HESI PSYCH MENTAL HEALTH TEST BANK ACTUAL EXAM 300
REAL EXAM QUESTIONS AND ANSWERS
A 35-year-old male client who has been hospitalized for two weeks for chronic paranoia continues to
state that someone is trying to steal his clothing- Which action should the nurse implement?
A- Encourage the client to actively participate in assigned activities on the unit
B- Place a lock on the client's closet
C- Ignore the client's paranoid ideation to extinguish these behaviors
D- Explain to the client that his suspicions are false - ANSWER-ANSWER A
Diverting the client's attention from paranoid ideation and encouraging him to complete assignments
can be helpful in assisting him to develop a positive self-image (A)- The clients problem is not security,
and (B) actually supports his paranoid ideation- (C) is not correct because ignoring the client's
symptoms may lower his self-esteem- The nurse should not argue with the client about his delusions
(D), and should not try to reason with the client regarding his paranoid ideation
A male client with mental illness and substance dependency tells the mental health nurse that he has
started using illegal drugs again and wants to seek treatment. Since he has a dual diagnosis, which
person is best for the nurse to refer this client to first?
A. The emergency room nurse.
B. His case manager.
C. The clinic healthcare provider.
D. His support group sponsor. - ANSWER-ANSWER B
The case manager (B) is responsible for coordinating community services, and since this client has a
dual diagnosis, this is the best person to describe available treatment options. (A) is unnecessary,
unless the client experiences behaviors that threaten his safety or the safety of others. (C and D)
might also be useful, but it is most important at this time that a treatment program be coordinated to
meet this client's needs.
Based on non-compliance with the medication regimen, an adult client with a medical diagnosis of
substance abuse and schizophrenia was recently switched from oral fluphenazine HCI (Prolixin) to IM
fluphenazine decanoate (Prolixin Decanoate)- What is most important to teach the client and family
about this change in medication regimen?
A- Signs and symptoms of extrapyramidal effects (EPS)-
B- Information about substance abuse and schizophrenia-
C- The effects of alcohol and drug interaction-
D- The availability of support groups for those with dual diagnoses- - ANSWER-ANSWER C
Alcohol enhances the EPS side effects of Prolixin. The half-life of Prolixin PO is 8 hours, whereas the
half-life of the Prolixin Decanoate IM is 2 to 4 weeks- That means the side effects of drinking alcohol
are far more severe when the client drinks alcohol alter taking the long-acting Prolixin Decanoate IM-
(A, B, and D) provide valuable information and should be included in the client/family teaching, but
they do not have the priority of (C).
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 know 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 poison 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 changing your diet- - ANSWER-
ANSWER A
(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-)
,A woman arrives in the Emergency Center and tells the nurse she thinks she has been raped- The
client is sobbing and expresses disbelief that a rape could happen because the man is her best friend-
After acknowledging the client's fear and anxiety, how should the nurse respond?
A- "I would be very upset and mad if my best friend did that to me"
B- "You must feel betrayed, but maybe you might have led him on?"
C- "Rape is not limited to strangers and frequently occurs by someone who is known to the victim"
D- "This does not sound like rape- Did you change your mind about having sex after the fact?" -
ANSWER-ANSWER C
A victim of date rape or acquaintance rape is less prone to recognize what is happening because the
incident usually involves persons who know each other and the dynamics are different than rape by a
stranger. (C) provides confrontation for the client's denial because the victim frequently knows and
trusts the perpetrator. Nurses should not express personal feelings (A) when dealing with victims-
Suggesting that the client led on the rapist (B) indicates that the sexual assault was somehow the
victim's fault- (D) is judgmental and does not display compassion or establish trust between the nurse
and the client
A child is brought to the emergency room with a broken arm- Because of other injuries, the nurse
suspects the child may be a victim of abuse- When the nurse tries to give the child an injection, the
child's mother becomes very loud and shouts, "I won't leave my son! Don't you touch him! You'll hurt
my child!" What is the best interpretation of the mother's statements? The mother is
A- regressing to an earlier behavior pattern-
B- sublimating her anger-
C- projecting her feelings onto the nurse-
D- suppressing her fear- - ANSWER-ANSWER C
Projection is attributing one's own thoughts, impulses, or behaviors onto another-it is the mother
who is probably harming the child and she is attributing her actions to the nurse (C)- The mother may
be immature, but (A) is not the best description of her behavior. (B) is substituting a socially
acceptable feeling for an unacceptable one- These are not socially acceptable feelings- The mother
may be suppressing her fear (D) by displaying anger, but such an interpretation cannot be concluded
from the data presented
The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is
schizophrenia? Is my husband all right?" Which response is best for the nurse to provide to this family
member?
