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HESI MENTAL HEALTH RN
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HESI MENTAL HEALTH RN V1-V3 2020 TEST BANK.
HESI MENTAL HEALTH RN V1-V3 2020 TEST BANK. A client with depression remains in bed most of the day, and declines activities. Which nursing problem has... [Show More] the greatest priority for this client? A. Loss of interest in diversional activity. B. Social isolation. C. Refusal to address nutritional needs. D. Low self-esteem. The RN is preparing medications for a client with bipolar disorder and notices that the client discontinued antipsychotic medication for several days. Which medication should also be discontinued? a. Lithium. (Lithotabs) b. Benzotropine (Cogentin). c. Alprazolam (Xanax). d. Magnesium (Milk of Magnesia). The RN is teaching a client about the initiation of the 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 for 12 hours prior to the first dose. C. Attend monthly meetings of alcoholics anonymous. D. Admit to others that he is a substance user. A male client with schizophrenia is admitted to the mental health unit after abruptly stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most important for the RN to ask the client? A. Have you lost interest in the things that you used to enjoy? B. Is your ability to think or concentrate decreased? C. How many continuous hours do you sleep at night? D. Do you hear sounds or voices that others do not hear? A female client requests that her husband be allowed to stay in the room during the admission assessment. When interviewing the client, the RN notes a discrepancy between the client’s verbal and nonverbal communication. What action does the RN take? A. Pay close attention and document the nonverbal messages. B. Ask the client’s husband to interpret the discrepancy. C. Ignore the nonverbal behavior and focus on the client’s verbal messages. D. Integrate the verbal and nonverbal messages and interpret them as one. A male client approaches the RN with an angry expression on his face and raises his voice, saying “My roommate is the most selfish, self-centered, angry person I have ever met. If he loses his temper one more time with me, I am going to punch him out!” The RN recognizes that the client is using which defense mechanism? A. Denial. B. Projection. C. Rationalization. D. Splitting. A mental health worker is caring for a client with escalating aggressive behavior. Which action by the MHW warrant immediate intervention by the RN? A. Is attempting to physically restrain the patient. B. Tells the client to go to the quiet area of the unit. C. Is using a loid voice to talk to the client. D. Remains at a distance of 4 feet from the client. A client on the mental health unit is becoming more agitated, shouting at the staff, and pacing in the hallway. When the PRN medication is offered, the client refuses the medication and defiantly sits on the floor in the middle of the unit hallway. What nursing intervention should the RN implement first? A. Transport of the client to the seclusion room. B. Quietly approach the client with additional staff members. C. Take other clients in the area to the client lounge. D. Administer medication to chemically restrain the patient. A male client with bipolar disorder who began taking lithium carbonate five days ago is complaining of excessive thirst, and the RN finds him attempting to drink water from the bathroom sink faucet. Which intervention should the RN implement? A. Report the client’s serum lithium level to the HCP. B. Encourage the client to suck on hard candy to relieve the symptoms. C. No action is needed since polydipsia is a common side effect. D. Tell the client that drinking from the faucet is not allowed. During an annual physical by the occupational RN working in a corporate clinic, a male employee tells the RN that is high-stress job is causing trouble in his personal life. He further explains that he often gets so angry while driving to and from work that he has considered “getting even” with other drivers. How should the RN respond? A. “Anger is contagious and could result in major confrontation.” B. “Try not to let your anger cause you to act impulsively.” C. “Expressing your anger to a stranger could result in an unsafe situation.” D. “It sounds as if there are many situations that make you feel angry.” A client who has agoraphobia (a fear of crowds) is beginning desensitization with the therapist, and the RN is reinforcing the process. Which intervention has the highest priority for this client’s plan of care? A. Encourage substitution of positive thoughts and negative ones. B. Establish trust by providing a calm, safe environment. C. Progressively expose the client to larger crowds. D. Encourage deep breathing when anxiety escalates in a crowd. Which nursing actions are likely to help promote the self-esteem of a male client with modern depression? A. Ask the 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 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 laterally contracted position, he states that something has made his body contort into a monster. What action should the RN 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. A client is admitted to the mental health unit and reports taking extra antianxiety medication because, “I’m so stressed out. I just want to go to sleep.” The RN 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 walk. Nothing matters anymore.” A male hospital employee is pushed out 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 RN. 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. The RN documents the mental status of a female client who has been hospitalized for several days by court order. The client states, “I don’t need to be here” and tells the RN that she believes the television talks to her. The RN should document these assessment findings in which section of the mental status exam/ A. Level of concentration. B. Insight and judgement. C. Remote memory. D. Mood and affect. A client is admitted to the mental health unit reports shortness of breath and dizziness. The client tells the RN, “I feel like I’m going to die”. Which nursing problem should the RN include in this client’s plan of care? A. Mood disturbance. B. Moderate anxiety. C. Altered thoughts. D. Social isolation. A female client who is wearing dirty clothes and has foul body odor, comes to the clinic reporting feeling scared because she is being stalked. What action is most important for the RN to take? A. Offer the client a safe place to relax before interviewing her. B. Ask the client to describe why she is being stalked. C. Recommend that the client talk with a social worker. D. Assure the client that the HCP will see her today. The RN leading a group session of adolescent clients gives the members a handout about anger management. One of the male clients is fidgety, interrupts peers when they try and talk, and talks about his pets at home. What nursing action is best for the RN to take? A. Explore the client’s feelings about his pets and home life. B. Encourage his peers to help involve him in the activity. C. Give the client permission to leave and return in 10 minutes. D. Redirect him by encouraging him to read from the handout. A male adolescent was admitted to the unit two days ago for depression. When the mental health RN tries to interview the client to establish rapport, he becomes very irritated and sarcastic. Which action is best for the RN to take? A. Report the behavior to the next shift. B. Offer to play a game of cards with the client. C. Document the behavior in the chart. D. Plan to talk with the client the next day. A male adult is admitted because of an acetaminophen (Tylenol) overdose. After transfer to the mental health unit, the client is told he has liver damage. Which information is most important for the nurse to include in the client's discharge plan? A. Do not take any over the counter meds. B. Eat a high carb, low fat, low protein diet. C. Call the crisis hotline if feeling lonely. D. Avoid exposure to large crowds. After receiving treatment for anorexia, a student asks the school RN for permission to work in the school cafeteria as part of the school’s work study program. What action should the RN take? A. Refer the student to a psychiatrist for further discussion. B. Recommend assignment to the receptionist’s office. C. Suggest that student work in the athletic department. D. Determine the parent’s opinion of the work assignment. The Rn accepts a transfer to the metal health unit and understands that the client is distractible and is exhibiting a decreased ability to concentrate. The RN only has 15 minutes to talk to the client. To develop treatment plan for this client, which assessment is most important for the RN to obtain? A. Motivation of treatment. B. History of substance use. C. Medication compliance. D. Mental status examination. A male client who recently lost a loved one arrives at the mental health center and tells the RN he is no longer interested is his usual activities and has not slept for several days. Which priority nursing problem should the RN include in the client’s plan of care? A. Risk for suicide. B. Sleep deprivation. C. Situational low self-esteem. D. Social isolation. A male client with long history of alcohol dependency arrives in the emergency department describing the feelings of bugs crawling on his body. His blood pressure is 170/102, his pulse rate is 110 bpm, and is blood alcohol level is 0mg/dL. Which prescription should the RN administer? A. Haloperidol (Haldol). B. Thiamine (Vitamin B1). C. Diphenhydramine (Benadryl). D. Lorazepam (Ativan). A client who refuses antipsychotic medications disrupts group activities, talks