HESI LPN
Mental Health HESI 2023
1. A client diagnosed with bipolar disorder tells the nurse that she wants to stop taking her lithium. She states, 'I feel fine, and I don't think I need it anymore.' What should the nurse do first?
- A. Agree with the client that she seems fine now.
- B. Remind the client of the importance of lithium.
- C. Ask the healthcare provider to discontinue the lithium prescription.
- D. Arrange for a psychiatric evaluation for the client.
Correct answer: B
Rationale: When a client with bipolar disorder expresses a desire to stop taking lithium because they feel fine, the nurse's initial action should be to remind the client of the importance of lithium. This approach helps educate the client about the necessity of medication adherence in managing bipolar disorder. Agreeing with the client or immediately arranging a psychiatric evaluation may not address the root issue of medication non-adherence. Asking the healthcare provider to discontinue the prescription without further assessment and intervention could potentially jeopardize the client's stability and treatment plan.
2. A client with a history of substance abuse is admitted to the hospital for detoxification. What is the most important intervention for the LPN/LVN to implement?
- A. Monitor the client for signs of withdrawal.
- B. Encourage the client to express feelings about substance use.
- C. Provide the client with information about support groups.
- D. Administer prescribed medications to manage withdrawal symptoms.
Correct answer: D
Rationale: Administering prescribed medications to manage withdrawal symptoms is the priority intervention for a client undergoing detoxification. This intervention aims to prevent severe complications that may arise during the detox process. Monitoring for signs of withdrawal (choice A) is important but providing immediate medical management through medications takes precedence to ensure the client's safety. Encouraging the client to express feelings (choice B) and providing information about support groups (choice C) are essential aspects of care but are not as urgent as administering medications to manage withdrawal symptoms.
3. A client with schizophrenia is being treated with haloperidol (Haldol). The LPN/LVN observes the client pacing in the hallway and appearing anxious. What should the nurse do first?
- A. Ask the client to sit down and relax.
- B. Administer a PRN dose of antipsychotic medication.
- C. Encourage the client to talk about what is making him anxious.
- D. Monitor the client for adverse reactions to the medication.
Correct answer: B
Rationale: Administering a PRN dose of antipsychotic medication is the first action the nurse should take to manage symptoms of anxiety in a client being treated with haloperidol. The priority is to address the client's escalating anxiety and pacing behavior, which can be managed effectively by providing additional antipsychotic medication. Asking the client to sit down and relax (Choice A) may not be effective if the anxiety is due to inadequate medication levels. Encouraging the client to talk about what is making him anxious (Choice C) may not be beneficial in this acute situation and can be considered after addressing the immediate need for symptom management. Monitoring for adverse reactions (Choice D) is important but is not the first action to take when the client is showing signs of increasing anxiety and agitation.
4. A client with generalized anxiety disorder (GAD) is prescribed alprazolam (Xanax). What is the most important teaching point for the nurse to include?
- A. Take this medication at the first sign of anxiety.
- B. Do not stop taking this medication abruptly.
- C. You may experience weight gain while taking this medication.
- D. This medication may cause vivid dreams.
Correct answer: B
Rationale: The most important teaching point for a client prescribed alprazolam is not to stop taking the medication abruptly. Abruptly stopping alprazolam, a benzodiazepine, can lead to withdrawal symptoms. It is crucial to taper off the medication under medical supervision to prevent adverse effects. Choice A is incorrect because taking the medication at the first sign of anxiety is not the key teaching point. Choice C is incorrect because weight gain is not a common side effect of alprazolam. Choice D is incorrect because vivid dreams are not a significant concern compared to the risks of abrupt discontinuation of the medication.
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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