HOSMERIT
PSYCH/MENTAL HEALTH EXIT HESI- SAUNDERS
EXAM LATEST UPDATE 100% PASS
The home care nurse is visiting an older client whose spouse died 6 months ago. Whichbehavior by
the client indicates ineffective coping?
a. Neglecting personal grooming
b. Looking at old snapshots of family
c. Participating in a senior citizens' program
d. Visiting their spouse's grave once a month - Answer 1. Neglecting personal grooming
Rationale:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death,
ineffective coping is manifested by an extreme behavior that in some cases maybe harmful to the
individual physically or psychologically. The correct option is indicative of a behavior that
identifies an ineffective coping behavior in the grieving process.
A client is admitted with major depression and a history of a suicide attempt. The client says to
the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which
response by the nurse is an example of therapeutic communication?
a. "You have everything to live for."
b. "Why do you see yourself as a failure?"
c. "Feeling like this is all part of being depressed."
d. "You've been feeling like a failure for a while?" - Answer 4. "You have been made tofeel like a
failure for some time?"
Rationale:
,A therapeutic way of responding to feelings expressed by the client is through responding. The
correct option is the use of reiterating. All the other options are closing responses as it minimizes
the client's experience and there is no exploration into the feelings expressed by the client. Also,
the use of the word "why" is not therapeutic.
When visiting a client at home, the client states to the mental health nurse, "I haven't slept at all the
last couple of nights." Which response by the nurse is an example of a therapeutic communication
response to this client?
a. "I see."
b. "Really?"
c. "You're having difficulty sleeping?"
d. "Sometimes, I have trouble sleeping too." - Response 3. "You're having difficultysleeping?"
Rationale:
The correct option applies the restatement therapeutic communication skill. Although this is a
skill that does have a cueing element to it, the core of the restatement is the repetition of the
client's main theme, which allows the nurse to start to understand the issue for the client more
clearly. The other options are not therapeutic responses because none of them encourage the
client to expand on the concern. Sharing personalexperience takes the discussion off the client and
onto the nurse.
A client with disturbed thought processes believes that his food is being poisoned. Whatis the
most appropriate communication technique by the nurse that would encourage the client to eat?
a. The use of open-ended questions and silence
b. Discussing personal preference in relation to food choices
c. Recording why the client does not wish to eat
d. Expressing opinions about the need for adequate nutrition - Answer 1. The use ofopen-ended
questions and silence
,Rationale:
Strategies to get the client talking about their problems include open-ended questions and
silence. Sharing personal food preferences is not a client-centered intervention. The other options
are not supportive of the client because they fail to lead the client intoan expression of feeling.
The nurse should not give an opinion and should lead the clientto determine the rationale for the
behavior.
A client is admitted to a psychiatric unit for treatment of psychotic behavior. The client spends
hours at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong
here." Which defense mechanism is the client utilizing?
a. Denial
b. Projection
c. Regression
d. Rationalization - Answer 1. Denial
Rationale:
Denial is the refusal to admit to a painful reality, which is treated as if it does not exist.
Projection involves the unconscious rejection of emotionally unacceptable features and
attributing it to other persons, objects, or situations. Regression allows the client to return to an
earlier, more comforting although less mature way of behaving.
Rationalization is justifying illogical or unreasonable ideas, actions, or feelings bydeveloping
acceptable explanations that satisfy the teller and the listener.
A patient with terminal cancer says to the nurse, "I'm going to die, and I wish my family would
stop hoping for a cure! I get so angry when they carry on like this. After all, I'm theone who's
dying." Which response by the nurse is therapeutic?
a. "Have you shared your feelings with your family?"
b. "I think we should talk more about your anger with your family."
c. "You're angry feeling your family continues to hope for you to be cured?"
, d. "You must be very depressed, which of course is understandable with such a diagnosis."
Response 3. "You're angry feeling your family continues to hope for you tobe cured?"
Rationale:
Restating is a therapeutic communication technique where the nurse repeats back to the client
what he says to show that he has understood and to review what has been said. While it is
appropriate for the nurse to attempt to assess the client's ability to discuss feelings openly with
family members, it does not help the client discuss the feelings causing the anger. The nurse's
attempt to focus on the central issue of anger ispremature. The nurse would never make a
judgment regarding the reason for the client's feeling; this is nontherapeutic in the one-to-one
relationship.
While conducting a review of the client's record, the nurse learns that the client was voluntarily
admitted because of their mental health problem. With this in mind, the nursewould be able to
anticipate which of the following responses the client might give?
a. Fears about the treatment interventions
b. Hostility and aggression towards others
c. Understanding about the pathology and symptoms associated with the diagnosis.
d. A wish to be involved in the planning of the care and treatment plan. -Answer 4. Awish to be
involved in the planning of the care and treatment plan.
Rationale:
Generally speaking, clients request voluntary admissions. In such cases, if a client requests
admission as a volunteer, most likely a client will cooperate with the treatmentprogram since they
are looking for help themselves. The rest of the options are not characteristics of this type of
admission. Fearfulness, anger, and aggressiveness are more typical for an involuntary admission.
Voluntary admission cannot guarantee a client's understanding of his or her illness, only the
understanding of his or her desire for help.
The nurse is reviewing the admission assessment and finds that this client was admitted to the
mental health unit involuntarily. This type of admission would necessitate that the nurse
implement which of the following interventions for this client?
