HESI RN Mental Health Exam Prep
Questions & Knowledge Review
A married male client with three children has lost his job and states that he feels useless. He is
tearful, upset, and embarrassed. What is an appropriate objective of care for this client?
1. Limiting tearfulness
2. Increasing self-esteem
3. Controlling feelings of sadness
4. Promoting acceptance by others - ANS 2. Increasing self-esteem
The loss of a job can precipitate negative feelings about the self and decrease self-esteem.
Feelings should be expressed, not limited; attempting to decrease a client's crying often ends up
worsening it. Crying is not necessarily an expression of sadness; other feelings are involved.
The focus should be on the client's self-acceptance, not acceptance by others.
A 44-year-old client has been unable to function since her husband asked for a divorce 2 weeks
ago. She is brought to the crisis intervention center by a friend. What type of crisis is this
situation?
1. Social
2. Situational
3. Maturational
4. Developmental - ANS 2. Situational
Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the
client. Social crises involve multiple losses such as those occurring during major disasters.
Maturational crises occur in response to stress experienced as one struggles with
developmental tasks. Developmental (maturational) crises are associated with developmental
tasks; divorce is not a developmental task.
A resident in a nursing home recently immigrated to the United States from Italy. How does the
nurse plan to provide emotional support?
1. By offering choices consistent with the client's heritage
2. By ensuring that the client understands American beliefs
3. By assisting the client in adjusting to the American culture
4. By correcting the client's misconceptions about appropriate health practices - ANS 1. By
offering choices consistent with the client's heritage
,Adherence to a plan of care is enhanced by the nurse's providing choices consistent with the
client's cultural beliefs and practices. The nurse's cultural or personal beliefs and biases should
not influence or interfere with the implementation of appropriate care. Helping the client adjust to
the American culture is not the priority at this time; care should be adapted to the client's needs
and culture. The person's cultural practices should not be addressed unless they are detrimental
to the person's health.
A nurse should reassess an older adult client's needs and current plan of care when the client's
behavior indicates the development of what symptom?
1. Confusion
2. Hypochondriasis
3. Additional complaints
4. Increased socialization - ANS 1. Confusion
The development of confusion indicates that the client's ability to maintain equilibrium has not
been achieved and that further disequilibrium is occurring. Hypochondriasis and additional
complaints do not indicate that the plan needs to be changed unless the client's history
demonstrates no prior use of these defenses. Increased socialization is a positive response to
the plan of care that does not require reassessment.
An injured child is brought to the emergency department by the parents. While interviewing the
parents, the nurse begins to suspect child abuse. Which parental behaviors might support this
conclusion? Select all that apply.
1. Demonstrating concern for the injured child
2. Focusing on the child's role in sustaining the injury
3. Changing the story of how the child sustained the injury
4. Asking questions about the injury and the child's prognosis
5. Giving an explanation of how the injury occurred that is not consistent with the injury - ANS
2. Focusing on the child's role in sustaining the injury
3. Changing the story of how the child sustained the injury
5. Giving an explanation of how the injury occurred that is not consistent with the injury
The child is often made the scapegoat in the situation; the parents blame the child because they
have unrealistic expectations of the child. Discrepancies or inconsistencies in the history result
from attempts to present a story that is not based in fact. Discrepancies between the parental
explanation for the child's injuries and the physical findings or discrepancies in the history that
each parent gives are common because the information that is being provided is not based in
fact. Abusive parents usually do not ask questions about the injury or prognosis and
demonstrate little or no interest in their child's well-being.
,A nurse is planning to teach a client about self-care. What level of anxiety will best enhance the
client's learning abilities?
1. Mild
2. Panic
3. Severe
4. Moderate - ANS 1. Mild
Mild anxiety motivates one to action, such as learning or making changes. Higher levels of
anxiety tend to blur the individual's perceptions and interfere with functioning. Attention is
severely reduced by panic. The perceptual field is greatly reduced with severe anxiety and
narrowed with moderate anxiety.
A nurse is caring for depressed older adults. What precipitating factors for depression are most
common in the older adult without cognitive problems? Select all that apply.
1. Dementia
2. Multiple losses
3. Declines in health
4. A milestone birthday
5. An injury requiring hospitalization - ANS 2. Multiple losses
3. Declines in health
Depression in the older adult is most often associated with the loss of family members and
friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health,
particularly when associated with a chronic illness, frequently precipitates depression in older
adults. Dementia is a cognitive problem. Research does not correlate the onset of depression
with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of
depression in the older adult as often as does a chronic illness.
The nurse observes biting, rocking, sucking, and lags in intellectual development in a child. She
also concludes the child is suffering from sleep disorders. What could be the reason for the
child's condition?
