history is most related to the reaction that occurred?
A) Is worried about losing his job to a woman
B) Tortured animals as a child.
C)Was physically abused by his mother
D) Hates to be touched by anyone
-----------C)Was physically abused by his mother
4. The nurse documents the mental status of a female client who has been hospitalized for several
days by court order. The client state, "I don't need to be here" and tells the nurse that she believes
that the television talks to her. The nurse should document these assessment findings in which
section of the mental status exam?
A) Level of concentration
B)Insight and judgment
C) Remote memory
D) Mood and affect
-----------B)Insight and judgment
,5. The nurse on the evening shift receives report that a client is scheduled for electroconvulsive
treatment (ECT) in the morning. Which intervention should the nurse implement the evening
before the scheduled ECT?
A) Hold all bedtime medication.
B)Keep the client NPO after midnight.
C) Implement elopement precautions.
D) Give client an enema at bedtime.
-----------B)Keep the client NPO after midnight.
6. A client who is admitted to the mental health unit report shortness of breath and dizziness. The
client tells the nurse, "I feel like I'm going to die" which nursing problem should the nurse
include in this client's plan of care?
A) Mood disturbance
B)Moderate anxiety
C) Altered thoughts
D) Social isolation
-----------B)Moderate anxiety
7. A female client is brought to the emergency department after police officers found her
disoriented, disorganized, and confuse. The nurse also determines that the client is homeless and
slightly suspicious. This client's treatment plan should include what priority problem?
A) Self-care deficit.
B) Disturbed sensory perception.
C) Ineffective community coping.
D)Acute confuse.
-----------D)Acute confuse.
8. A male client is admitted to the psychiatric unit for recurrent negative symptoms of chronic
schizophrenia and medication adjustment of risperidone (Risperdal). When the client walks to
the nurse's station in a literally contracted position, he states that something has made his body
confort into a monster. What action should the nurse take
a) Medicate the client with the prescribed antipsychotic thioridazine (mellaril)
b) Offer the client a prescribed physical therapy hot pack for muscle spasms.
c) Direct client to occupational therapy to distract him from somatic complaints.
d)Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia.
-----------D.Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia
, 9. A mental health worker (MHW) is caring for a client with escalating aggressive behavior.
Which action by the MHW warrants immediate intervention by the nurse?
A) Is attempting to physically restrain the client.
B) Tells the client to go to the quiet area of the unit.
C) Is using a loud voice to talk to the client.
D) Remains at a distance of 4 feet from the client
-----------A)Is attempting to physically restrain the client
10. Which nursing actions are likely to help promote the self-esteem of a male client with mental
depression. (Select all that apply)
A. Ask client what his long term goals are
B. Discuss the challenges of his medical condition
C. Include the client in determining treatment protocol
D. Encourage the client to engage in recreational therapy
E. Provide opportunities for the client to discuss his concerns
-----------A. Ask client what his long term goals are
D. Encourage the client to engage in recreational therapy
E. Provide opportunities for the client to discuss his concerns
11. The nurse is preparing medications for a client with bipolar disorder and notices that the
antipsychotic medication was discontinued several days ago. Which medication should also be
discontinued?
12. The nurse is teaching a client about the initiation of a prescribed abstinence therapy using
disulfiram (Antabuse). What information should the client acknowledge understanding?
a. Completely abstain from heroin or cocaine use
b. Remain alcohol free from 12 hours prior to the first dose
c. Attend monthly meetings of alcoholics anonymous
d. Admit to others that he is a substance abuse
-----------b. Remain alcohol free from 12 hours prior to the Frst dose
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