with nonsensical words and wanders into client’s rooms. The RN decides that the client needs constant observation based on which of these assessment findings? A. Wanders into the clients rooms. B. Refuses antipsychotic medications. C. Talks with nonsensical words. D. Disrupts group activities. A client with schizophrenia explains that she has 20 children and then very seriously points to the RN and explains that she is one of them. What is the most therapeutic response for the RN to provide/ A. “Let’s go ask another RN is this is true.” B. “My name tag shows that I am a RN here.” C. “I can’t possibly be one if your children.” D. “I know that you don’t have 20 children.” A high school girl reveals to the high school RN that she has been engaging in self-induced vomiting as weight-control measure. Which initial assessment should the RN focus on with this adolescent? A. National percentile of weight and height. B. Frequency of bingeing and purging behaviors. C. Perceptions of family and social relationships. D. School grades and extracurricular activities. Narcan was administered to an adult client following a suicide attempt with an overdose of hydrocodone bitartrate (Vicodin). Within 15 minutes, the client is alert and oriented. In planning nursing care, which intervention has the highest priority at this time? A. Encourage the client to increase fluid intake. B. Obtain the client’s serum Vicodin level. C. Observe the client for further narcotic effects. D. Determine the client’s reason for attempting suicide. Following surgery, a male client with antisocial personality disorder frequently requests that a specific RN be assigned to is care and is belligerent when another RN is assigned. What action should the charge RN implement? A. Reassure the client that his request will be met whenever possible. B. Advise the client that assignments are not based on the client’s request. C. Ask the client to explain why he constantly requests the RN. D. Encourage the client to verbalize his feelings about the RN. When preparing to administer a prescribed medication to a homeless male at a community clinic, the client tells the RN that he usually takes a different dosage. What action should the RN take? A. Tell him to take the medication then verify the dosage at the next healthcare team meeting. B. Withhold the medication until the dosage can be confirmed. C. Inform him that he may refuse the medication and document whether or not he takes it. D. Explain to the client that the dosage has been changed. The nurse orients a female client with depression to the new room on the mental health unit. The client states “It seems strange that I don’t have a T.V in my room.” Which statement would be best for the RN to provide? A. “You can watch T.V as much as you want outside of your room.” B. “Sometimes clients feel like the T.V is sending them messages.” C. “It’s important to be out of you room and talking to others.” D. “Watching T.V is a passive activity and we want you to be active.” A client admitted with a closed head injury after a fall has a blood alcohol level of 0.28 (28%) and is difficult to arouse. Which intervention during the first 6 hours following admission should the RN identify as the priority? A. Give lorazepam (Ativan) PRN for signs of withdrawal. B. Administer disulfiram (Antabuse) immediately. C. Place in a side lying position with head of bed elevated. D. Provide thiamine and folate supplements as prescribed. The RN is completing the admission assessment of an underweight adolescent who is admitted to a psychiatric unit with a diagnosis of depression. Which finding requires notification to the HCP? A. Potassium level of 2.9 mEq/dl. B. Blood pressure of 110/70 mmHg. C. WBC of 10,000mm^3. D. Body mass index of 21. The Rn is planning client teaching for a 35-year-old client with alcoholic cirrhosis. Which self-care measure should the RN emphasize for the client’s recovery? A. Support group meetings. B. Vitamin B and multivitamin supplements. C. Diet with adequate calories and protein. D. Alcohol abstinence. A teenager has lost 20 pounds in the last three months is admitted to the hospital with hypotension and tachycardia. The client reports irregular menses and hair loss. Which intervention is most important for the RN to include in the clients plan of care? A. Implement behavioral modification therapy. B. Initiate caloric and nutritional therapy. C. Evaluate the client for low self-esteem. D. Record daily weights and graft trend. While interviewing a client, the nurse takes notes to assist with accurate documentation later. Which statement is most accurate regarding note-taking during an interview? A. The client’s comfort level is increased when the RN breaks eye contact to take notes. B. The interview process is enhanced with note taking and allows the client to speak at a normal pace. C. Taking notes during an interview is a legal obligation of examining RN. D. The RN’s ability to directly observe the client’s non-verbal communication is limited with note taking. A client is receiving substitution therapy during withdrawal from benzodiazepines. Which expected outcome statement has the highest priority when planning nursing care? a. Client will not demonstrate cross addiction. b. Co-dependent behaviors will be decreased. c. CNS stimulation will be reduced. d. Client's level of consciousness will increase. A client who is being treated with lithium carbonate for manic depression begins to develop diarrhea, vomiting, and drowsiness. What action should the nurse take? a. Notify the physician immediately and force fluids. b. Prior to giving the next dose, notify the physician of the symptoms. c. Record the symptoms and continue medication as prescribed. d. Hold the medication and refuse to administer additional amounts of the drug. While caring for an older client, the RN observes multiple bruises in Over the client’s legs, arms, back, and gluteal areas. When the client Contact, the RN suspects elder abuse. What action should the RN take? A. Report family conversations and anger towards the client when visiting. B. Ask the client specific questions about someone causing the bruising. C. Question the family members and caregiver how the bruising occurred. D. Measure and document size, shape and color of the bruised areas. The RN is performing intake interviews at a psychiatric clinic. A female client with a known history of drug abuse reports that she had a heart attack four years ago. Use of which substance places the client at highest risk for myocardial infarction? A. Benzodiazepine B. Alcohol C. Methamphetamine D. Marijuana After receiving treatment for anorexia, a student asks the school RN for permission to work in the school cafeteria as part of the school’s work study program. What action should the RN take? A. Suggest that the student work in the athletic department. B. Determine the parent’s opinion of the work assignments. C. Refer the student to a psychiatrist for further discussion. D. Recommend assignment to the receptionist’s office. A client who is homeless is diagnosed with schizophrenia and admitted on an involuntary basis to a mental health hospital 4 days ago. The client stopped taking prescribed antipsychotic drugs approximately one month ago. Since hospitalization the client continues to have poor judgment and refuses all medications. What action should the RN take? A. Encourage the client to stay in the hospital so the client does not have to be homeless. B. Provide the client with medication if the client presents an imminent risk to self and others. C. Administer a long acting antipsychotic medication so that the client can be discharged to a shelter. D. Describe to the client treatment options provided at the community mental health clinics. A male client comes to the emergency center because he has an erection that will not resolve. The client reports that he is taking trazodone (Desyrel) for insomnia. Which information is most important for the nurse ask the client? A. When was the last time you drank alcoholic beverage? B. Have you taken any medications for erectile dysfunction? C. Are you having any other sexual dysfunctions or problems? D. Do you have a history of angina or high blood pressure? On admission to the mental health unit, a client diagnosed with schizophrenia tells the RN that he is the son of god. Based on this statement, which intervention should the RN include in this client’s plan of care? A. Lead the client by his arm to the seclusion room. B. Ensure the client’s environment is safe. C. Schedule activity therapy twice a week. D. Confront his delusion as not consistent with reality. The RN on the day shift receive report about a client with depression who was in bed most of the weekend. The RN walks into the client’s room in the morning and finds the client in bed. What intervention is best for the RN to implement? A. Monitor the client’s appetite and pattern of sleep. B. Assess the client’s feelings about the hospital stay. C. Assist the client to get out of bed and involved in an activity. D. Explain that staff will check on the client every 30 minutes. Which client information indicates the need for the RN to use CAGE questionnaire during the admission interview? A. Client’s medication history includes the frequent use of antidepressants. B. Describe self as a social drinker who drinks alcoholic beverages daily. C. Reports difficulties with short term memory since traumatic brain injury. D. Medical history includes that the client was recently sexually assaulted. A female client admitted to the mental health unit starts to shout and scream at the RN. What is the best approach for the RN to take? A. Stay quietly with the patient B. Tell her that