1. Physical neglect
2. Sexual abuse
3. Physical abuse
4. Emotional abuse - ANS 4. Emotional abuse
The child may be neglected if the parent is having a mental illness such as psychosis. Sleep
disorders, feeding disorders, biting, rocking, sucking, and lags in intellectual development are
behavioral findings associated with emotional abuse. Physical neglect, sexual abuse, and
physical abuse manifest in different sets of signs and symptoms.
, Which emotional condition may be apparent in a client with an addiction?
1. Insomnia
2. Social isolation
3. Acute confusion
4. Functional urinary incontinence - ANS 2. Social isolation
Social isolation is an emotional condition that may be apparent in a client with an addiction.
Insomnia, acute confusion, and functional urinary incontinence are physical, not emotional,
conditions that may be apparent in clients with addiction.
A client who has been battling cancer of the ovary for 7 years is admitted to the hospital in a
debilitated state. The healthcare provider tells the client that she is too frail for surgery or further
chemotherapy. When making rounds during the night, the nurse enters the client's room and
finds her crying. Which is the most appropriate intervention by the nurse?
1. Sit down quietly next to the bed and allow her to cry.
2. Pull the curtain and leave the room to provide privacy for the client.
3. Explain to the client that her feelings are expected and they will pass with time.
4. Observe the length of time the client cries and document her difficulty accepting her
impending death. - ANS 1. Sit down quietly next to the bed and allow her to cry.
Sitting down quietly next to the bed and allowing her to cry demonstrates acceptance of the
client's behavior and provides an opportunity for the client to verbally express feelings if desired.
Pulling the curtain and leaving the room to provide privacy for the client may make the client feel
that the behavior is wrong or is annoying others. Also, it abandons the client when support is
needed. Explaining to the client that her feelings are expected and they will pass with time
closes off communication and does not provide an opportunity for the client to talk about
feelings. Also, it provides false reassurance. The length of time she cries is unimportant at this
time. Assuming that she is having difficulty accepting her impending death is a conclusion
without enough information.
Which of these are symptoms of depression commonly observed in older adults? Select all that
apply.
1. Fatigue
2. Sadness
3. Agitation
4. Increased sleep
5. Increased appetite - ANS 1. Fatigue
2. Sadness
3. Agitation
Questions & Knowledge Review
A married male client with three children has lost his job and states that he feels useless. He is
tearful, upset, and embarrassed. What is an appropriate objective of care for this client?
1. Limiting tearfulness
2. Increasing self-esteem
3. Controlling feelings of sadness
4. Promoting acceptance by others - ANS 2. Increasing self-esteem
The loss of a job can precipitate negative feelings about the self and decrease self-esteem.
Feelings should be expressed, not limited; attempting to decrease a client's crying often ends up
worsening it. Crying is not necessarily an expression of sadness; other feelings are involved.
The focus should be on the client's self-acceptance, not acceptance by others.
A 44-year-old client has been unable to function since her husband asked for a divorce 2 weeks
ago. She is brought to the crisis intervention center by a friend. What type of crisis is this
situation?
1. Social
2. Situational
3. Maturational
4. Developmental - ANS 2. Situational
Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the
client. Social crises involve multiple losses such as those occurring during major disasters.
Maturational crises occur in response to stress experienced as one struggles with
developmental tasks. Developmental (maturational) crises are associated with developmental
tasks; divorce is not a developmental task.
A resident in a nursing home recently immigrated to the United States from Italy. How does the
nurse plan to provide emotional support?
1. By offering choices consistent with the client's heritage
2. By ensuring that the client understands American beliefs
3. By assisting the client in adjusting to the American culture
4. By correcting the client's misconceptions about appropriate health practices - ANS 1. By
offering choices consistent with the client's heritage
,Adherence to a plan of care is enhanced by the nurse's providing choices consistent with the
client's cultural beliefs and practices. The nurse's cultural or personal beliefs and biases should
not influence or interfere with the implementation of appropriate care. Helping the client adjust to
the American culture is not the priority at this time; care should be adapted to the client's needs
and culture. The person's cultural practices should not be addressed unless they are detrimental
to the person's health.
A nurse should reassess an older adult client's needs and current plan of care when the client's
behavior indicates the development of what symptom?
1. Confusion
2. Hypochondriasis
3. Additional complaints
4. Increased socialization - ANS 1. Confusion
The development of confusion indicates that the client's ability to maintain equilibrium has not
been achieved and that further disequilibrium is occurring. Hypochondriasis and additional
complaints do not indicate that the plan needs to be changed unless the client's history
demonstrates no prior use of these defenses. Increased socialization is a positive response to
the plan of care that does not require reassessment.
