HESI MENTAL HEALTH VERSION 2 (2019)
1.An older male resident of a long-term care facility who is chronically depressed has become more reclusive and refuses to leave his room today. His family moved away from the loca
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HESI MENTAL HEALTH VERSION 2 (2019)
1.An older male resident of a long-term care facility who is chronically depressed has become more reclusive and refuses to leave his room today. His family moved away from the local area, and they are unable to visit as much as they did in the past. Which comment by the nurse is likely to be most helpful to this client?
May I sit with you for a while?
2.A male client with long history of alcohol dependency arrives in the emergency department describing the feelings of bugs crawling on his body. His blood pressure is 170/102, his pulse rate is 110 bpm, and is blood alcohol level is 0mg/dL. Which prescription should the RN administer?
Lorazepam (Ativan).
3.The RN is completing the admission assessment of an underweight adolescent who is admitted to a psychiatric unit with a diagnosis of depression. Which finding requires notification to the HCP?
Potassium level of 2.9 mEq/dl.
4.A woman is brought to the psychiatric clinic by her husband. He reports that his wife is reluctant to leave home because of what she describes as a fear of open places and crowds. Which nursing problem applies to this client’s behavior?
Anxiety related to real or perceived threat to physical integrity.
5.A client is receiving benztropine mesylate (Cogentin) for drug-induced extrapyramidal syndrome (EPS). Which finding indicates that the RN should further evaluate the client?
Presence of a dry mouth.
6.A male client in the mental health unit is guarded and vaguely answers the nurse’s questions. He isolates in his room and sometimes opens the door to peek into the hall. Which problem can the RN anticipate?
Delusions of persecution.
7.A female client with obsessive compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving, and reports her findings to the RN at bedtime. What action should the nurse implement?
Encourage the client to express her feelings regarding the upcoming procedure.
8.During admission to the psychiatric unit, a female client is extremely anxious and states that she is worried about the sun coming up the next day. What intervention is most important for the RN to implement during the admission process?
Assist the client in developing alternative coping skills.
9.A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The RN also determines that the client is homeless and is exhibiting suspiciousness. The client’s plan of care should include what priority problem?
Acute confusion.
10.The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, “I can’t believe this. What should I do?” Which response is best for the RN to provide in this crisis?
Call for transportation to the hospital.
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