PSYCH/MENTAL HEALTH EXIT HESI- SAUNDERS
EXAM LATEST UPDATE 100% PASS
The home care nurse is visiting an older client whose spouse died 6 months ago. Whichbehavior by
the client indicates ineffective coping?
a. Neglecting personal grooming
b. Looking at old snapshots of family
c. Participating in a senior citizens' program
d. Visiting their spouse's grave once a month - Answer 1. Neglecting personal grooming
Rationale:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death,
ineffective coping is manifested by an extreme behavior that in some cases maybe harmful to the
individual physically or psychologically. The correct option is indicative of a behavior that
identifies an ineffective coping behavior in the grieving process.
A client is admitted with major depression and a history of a suicide attempt. The client says to
the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which
response by the nurse is an example of therapeutic communication?
a. "You have everything to live for."
b. "Why do you see yourself as a failure?"
c. "Feeling like this is all part of being depressed."
d. "You've been feeling like a failure for a while?" - Answer 4. "You have been made tofeel like a
failure for some time?"
Rationale:
,A therapeutic way of responding to feelings expressed by the client is through responding. The
correct option is the use of reiterating. All the other options are closing responses as it minimizes
the client's experience and there is no exploration into the feelings expressed by the client. Also,
the use of the word "why" is not therapeutic.
When visiting a client at home, the client states to the mental health nurse, "I haven't slept at all the
last couple of nights." Which response by the nurse is an example of a therapeutic communication
response to this client?
a. "I see."
b. "Really?"
c. "You're having difficulty sleeping?"
d. "Sometimes, I have trouble sleeping too." - Response 3. "You're having difficultysleeping?"
Rationale:
The correct option applies the restatement therapeutic communication skill. Although this is a
skill that does have a cueing element to it, the core of the restatement is the repetition of the
client's main theme, which allows the nurse to start to understand the issue for the client more
clearly. The other options are not therapeutic responses because none of them encourage the
client to expand on the concern. Sharing personalexperience takes the discussion off the client and
onto the nurse.
A client with disturbed thought processes believes that his food is being poisoned. Whatis the
most appropriate communication technique by the nurse that would encourage the client to eat?
a. The use of open-ended questions and silence
b. Discussing personal preference in relation to food choices
c. Recording why the client does not wish to eat
d. Expressing opinions about the need for adequate nutrition - Answer 1. The use ofopen-ended
questions and silence
,Rationale:
Strategies to get the client talking about their problems include open-ended questions and
silence. Sharing personal food preferences is not a client-centered intervention. The other options
are not supportive of the client because they fail to lead the client intoan expression of feeling.
The nurse should not give an opinion and should lead the clientto determine the rationale for the
behavior.
A client is admitted to a psychiatric unit for treatment of psychotic behavior. The client spends
hours at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong
here." Which defense mechanism is the client utilizing?
a. Denial
b. Projection
c. Regression
d. Rationalization - Answer 1. Denial
Rationale:
Denial is the refusal to admit to a painful reality, which is treated as if it does not exist.
Projection involves the unconscious rejection of emotionally unacceptable features and
attributing it to other persons, objects, or situations. Regression allows the client to return to an
earlier, more comforting although less mature way of behaving.
Rationalization is justifying illogical or unreasonable ideas, actions, or feelings bydeveloping
acceptable explanations that satisfy the teller and the listener.
A patient with terminal cancer says to the nurse, "I'm going to die, and I wish my family would
stop hoping for a cure! I get so angry when they carry on like this. After all, I'm theone who's
dying." Which response by the nurse is therapeutic?
a. "Have you shared your feelings with your family?"
b. "I think we should talk more about your anger with your family."
c. "You're angry feeling your family continues to hope for you to be cured?"
, d. "You must be very depressed, which of course is understandable with such a diagnosis."
Response 3. "You're angry feeling your family continues to hope for you tobe cured?"
Rationale:
Restating is a therapeutic communication technique where the nurse repeats back to the client
what he says to show that he has understood and to review what has been said. While it is
appropriate for the nurse to attempt to assess the client's ability to discuss feelings openly with
family members, it does not help the client discuss the feelings causing the anger. The nurse's
attempt to focus on the central issue of anger ispremature. The nurse would never make a
judgment regarding the reason for the client's feeling; this is nontherapeutic in the one-to-one
relationship.
While conducting a review of the client's record, the nurse learns that the client was voluntarily
admitted because of their mental health problem. With this in mind, the nursewould be able to
anticipate which of the following responses the client might give?
a. Fears about the treatment interventions
b. Hostility and aggression towards others
c. Understanding about the pathology and symptoms associated with the diagnosis.
d. A wish to be involved in the planning of the care and treatment plan. -Answer 4. Awish to be
involved in the planning of the care and treatment plan.
Rationale:
Generally speaking, clients request voluntary admissions. In such cases, if a client requests
admission as a volunteer, most likely a client will cooperate with the treatmentprogram since they
are looking for help themselves. The rest of the options are not characteristics of this type of
admission. Fearfulness, anger, and aggressiveness are more typical for an involuntary admission.
Voluntary admission cannot guarantee a client's understanding of his or her illness, only the
understanding of his or her desire for help.
The nurse is reviewing the admission assessment and finds that this client was admitted to the
mental health unit involuntarily. This type of admission would necessitate that the nurse
implement which of the following interventions for this client?
