Psychiatric-Mental Health Practice Exam
HESI
Photosensitivity is a side effect of Prolixin and a vacation in the Bahamas (with its
tropical island climate) increases the client's chance of experiencing this side effect. He
should be instructed to avoid direct sun (A) and wear sunscreen. (B, C, and D) indicate
accurate knowledge. Alcohol acts synergistically with Prolixin (B). (C) lists signs of
agranulocytosis, which is also a side effect of Prolixin. In order to avoid extrapyramidal
symptoms (EPS), anticholinergic drugs, such as Cogentin, are often prescribed
prophylactically with Prolixin.
Correct Answer(s): A - ✅✅ -1.
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin
decanoate) is being discharged in the morning. A repeat dose of medication is
scheduled for 20 days after discharge. The client tells the nurse that he is going on
vacation in the Bahamas and will return in 18 days. Which statement by the client
indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to the clinic to get my Prolixin
injection.
B) While I am on vacation and when I return, I will not eat or drink anything that contains
alcohol.
C) I will notify the healthcare provider if I have a sore throat or flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin) every day.
The most important nursing diagnosis is related to alcohol detoxification (B) because
the client has elevated vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client Ativan for elevated vital
signs secondary to alcohol withdrawal. (C and D) can be addressed when immediate
needs for safety are met.
Correct Answer(s): B - ✅✅ -2.
A male client is admitted to the mental health unit because he was feeling depressed
about the loss of his wife and job. The client has a history of alcohol dependency and
admits that he was drinking alcohol 12 hours ago. Vital signs are: temperature, 100° F,
pulse 100, and BP 142/100. The nurse plans to give the client lorazepam (Ativan) based
on which priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
,D) Health seeking behaviors related to personal crisis.
The most important reason for closely observing a depressed client immediately after
admission is to maintain safety (B), since suicide is a risk with depression. (A, C, and D)
are all important interventions, but safety is the priority.
Correct Answer(s): B - ✅✅ -3.
The charge nurse is collaborating with the nursing staff about the plan of care for a
client who is very depressed. What is the most important intervention to implement
during the first 48 hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities.
(A) is the best choice cited. The nurse does not argue with the client nor demand that
she eat, but offers support by agreeing to "be there if needed", e.g., to warm the food.
(B and C) are arguing with the client's delusions, and (B) asks "why" which is usually not
a good question for a psychotic client. (D) has nothing to do with the actual problem;
i.e., the problem is not the diet (she thinks any food given to her is poisoned.)
Correct Answer(s): A - ✅✅ -4.
A 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia.
When her tray is brought to her, she refuses to eat and tells the nurse, "I know you are
trying to poison me with that food." Which response is most appropriate for the nurse to
make?
A) I'll leave your tray here. I am available if you need anything else.
B) You're not being poisoned. Why do you think someone is trying to poison you?
C) No one on this unit has ever died from poisoning. You're safe here.
D) I will talk to your healthcare provider about the possibility of changing your diet.
Early side effects of lithium carbonate (occurring with serum lithium levels below 2.0
mEq per liter) generally follow a progressive pattern beginning with diarrhea, vomiting,
drowsiness, and muscular weakness. At higher levels, ataxia, tinnitus, blurred vision,
and large dilute urine output may occur. (B) is the best choice. Although these are
expected symptoms, the healthcare provider should be notified prior to the next
administration of the drug. (A, C, and D) would not reflect good nursing judgment.
Correct Answer(s): B - ✅✅-5.
,A client who is being treated with lithium carbonate for bipolar disorder develops
diarrhea, vomiting, and drowsiness. What action should the nurse take?
A) Notify the healthcare provider immediately and prepare for administration of an
antidote.
B) Notify the healthcare provider of the symptoms prior to the next administration of the
drug.
C) Record the symptoms as normal side effects and continue administration of the
prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the drug.
Knowledge of all substances taken (C) will guide further treatment, such as
administration of antagonists, so obtaining this information has the highest priority. (A
and B) are also valuable in planning treatment. (D) is not appropriate during the acute
management of a drug overdose.
Correct Answer(s): C - ✅✅ -6.
The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but
responsive. The mother states, "I think he took some of my pain pills." During initial
assessment of the teenager, what information is most important for the nurse to obtain
from the parents?
A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs.
The nurse should answer the client's question with factual information and explain that
schizophrenia is a chemical imbalance in the brain (B). (A) is a therapeutic response but
does not answer the question, and may be an appropriate response after the nurse
answers the question asked. Although (C) is likely true to some degree, it is also true
that some clients continue to have disorganized thinking even with antipsychotic
medications. Referring the spouse to the psychologist (D) is avoiding the issue; the
nurse can and should answer the question.
