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HESI Mental Health Practice Questions
1. A female client with anorexia nervosa is admitted to the hospital. What is the priority assessment for the nurse to perform?
- A. Assess the client's body image perception.
- B. Monitor the client's electrolyte levels.
- C. Evaluate the client's exercise habits.
- D. Assess the client's relationship with her family.
Correct answer: B
Rationale: The correct answer is to monitor the client's electrolyte levels. In clients with anorexia nervosa, electrolyte imbalances can lead to serious, potentially life-threatening complications such as cardiac arrhythmias. Assessing body image perception (choice A) is important but not the priority when compared to monitoring electrolyte levels. Evaluating exercise habits (choice C) and assessing the client's relationship with her family (choice D) are also important aspects of care but do not take precedence over monitoring electrolyte levels in a client with anorexia nervosa.
2. A client with major depressive disorder is being treated with cognitive-behavioral therapy (CBT). Which client statement indicates that CBT is having a positive effect?
- A. "I understand now that my negative thoughts are not always true."
- B. "I still feel down, but I am able to go to work."
- C. "I have stopped taking my antidepressant medication."
- D. "I avoid situations that make me feel anxious."
Correct answer: A
Rationale: The correct answer is A. Recognizing and challenging negative thoughts is a fundamental aspect of cognitive-behavioral therapy (CBT). In this statement, the client demonstrates insight into the fact that their negative thoughts may not always be accurate, showing progress in reframing their thoughts. Choice B indicates some improvement in functioning but does not directly relate to the core principles of CBT. Choice C is concerning as abruptly stopping antidepressant medication can be detrimental to the client's well-being. Choice D reflects avoidance behavior, which is typically a target for intervention in CBT rather than a sign of positive progress.
3. Based on non-compliance with the medication regimen, an adult client with a medical diagnosis of substance abuse and schizophrenia was recently switched from oral fluphenazine HCl (Prolixin) to IM fluphenazine decanoate (Prolixin Decanoate). What is most important to teach the client and family about this change in medication regimen?
- A. Signs and symptoms of extrapyramidal effects (EPS).
- B. Information about substance abuse and schizophrenia.
- C. The effects of alcohol and drug interaction.
- D. The availability of support groups for those with dual diagnoses.
Correct answer: C
Rationale: Teaching about the effects of alcohol and drug interaction is crucial to prevent adverse reactions, especially with the long-acting injectable form of fluphenazine. Understanding how alcohol and drugs can interact with the medication will help the client and family to ensure medication effectiveness and avoid potential harmful effects. Choices A, B, and D are not the most important to teach in this scenario. While knowing the signs and symptoms of extrapyramidal effects (EPS) is important, understanding the effects of alcohol and drug interaction is more critical in this specific situation. Information about substance abuse and schizophrenia, as well as the availability of support groups, are essential aspects of care but are not the primary focus when switching to a long-acting injectable medication due to non-compliance.
4. During a mental status exam, what factor should the nurse remember when assessing a client's intelligence?
- A. Acute psychiatric illnesses can impair intelligence
- B. Intelligence can be influenced by social and cultural beliefs
- C. Poor concentration skills suggest limited intelligence
- D. The inability to think abstractly indicates limited intelligence
Correct answer: B
Rationale: The correct answer is B. Intelligence is indeed influenced by social and cultural beliefs. It is essential to recognize that intelligence is not solely determined by innate abilities but can also be shaped by various external factors such as cultural background, education, and social environment. Choices A, C, and D are incorrect because acute psychiatric illnesses do not necessarily impair intelligence, poor concentration skills do not always suggest limited intelligence, and the inability to think abstractly alone does not always indicate limited intelligence.
5. Which action should the nurse implement first for a client experiencing alcohol withdrawal?
- A. Apply vest or extremity restraints.
- B. Give an alpha-adrenergic blocker.
- C. Provide a diet high in protein and calories.
- D. Prepare the environment to prevent self-injury.
Correct answer: D
Rationale: The correct action for the nurse to implement first for a client experiencing alcohol withdrawal is to prepare the environment to prevent self-injury. Clients undergoing alcohol withdrawal are at risk of seizures and other symptoms that may lead to self-harm. By ensuring a safe environment, the nurse can mitigate the risk of injury. Applying restraints (Choice A) should only be considered if less restrictive measures fail, as restraints can agitate the client further. Giving an alpha-adrenergic blocker (Choice B) may be part of the treatment plan for alcohol withdrawal but is not the first action to take. Providing a diet high in protein and calories (Choice C) is important for overall health but is not the priority when addressing immediate safety concerns.
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