she is out of control. C. Distract her by offering her finger foods. D. Ignore the client’s acting out behavior. A woman is brought to the psychiatric clinic by her husband. He reports that his wife is reluctant to leave home because of what she describes as a fear of open places and crowds. Which nursing problem applies to this client’s behavior? A. Ineffective protection to guard self from internal or external threats. B. Risk for injury related to inability to communicate. C. Risk prone health behavior related to self-esteem assault. D. Anxiety related to real or perceived threat to physical integrity. A client is receiving benztropine mesylate (Cogentin) for drug-induced extrapyramidal syndrome (EPS). Which finding indicates that the RN should further evaluate the client? A. Decreased bowel movements. B. Presence of a dry mouth. C. Decreasing hand tremors. D. Increased mouth movements. A male client in the mental health unit is guarded and vaguely answers the nurse’s questions. He isolates in his room and sometimes opens the door to peek into the hall. Which problem can the RN anticipate? A. Visual hallucinations. B. Auditory hallucinations. C. Excessive motor activity. D. Delusions of persecution. A female client with obsessive compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving, and reports her findings to the RN at bedtime. What action should the nurse implement? A. Explain to the client that her behavior invades the rights of the nursing staff. B. Ask the client to explain why she is keeping a detailed record of her nursing care. C. Teach the client strategies to control her obsessive compulsive behavior. D. Encourage the client to express her feelings regarding the upcoming procedure. During admission to the psychiatric unit, a female client is extremely anxious and states that she is worried about the sun coming up the next day. What intervention is most important for the RN to implement during the admission process? A. Assist the client in developing alternative coping skills. B. Remain calm and use a matter of fact approach. C. Ask the client why she is so anxious D. Administer a PRN sedative to help relieve her anxiety. A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The RN also determines that the client is homeless and is exhibiting suspiciousness. The client’s plan of care should include what priority problem? A. Acute confusion. B. Ineffective community coping C. Disturbed sensory perception. D. Self-care deficit. The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the RN to provide in this crisis? A. Tell me what you think should happen. B. How serious was the collision? C. What do you think you should do? D. Call for transportation to the hospital. A client tells the RN that he has an IQ of 400+ and is a genius and an inventor. He also reports that he is married to a female movie star and thinks that his brother wants a sexual relationship with her. What is the priority nursing problem for admission to the psychiatric unit? A. Ineffective sexual patterns. B. Impaired environmental interpretation. C. Disturbed sensory perception. D. Compromised family coping. The RN is providing care for a client diagnosed with borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the RN use when changing this client’s dressing? A. Provide detailed thorough explanations when cleansing wound. B. Perform the dressing change in a non-judgmental manner. C. Ask in a non-threatening manner why the client cut own abdomen. D. Request another staff member assist with the dressing change. While sitting in the day room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the RN. The two trade places, and the RN demonstrates the client’s behaviors. What is the main goal of this therapeutic technique? A. Initiate a non-threatening conversation with the client. B. Dialog about the ineffectiveness of his interactions. C. Allow the client to identify the way he interacts. D. Discuss the client’s feelings when he responds. An antidepressant medication is prescribed for a client who reports sleeping only 4 hours in the past 2 days and weight loss of 9 lbs within the last month. Which client goal is most important to achieve within the first three days of treatment? A. Meet scheduled appointment with dietitian. B. Sleep at least 6 hours a night. C. Understands the purpose of the medication regimen. D. Describes the reasons for hospitalization. When preparing to administer to domestic violence screening tool to a female client, which statement should the RN provide? A. If your partner is abusing you, I need to ask these questions. B. State law mandates that I ask if you are a victim of domestic violence. C. The HCP provider needs to know if you are experiencing any domestic abuse. D. All clients are screened for domestic abuse because it is common in our society. A young adult female visits the mental health clinic complaining of diarrhea, headache, and muscle aches. She is afebrile, denies chills, and all laboratory findings are within normal limits. During the physical assessment, the client tells the RN that her sister thinks she is neurotic and calls her a hypochondriac. Which response is best for the RN to provide? A. Unless your sister has a medical education, ignore her comments. B. I can hear that your sister comments are over-whelming you. C. Do you think it’s possible that you might be a hypochondriac? D. Besides your sister’s comments, what in your life is troubling you? The RN is leading a group on the inpatient psychiatric unit. Which approach should the RN use during the working phase of group development? A. Establishing a rapport with group members. B. Clarifying the nurse’s role and clients’ responsibilities. C. Discussing ways to use new coping skills learned. D. Helping clients identify areas of problem in their lives. A male client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. What intervention is best for the RN to implement? A. Isolate the client from the other clients. B. Administer PRN sedative. C. Avoid recognizing the behavior. D. Escort the client to his room. A client is admitted for bipolar disorder and alcohol withdrawal, depressive phase. Based on which assessment finding will the RN withhold the clonidine (Catapres) prescription? A. Blood pressure readings of 90/62 mmHg to 92/58 mmHg. B. Pulse rate of 68-78 BPM. C. Temperature of 99.5-99.7 F. D. Respiration rate of 24 breaths per minute. The RN on the evening shift receives report that a client is scheduled for electroconvulsive treatment (ECT) in the morning. Which intervention should the Rn implement the evening before the scheduled ECT? A. Hold all bedtime medications. B. Keep the client NPO after mid-night. C. Implement elopement precautions. D. Give the client an enema at bedtime. A client with Bulimia and depression who is taking phenelzine (Nardil) 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. What dietary choices should the RN instruct the client to avoid? A. Pan-seared catfish. B. Peperoni pizza. C. Deep fried shrimp. D. Beef trips with gravy. A mental health worker is caring for a client with escalating aggressive behavior. Which action by the mental health worker warrants immediate intervention by the RN? A. Is attempting the physically restrain the patient. B. Remains at a distance of 4 feet from the client. C. Tells the client to go to the quiet area of the unit. D. Is using a load voice to talk to the client. A client who recently experienced the death of a significant other arrives at the mental health center. The client reports loss of interest in usual activities, expresses a wish to be with the decreased significant other, has been eating very little, and has not slept in several days. Which client statement is most important for the RN to explore at this time? A. Not sleeping for several days. B. Wishing to be with spouse. C. Lack of interest in usual activities. D. Eating very little. A middle aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning? A. Provide education on methods to enhance sleep. B. Teach the client to develop a plan for daily structured activities. C. Suggest that the client develop a list of pleasurable activities. D. Encourage the client to exercise. When developing a plan of care for a client admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt, which nursing problem has the highest priority? A. Impaired comfort. B. Risk for injury. C. Ineffective breathing pattern. D. Ineffective coping. A female client on a psychiatric unit is sweating profusely while she vigorously does push-ups and then runs the length of the corridor several times before crashing into furniture in the sitting room. Picking herself up, she begins to toss chairs aside, looking for a red one to sit in. When another client objects to the disturbance, the client shouts, “I am the boss here. I do what I want.” Which nursing problem best supports these observations? A. Deficient diversional activity related to excess energy level. B. Risk for other related violence related to disruptive behavior. C. Risk for activity intolerance related to hyperactivity. D. Disturbed personal identity related to grandiosity. A RN is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview? A. Dim the lights in the room to help the patient feel calm. B. Sit within two feet of the client to enhance level of safety and security. C. Reduce the noise level in the room by turning off the television and radio. D. Position table between the client and the RN for extra personal space. An older homeless client visits the psychiatric clinic to obtain a prescription renewal for alprazolam (Xanax). During the health assessment, the client complains of chest pain. Which action should the RN take first? A. Refer the client to the cardiology unit. B. Obtain the client Blood pressure. C. Assess the client for substance abuse. D. Determine if Xanax was taken recently. The mother of an 8-month-old infant with profound mental and physical disabilities tells he RN how depressed she is because she realized that her child will never achieve normal growth and development milestones. How should the RN respond to the mother? A. Ask the mother if she has ever thought about harming herself or her child. B. Reassure the mother that her child will achieve some growth and development milestones. C. Determine if the mother has other children who do not have developmental disabilities. D. Encourage the mother to write thoughts and feelings in journal. Several clients with chronic mental illness and multiple substance abuse histories live in a group residential home and attend daycare mental health facility where group and individual therapies are provided. The RN finds the common bathroom at the facility with sputum on the walls, urine [Show Less]