Correct Answer(s): B - ✅✅ -7.
The wife of a male client recently diagnosed with schizophrenia asks the nurse, "What
exactly is schizophrenia? Is my husband all right?" Which response is best for the nurse
to provide to this family member?
A) It sounds like you're worried about your husband. Let's sit down and talk.
B) It is a chemical imbalance in the brain that causes disorganized thinking.
C) Your husband will be just fine if he takes his medications regularly.
, D) I think you should talk to your husband's psychologist about this question.
The most important nursing problem is medication management (C) because
compliance with the medication regimen will help prevent hospitalization. The client is
also exhibiting signs of (A, B, and C); however, these problems do not have the priority
of medication management.
Correct Answer(s): C - ✅✅ -8.
The community health nurse talks to a male client who has bipolar disorder. The client
explains that he sleeps 4 to 5 hours a night and is working with his partner to start two
new businesses and build an empire. The client stopped taking his medications several
days ago. What nursing problem has the highest priority?
A) Excessive work activity.
B) Decreased need for sleep.
C) Medication management.
D) Inflated self-esteem.
The priority is to teach the parents that their son will need monitoring and support during
withdrawal (D) to ensure that he does not attempt suicide. Although (A and C) are true,
they are not as relevant to the parent's expressed concern. There is no information to
support (B).
Correct Answer(s): D - ✅✅ -9.
At a support meeting of parents of a teenager with polysubstance dependency, a parent
states, "Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid
he will commit suicide." The nurse's response should be based on which information?
A) Addiction is a chronic, incurable disease.
B) Tolerance to the effects of drugs causes feelings of depression.
C) Feelings of depression frequently lead to drug abuse and addiction.
D) Careful monitoring should be provided during withdrawal from the drugs.
It is imperative that the nurse determine what the client believes she heard (A). The idea
of reference may be to hurt herself or someone else, and the main function of a
psychiatric nurse is to maintain safety. (B) is acceptable, but it is best to determine the
client's beliefs. (C) is validating the idea of reference, while (D) is challenging the client.
Correct Answer(s): A - ✅✅ -10.
The nurse observes a female client with schizophrenia watching the news on TV. She
begins to laugh softly and says, "Yes, my love, I'll do it." When the nurse questions the
client about her comment she states, "The news commentator is my lover and he
HESI
Photosensitivity is a side effect of Prolixin and a vacation in the Bahamas (with its
tropical island climate) increases the client's chance of experiencing this side effect. He
should be instructed to avoid direct sun (A) and wear sunscreen. (B, C, and D) indicate
accurate knowledge. Alcohol acts synergistically with Prolixin (B). (C) lists signs of
agranulocytosis, which is also a side effect of Prolixin. In order to avoid extrapyramidal
symptoms (EPS), anticholinergic drugs, such as Cogentin, are often prescribed
prophylactically with Prolixin.
Correct Answer(s): A - ✅✅ -1.
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin
decanoate) is being discharged in the morning. A repeat dose of medication is
scheduled for 20 days after discharge. The client tells the nurse that he is going on
vacation in the Bahamas and will return in 18 days. Which statement by the client
indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to the clinic to get my Prolixin
injection.
B) While I am on vacation and when I return, I will not eat or drink anything that contains
alcohol.
C) I will notify the healthcare provider if I have a sore throat or flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin) every day.
The most important nursing diagnosis is related to alcohol detoxification (B) because
the client has elevated vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client Ativan for elevated vital
signs secondary to alcohol withdrawal. (C and D) can be addressed when immediate
needs for safety are met.
Correct Answer(s): B - ✅✅ -2.
A male client is admitted to the mental health unit because he was feeling depressed
about the loss of his wife and job. The client has a history of alcohol dependency and
admits that he was drinking alcohol 12 hours ago. Vital signs are: temperature, 100° F,
pulse 100, and BP 142/100. The nurse plans to give the client lorazepam (Ativan) based
on which priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
,D) Health seeking behaviors related to personal crisis.
The most important reason for closely observing a depressed client immediately after
admission is to maintain safety (B), since suicide is a risk with depression. (A, C, and D)
are all important interventions, but safety is the priority.
Correct Answer(s): B - ✅✅ -3.
The charge nurse is collaborating with the nursing staff about the plan of care for a
client who is very depressed. What is the most important intervention to implement
during the first 48 hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities.
(A) is the best choice cited. The nurse does not argue with the client nor demand that
she eat, but offers support by agreeing to "be there if needed", e.g., to warm the food.
(B and C) are arguing with the client's delusions, and (B) asks "why" which is usually not
a good question for a psychotic client. (D) has nothing to do with the actual problem;
i.e., the problem is not the diet (she thinks any food given to her is poisoned.)