A- It sounds like you're worried about your husband- Let's sit down and talk
B- It is a chemical imbalance in the brain that causes disorganized thinking
C- Your husband will be just fine if he takes his medications regularly
D- I think you should talk to your husband's psychologist about this question - ANSWER-ANSWER B
The nurse should answer the client's question with factual information and explain that schizophrenia
is a chemical imbalance in the brain (B)
(A) is a therapeutic response but does not answer the question, and may be an appropriate response
after the nurse answers the question asked Although (C) is likely true to some degree, it is also true
that some clients continue to have disorganized thinking even with antipsychotic medications-
Referring the spouse to the psychologist (D) is avoiding the issue; the nurse can and should answer
the question
A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any
visitors or phone calls since admission. He reports he has no family that cares about him and was
living on the streets prior to this admission. According to Erikson's theory of psychosocial
development, which stage is the client in at this time?
A. Isolation.
B. Stagnation.
C. Despair.
D. Role confusion. - ANSWER-ANSWER B
, The client is in Erikson's "Generativity vs- Stagnation" stage (age 24 to 45), and meeting the task
includes maintaining intimate relationships and moving toward developing a family (B)- (A) occurs in
young adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in
adolescence (age 12 to 20)- These are all stages that occur if individuals are not successfully coping
with their psychosocial developmental stage
The community health nurse talks to a male client who has bipolar disorder. The client explains that
he sleeps 4 to 5 hours a night and is working with his partner to start two new businesses and build an
empire. The client stopped taking his medications several days ago. What nursing problem has the
highest priority?
A. Excessive work activity.
B. Decreased need for sleep.
C. . Medication management.
D. Inflated self-esteem. - ANSWER-ANSWER C
The most important nursing problem is medication management (C) because compliance with the
medication regimen will help prevent hospitalization. The client is also exhibiting signs of (A, B, and C);
however, these problems do not have the priority of medication management.
The nurse is assessing a client's intelligence- Which factor should the nurse remember during this part
of the mental status exam?
A- Acute psychiatric illnesses impair intelligence-
B- Intelligence is influenced by social and cultural beliefs-
C- Poor concentration skills suggests limited intelligence-
D- The inability to think abstractly indicates limited intelligence- - ANSWER-ANSWER B
Social and cultural beliefs (B) have significant impact on intelligence- Chronic psychiatric illness may
impair intelligence (A), especially if it remains untreated- Limited concentration does not suggest
limited intelligence (C)- Dilficulties with abstractions are suggestive of psychotic thinking (D), not
limited intelligence
At a support meeting of parents of a teenager with polysubstance dependency, a parent states, "Each
time my son tries to quit taking drugs, he gets so depressed that I'm afraid he will commit suicide-"
The nurse's response should be based on which information?
A- Addiction is a chronic, incurable disease-
B- Tolerance to the effects of drugs causes feelings of depression-
C- Feelings of depression frequently lead to drug abuse and addiction-
D- . Careful monitoring should be provided during withdrawal from the drugs- - ANSWER-ANSWER D
The priority is to teach the parents that their son will need monitoring and support during withdrawal
(D) to ensure that he does not attempt suicide- Although (A and C) are true, they are not as relevant
to the parent's expressed concern- There is no information to support (B)-
A female client with depression attends group and states that she sometimes misses her medication
appointments because she feels very anxious about riding the bus. Which statement is the nurse's
best response?
A. Can your case manager take you to your appointments?
B. Take your medication for anxiety before you ride the bus.
C. Let's talk about what happens when you feel very anxious.
D. What are some ways that you can cope with your anxiety? - ANSWER-ANSWER D
The best response is to explore ways for the client to cope with anxiety (D). The nurse should
encourage problem-solving rather than dependence on the case manager (A) for transportation.
Strategies for coping with anxiety should be encouraged before suggesting (B). (C) is therapeutic, but
the best response is an open-ended question to explore ways to cope with the anxiety.
A 65-year-old female client complains to the nurse that recently she has been hearing voices. What
question should the nurse ask this client first?
A. Do you have problems with hallucinations?
B. Are you ever alone when you hear the voices?
C. Has anyone in your family had hearing problems?
REAL EXAM QUESTIONS AND ANSWERS
A 35-year-old male client who has been hospitalized for two weeks for chronic paranoia continues to
state that someone is trying to steal his clothing- Which action should the nurse implement?