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HESI Mental Health RN Questions and Answers from V1-V3 Test Banks and Actual Exams Solution
HESI Mental Health RN Questions and Answers from V1-V3 Test Banks and Actual Exams (Latest Update 2020) Rated A+ 1. During admission to the psychiatric ... [Show More] unit, a female client is extremely anxious and states that she is worried about the sun coming up the next day. What intervention is most important for the RN to implement during the admission process? A. Assist the client in developing alternative coping skills. B. Remain calm and use a matter of fact approach. C. Ask the client why she is so anxious D. Administer a PRN sedative to help relieve her anxiety. 2. A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The RN also determines that the client is homeless and is exhibiting suspiciousness. The client’s plan of care should include what priority problem? A. Acute confusion. B. Ineffective community coping C. Disturbed sensory perception. D. Self-care deficit. 3. The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the RN to provide in this crisis? A. Tell me what you think should happen. B. How serious was the collision? C. What do you think you should do? D. Call for transportation to the hospital. 4. A client tells the RN that he has an IQ of 400+ and is a genius and an inventor. He also reports that he is married to a female movie star and thinks that his brother wants a sexual relationship with her. What is the priority nursing problem for admission to the psychiatric unit? A. Ineffective sexual patterns. B. Impaired environmental interpretation. C. Disturbed sensory perception. D. Compromised family coping. 5. The RN is providing care for a client diagnosed with borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the RN use when changing this client’s dressing? A. Provide detailed thorough explanations when cleansing wound. B. Perform the dressing change in a non-judgmental manner. C. Ask in a non-threatening manner why the client cut own abdomen. D. Request another staff member assist with the dressing change. 6. While sitting in the day room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the RN. The two trade places, and the RN demonstrates the client’s behaviors. What is the main goal of this therapeutic technique? A. Initiate a non-threatening conversation with the client. B. Dialog about the ineffectiveness of his interactions. C. Allow the client to identify the way he interacts. D. Discuss the client’s feelings when he responds. 7. An antidepressant medication is prescribed for a client who reports sleeping only 4 hours in the past 2 days and weight loss of 9 lbs within the last month. Which client goal is most important to achieve within the first three days of treatment? A. Meet scheduled appointment with dietitian. B. Sleep at least 6 hours a night. C. Understands the purpose of the medication regimen. D. Describes the reasons for hospitalization. 8. When preparing to administer to domestic violence screening tool to a female client, which statement should the RN provide? A. If your partner is abusing you, I need to ask these questions. B. State law mandates that I ask if you are a victim of domestic violence. C. The HCP provider needs to know if you are experiencing any domestic abuse. D. All clients are screened for domestic abuse because it is common in our society. 9. A young adult female visits the mental health clinic complaining of diarrhea, headache, and muscle aches. She is afebrile, denies chills, and all laboratory findings are within normal limits. During the physical assessment, the client tells the RN that her sister thinks she is neurotic and calls her a hypochondriac. Which response is best for the RN to provide? A. Unless your sister has a medical education, ignore her comments. B. I can hear that your sister comments are over-whelming you. C. Do you think it’s possible that you might be a hypochondriac? D. Besides your sister’s comments, what in your life is troubling you? 10. The RN is leading a group on the inpatient psychiatric unit. Which approach should the RN use during the working phase of group development? A. Establishing a rapport with group members. B. Clarifying the nurse’s role and clients’ responsibilities. C. Discussing ways to use new coping skills learned. D. Helping clients identify areas of problem in their lives. 11. A male client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. What intervention is best for the RN to implement? A. Isolate the client from the other clients. B. Administer PRN sedative. C. Avoid recognizing the behavior. D. Escort the client to his room. 12. A client is admitted for bipolar disorder and alcohol withdrawal, depressive phase. Based on which assessment finding will the RN withhold the clonidine (Catapres) prescription? A. Blood pressure readings of 90/62 mmHg to 92/58 mmHg. B. Pulse rate of 68-78 BPM. C. Temperature of 99.5-99.7 F. D. Respiration rate of 24 breaths per minute. 13. The RN on the evening shift receives report that a client is scheduled for electroconvulsive treatment (ECT) in the morning. Which intervention should the Rn implement the evening before the scheduled ECT? A. Hold all bedtime medications. B. Keep the client NPO after mid-night. C. Implement elopement precautions. D. Give the client an enema at bedtime. 14. A client with Bulimia and depression who is taking phenelzine (Nardil) 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. What dietary choices should the RN instruct the client to avoid? A. Pan-seared catfish. B. Peperoni pizza. C. Deep fried shrimp. D. Beef trips with gravy. 15. A mental health worker is caring for a client with escalating aggressive behavior. Which action by the mental health worker warrants immediate intervention by the RN? A. Is attempting the physically restrain the patient. B. Remains at a distance of 4 feet from the client. C. Tells the client to go to the quiet area of the unit. D. Is using a load voice to talk to the client. 16. A client who recently experienced the death of a significant other arrives at the mental health center. The client reports loss of interest in usual activities, expresses a wish to be with the decreased significant other, has been eating very little, and has not slept in several days. Which client statement is most important for the RN to explore at this time? A. Not sleeping for several days. B. Wishing to be with spouse. C. Lack of interest in usual activities. D. Eating very little. 17. A middle aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning? A. Provide education on methods to enhance sleep. B. Teach the client to develop a plan for daily structured activities. C. Suggest that the client develop a list of pleasurable activities. D. Encourage the client to exercise. 18. When developing a plan of care for a client admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt, which nursing problem has the highest priority? A. Impaired comfort. B. Risk for injury. C. Ineffective breathing pattern. D. Ineffective coping. 19. A female client on a psychiatric unit is sweating profusely while she vigorously does push-ups and then runs the length of the corridor several times before crashing into furniture in the sitting room. Picking herself up, she begins to toss chairs aside, looking for a red one to sit in. When another client objects to the disturbance, the client shouts, “I am the boss here. I do what I want.” Which nursing problem best supports these observations? A. Deficient diversional activity related to excess energy level. B. Risk for other related violence related to disruptive behavior. C. Risk for activity intolerance related to hyperactivity. D. Disturbed personal identity related to grandiosity. 20. A RN is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview? A. Dim the lights in the room to help the patient feel calm. B. Sit within two feet of the client to enhance level of safety and security. C. Reduce the noise level in the room by turning off the television and radio. D. Position table between the client and the RN for extra personal space. 21. An older homeless client visits the psychiatric clinic to obtain a prescription renewal for alprazolam (Xanax). During the health assessment, the client complains of chest pain. Which action should the RN take first? A. Refer the client to the cardiology unit. B. Obtain the client Blood pressure. C. Assess the client for substance abuse. D. Determine if Xanax was taken recently. 