An injured child is brought to the emergency department by the parents. While interviewing the
parents, the nurse begins to suspect child abuse. Which parental behaviors might support this
conclusion? Select all that apply.
1. Demonstrating concern for the injured child
2. Focusing on the child's role in sustaining the injury
3. Changing the story of how the child sustained the injury
4. Asking questions about the injury and the child's prognosis
5. Giving an explanation of how the injury occurred that is not consistent with the injury - ANS
2. Focusing on the child's role in sustaining the injury
3. Changing the story of how the child sustained the injury
5. Giving an explanation of how the injury occurred that is not consistent with the injury
The child is often made the scapegoat in the situation; the parents blame the child because they
have unrealistic expectations of the child. Discrepancies or inconsistencies in the history result
from attempts to present a story that is not based in fact. Discrepancies between the parental
explanation for the child's injuries and the physical findings or discrepancies in the history that
each parent gives are common because the information that is being provided is not based in
fact. Abusive parents usually do not ask questions about the injury or prognosis and
demonstrate little or no interest in their child's well-being.
,A nurse is planning to teach a client about self-care. What level of anxiety will best enhance the
client's learning abilities?
1. Mild
2. Panic
3. Severe
4. Moderate - ANS 1. Mild
Mild anxiety motivates one to action, such as learning or making changes. Higher levels of
anxiety tend to blur the individual's perceptions and interfere with functioning. Attention is
severely reduced by panic. The perceptual field is greatly reduced with severe anxiety and
narrowed with moderate anxiety.
A nurse is caring for depressed older adults. What precipitating factors for depression are most
common in the older adult without cognitive problems? Select all that apply.
1. Dementia
2. Multiple losses
3. Declines in health
4. A milestone birthday
5. An injury requiring hospitalization - ANS 2. Multiple losses
3. Declines in health
Depression in the older adult is most often associated with the loss of family members and
friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health,
particularly when associated with a chronic illness, frequently precipitates depression in older
adults. Dementia is a cognitive problem. Research does not correlate the onset of depression
with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of
depression in the older adult as often as does a chronic illness.
The nurse observes biting, rocking, sucking, and lags in intellectual development in a child. She
also concludes the child is suffering from sleep disorders. What could be the reason for the
child's condition?
1. Physical neglect
2. Sexual abuse
3. Physical abuse
4. Emotional abuse - ANS 4. Emotional abuse
The child may be neglected if the parent is having a mental illness such as psychosis. Sleep
disorders, feeding disorders, biting, rocking, sucking, and lags in intellectual development are
behavioral findings associated with emotional abuse. Physical neglect, sexual abuse, and
physical abuse manifest in different sets of signs and symptoms.
, Which emotional condition may be apparent in a client with an addiction?
1. Insomnia
2. Social isolation
3. Acute confusion
4. Functional urinary incontinence - ANS 2. Social isolation
Social isolation is an emotional condition that may be apparent in a client with an addiction.
Insomnia, acute confusion, and functional urinary incontinence are physical, not emotional,
conditions that may be apparent in clients with addiction.
A client who has been battling cancer of the ovary for 7 years is admitted to the hospital in a
debilitated state. The healthcare provider tells the client that she is too frail for surgery or further
chemotherapy. When making rounds during the night, the nurse enters the client's room and
finds her crying. Which is the most appropriate intervention by the nurse?
1. Sit down quietly next to the bed and allow her to cry.
2. Pull the curtain and leave the room to provide privacy for the client.
3. Explain to the client that her feelings are expected and they will pass with time.
4. Observe the length of time the client cries and document her difficulty accepting her
impending death. - ANS 1. Sit down quietly next to the bed and allow her to cry.
Sitting down quietly next to the bed and allowing her to cry demonstrates acceptance of the
client's behavior and provides an opportunity for the client to verbally express feelings if desired.
Pulling the curtain and leaving the room to provide privacy for the client may make the client feel
that the behavior is wrong or is annoying others. Also, it abandons the client when support is
needed. Explaining to the client that her feelings are expected and they will pass with time
closes off communication and does not provide an opportunity for the client to talk about
feelings. Also, it provides false reassurance. The length of time she cries is unimportant at this
time. Assuming that she is having difficulty accepting her impending death is a conclusion
without enough information.
Which of these are symptoms of depression commonly observed in older adults? Select all that
apply.
1. Fatigue
2. Sadness
3. Agitation
4. Increased sleep
5. Increased appetite - ANS 1. Fatigue
2. Sadness
3. Agitation
