HESI LPN
HESI Mental Health
1. A male client is admitted to a mental health unit on Friday afternoon and is very upset on Sunday because he has not had the opportunity to talk with the healthcare provider. Which response is best for the nurse to provide this client?
- A. Let me call and leave a message for your healthcare provider.
- B. The healthcare provider should be here on Monday morning.
- C. How can I help answer your questions?
- D. What concerns do you have at this time?
Correct answer: A
Rationale: It is best for the nurse to call the healthcare provider (A) because clients have the right to information about their treatment. Suggesting that the healthcare provider will be available the following day (B) does not provide immediate reassurance to the client. While offering to help answer questions (C) and inquiring about concerns (D) are supportive approaches, contacting the healthcare provider is the most appropriate action to address the client's immediate need for communication with their healthcare provider.
2. 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? (select one that does not apply)
- A. Purchase a gun to use for protection.
- B. Keep quiet and calm.
- C. Take a self-defense course that retaliates against the abuser with injury.
- D. Have a bag ready that has extra clothes for self and children.
Correct answer: C
Rationale: Taking a self-defense course that retaliates against the abuser with injury can escalate the level of violence and is not recommended in a safety plan for a victim of intimate partner violence. The correct strategies include establishing a code, having a bag ready, and planning an escape route, which enhance safety without increasing the risk of harm.
3. A young adult male with a history of substance abuse is admitted to the psychiatric unit for detoxification. He is agitated, sweating, and reports seeing bugs crawling on the walls. What is the priority nursing intervention?
- A. Reassure the client that the bugs are not real.
- B. Administer the prescribed benzodiazepine.
- C. Place the client in a quiet, dark room.
- D. Encourage the client to express his feelings.
Correct answer: B
Rationale: The correct answer is to administer the prescribed benzodiazepine. This intervention helps manage the client's agitation and hallucinations, which are common symptoms during detoxification from substances. Reassuring the client that the bugs are not real (Choice A) may not be effective in addressing the underlying causes of the hallucinations. Placing the client in a quiet, dark room (Choice C) may help reduce sensory stimulation but does not directly address the client's symptoms. Encouraging the client to express his feelings (Choice D) is important for therapeutic communication but may not be the priority when the client is experiencing severe agitation and hallucinations.
4. A client is diagnosed with schizophrenia and exhibits apathy, lack of energy, and lack of interest in daily activities. The nurse should recognize that these symptoms are most likely due to which of the following?
- A. Negative symptoms of schizophrenia.
- B. Positive symptoms of schizophrenia.
- C. Side effects of antipsychotic medication.
- D. Symptoms of depression.
Correct answer: A
Rationale: Apathy, lack of energy, and lack of interest in daily activities are negative symptoms of schizophrenia (A). Positive symptoms of schizophrenia include hallucinations and delusions (B). While antipsychotic medication side effects can sometimes cause lethargy or sedation (C), the scenario specifically describes negative symptoms. Depression can also cause similar symptoms (D), but in the context of schizophrenia, these are recognized as negative symptoms.
5. A client with depression is prescribed an SSRI. The client asks, 'Why do I need to take this medication every day?' What is the best response by the nurse?
- A. This medication will help balance the chemicals in your brain.
- B. This medication needs to be taken regularly to be effective.
- C. This medication will start working immediately to improve your mood.
- D. You should take this medication only when you feel sad or depressed.
Correct answer: D
Rationale: Explaining that the medication may take several weeks to take full effect helps manage the client's expectations and encourages adherence to the prescribed treatment.
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