22. The mother of an 8-month-old infant with profound mental and physical disabilities tells he RN how depressed she is because she realized that her child will never achieve normal growth and development milestones. How should the RN respond to the mother? A. Ask the mother if she has ever thought about harming herself or her child. B. Reassure the mother that her child will achieve some growth and development milestones. C. Determine if the mother has other children who do not have developmental disabilities. D. Encourage the mother to write thoughts and feelings in journal. 23. Several clients with chronic mental illness and multiple substance abuse histories live in a group residential home and attend daycare mental health facility where group and individual therapies are provided. The RN finds the common bathroom at the facility with sputum on the walls, urine in the sink and on the floors, and the toilet stopped up with tissue, paper towels, and feces. What is the priority issue that the RN should address? A. Medication non-compliance. B. Number of bathroom facilities. C. Infection control. D. Acting out behaviors. 24. A client with schizophrenia is admitted to the psychiatric care unit for aggressive behavior, auditory hallucinations, and potential for safe harm. The client has not been taking medications as prescribed and insists that the food has been poisoned and refuses to eat. What intervention should the RN implement? A. Assure the client that all food served in the hospital is safe to eat. B. Tell the client that irrational thinking is a symptom of schizophrenia. C. Obtain an order for a tube feeding for the client. D. Provide the client with food in unopened containers. 25. The RN is providing education about strategies for a safety plan for a female client who is a victim of intimate partner violence. Which strategies should be included in the safety plan? (SOA) A. Purchase a gun to use for protection. B. Establish a code with family and friends to signify violence. C. Take a self-defense course that retaliates the abuser with injury. D. Have a bag ready that has extra clothes for self and children. E. Plan an escape route to use if the abuser blocks the main exit. 26. The RN is admitting a male client who take lithium carbonate (Eskalith) twice a day. Which information should the RN report to the HCP immediately? A. Short term memory loss. B. Five pound weight gain C. Decreased affect. D. Nausea and vomiting. 27. A male client who is admitted with delirium tremens is dehydrated and experiencing auditory hallucinations. He has a bruised, swollen tongue and is confused. In developing a plan of care, which action should the RN include to ensure the client is physiologically stable? A. Encourage oral fluids. B. Monitor vital signs. C. Keep the room dark. D. Apply ice to his tongue. 28. A RN is teaching a client about initiation of a prescribed abstinence therapy using Disulfiram (Antabuse). What information should the client acknowledge understanding? A. Admit to others that he is a substance abuser. B. Remain alcohol free for 12 hours prior to first dose. C. Attend monthly meetings of alcoholics anonymous. D. Completely sustain from heroin or cocaine use. 29. The RN is working with a male client at a community mental health center when the client reports hearing voices that tell him to get a knife from the kitchen and hurt himself. What intervention is most important for the RN to implement? A. Don’t allow the client to go into the kitchen until the hallucination has subsided. B. Report the behavior to the client’s case workers so that the family can be notified. C. Assign the UAP to remain with the client at all times. D. Document the behavior in the client’s record and notify the HCP. 30. A homeless client who reports feeling sad and depressed tells the mental health nurse that in the past 2 days she has only had 4 hours of sleep. Which action is most important for the RN to implement within the first 24 hours after treatment is initiated? A. Allow the client to rest and sleep. B. Ensure client attend groups addressing coping skills for dealing with depression. C. Begin planning for the clients discharge. D. Encourage verbalization of feelings. 20. Which client statement suggests the RN that the client is using a defense mechanism of projection to deal with anxiety related to admission to a psychiatric unit? A. At least I hit the wall instead of hitting the psychiatric aide. B. I am here because the police thought I was doing something wrong. C. I want to be here because I know it is the best psychiatric facility. D. Don’t believe everything my family tells you, I am not crazy. 13. A male client is admitted to the psychiatric inpatient unit with a bandaged flesh wound after attempting to shoot himself. He was divorced one year ago. Lost his job four months ago, and suffered a breakup of is current relationship last week. What is most likely source of this client’s current feelings of depression? A. Feelings of frustration. B. A sense of loss C. Poor self-esteem. D. A lack of intimate relationships. 22. The RN documents the mental status of a female client who has been hospitalized for several days by court order. The client states”I don’t need to be here,” and tells the RN that she believes that the t.v talks to her. The RN should document these assessment statements in which section of the mental status exam? A. Insight and judgement. B. Mood and affect. C. Remote memory. D. Level of concentration. 23. An older ale client with schizophrenia is found smearing feces n the bathroom walls of the chronic mental health unit where he resides. What action should the RN implement? A. Explain that the feces belong in the toilet. B. Show the client how to clean the walls. C. Escort the client out of the bathroom. D. Assist the client to clean the walls. 24. A male client tells the RN that he does not want to take the atypical antipsychotic drug, olanzapine (Zypexa), because of the side effects he experienced when he took the drug for a year. Which experience is most likely related to taking olanzapine? A. Weight gain of 75 lbs. B. Thoughts of wanting to hurt himself. C. Frequent days with diarrhea. D. Alerted liver function test. 25. A college student who is a victim of a car-jacking presents to the community health center and report increased anxiety. During the interview, what nursing intervention should take the highest priority? A. Identify support systems in the community that may be helpful. B. Help the client feel safe to decrease anxiety. C. Ask the client to describe coping strategies that were helpful in the past. D. Encourage the client to verbalize anxiety related to event. 26. The RN completes an assessment of a client who is experiencing intimate partner violence (IPV). Which finding of the injuries should the RN include in the documentation? A. A summary of the client’s feelings. B. Photographs. C. A general description. D. A client’s significant other’s statement. 19. Following involvement in a MVC, a middle aged adult client is admitted to the hospital with multiple facial fractures. The client’s blood alcohol level is high on admission. Which PRN prescription should be administered if the client begins to exhibit signs and symptoms of delirium tremens (DTs)? A. Prochlorperazine (Compazine) 5 mg IM. B. Hydromorphone (Dialuadid) 2 mg IM. C. Chlorpromazine (Thorazine) 50 mg IM. D. Lorazepam (Ativan) 2 mg IM. 1. Part Three 2. A male adult comes to the mental health clinic and walks back and forth in front of the office door, but does not enter the office. He then walks around a chair that is in the hallway several times before sitting down in the chair. What action should the nurse take first observe the client in the chair? 3. A female client engages in repeated checks of door and window locks. Behavior that prevents her from arriving on time and interferes with her ability to function e²ectively. What action should the nurse take plan a list of activities to be carried out daily. 4. A male client with schizophrenia is admitted to the mental health unit after abruptly stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most important for the nurse to ask the client Do you hear voices. 5. A female client with a history of drinking who was admitted 8 hours ago after receiving treatment for minor abrasions occurred from a fall at home. 6. The nurse determines the client's blood alcohol level (BAL) was not analyzed on administration action should the nurse take Ask client about alcohol quantity, frequency, and time of last drink 7. Which client statement suggests to the nurse that the client is using the defense mechanism of projection to deal with anxiety related to admission to a psychiatric unit I am here because the police thought I was doing something wrong 8. A female client on a psychiatric unit is sweating profusely while she vigorously does push-ups and then runs the length of the corridor several times before crashing into the furniture in the sitting room. Picking herself up, she begins to toss chairs aside, looking for a red one to sit in. When another client objects to the disturbances, the client shouts," I am the boss here. I do what I want." Which nursing problem best supports these observations Risk for other related violence related to disruptive 9. What is the most important goal for a client diagnosed with major depression who has been receiving an antidepressant medication for two weeks not attempt to commit suicide 10. Alcohol-Pancreatitis health assessment of history of alcohol dependency WHAT ELSE WOULD BE A CONCERN pancreatitis 11. Anorexia Nervosa-syncope Syncope is a clinical feature Abuse-BAL- 12. Admission A female client with a history of drinking who was admitted 8 hours ago after receiving treatment for minor abrasions occurred from a fall at home. The nurse determines the client's blood alcohol level (BAL) was not analyzed on administration action should the nurse take Blood alcohol level- ask the client about alcohol quantity, frequency, and time of the last drink. 