A- Encourage the client to actively participate in assigned activities on the unit
B- Place a lock on the client's closet
C- Ignore the client's paranoid ideation to extinguish these behaviors
D- Explain to the client that his suspicions are false - ANSWER-ANSWER A
Diverting the client's attention from paranoid ideation and encouraging him to complete assignments
can be helpful in assisting him to develop a positive self-image (A)- The clients problem is not security,
and (B) actually supports his paranoid ideation- (C) is not correct because ignoring the client's
symptoms may lower his self-esteem- The nurse should not argue with the client about his delusions
(D), and should not try to reason with the client regarding his paranoid ideation
A male client with mental illness and substance dependency tells the mental health nurse that he has
started using illegal drugs again and wants to seek treatment. Since he has a dual diagnosis, which
person is best for the nurse to refer this client to first?
A. The emergency room nurse.
B. His case manager.
C. The clinic healthcare provider.
D. His support group sponsor. - ANSWER-ANSWER B
The case manager (B) is responsible for coordinating community services, and since this client has a
dual diagnosis, this is the best person to describe available treatment options. (A) is unnecessary,
unless the client experiences behaviors that threaten his safety or the safety of others. (C and D)
might also be useful, but it is most important at this time that a treatment program be coordinated to
meet this client's needs.
Based on non-compliance with the medication regimen, an adult client with a medical diagnosis of
substance abuse and schizophrenia was recently switched from oral fluphenazine HCI (Prolixin) to IM
fluphenazine decanoate (Prolixin Decanoate)- What is most important to teach the client and family
about this change in medication regimen?
A- Signs and symptoms of extrapyramidal effects (EPS)-
B- Information about substance abuse and schizophrenia-
C- The effects of alcohol and drug interaction-
D- The availability of support groups for those with dual diagnoses- - ANSWER-ANSWER C
Alcohol enhances the EPS side effects of Prolixin. The half-life of Prolixin PO is 8 hours, whereas the
half-life of the Prolixin Decanoate IM is 2 to 4 weeks- That means the side effects of drinking alcohol
are far more severe when the client drinks alcohol alter taking the long-acting Prolixin Decanoate IM-
(A, B, and D) provide valuable information and should be included in the client/family teaching, but
they do not have the priority of (C).
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 know 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 poison 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 changing your diet- - ANSWER-
ANSWER A
(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-)
,A woman arrives in the Emergency Center and tells the nurse she thinks she has been raped- The
client is sobbing and expresses disbelief that a rape could happen because the man is her best friend-
After acknowledging the client's fear and anxiety, how should the nurse respond?
A- "I would be very upset and mad if my best friend did that to me"
B- "You must feel betrayed, but maybe you might have led him on?"
C- "Rape is not limited to strangers and frequently occurs by someone who is known to the victim"
D- "This does not sound like rape- Did you change your mind about having sex after the fact?" -
ANSWER-ANSWER C
A victim of date rape or acquaintance rape is less prone to recognize what is happening because the
incident usually involves persons who know each other and the dynamics are different than rape by a
stranger. (C) provides confrontation for the client's denial because the victim frequently knows and
trusts the perpetrator. Nurses should not express personal feelings (A) when dealing with victims-
Suggesting that the client led on the rapist (B) indicates that the sexual assault was somehow the
victim's fault- (D) is judgmental and does not display compassion or establish trust between the nurse
and the client
A child is brought to the emergency room with a broken arm- Because of other injuries, the nurse
suspects the child may be a victim of abuse- When the nurse tries to give the child an injection, the
child's mother becomes very loud and shouts, "I won't leave my son! Don't you touch him! You'll hurt
my child!" What is the best interpretation of the mother's statements? The mother is
A- regressing to an earlier behavior pattern-
B- sublimating her anger-
C- projecting her feelings onto the nurse-
D- suppressing her fear- - ANSWER-ANSWER C
Projection is attributing one's own thoughts, impulses, or behaviors onto another-it is the mother
who is probably harming the child and she is attributing her actions to the nurse (C)- The mother may
be immature, but (A) is not the best description of her behavior. (B) is substituting a socially
acceptable feeling for an unacceptable one- These are not socially acceptable feelings- The mother
may be suppressing her fear (D) by displaying anger, but such an interpretation cannot be concluded
from the data presented
The wife of a male client recently diagnosed with schizophrenia asks the nurse, 'What exactly is
schizophrenia? Is my husband all right?" Which response is best for the nurse to provide to this family
member?
