Mental Health/Psych HESI Review Questions (50 Q study with rationale)

At the first meeting of a group at a daycare center for older adults, the nurse asks one of the members what kinds of things the client would like to do with the group. The older adult shrugs and says, "You tell me. You're the leader." What would be the best response for the nurse to make? A."Yes, I am the leader today. Would you like to be the leader tomorrow?" B."Yes, I will be leading this group. What would you like to accomplish?" C."Yes, I have been assigned to lead this group. I will be here for the next 6 weeks." D. "Yes, I am the leader. You seem angry about not being the leader yourself." - ANSWER ANS: B Anxiety over participation in a group and testing of the leader characteristically occur in the initial phase of group dynamics. (B) provides information and refocuses the group to defining its function. (A) is manipulative bargaining. (C) does not focus the group on its purpose or task. (D) is interpreting the client's feelings and is almost challenging. A client who is being treated with lithium carbonate for manic depression begins to develop diarrhea, vomiting, and drowsiness. Which action should the nurse take? A. Notify the health care provider immediately and force fluids. B. Prior to giving the next dose, notify the health care provider of these symptoms. C. Record the symptoms and continue with medication as prescribed. D. Hold the medication and refuse to administer additional doses. - ANSWER ANS: B Although these are expected symptoms, the health care provider should be notified prior to the next administration of the drug (B). Early side effects of lithium carbonate (occurring with serum lithium levels below 2 mEq/L) generally follow a progressive pattern, beginning with diarrhea, vomiting, drowsiness, and muscular weakness (C). At higher levels, ataxia, tinnitus, blurred vision, and large dilute urine output may occur. (A) will lower the lithium level. (D) is not warranted.