13. IPV- difficulty leaving victim of intimate partner violence what 3 things should you do 1. establish a code with family and friends to signify violence, 2. plan an escape route to use if the abuser blocks main exit, 3.have a bag ready that has extra clothes for self and children 14. Anger Management Give the client permission to be angry 15. Antisocial- interrupting A female client with bipolar disorder, manic phase, is planning weekend activities with the other clients on the unit. The client interrupts the group, insists that they change their plans to a disco party, and begins to curse loudly when the group refuses to change the plans. Which intervention should the nurse implement? C. Escort the client to a quieter place. 16. borderline personality disorder self-inflicted lacerations on abdomen perform the dressing change in a non-judgemental manner *ask to summarize-others need time also Borderline-interaction The nurse is assessing a client who is believed to have a borderline personality disorder. Which question is most important to include in this assessment? C. Do you frequently have temper tantrums? Self-critical demanding, whiney, manipulative, argumentative and can be verbally abusive suicidal gestures. borderline personality disorder self-inflicted lacerations on abdomen perform the dressing change in a non -judge mental manner. 17. Conversion disorder patient complains of blindness Conversion disorder Disorder characterized by transferring a mental conflict into a physical symptom for which there is no organic cause. Ex: blindness, paralysis, seizures, deafness, and pseudocyesis(false pregnancy). 18. Countertransference occurs when a mental health care professional redirects his or her feelings toward a client or becomes emotionally entangled with a client counter transference. 19. Part five 20. After returning to work after a weekend off the nurse gets report that a depressed client has been in bed all weekend. What should the nurse to first? 21. Assist the client out of bed and involve in activity. 22. A client with dementia uses the defense mechanism of confabulation. What is the reasoning? 23. To decrease anxiety. 24. A husband states to the nurse that his wife is not sleeping, buying impulsively, taking last minute trips, and has lost 22 pounds one month. What is an appropriate nursing dx? HESI MENTAL HEALTH V3 2017 55 QUESTIONS 25. Disturbed thought process. 26. A nurse is explaining a fire drill routine to a group of clients. A client becomes disruptive and continually interrupts the group. What is the nurse's best response? 27. When you interrupt, I cannot explain what to do to the group. 28. When performing a MSE on a client which assessment intervention would best assist the nurse? 29. Ask the client to interpret the proverb a stitch in time saves nine. 30. A client comes in after being in a car accident and is experiencing alcohol withdrawal, magnesium level of 1.1, cardiac dysthrythmias. What would you give first? 31. Magnesium. 32. A woman is just told of her husband's dx of terminal cancer. What would the nurse offer for the spouse (wife)? 33. How would you like to be involved with your husband's care? 34. A nurse is to remove staples from an abdominal incision, the client is very anxious. What is the most important intervention? 35. Attempt to distract the client with general conversation. 36. A man who was stranded on the roof of his house for two days after a natural disaster, months later ... 37. Implement anxiety control strategies 38. A man dx with bipolar disorder states, "I don't understand, I believe in God and have not done anything to deserve this". What is the nurse's best response? 39. You didn't do anything wrong. You have a chemical imbalance in your brain. 40. A client becomes upset when the nurse he requests is not assigned to him, what is the nurse's best response? 41. Advise the client that nursing assignments are not based on client requests. 42. A client needs to wash her hands for two hours before able to go on with her morning. She doesn't want to sit on the chairs in the dayroom for fear of getting dirty. What is this mechanism? 43. Compulsion. 44. A client in group is talking about her prostitution, the nurse asks her if she was abused by her parents. She states "my mother ran my father out when I was young". What defense mechanism was used? 45. Repression. 46. A woman calls the crisis hotline and says she has a loaded gun and is going to kill herself. To maintain patient confidentiality what would the nurse do? 47. Contact the person the client chooses to go to the home and remove the weapon. 48. A client with anger management issues uses belt making and bangs the leather heavily. What defense mechanisms is being used? 49. Sublimation. 50. A bipolar client comes into the clinic and tells the nurse that the next time she sees her sister I'm going to kill her. What should the nurse do? 51. Inform the sister. 52. What would be the nurse's highest priority for a newly admitted depressed client upon admission? 53. The nurse should go through the client's belongings. 54. Who is most prone to being abused (elder abuse)? 55. Females over 75 living with their families. 56. A client in the dayroom had tipped over a table and is escalating and has picked up a chair which he is threatening to throw at another client. What should the nurse do first? 57. Go and get more staff assistance. 58. A woman who is psychotic is carrying all of her belongings around with her because she is afraid that someone will steal it. What is the best way to establish trust? 59. Make brief contact with the client throughout the day. 60. In adolescent group discussing a handout on anger management, a client is becoming increasingly interruptive and talking about his home and pets. What is the nurse's most appropriate response? 61. Redirect the client to read the handout. 62. What is the most important intervention for a client with bulimia? 63. Plan scheduled meals. 64. A client comes into the ED with DTs. What should the nurse do first? 65. Administer Ativan. 66. What are the side effects of Resperdal? 67. Fever, tachycardia, and sweating. 68. A client who is refusing to take his medication is wandering on the unit and going in and out of resident's rooms. What is the priority? 69. Wandering in and out of other client's rooms. 70. A nurse observes a client in the dayroom talking to himself. What should the nurse do first? 71. Ask the client if he’s currently hearing voices? 72. A client comes to the nurses' station and told the nurse that her roommate had cut her wrists in the bathroom. After assessing and dressing the wounds, what should the nurse do next? 73. Move the client to a private room by the nurse's station. 74. A man comes into the ER after being in a car accident with an alcohol level greater than 2, what should the nurse prepare to administer? 75. Give Ativan (I DONT THINK THIS ONE IS CORRECT) 76. What would be proper teaching for a client who is to start taking Antabuse? 77. Has not had anything alcoholic to drink for the last 48 hours. 78. Alzheimer's patient-nurse goes to do dressing change and the client refuses. What should the nurse do? 79. Leave and come back 30 minutes later. 80. A client is confused in an acute care hospital setting. What would support the dx of delirium instead of dementia? 81. Delirium: Started in hospital. 82. An elderly woman is brought to the ER with multiple stages of healing bruises. What should the nurse do? 83. Take the woman aside and ask her about abuse. 84. A business man is stressed about his finances, has anxiety and sleeplessness. 85. Limit intake of sugar and caffeine. 86. A mother comes into the clinic with her son who is being accused of a crime. She is worried her son will go to jail. What should the nurse say to the mother? 87. Consequences of enabling behaviors. 88. What is a common side effect of cocaine use. 89. Heart attack. 90. A client on LSD comes into the ER. How do you approach the client? 91. Talk calmly and soothing to the client. 92. A client taking Meth and Benzo's, what would the nurse prepare to do for overdose? 93. Give Narcan. 94. An alcoholic father tells his wife and children to stay away from him. What is the most important nursing dx? 95. Risk for injury. 96. onWhat should you advise a patient a MAOI not to eat? 97. Cheese, beer, and avocado. 98. The parents of a teenager who has overdosed what is the first question to ask? 99. What drug did the client ingest? 100. A client becomes agitated when the nurse is talking to his wife. He has not eaten in 3 days. What should the nurse do? 101. Take to quiet room and give PB crackers. 102. When opening a mental health clinic... 103. American Nursing Association. 104. A client with a hx of depression and abusing alcohol with their depression getting worse. What is the most important nursing dx? 105. Ineffective coping. 106. A woman is being abused by her husband, the abuse is escalating. What would the nurse ask first? 107. Do you have a plan in place when you are not safe? (SAFETY!!!) 108. A patient has stopped taking Depakote six months ago, what would the nurse assess? 109. Mood. 110. A nurse visits a community half way house with one bathroom. The nurse notices urine all over the walls of the bathroom. The toilet is clogged with feces and paper towels. 111. Infection control. 112. A client with Alzheimer's keeps asking for his mother. What is the nurses appropriate response? [Show Less]
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Hesi RN Mental Health Final Exam Practice Questions with Answers.
