Mental Health/Psych Hesi Review Questions And
Answers Verified 2025
Distracting the client, or redirecting him toward a constructive activity (C),
prevents further escalation of the inappropriate behavior. (A) could result in
escalating the abuse and might unnecessarily involve another staff member in
the abusive situation. (B) may be more threatening to the client. (D) may be
indicated if the behavior escalates, but at this time the best initial action is (C).
A client in the critical care unit who has been oriented suddenly becomes
disoriented and fearful. Assessment of vital signs and other physical
parameters reveals no significant changes, and the nurse formulates the
diagnosis of Confusion related to ICU psychosis. Which intervention is best to
implement based on this client's behavior?
A.Move all medical equipment away from the client's bedside.
B.Allay fears by teaching the client about the causes of the disease.
C.Cluster care to allow for brief rest periods during the day.
D.Encourage visitation by the client's family members, including the client's
young children. -Answer- C
The best intervention is to organize care so that the client can experience rest
periods (C). The critical care unit contains many lifesaving treatment
modalities that offer clients an array of auditory, visual, and even painful
stimuli. These stressors can result in isolation and confusion. (A) is not
practical because the client may need assistance from medical equipment to
survive. The client is too ill to receive teaching (B). Although (D) may be
supportive, young children are routinely prohibited from critical care units
,because of increased risk of infectious disease transmission.
A client is admitted with a diagnosis of depression. Which of the following
characteristics is most indicative of depression?
A.Grandiose ideation
B.Self-destructive thoughts
C.Suspiciousness of others
D.Negative self-image -Answer- D
A negative self-image (D) is a specific indicator for depression. (A) occurs with
paranoia or paranoid ideation (C). (B) may be seen in depressed clients, but
not always.
The nurse notes multiple burns on the arms and chest of a 2-year-old
Vietnamese child who is being treated for dehydration. When questioned, the
child's father states that he treated the child's vomiting with the cultural
practice termed coining, which resulted in burned areas. Which expected
outcome statement has the highest priority?
A.The child will be protected from further harm.
B.The family's cultural values will be respected.
C.The parents will express regret at harming their child.
D.The parents will demonstrate an ability to care for burn wounds. -Answer-
A
The nurse's highest priority is to ensure that no further harm befalls the child
(A). (B, C, and D) are also important objectives but are secondary to (A).
, An 8-year-old child is seen in the clinic with a green vaginal discharge. Which
action is most important for the nurse to implement?
A.Assess the child's blood pressure.
B.Counsel the child to wear cotton underwear.
C.Report as suspected child abuse.
D.Determine if the child takes bubble baths. -Answer- C
A green vaginal discharge is indicative of gonorrhea, a sexually transmitted
disease. Because the child is 8 years old, the nurse should suspect child abuse
and report the incident to the proper authorities (C). (A) is usually not related
to infection. (B and D) are helpful in preventing bladder infections, but a green
vaginal discharge is not a symptom of a bladder infection.
A 38-year-old client is admitted with a diagnosis of paranoid schizophrenia.
When the lunch tray is brought to the room, the client refuses to eat and tells
the nurse, "I know you are trying to poison me with that food." Which
response by the nurse is the most therapeutic?
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 health care provider about the possibility of changing
your diet." -Answer- A
(A) is the best choice because the nurse does not argue with the client or
demand that that the client eat but offers support by agreeing to be there if
needed, which provides an open, rather than closed, response to the client's
Answers Verified 2025
Distracting the client, or redirecting him toward a constructive activity (C),
prevents further escalation of the inappropriate behavior. (A) could result in
escalating the abuse and might unnecessarily involve another staff member in
the abusive situation. (B) may be more threatening to the client. (D) may be
indicated if the behavior escalates, but at this time the best initial action is (C).
A client in the critical care unit who has been oriented suddenly becomes
disoriented and fearful. Assessment of vital signs and other physical
parameters reveals no significant changes, and the nurse formulates the
diagnosis of Confusion related to ICU psychosis. Which intervention is best to
implement based on this client's behavior?
A.Move all medical equipment away from the client's bedside.
B.Allay fears by teaching the client about the causes of the disease.
C.Cluster care to allow for brief rest periods during the day.
D.Encourage visitation by the client's family members, including the client's
young children. -Answer- C
The best intervention is to organize care so that the client can experience rest
periods (C). The critical care unit contains many lifesaving treatment
modalities that offer clients an array of auditory, visual, and even painful
stimuli. These stressors can result in isolation and confusion. (A) is not
practical because the client may need assistance from medical equipment to
survive. The client is too ill to receive teaching (B). Although (D) may be
supportive, young children are routinely prohibited from critical care units
,because of increased risk of infectious disease transmission.
A client is admitted with a diagnosis of depression. Which of the following
characteristics is most indicative of depression?
A.Grandiose ideation
B.Self-destructive thoughts
C.Suspiciousness of others
D.Negative self-image -Answer- D
A negative self-image (D) is a specific indicator for depression. (A) occurs with
paranoia or paranoid ideation (C). (B) may be seen in depressed clients, but
not always.
The nurse notes multiple burns on the arms and chest of a 2-year-old
Vietnamese child who is being treated for dehydration. When questioned, the
child's father states that he treated the child's vomiting with the cultural
practice termed coining, which resulted in burned areas. Which expected
outcome statement has the highest priority?
A.The child will be protected from further harm.
B.The family's cultural values will be respected.
C.The parents will express regret at harming their child.
D.The parents will demonstrate an ability to care for burn wounds. -Answer-
A
The nurse's highest priority is to ensure that no further harm befalls the child
(A). (B, C, and D) are also important objectives but are secondary to (A).
, An 8-year-old child is seen in the clinic with a green vaginal discharge. Which
action is most important for the nurse to implement?
A.Assess the child's blood pressure.
B.Counsel the child to wear cotton underwear.
C.Report as suspected child abuse.
D.Determine if the child takes bubble baths. -Answer- C
A green vaginal discharge is indicative of gonorrhea, a sexually transmitted
disease. Because the child is 8 years old, the nurse should suspect child abuse
and report the incident to the proper authorities (C). (A) is usually not related
to infection. (B and D) are helpful in preventing bladder infections, but a green
vaginal discharge is not a symptom of a bladder infection.
A 38-year-old client is admitted with a diagnosis of paranoid schizophrenia.
When the lunch tray is brought to the room, the client refuses to eat and tells
the nurse, "I know you are trying to poison me with that food." Which
response by the nurse is the most therapeutic?
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 health care provider about the possibility of changing
your diet." -Answer- A
(A) is the best choice because the nurse does not argue with the client or
demand that that the client eat but offers support by agreeing to be there if
needed, which provides an open, rather than closed, response to the client's