A- It sounds like you're worried about your husband- Let's sit down and talk
B- It is a chemical imbalance in the brain that causes disorganized thinking
C- Your husband will be just fine if he takes his medications regularly
D- I think you should talk to your husband's psychologist about this question - ANSWER-ANSWER B
The nurse should answer the client's question with factual information and explain that schizophrenia
is a chemical imbalance in the brain (B)
(A) is a therapeutic response but does not answer the question, and may be an appropriate response
after the nurse answers the question asked Although (C) is likely true to some degree, it is also true
that some clients continue to have disorganized thinking even with antipsychotic medications-
Referring the spouse to the psychologist (D) is avoiding the issue; the nurse can and should answer
the question
A 40-year-old male client diagnosed with schizophrenia and alcohol dependence has not had any
visitors or phone calls since admission. He reports he has no family that cares about him and was
living on the streets prior to this admission. According to Erikson's theory of psychosocial
development, which stage is the client in at this time?
A. Isolation.
B. Stagnation.
C. Despair.
D. Role confusion. - ANSWER-ANSWER B
, The client is in Erikson's "Generativity vs- Stagnation" stage (age 24 to 45), and meeting the task
includes maintaining intimate relationships and moving toward developing a family (B)- (A) occurs in
young adulthood (age 18 to 25), (C) occurs in maturity (age 45 to death), and (D) occurs in
adolescence (age 12 to 20)- These are all stages that occur if individuals are not successfully coping
with their psychosocial developmental stage
The community health nurse talks to a male client who has bipolar disorder. The client explains that
he sleeps 4 to 5 hours a night and is working with his partner to start two new businesses and build an
empire. The client stopped taking his medications several days ago. What nursing problem has the
highest priority?
A. Excessive work activity.
B. Decreased need for sleep.
C. . Medication management.
D. Inflated self-esteem. - ANSWER-ANSWER C
The most important nursing problem is medication management (C) because compliance with the
medication regimen will help prevent hospitalization. The client is also exhibiting signs of (A, B, and C);
however, these problems do not have the priority of medication management.
The nurse is assessing a client's intelligence- Which factor should the nurse remember during this part
of the mental status exam?
A- Acute psychiatric illnesses impair intelligence-
B- Intelligence is influenced by social and cultural beliefs-
C- Poor concentration skills suggests limited intelligence-
D- The inability to think abstractly indicates limited intelligence- - ANSWER-ANSWER B
Social and cultural beliefs (B) have significant impact on intelligence- Chronic psychiatric illness may
impair intelligence (A), especially if it remains untreated- Limited concentration does not suggest
limited intelligence (C)- Dilficulties with abstractions are suggestive of psychotic thinking (D), not
limited intelligence
At a support meeting of parents of a teenager with polysubstance dependency, a parent states, "Each
time my son tries to quit taking drugs, he gets so depressed that I'm afraid he will commit suicide-"
The nurse's response should be based on which information?
A- Addiction is a chronic, incurable disease-
B- Tolerance to the effects of drugs causes feelings of depression-
C- Feelings of depression frequently lead to drug abuse and addiction-
D- . Careful monitoring should be provided during withdrawal from the drugs- - ANSWER-ANSWER D
The priority is to teach the parents that their son will need monitoring and support during withdrawal
(D) to ensure that he does not attempt suicide- Although (A and C) are true, they are not as relevant
to the parent's expressed concern- There is no information to support (B)-
A female client with depression attends group and states that she sometimes misses her medication
appointments because she feels very anxious about riding the bus. Which statement is the nurse's
best response?
A. Can your case manager take you to your appointments?
B. Take your medication for anxiety before you ride the bus.
C. Let's talk about what happens when you feel very anxious.
D. What are some ways that you can cope with your anxiety? - ANSWER-ANSWER D
The best response is to explore ways for the client to cope with anxiety (D). The nurse should
encourage problem-solving rather than dependence on the case manager (A) for transportation.
Strategies for coping with anxiety should be encouraged before suggesting (B). (C) is therapeutic, but
the best response is an open-ended question to explore ways to cope with the anxiety.
A 65-year-old female client complains to the nurse that recently she has been hearing voices. What
question should the nurse ask this client first?
A. Do you have problems with hallucinations?
B. Are you ever alone when you hear the voices?
C. Has anyone in your family had hearing problems?