Hesi RN Mental Health Final Exam Practice Questions with Answers. 1. A nursing student new to psychiatric-mental health nursing asks a peer what resou... [Show More] rces he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be: a. Nursing Interventions Classification (NIC) b. Nursing Outcomes Classification (NOC) c. NANDA-I nursing diagnoses d. DSM-5 2. Epidemiological studies contribute to improvements in care for individuals with mental disorders by: a. Providing information about effective nursing techniques. b. Identifying risk factors that contribute to the development of a disorder. c. Identifying individuals in the general population who will develop a specific disorder. d. Identifying which individuals will respond favorably to a specific treatment. 3. Besides antianxiety agents, which classification of drugs is also commonly given to treat anxiety and anxiety disorders? a. Antipsychotics b. Mood stabilizers c. Antidepressants d. Cholinesterase inhibitors 4. What assessment question will provide the nurse with information regarding the effects of a woman’s circadian rhythms on her quality of life? a. “How much sleep do you usually get each night?” b. “Does your heart ever seem to skip a beat?” c. “When was the last time you had a fever?” d. “Do you have problems urinating?” 5. You realize that your patient who is being treated for a major depressive disorder requires more teaching when she makes the following statement: a. “I have been on this antidepressant for 3 days. I realize that the full effect may not happen for a period of weeks.” b. “I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.” c. “I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.” d. “I realize that there are many antidepressants and it might take a while until we find the one that works best for me.” 6. A patient being treated for insomnia is prescribed ramel-teon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for this particular patient? a. Obsessive-compulsive disorder b. Generalized anxiety disorder c. Persistent depressive disorder d. Substance use disorder 7. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication education the patient received was effective? Select all that apply. a. “I hope Wellbutrin will help my depression and also help me to finally quit smoking.” b. “I’m happy to hear that I won’t need to worry too much about weight gain.” c. “It’s okay to take Wellbutrin since I haven’t had a seizure in 6 months.” d. “I need to be careful about driving since the medication could make me drowsy.” e. “My partner and I have discussed the possible effects this medication could have on our sex life.” 8. Which drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages? a. SSRIs b. antipsychotics c. benzodiazepines d. tricyclic antidepressants 9. The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving: a. lithium (Eskalith) b. clozapine (Clozaril) c. diazepam (Valium) d. amitriptyline 10. A psychiatric nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs: a. Selective serotonin reuptake inhibitors b. Monoamine oxidase inhibitors c. Serotonin and norepinephrine reuptake inhibitors d. All of the above 11. The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply. a. “Is the patient expressing suicidal thoughts?” b. “Does the patient have intact judgment and insight into his situation?” c. “Does the patient have experiences with either community or inpatient mental healthcare facilities?” d. “Does the patient require a therapeutic environment to support the management of psychotic symptoms?” e. “Does the patient require the regular involvement of their family/significant other in planning and executing the plan of care?” 12. Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select all that apply. a. Intermittent supervision is available in inpatient settings. b. He requires stabilization of multiple symptoms. c. He has nutritional and self-care needs. d. Medication adherence will be mandated. e. He is in imminent danger of harming himself. 1. Which statement made by the nurse demonstrates the best understanding of nonverbal communication? a. “The patient’s verbal and nonverbal communication is often different.” b. “When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.” c. “If a patient is slumped in the chair, I can be sure he’s angry or depressed.” d. “It’s easier to understand verbal communication that nonverbal communication.” 2. Which nursing statement is an example of reflection? a. “I think this feeling will pass.” b. “So you are saying that life has no meaning.” c. “I’m not sure I understand what you mean.” d. “You look sad.” 3. When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient? a. Change of shift report b. Admission interviews c. One-to-one conversations with patients d. Conversations with patient families 4. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply. a. Auditory b. Visual c. Written d. Tactile e. Olfactory 5. What principle about nurse-patient communication should guide a nurse’s fear about “saying the wrong thing” to a patient? a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c. Considering the patient’s history, there is little chance that the comment will do any actual harm. d. Most people with a mentally illness have by necessity developed a high tolerance of forgiveness. 6. You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? a. “A new psychiatrist is a chance to start fresh; I’m sure it will go well for you.” b. “You say you look forward to the meeting, but you appear anxious or unhappy.” c. “I notice that you frowned and avoided eye contact just now. Don’t you feel well?” d. “I get the impression you don’t really want to see your psychiatrist—can you tell me why?” 7. Which student behavior is consistent with therapeutic communication? a. Offering your opinion when asked to convey support. b. Summarizing the essence of the patient’s comments in your own words. c. Interrupting periods of silence before they become awkward for the patient. d. Telling the patient he did well when you approve of his statements or actions. 8. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic? a. “There are no such things as demons. What you saw were hallucinations.” b. “It is not possible for anyone to enter your room at night. You are safe here.” c. “You seem very upset. Please tell me more about what you experienced last night.” d. “That must have been very frightening, but we’ll check on you at night and you’ll be safe.” 9. Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic? a. Restating b. Encouraging description of perception c. Summarizing d. Asking “why” questions 10. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, “I don’t need to come see you anymore. I have found a therapy app on my phone that I love.” How should Carolina respond to this news? a. “That sounds exciting, would you be willing to visit and show me the app?” b. “At this time, there is no real evidence that the app can replace our therapy.” c. “I am not sure that is a good idea right now, we are so close to progress.” d. “Why would you think that is a better option than meeting with me?” 1. Which statement demonstrates a well-structured attempt at limit setting? a. “Hitting me when you are angry is unacceptable.” b. “I expect you to behave yourself during dinner.” c. “Come here, right now!” d. “Good boys don’t bite.” 2. Which activity is most appropriate for a child with ADHD? a. Reading an adventure novel b. Monopoly c. Checkers d. Tennis 3. Cognitive-behavioral therapy is going well when a 12-year- old patient in therapy reports to the nurse practitioner: a. “I was so mad I wanted to hit my mother.” b. “I thought that everyone at school hated me. That’s not true. Most people like me and I have a friend named Todd.” c. “I forgot that you told me to breathe when I become angry.” d. “I scream as loud as I can when the train goes by the house.” 4. What assessment question should the nurse ask when attempting to determine a teenager’s mental health resilience? Select all that apply. a. “How did you cope when your father deployed with the Army for a year in Iraq?” b. “Who did you go to for advice while your father was away for a year in Iraq?” c. “How do you feel about talking to a mental health counselor?” d. “Where do you see yourself in 10 years?” e. “Do you like the school you go to?” 5. Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply. a. Limited language skills b. Level of cognitive development c. Level of emotional development d. Parental denial that a problem exists e. Severity of the typical mental illnesses observed in young children 7. In pediatric mental health there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: Select all that apply. a. Children of color and poor economic conditions being underserved b. Increased stress in the family unit c. Markedly increased funding d. Premature termination of services 8. Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his “nice” mom, that he loves school, and gets above average grades. The strongest explanation of this response is: a. Temperament b. Genetic factors c. Resilience d. Paradoxical effects of neglect 9. April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April’s mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that: a. Time-out is an important part of April’s baseline discipline. b. Time-out is no longer an effective therapeutic measure. c. April enjoys time-out, and acts out to get some alone time. d. Time-out will need to be replaced with seclusion and restraint. 10. Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to: a. Limited executive function b. Cerebellum maturation c. Cerebral stasis and hormonal changes d. A slight reduction in brain volume 1. Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia? a. Always afraid another student will steal her belongings. b. An unusual interest in numbers and specific topics. c. Demonstrates no interest in athletics or organized sports. d. Appears more comfortable among males. 2. Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia? a. Screening a group of males between the ages of 15 and 25 for early symptoms. b. Forming a support group for females aged 25 to 35 who are diagnosed with substance use issues. c. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective. d. Educating the parents of a group of developmentally delayed 5- to 6-year-olds on the importance of early intervention. 3. To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated condition? Select all that apply. a. Alcohol use disorder b. Major depressive disorder c. Stomach cancer d. Polydipsia e. Metabolic syndrome 4. A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms? a. Her memory problems will likely decrease. b. Depressive episodes should be less severe. c. She will probably enjoy social interactions more. d. She should experience a reduction in hallucinations. 5. Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia? a. Depersonalization b. Pressured speech c. Negative symptoms d. Paranoia 6. Gilbert, age 19, is described by his parents as a “moody child” with an onset of odd behavior about at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert’s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered: a. Favorable with medication b. In the relapse stage c. Improvable with psychosocial interventions d. To have a less positive outcome 7. Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient’s nursing diagnosis is altered thought processes? a. “I know you say you hear voices, but I cannot hear them.” b. “Stop listening to the voices, they are NOT real.” c. “You say you hear voices, what are they telling you?” d. “Please tell the voices to leave you alone for now.” 8. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that: a. Medications provided are ineffective. b. Nurses are trying to control their minds. c. The medications will make them sick. d. They are not actually ill. 9. Kyle, a patient with schizophrenia, began to take the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select all that apply. a. Hold his medication and contact his prescriber. b. Wipe him with a washcloth wet with cold water or alcohol. c. Administer a medication such as benztropine IM to correct this dystonic reaction. d. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass. e. Hold his medication for now and consult his prescriber when he comes to the unit later today. 10. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas’s nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co- occur along with: a. Generally good health despite the mental illness. b. An aversion to drinking fluids. c. Anxiety and depression. d. The ability to express his needs. 1. Which nursing response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar and her support system? Select all that apply. a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms.” b. “Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder. c. “It’s critical to let your healthcare provider know immediately if you aren’t sleeping well.” d. “Is your family prepared to be actively involved in helping manage this disorder?” e. “The symptoms tend to come and go and so you need to be able to recognize the early signs.” 2. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select all that apply. a. “I have to keep reminding myself to consistently drink six 12-ounce glasses of fluid every day.” b. “I discussed the diuretic my cardiologist prescribed with my psychiatric care provider.” c. “Lithium may help me lose the few extra pounds I tend to carry around.” d. “I take my lithium on an empty stomach to help with absorption.” e. “I’ve already made arrangements for my monthly lab work.” 3. The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient? Select all that apply. a. Increased attentiveness b. Getting up at night to urinate c. Improved vision d. An upset stomach for no apparent reason e. Shaky hands that make holding a cup difficult 4. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially? a. Reinforce that the level is considered therapeutic. b. Instruct the patient to hold the next dose of medication and contact the prescriber. c. Have the patient go to the hospital emergency room immediately. d. Alert the patient to the possibility of seizures and appropriate precautions. 5. Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select all that apply. a. Monitor the patient’s vital signs frequently. b. Keep the patient distracted with group-oriented activities. c. Provide the patient with frequent milkshakes and protein drinks. d. Reduce the volume on the television and dim bright lights in the environment. e. Use a firm but calm voice to give specific concise directions to the patient. 6. Substance abuse is often present in people diagnosed with bipolar disorder. Laura, a 28-year- old with a diagnosis of bipolar disorder, drinks alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that: a. Anxiety may be present. b. Alcohol ingestion is a form of self-medication. c. The patient is lacking a sufficient number of neurotransmitters. d. The patient is using alcohol because she is depressed. 7. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted’s wife and his blood tests confirm. To reduce Ted’s mania the psychiatric nurse practitioner recommends: a. Clonazepam (Klonopin) b. Fluoxetine (Prozac) c. Electroconvulsive therapy (ECT) d. Lurasidone (Latuda) 8. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, “You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing”: a. A higher dosage b. Once a week dosing c. A lower dosage d. A different drug 9. Tatiana has been hospitalized for an acute manic episode. On admission the nurse suspects lithium toxicity. What assessment findings would indicate the nurse’s suspicion as correct? a. Shortness of breath, gastrointestinal distress, chronic cough b. Ataxia, severe hypotension, large volume of dilute urine c. Gastrointestinal distress, thirst, nystagmus d. Electroencephalographic changes, chest pain, dizziness 10. Luc’s family comes home one evening to find him extremely agitated and they suspect in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting? a. Hypodermic needles b. Fast food wrappers c. Empty soda cans d. Energy drink containers 1. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder? a. “I’m so restless. I can’t seem to sit still.” b. “I spend most of my time studying. I have to get into a good college.” c. “I’m not trying to diet, but I’ve lost about 5 pounds in the past 5 months.” d. “I go to sleep around 11 p.m. but I’m always up by 3 a.m. and can’t go back to sleep.” 2. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select all that apply. a. “Do rules apply to you?” b. “What do you do to manage anxiety?” c. “Do you have a history of disordered eating?” d. “Do you think that you drink too much?” e. “Have you ever been arrested for committing a crime?” 3. Which nursing intervention focuses on managing a common characteristic of major depressive disorder associated with the older population? a. Conducting routine suicide screenings at a senior center. b. Identifying depression as a natural, but treatable result of aging. c. Identifying males as being at a greater risk for developing depression. d. Stressing that most individuals experience just a single episode of major depression in a lifetime. 4. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select all that apply. a. Female b. 7 years old c. Comorbid autism diagnosis d. Outbursts occur at least once a week e. Temper tantrums occur at home and in school 5. Which chronic medical condition is a common trigger for major depressive disorder? a. Pain b. Hypertension [Show Less]
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