HESI LPN
HESI Mental Health
1. A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A mental health aide asks the nurse why the client is this way after being on fluphenazine (Prolix) 10 mg for 7 days. The LPN/LVN should tell the health aide:
- A. Prolixin is the most effective with positive symptoms of schizophrenia.
- B. The client will be less withdrawn and unmotivated when the Prolixin takes effect.
- C. The client's Prolixin dose probably needs to be increased again.
- D. Lack of motivation is a common side effect of the Prolixin.
Correct answer: A
Rationale: Prolixin is more effective with positive symptoms of schizophrenia, such as hallucinations and delusions, rather than negative symptoms like withdrawal and lack of motivation.
2. A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the LPN/LVN take?
- A. Notify the healthcare provider immediately and prepare for administration of an antidote.
- B. Notify the healthcare provider of the symptoms prior to the next administration of the drug.
- C. Record the symptoms as normal side effects and continue administration of the prescribed dosage.
- D. Hold the medication and refuse to administer additional amounts of the drug.
Correct answer: B
Rationale: When a client being treated with lithium carbonate for bipolar disorder develops symptoms like diarrhea, vomiting, and drowsiness, it could indicate lithium toxicity. The appropriate action for the LPN/LVN is to notify the healthcare provider immediately of these symptoms before the next administration of the drug. This prompt communication is crucial to ensure that the healthcare provider can assess the situation, adjust the treatment plan if necessary, and prevent potential complications associated with lithium toxicity. Option A is incorrect because administering an antidote should be based on the healthcare provider's assessment. Option C is incorrect as these symptoms are not normal side effects and could indicate a serious issue. Option D is incorrect because refusing to administer the drug without consulting the healthcare provider could delay necessary interventions.
3. An LPN/LVN is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse determines that this type of crisis is caused by:
- A. Witnessing a murder
- B. The death of a loved one
- C. A fire that destroyed the client's home
- D. A recent rape episode experienced by the client
Correct answer: B
Rationale: The correct answer is B: 'The death of a loved one.' A situational crisis, like the death of a loved one, can lead to anxiety due to a significant change or loss in the person's life. Choices A, C, and D involve traumatic events, but a situational crisis typically refers to life events that disrupt an individual's normal pattern of living, such as the death of a loved one.
4. A 72-year-old female client is admitted to the psychiatric unit with a diagnosis of major depression. Which statement by the client should be of greatest concern to the nurse and require further assessment?
- A. "I will die if my cat dies."
- B. "I don't feel like eating this morning."
- C. "I just went to my friend's funeral."
- D. "Don't you have more important things to do?"
Correct answer: A
Rationale: Sometimes a client will use an analogy to describe themselves, and (A) would be an indication for conducting a suicide assessment. (B) could have a variety of etiologies, and while further assessment is indicated, this statement does not indicate potential suicide. The normal grief process differs from depression, and at this client's age, peer/cohort deaths are more frequent, so (C) would be within normal limits. (D) is an expression of low self-esteem typical of depression. Choices (B), (C), and (D) are examples of decreased energy and mood levels which would negate suicide ideation at this time.
5. A client with schizophrenia is being treated with haloperidol (Haldol) and begins to exhibit symptoms of tardive dyskinesia. What is the nurse's priority action?
- A. Continue the medication and monitor for worsening symptoms.
- B. Administer the next dose of haloperidol with food.
- C. Report the symptoms to the healthcare provider immediately.
- D. Educate the client about the side effects of haloperidol.
Correct answer: C
Rationale: The correct answer is to report the symptoms to the healthcare provider immediately. Tardive dyskinesia is a serious side effect of antipsychotic medications, including haloperidol. Prompt reporting is crucial to evaluate the need for medication adjustment or change in treatment. Continuing the medication without intervention (choice A) can worsen the symptoms. Administering the next dose (choice B) is not appropriate when tardive dyskinesia is suspected. Educating the client (choice D) is important but not the priority when dealing with acute symptoms of tardive dyskinesia.
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