MENTAL HEALTH HESI EXIT REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || ALREADY GRADED A+ <LATEST VERSION>
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Course
MENTAL HEALTH HESI EXIT
Institution
MENTAL HEALTH HESI EXIT
MENTAL HEALTH HESI EXIT REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES || ALREADY GRADED A+
<LATEST VERSION>
1.The nurse is planning activities for a client diagnosed with bipolar disorder with
aggressive social behavior. Which activity would be most app...
MENTAL HEALTH HESI EXIT REAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES || ALREADY GRADED A+
<LATEST VERSION>
1.The nurse is planning activities for a client diagnosed with bipolar disorder with
aggressive social behavior. Which activity would be most appropriate for this
client?
Rationale:
Solitary activities that require a short attention span with mild physical exertion are
the most appropriate activities for a client who is exhibiting aggressive behavior.
Writing (journaling), walks with staff, and finger painting are activities that
minimize stimuli and provide a constructive release for tension. The remaining
options have a competitive element to them and should be avoided because they
can stimulate aggression and increase psychomotor activity.
2. The home health nurse visits a client at home and determines that the client is
dependent on drugs. During the assessment, which action should the nurse take to
plan appropriate nursing care?
1. Ask the client why he started taking illegal drugs.
2. Ask the client about the amount of drug use and its effect.
3. Ask the client how long he thought that he could take drugs without someone
finding out.
,4. Not ask any questions for fear that the client is in denial and will throw the nurse
out of the home. - ANSWER ✔ 1. Ask the client why he started taking illegal
drugs.
Rationale:
Whenever the nurse carries out an assessment for a client who is dependent on
drugs, it is best for the nurse to attempt to elicit information by being
nonjudgmental and direct. Option 1 is incorrect because it is judgmental and off-
focus, and reflects the nurse's bias. Option 3 is incorrect because it is judgmental,
insensitive, and aggressive, which is nontherapeutic. Option 4 is incorrect because
it indicates passivity on the nurse's part and uses rationalization to avoid the
therapeutic nursing intervention.
3. Which interventions are most appropriate for caring for a client in alcohol
withdrawal? Select all that apply.
1. Monitor vital signs.
2. Maintain NPO status.
3. Provide a safe environment.
4. Address hallucinations therapeutically.
5. Provide stimulation in the environment.
6. Provide reality orientation as appropriate. - ANSWER ✔ 1, 3, 4, 6
Rationale:
When the client is experiencing withdrawal from alcohol, the priority for care is to
prevent the client from harming self or others. The nurse would provide a low-
stimulation environment to maintain the client in as calm a state as possible. The
nurse would monitor the vital signs closely and report abnormal findings. The
nurse would reorient the client to reality frequently and would address
hallucinations therapeutically. Adequate nutritional and fluid intake need to be
maintained.
4. The nurse determines that the wife of an alcoholic client is benefiting from
attending an Al-Anon group if the nurse hears the wife make which statement?
1. "I no longer feel that I deserve the beatings my husband inflicts on me."
2. "My attendance at the meetings has helped me to see that I provoke my
husband's violence."
,3. "I enjoy attending the meetings because they get me out of the house and away
from my husband."
4. "I can tolerate my husband's destructive behaviors now that I know they are
common with alcoholics." - ANSWER ✔ 1. "I no longer feel that I deserve the
beatings my husband inflicts on me."
Rationale:
Al-Anon support groups are a protected, supportive opportunity for spouses and
significant others to learn what to expect and to obtain excellent pointers about
successful behavioral changes. The correct option is the healthiest response
because it exemplifies an understanding that the alcoholic partner is responsible for
his behavior and cannot be allowed to blame family members for loss of control.
Option 2 is incorrect because the nonalcoholic partner should not feel responsible
when the spouse loses control. Option 3 indicates that the group is viewed as an
escape, not as a place to work on issues. Option 4 indicates that the wife remains
codependent.
5. A hospitalized client with a history of alcohol abuse tells the nurse, "I am
leaving now. I have to go. I don't want any more treatment. I have things that I
have to do right away." The client has not been discharged and is scheduled for an
important diagnostic test to be performed in 1 hour. After the nurse discusses the
client's concerns with the client, the client dresses and begins to walk out of the
hospital room. What action should the nurse take?
1. Call the nursing supervisor.
2. Call security to block all exit areas.
3. Restrain the client until the health care provider (HCP) can be reached.
4. Tell the client that the client cannot return to this hospital again if the client
leaves now. - ANSWER ✔ 1. Call the nursing supervisor.
Rationale:
Most health care facilities have documents that the client is asked to sign relating
to the client's responsibilities when the client leaves against medical advice. The
client should be asked to wait to speak to the HCP before leaving and to sign the
"against medical advice" document before leaving. If the client refuses to do so,
the nurse cannot hold the client against the client's will. Therefore, in this situation,
the nurse should call the nursing supervisor. The nurse can be charged with false
imprisonment if a client is made to believe wrongfully that he or she cannot leave
, the hospital. Restraining the client and calling security to block exits constitutes
false imprisonment. All clients have a right to health care and cannot be told
otherwise.
6. The nurse is preparing to perform an admission assessment on a client with a
diagnosis of bulimia nervosa. Which assessment findings does the nurse expect to
note? Select all that apply.
1. Dental decay
2. Moist oily skin
3. Loss of tooth enamel
4. Electrolyte imbalances
5. Body weight well below ideal range - ANSWER ✔ 1, 3, 4
Rationale:
Clients with bulimia nervosa initially may not appear to be physically or
emotionally ill. They are often at or slightly below ideal body weight. On further
inspection, a client exhibits dental decay and loss of tooth enamel if the client has
been inducing vomiting. Electrolyte imbalances are present. Dry, scaly skin (rather
than moist, oily skin) is present.
7. The nurse is caring for a female client who was admitted to the mental health
unit recently for anorexia nervosa. The nurse enters the client's room and notes that
the client is engaged in rigorous push-ups. Which nursing action is most
appropriate?
1. Interrupt the client and weigh her immediately.
2. Interrupt the client and offer to take her for a walk.
3. Allow the client to complete her exercise program.
4. Tell the client that she is not allowed to exercise rigorously. - ANSWER ✔ 2.
Interrupt the client and offer to take her for a walk.
Rationale:
Clients with anorexia nervosa frequently are preoccupied with rigorous exercise
and push themselves beyond normal limits to work off caloric intake. The nurse
must provide for appropriate exercise and place limits on rigorous activities. The
correct option stops the harmful behavior yet provides the client with an activity to
decrease anxiety that is not harmful. Weighing the client immediately reinforces
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