Correct Answer(s): A - ✅✅ -4.
A 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia.
When her tray is brought to her, she refuses to eat and tells the nurse, "I know you are
trying to poison me with that food." Which response is most appropriate for the nurse to
make?
A) I'll leave your tray here. I am available if you need anything else.
B) You're not being poisoned. Why do you think someone is trying to poison you?
C) No one on this unit has ever died from poisoning. You're safe here.
D) I will talk to your healthcare provider about the possibility of changing your diet.
Early side effects of lithium carbonate (occurring with serum lithium levels below 2.0
mEq per liter) generally follow a progressive pattern beginning with diarrhea, vomiting,
drowsiness, and muscular weakness. At higher levels, ataxia, tinnitus, blurred vision,
and large dilute urine output may occur. (B) is the best choice. Although these are
expected symptoms, the healthcare provider should be notified prior to the next
administration of the drug. (A, C, and D) would not reflect good nursing judgment.
Correct Answer(s): B - ✅✅-5.
,A client who is being treated with lithium carbonate for bipolar disorder develops
diarrhea, vomiting, and drowsiness. What action should the nurse take?
A) Notify the healthcare provider immediately and prepare for administration of an
antidote.
B) Notify the healthcare provider of the symptoms prior to the next administration of the
drug.
C) Record the symptoms as normal side effects and continue administration of the
prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the drug.
Knowledge of all substances taken (C) will guide further treatment, such as
administration of antagonists, so obtaining this information has the highest priority. (A
and B) are also valuable in planning treatment. (D) is not appropriate during the acute
management of a drug overdose.
Correct Answer(s): C - ✅✅ -6.
The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but
responsive. The mother states, "I think he took some of my pain pills." During initial
assessment of the teenager, what information is most important for the nurse to obtain
from the parents?
A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs.
The nurse should answer the client's question with factual information and explain that
schizophrenia is a chemical imbalance in the brain (B). (A) is a therapeutic response but
does not answer the question, and may be an appropriate response after the nurse
answers the question asked. Although (C) is likely true to some degree, it is also true
that some clients continue to have disorganized thinking even with antipsychotic
medications. Referring the spouse to the psychologist (D) is avoiding the issue; the
nurse can and should answer the question.
Correct Answer(s): B - ✅✅ -7.
The wife of a male client recently diagnosed with schizophrenia asks the nurse, "What
exactly is schizophrenia? Is my husband all right?" Which response is best for the nurse
to provide to this family member?
A) It sounds like you're worried about your husband. Let's sit down and talk.
B) It is a chemical imbalance in the brain that causes disorganized thinking.
C) Your husband will be just fine if he takes his medications regularly.
, D) I think you should talk to your husband's psychologist about this question.
The most important nursing problem is medication management (C) because
compliance with the medication regimen will help prevent hospitalization. The client is
also exhibiting signs of (A, B, and C); however, these problems do not have the priority
of medication management.
Correct Answer(s): C - ✅✅ -8.
The community health nurse talks to a male client who has bipolar disorder. The client
explains that he sleeps 4 to 5 hours a night and is working with his partner to start two
new businesses and build an empire. The client stopped taking his medications several
days ago. What nursing problem has the highest priority?
A) Excessive work activity.
B) Decreased need for sleep.
C) Medication management.
D) Inflated self-esteem.
The priority is to teach the parents that their son will need monitoring and support during
withdrawal (D) to ensure that he does not attempt suicide. Although (A and C) are true,
they are not as relevant to the parent's expressed concern. There is no information to
support (B).
Correct Answer(s): D - ✅✅ -9.
At a support meeting of parents of a teenager with polysubstance dependency, a parent
states, "Each time my son tries to quit taking drugs, he gets so depressed that I'm afraid
he will commit suicide." The nurse's response should be based on which information?
A) Addiction is a chronic, incurable disease.
B) Tolerance to the effects of drugs causes feelings of depression.
C) Feelings of depression frequently lead to drug abuse and addiction.
D) Careful monitoring should be provided during withdrawal from the drugs.
It is imperative that the nurse determine what the client believes she heard (A). The idea
of reference may be to hurt herself or someone else, and the main function of a
psychiatric nurse is to maintain safety. (B) is acceptable, but it is best to determine the
client's beliefs. (C) is validating the idea of reference, while (D) is challenging the client.
Correct Answer(s): A - ✅✅ -10.
The nurse observes a female client with schizophrenia watching the news on TV. She
begins to laugh softly and says, "Yes, my love, I'll do it." When the nurse questions the
client about her comment she states, "The news commentator is my lover and he
