Psychiatric-Mental.,Health.,Practice.,Exam.,HESI
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.,n
urse.,that.,he.,is.,going.,on.,vacation.,in.,the.,Bahamas.,and.,will.,return.,in.,18.,day
s..,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.,t
o.,get.,my.,Prolixin.,injection..,
B).,While.,I.,am.,on.,vacation.,and.,when.,I.,return,.,I.,will.,not.,eat.,or.,drink.,anythi
ng.,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..
,-.,correct.,answer.,✔ ✔
Photosensitivity.,is.,a.,side.,effect.,of.,Prolixin.,and.,a.,vacation.,in.,the.,Baham
as.,(with.,its.,tropical.,island.,climate).,increases.,the.,client's.,chance.,of.,experie
ncing.,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.,sympto
ms.,(EPS),.,anticholinergic.,drugs,.,such.,as.,Cogentin,.,are.,often.,prescribed.,p
rophylactically.,with.,Prolixin.
Correct.,Answer(s):.,A
,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.,al
cohol.,dependency.,and.,admits.,that.,he.,was.,drinking.,alcohol.,12.,hours.,ago..,
Vital.,signs.,are:.,temperature,.,100°.,F,.,pulse.,100,.,and.,BP.,142/100..,The.,nurs
e.,plans.,to.,give.,the.,client.,lorazepam.,(Ativan).,based.,on.,which.,priority.,nurs
ing.,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..,-.,correct.,answer.,
✔ ✔
The.,most.,important.,nursing.,diagnosis.,is.,related.,to.,alcohol.,detoxificatio
n.,(B).,because.,the.,client.,has.,elevated.,vital.,signs,.,a.,sign.,of.,alcohol.,detoxifi
cation..,Maintaining.,client.,safety.,related.,to.,(A).,should.,be.,addressed.,after.,
giving.,the.,client.,Ativan.,for.,elevated.,vital.,signs.,secondary.,to.,alcohol.,with
drawal..,(C.,and.,D).,can.,be.,addressed.,when.,immediate.,needs.,for.,safety.,are.,
met.
.,
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.,interv
,ention.,to.,implement.,during.,the.,first.,48.,hours.,after.,the.,client's.,admission.,t
o.,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..,-.,correct.,answer.,✔ ✔
The.,most.,important.,reason.,for.,closely.,observing.,a.,depressed.,client.,im
mediately.,after.,admission.,is.,to.,maintain.,safety.,(B),.,since.,suicide.,is.,a.,risk.,
with.,depression..,(A,.,C,.,and.,D).,are.,all.,important.,interventions,.,but.,safety.,i
s.,the.,priority.
.,
Correct.,Answer(s):.,B
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.,k
now.,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.,poi
son.,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.,changin
g.,your.,diet..,-.,correct.,answer.,✔ ✔
(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
5.
A.,client.,who.,is.,being.,treated.,with.,lithium.,carbonate.,for.,bipolar.,disorder.,d
evelops.,diarrhea,.,vomiting,.,and.,drowsiness..,What.,action.,should.,the.,nurse
.,take?
A).,Notify.,the.,healthcare.,provider.,immediately.,and.,prepare.,for.,administra
tion.,of.,an.,antidote..,
B).,Notify.,the.,healthcare.,provider.,of.,the.,symptoms.,prior.,to.,the.,next.,admi
nistration.,of.,the.,drug..,
C).,Record.,the.,symptoms.,as.,normal.,side.,effects.,and.,continue.,administrati
on.,of.,the.,prescribed.,dosage..,
D).,Hold.,the.,medication.,and.,refuse.,to.,administer.,additional.,amounts.,of.,th
e.,drug..,-.,correct.,answer.,✔ ✔
Early.,side.,effects.,of.,lithium.,carbonate.,(occurring.,with.,serum.,lithium.,le
vels.,below.,2.0.,mEq.,per.,liter).,generally.,follow.,a.,progressive.,pattern.,begin
ning.,with.,diarrhea,.,vomiting,.,drowsiness,.,and.,muscular.,weakness..,At.,hig
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.,n
urse.,that.,he.,is.,going.,on.,vacation.,in.,the.,Bahamas.,and.,will.,return.,in.,18.,day
s..,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.,t
o.,get.,my.,Prolixin.,injection..,
B).,While.,I.,am.,on.,vacation.,and.,when.,I.,return,.,I.,will.,not.,eat.,or.,drink.,anythi
ng.,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..
