HESI LPN
Mental Health HESI 2023
1. A nurse working on a mental health unit receives a community call from a person who is tearful and states, 'I just feel so nervous all of the time. I don't know what to do about my problems. I haven't been able to sleep at night and have hardly eaten for the past 3 or 4 days.' The nurse should initiate a referral based on which assessment?
- A. Altered thought processes.
- B. Moderate levels of anxiety.
- C. Inadequate social support.
- D. Altered health maintenance.
Correct answer: B
Rationale: The nurse should initiate a referral based on moderate levels of anxiety (B) as the client reports feeling nervous all the time, sleep disturbances, poor appetite, and difficulty solving problems. These symptoms are indicative of significant anxiety levels. The client does not mention symptoms related to altered thought processes (A) or inadequate social support (C). There is insufficient information to suggest altered health maintenance (D) as a reason for referral in this scenario.
2. A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to a nurse, 'I'm finally cured.' The LPN/LVN interprets this behavior as a cue to modify the treatment plan by:
- A. Suggesting a reduction of medication
- B. Allowing increased 'in-room' activities
- C. Increasing the level of suicide precautions
- D. Allowing the client off-unit privileges as needed
Correct answer: C
Rationale: A sudden improvement in mood and declaring being cured can be warning signs of a decision to attempt suicide. Therefore, the appropriate action would be to increase the level of suicide precautions to ensure the safety of the client. This can involve closer monitoring and restriction of items that could be harmful. Choices A, B, and D are incorrect as they do not address the potential risk of suicide that may be present with the sudden change in behavior.
3. A woman brings her 48-year-old husband to the outpatient psychiatric unit and describes his behavior to the admitting nurse. She states that he has been sleepwalking, cannot remember who he is, and exhibits multiple personalities. The nurse knows that these behaviors are often associated with
- A. dissociative disorder.
- B. obsessive-compulsive disorder.
- C. panic disorder.
- D. post-traumatic stress disorder.
Correct answer: A
Rationale: The correct answer is A: dissociative disorder. Sleepwalking, amnesia, and multiple personalities are examples of detaching emotional conflict from one's consciousness, which is the definition of a dissociative disorder. Obsessive-compulsive disorder (B) is characterized by persistent, recurrent intrusive thoughts or urges (obsessions) and compulsions. Panic disorder (C) is characterized by acute attacks of anxiety. Post-traumatic stress disorder (D) involves re-experiencing psychologically distressing events.
4. A client with bipolar disorder is prescribed valproic acid (Depakote). What is the most important laboratory test for the LPN/LVN to monitor?
- A. Liver function tests.
- B. Kidney function tests.
- C. Thyroid function tests.
- D. Complete blood count.
Correct answer: A
Rationale: The correct answer is A: Liver function tests. Monitoring liver function tests is crucial for clients prescribed valproic acid (Depakote) due to the medication's potential to affect liver function and increase the risk of liver toxicity. While kidney function tests (choice B), thyroid function tests (choice C), and complete blood count (choice D) are important in various clinical scenarios, the priority when administering valproic acid is to monitor liver function to prevent adverse effects associated with this medication.
5. 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 her thoughts and feelings in a journal.
Correct answer: A
Rationale: The correct response is to ask the mother if she has ever thought about harming herself or her child. This is crucial to assess for suicidal or homicidal thoughts, ensuring the safety of both the mother and the child. Reassuring the mother about achieving some milestones may not address her immediate emotional distress. Inquiring about other children's developmental status is not the priority when safety concerns are present. While journaling can be therapeutic, in this situation, addressing safety takes precedence.
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