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HESI RN Mental Health Exam / 20 Exam / 1500+ Questions and answers / 2021
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HESI RN Mental Health Exam / 20 Exam / 1500+ Questions and answers / 2021
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HESI MENTAL HEALTH1. A 30-year-old sales manager tells the nurse, "I am thinking about a job change. I don't feel
like I am living up to my potential." Which of Maslow's developmental stages is the sales
manager attempting to achieve?
A. Self-Actualization. Correct
B. Loving and Belonging.
C. Basic Needs.
D. Safety and Security.
Self-actualization is the highest level of Maslow's development stages, which is an attempt to
fulfill one's full potential (C). (B) is identifying support systems. (C) is the first level of Maslow's
developmental stages and is the foundation upon which higher needs rest. Individuals who feel
safe and secure (D) in their environment perceive themselves as having physical safety and lack
fear of harm.
2. The nurse observes a client who is admitted to the mental health unit and identifies that
the client is talking continuously, using words that rhyme but that have no context or
relationship with one topic to the next in the conversation. This client's behavior and thought
processes are consistent with which syndrome?
A. Dementia.
B. Depression.
C. Schizophrenia. Correct
D. Chronic brain syndrome.
The client is demonstrating symptoms of schizophrenia (C), such as disorganized speech that
may include word salad (communication that includes both real and imaginary words in no
logical order), incoherent speech, and clanging (rhyming). Dementia (A) is a global impairment
of intellectual (cognitive) functions that may be progressive, such as Alzheimer's or organic
brain syndrome (D). Depression (C) is typified by psychomotor retardation, and the client
appears to be slowed down in movement, in speech, and would appear listless and disheveled.
3. A homeless person who is in the manic phase of bipolar disorder is admitted to the mental
health unit. Which laboratory finding obtained on admission is most important for the nurse
to report to the healthcare provider?
A. Decreased thyroid stimulating hormone level. Correct
B. Elevated liver function profile.
C. Increased white blood cell count.
D. Decreased hematocrit and hemoglobin levels.
Hyperthyroidism causes an increased level of serum thyroid hormones (T3 and T4), which
inhibit the release of TSH (A), so the client's manic behavior may be related to an endocrine
,disorder. (B, C, and D) are abnormal findings that are commonly found in the homeless
population because of poor sanitation, poor nutrition, and the prevalence of substance abuse.
4. An adult male client who was admitted to the mental health unit yesterday tells the nurse
that microchips were planted in his head for military surveillance of his every move. Which
response is best for the nurse to provide?
A. You are in the hospital, and I am the nurse caring for you.
B. It must be difficult for you to control your anxious feelings.
C. Go to occupational therapy and start a project. Correct
D. You are not in a war area now; this is the United States.
Delusions often generate fear and isolation, so the nurse should help the client participate in
activities that avoid focusing on the false belief and encourage interaction with others (C).
Delusions are often well-fixed, and though (A) reinforces reality, it is argumentative and
dismisses the client's fears. It is often difficult for the client to recognize the relationship
between delusions and anxiety (B), and the nurse should reassure the client that he is in a safe
place. Dismissing delusional thinking (D) is unrealistic because neurochemical imbalances that
cause positive symptoms of schizophrenia require antipsychotic drug therapy.
5. The nurse is assessing a client's intelligence. Which factor should the nurse remember
during this part of the mental status exam?
A. Acute psychiatric illnesses impair intelligence.
B. Intelligence is influenced by social and cultural beliefs. Correct
C. Poor concentration skills suggests limited intelligence.
D. The inability to think abstractly indicates limited intelligence.
Social and cultural beliefs (B) have significant impact on intelligence. Chronic psychiatric illness
may impair intelligence (A), especially if it remains untreated. Limited concentration does not
suggest limited intelligence (C). Difficulties with abstractions are suggestive of psychotic
thinking (D), not limited intelligence.
6. At a support meeting of parents of a teenager with polysubstance dependency, a parent
states, "Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid he
will commit suicide." The nurse's response should be based on which information?
A. Addiction is a chronic, incurable disease.
B. Tolerance to the effects of drugs causes feelings of depression.
C. Feelings of depression frequently lead to drug abuse and addiction.
D. Careful monitoring should be provided during withdrawal from the drugs. Correct
The priority is to teach the parents that their son will need monitoring and support during
withdrawal (D) to ensure that he does not attempt suicide. Although (A and C) are true, they
are not as relevant to the parent's expressed concern. There is no information to support (B).