,-.,correct.,answer.,✔ ✔
Photosensitivity.,is.,a.,side.,effect.,of.,Prolixin.,and.,a.,vacation.,in.,the.,Baham
as.,(with.,its.,tropical.,island.,climate).,increases.,the.,client's.,chance.,of.,experie
ncing.,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.,sympto
ms.,(EPS),.,anticholinergic.,drugs,.,such.,as.,Cogentin,.,are.,often.,prescribed.,p
rophylactically.,with.,Prolixin.
Correct.,Answer(s):.,A
,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.,al
cohol.,dependency.,and.,admits.,that.,he.,was.,drinking.,alcohol.,12.,hours.,ago..,
Vital.,signs.,are:.,temperature,.,100°.,F,.,pulse.,100,.,and.,BP.,142/100..,The.,nurs
e.,plans.,to.,give.,the.,client.,lorazepam.,(Ativan).,based.,on.,which.,priority.,nurs
ing.,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..,-.,correct.,answer.,
✔ ✔
The.,most.,important.,nursing.,diagnosis.,is.,related.,to.,alcohol.,detoxificatio
n.,(B).,because.,the.,client.,has.,elevated.,vital.,signs,.,a.,sign.,of.,alcohol.,detoxifi
cation..,Maintaining.,client.,safety.,related.,to.,(A).,should.,be.,addressed.,after.,
giving.,the.,client.,Ativan.,for.,elevated.,vital.,signs.,secondary.,to.,alcohol.,with
drawal..,(C.,and.,D).,can.,be.,addressed.,when.,immediate.,needs.,for.,safety.,are.,
met.
.,
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.,interv
,ention.,to.,implement.,during.,the.,first.,48.,hours.,after.,the.,client's.,admission.,t
o.,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..,-.,correct.,answer.,✔ ✔
The.,most.,important.,reason.,for.,closely.,observing.,a.,depressed.,client.,im
mediately.,after.,admission.,is.,to.,maintain.,safety.,(B),.,since.,suicide.,is.,a.,risk.,
with.,depression..,(A,.,C,.,and.,D).,are.,all.,important.,interventions,.,but.,safety.,i
s.,the.,priority.
.,
Correct.,Answer(s):.,B
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.,k
now.,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.,poi
son.,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.,changin
g.,your.,diet..,-.,correct.,answer.,✔ ✔
(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
5.
A.,client.,who.,is.,being.,treated.,with.,lithium.,carbonate.,for.,bipolar.,disorder.,d
evelops.,diarrhea,.,vomiting,.,and.,drowsiness..,What.,action.,should.,the.,nurse
.,take?
A).,Notify.,the.,healthcare.,provider.,immediately.,and.,prepare.,for.,administra
tion.,of.,an.,antidote..,
B).,Notify.,the.,healthcare.,provider.,of.,the.,symptoms.,prior.,to.,the.,next.,admi
nistration.,of.,the.,drug..,
C).,Record.,the.,symptoms.,as.,normal.,side.,effects.,and.,continue.,administrati
on.,of.,the.,prescribed.,dosage..,
D).,Hold.,the.,medication.,and.,refuse.,to.,administer.,additional.,amounts.,of.,th
e.,drug..,-.,correct.,answer.,✔ ✔
Early.,side.,effects.,of.,lithium.,carbonate.,(occurring.,with.,serum.,lithium.,le
vels.,below.,2.0.,mEq.,per.,liter).,generally.,follow.,a.,progressive.,pattern.,begin
ning.,with.,diarrhea,.,vomiting,.,drowsiness,.,and.,muscular.,weakness..,At.,hig
