(N125) HESI Practice Questions (Answer With Rationale)
With Complete Solutions
A client with the diagnosis of borderline personality disorder has
been exhibiting manipulative, inappropriate behavior and
consistently attempting to take advantage of the other clients.
What should the nurse consider first before confronting the
client?
1. The last time medication was given
2. The depth of their working relationship
3. The client’s ability to be empathic toward others
4. The degree of self-awareness exhibited by the client
2
Rationale:
The establishment of trust between the client and nurse should
be a prerequisite for the use of confrontation. The last time
medication was administered is not a significant factor in
relation to the use of confrontation. Clients with the diagnosis of
borderline personality disorder tend to be impulsive and
egocentric and have difficulty being empathic toward others.
Client self-awareness is not a prerequisite for the use of
confrontation; the purpose of confrontation is to help the client
become self-aware.
,A client calls the emergency department of the hospital after
taking 24 sleeping pills. Which statement best describes the
psychodynamics of calling the emergency department during the
very act of a suicide attempt?
1. A need for attention
2. A need to punish others
3. Ambivalence about dying
4. An inability to stick to a decision
3
Rationale:
Calling for help during a suicide attempt demonstrates the
client's unconscious will to live or to be stopped from dying; the
contrasting feelings of wanting to die and yet wanting to live
demonstrate ambivalence. Seeking help is not always an
attention-getting device. This is a cry for help rather than an
expression of anger or an attempt to punish anyone else. The
client obviously had the intention of suicide, but the wish to live
was apparently stronger than the wish to die.
A client tells the nurse, "I’m a terrible, evil person. The voices
are telling me that God needs to punish me." What is
the most therapeutic initial response by the nurse?
1. "God is loving and won’t punish you."
,2. "Those voices you’re hearing are a fantasy."
3. "Tell me what you’re thinking about yourself."
4. "You aren’t wicked—both God and I love you."
3
Rationale:
Encouraging the client to focus on the self will facilitate
communication and foster self-perception. Stating that God will
not punish the client denies the client's feelings and provides
false reassurance. Stating that the voices are fantasy denies the
client's experience. Stating that the client is not wicked denies
the client's feelings and provides false reassurance.
A nurse is caring for a client with antisocial personality disorder.
What client characteristic should the nurse consider when
formulating a plan of care?
1. Suffers from extreme anxiety
2. Rapidly learns by experience if punished
3. Usually is unable to postpone gratification
4. Has a great sense of responsibility toward others
3
, Rationale:
Individuals with antisocial personality disorder tend to be self-
centered and impulsive. They lack judgment and self-control
and are unable to postpone gratification. Generally they do not
suffer from anxiety. These individuals believe that the rules do
not apply to them, and they do not profit from their mistakes.
These people are too self-centered to have a sense of
responsibility to anyone.
A man with bipolar disorder, manic episode, has been traveling
around the country, dating multiple women, and buying his
dates expensive gifts. He is admitted to the hospital when he
becomes exhausted and runs out of money. The nurse anticipates
that during a manic episode the client is most likely
experiencing feelings of what?
1. Guilt
2. Grandeur
3. Worthlessness
4. Self-deprecation
2
Rationale:
During a manic episode a client has an inflated self-esteem that
replaces feelings with which the client cannot cope. Feelings of
With Complete Solutions
A client with the diagnosis of borderline personality disorder has
been exhibiting manipulative, inappropriate behavior and
consistently attempting to take advantage of the other clients.
What should the nurse consider first before confronting the
client?
1. The last time medication was given
2. The depth of their working relationship
3. The client’s ability to be empathic toward others
4. The degree of self-awareness exhibited by the client
2
Rationale:
The establishment of trust between the client and nurse should
be a prerequisite for the use of confrontation. The last time
medication was administered is not a significant factor in
relation to the use of confrontation. Clients with the diagnosis of
borderline personality disorder tend to be impulsive and
egocentric and have difficulty being empathic toward others.
Client self-awareness is not a prerequisite for the use of
confrontation; the purpose of confrontation is to help the client
become self-aware.
,A client calls the emergency department of the hospital after
taking 24 sleeping pills. Which statement best describes the
psychodynamics of calling the emergency department during the
very act of a suicide attempt?
1. A need for attention
2. A need to punish others
3. Ambivalence about dying
4. An inability to stick to a decision
3
Rationale:
Calling for help during a suicide attempt demonstrates the
client's unconscious will to live or to be stopped from dying; the
contrasting feelings of wanting to die and yet wanting to live
demonstrate ambivalence. Seeking help is not always an
attention-getting device. This is a cry for help rather than an
expression of anger or an attempt to punish anyone else. The
client obviously had the intention of suicide, but the wish to live
was apparently stronger than the wish to die.
A client tells the nurse, "I’m a terrible, evil person. The voices
are telling me that God needs to punish me." What is
the most therapeutic initial response by the nurse?
1. "God is loving and won’t punish you."
,2. "Those voices you’re hearing are a fantasy."
3. "Tell me what you’re thinking about yourself."
4. "You aren’t wicked—both God and I love you."
3
Rationale:
Encouraging the client to focus on the self will facilitate
communication and foster self-perception. Stating that God will
not punish the client denies the client's feelings and provides
false reassurance. Stating that the voices are fantasy denies the
client's experience. Stating that the client is not wicked denies
the client's feelings and provides false reassurance.
A nurse is caring for a client with antisocial personality disorder.
What client characteristic should the nurse consider when
formulating a plan of care?
1. Suffers from extreme anxiety
2. Rapidly learns by experience if punished
3. Usually is unable to postpone gratification
4. Has a great sense of responsibility toward others
3
, Rationale:
Individuals with antisocial personality disorder tend to be self-
centered and impulsive. They lack judgment and self-control
and are unable to postpone gratification. Generally they do not
suffer from anxiety. These individuals believe that the rules do
not apply to them, and they do not profit from their mistakes.
These people are too self-centered to have a sense of
responsibility to anyone.
A man with bipolar disorder, manic episode, has been traveling
around the country, dating multiple women, and buying his
dates expensive gifts. He is admitted to the hospital when he
becomes exhausted and runs out of money. The nurse anticipates
that during a manic episode the client is most likely
experiencing feelings of what?
1. Guilt
2. Grandeur
3. Worthlessness
4. Self-deprecation
2
Rationale:
During a manic episode a client has an inflated self-esteem that
replaces feelings with which the client cannot cope. Feelings of