,7. The wife of a male client recently diagnosed with schizophrenia asks the nurse, "What
exactly is schizophrenia? Is my husband all right?" Which response is best for the nurse to
provide to this family member?
A. It sounds like you're worried about your husband. Let's sit down and talk.
B. It is a chemical imbalance in the brain that causes disorganized thinking. Correct
C. Your husband will be just fine if he takes his medications regularly.
D. I think you should talk to your husband's psychologist about this question.
The nurse should answer the client's question with factual information and explain that
schizophrenia is a chemical imbalance in the brain (B). (A) is a therapeutic response but does
not answer the question, and may be an appropriate response after the nurse answers the
question asked. Although (C) is likely true to some degree, it is also true that some clients
continue to have disorganized thinking even with antipsychotic medications. Referring the
spouse to the psychologist (D) is avoiding the issue; the nurse can and should answer the
question.
8. A young adult male client, diagnosed with paranoid schizophrenia, believes that world is
trying poison him. What intervention should the nurse include in this client's plan of care?
A. Remind the client that his suspicions are not true.
B. Ask one nurse to spend time with the client daily. Correct
C. Encourage the client to participate in group activities.
D. Assign the client to a room closest to the activity room.
A client with paranoid schizophrenia has difficulty with trust and developing a trusting
relationship with one nurse (B) is likely to be therapeutic for this client. (A) is argumentative.
Stress increases anxiety, and anxiety increases paranoid ideation; (C) would be too stressful and
anxiety-promoting for a client who is experiencing pathological suspicions. (D) also might
increase anxiety and stress.
9. The community health nurse talks to a male client who has bipolar disorder. The client
explains that he sleeps 4 to 5 hours a night and is working with his partner to start two new
businesses and build an empire. The client stopped taking his medications several days ago.
What nursing problem has the highest priority?
A. Excessive work activity.
B. Decreased need for sleep.
C. Medication management. Correct
D. Inflated self-esteem.
The most important nursing problem is medication management (C) because compliance with
the medication regimen will help prevent hospitalization. The client is also exhibiting signs of
(A, B, and C); however, these problems do not have the priority of medication management.
, 10. A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and
compulsions and asks the nurse why these make her feel safer. What information should the
nurse include in this client's teaching plan? (Select all that apply.)
A. Compulsions relieve anxiety. Correct
B. Anxiety is the key reason for OCD. Correct
C. Obsessions cause compulsions.
D. Obsessive thoughts are linked to levels of neurochemicals. Correct
E. Antidepressant medications increase serotonin levels. Correct
Correct choices are (A, B, D, and E). To promote client understanding and compliance, the
teaching plan should include explanations about the origin and treatment options of OCD
symptomology. Compulsions are behaviors that help relieve anxiety (A), which is a vague
feeling related to unknown fears, that motivate behavior (B) to help the client cope and feel
secure. All obsessions (C) do not result in compulsive behavior. OCD is supported by the
neurophysiology theory, which attributes a diminished level of neurochemicals (D), particularly
serotonin, and responds to selective serotonin reuptake inhibitors (SSRI).
11. The nurse observes a female client with schizophrenia watching the news on TV. She
begins to laugh softly and says, "Yes, my love, I'll do it." When the nurse questions the client
about her comment she states, "The news commentator is my lover and he speaks to me
each evening. Only I can understand what he says." What is the best response for the nurse
to make?
A. What do you believe the news commentator said to you? Correct
B. Let's watch news on a different television channel.
C. Does the news commentator have plans to harm you or others?
D. The news commentator is not talking to you.
It is imperative that the nurse determine what the client believes she heard (A). The idea of
reference may be to hurt herself or someone else, and the main function of a psychiatric nurse
is to maintain safety. (B) is acceptable, but it is best to determine the client's beliefs. (C) is
validating the idea of reference, while (D) is challenging the client.
12. A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not
had any visitors or phone calls since admission. He reports he has no family that cares about
him and was living on the streets prior to this admission. According to Erikson's theory of
psychosocial development, which stage is the client in at this time?
A. Isolation.
B. Stagnation. Correct
C. Despair.
D. Role confusion.
The client is in Erikson's "Generativity vs. Stagnation" stage (age 24 to 45), and meeting the task
includes maintaining intimate relationships and moving toward developing a family (B). (A)
occurs in young adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D)
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