PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
1. At the first meeting of a group of older adults at a daycare center for the
elderly, the nurse asks one of the members what kinds of things she would
like to do with the group. The older woman shrugs her shoulders and says,
"You tell me, you're the leader." What is 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 during
this time?"
C. "Yes, I have been assigned to be the leader of this group. I will be here for
the next six weeks."
D. "Yes, I am the leader. You seem angry about not being the leader yourself."-
: B. "Yes, I will be leading this group. What would you like to accomplish during this
time?"
Anxiety over participation in a group and testing of the leader characteristically occur
in the initial phase of group dynamics.
(B) provides information and focuses the group back to defining its function.
(A) is manipulative bargaining.
Although (C) provides information, it does not focus the group on its purpose or task.
(D) is interpreting the client's feelings and is almost challenging.
2. Over a period of several weeks, one male participant of a socialization
group at a community day care center for the elderly monopolizes most of
the group's time and interrupts others when they are talking. What is the best
action for the nurse to take in this situation?
A. Talk to the client outside the group about his behavior during group meet-
ings.
B. Remind the client to allow others in the group a chance to talk.
C. Allow the group to handle the problem.
D. Ask the client to join another group.: C. Allow the group to handle the problem.
After several weeks, the group is in the working phase and the group members
should be allowed to determine the direction of the group. The nurse should ignore
the client's comments and allow the group to handle the situation (C). A good leader
should not have separate meetings with group members (A), as such behavior is
manipulative on the part of the leader. (B) is dictatorial and is not in keeping with good
leadership skills. (D) is avoiding the problem. Remember, identify what phase the
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
group is in--initial, working, or termination--this will help determine communication
style.
3. An 86-year-old female client with Alzheimer's disease is wandering the busy
halls of the extended care facility and asks the nurse, "Where should I stand
for the parade?" Which response is best for the nurse to provide?
A. "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B. "You are confused because of all the activity in the hall. There is no parade."
C. "Let's go back to the activity room and see what is going on in there."
D. "Remember I told you that this is a nursing home and I am your nurse.": C.
"Let's go back to the activity room and see what is going on in there."
It is common for those with Alzheimer's disease to use the wrong words. Redirecting
the client (using an accepting non-judgmental dialogue) to a safer place and familiar
activities (C) is most helpful because clients experience short-term memory loss.
(A) dismisses the client's attempt to find order and does not help her relate to her
surroundings. (B) dismisses the client and may increase her anxiety level because
it merely labels the client's behavior and offers no solution. It is very frustrating for
those with Alzheimer's disease to "remember," and scolding them (D) may hurt their
feelings.
4. Physical examination of a 6-year-old reveals several bite marks in various
locations on his body. X-ray examination reveals healed fractures of the ribs.
The mother tells the nurse that her child is always having accidents. Which
initial response by the nurse is most appropriate?
A. "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B. "Tell me more specifically about your child's accidents."
C. "I must report these injuries to the authorities because they do not seem
accidental."
D. "Boys this age always seem to require more supervision and can be quite
accident prone.": B. "Tell me more specifically about your child's accidents."
(B) seeks more information using an open ended, non-threatening statement. (A)
could be appropriate, but it is not the best answer because the nurse is being
somewhat sarcastic and is also avoiding the situation by referring it to the healthcare
provider for resolution. Although it is true that suspected cases of child abuse
must be reported, (C) is virtually an attack and is jumping to conclusions before
conclusive data has been obtained. (D) is a cliché and dismisses the seriousness
of the situation.
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
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5. 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.: C. projecting her feelings onto the nurse.
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.
6. A 38-year-old female client is admitted with a diagnosis of paranoid schizo-
phrenia. 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 would be
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.": A. "I'll leave your tray here. I am available if you need anything else."
(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).
7. A 25-year-old female client has been particularly restless and the nurse
finds her trying to leave the psychiatric unit. She tells the nurse, "Please let
me go! I must leave because the secret police are after me." Which response
is best for the nurse to make?
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
A. "No one is after you, you're safe here."
B. "You'll feel better after you have rested."
C. "I know you must feel lonely and frightened."
D. "Come with me to your room and I will sit with you.": D. "Come with me to
your room and I will sit with you."
(D) is the best response because it offers support without judgment or demands. (A)
is arguing with the client's delusion. (B) is offering false reassurance. (C) is a violation
of therapeutic communication in that the nurse is telling the client how she feels
(frightened and lonely), rather than allowing the client to describe her own feelings.
Hallucinating and/or delusional clients are not capable of discussing their feelings,
particularly when they perceive a crisis.
8. A 45-year-old male client tells the nurse that he used to believe that he was
Jesus Christ, but now he knows he is not. Which response is best for the nurse
to make?
A. "Did you really believe you were Jesus Christ?"
B. "I think you're getting well."
C. "Others have had similar thoughts when under stress."
D. "Why did you think you were Jesus Christ?": C. "Others have had similar
thoughts when under stress."
(C) offers support by assuring the client that others have suffered as he has (also
the principle on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an
inappropriate judgment. You may have narrowed your choices to (C and D). However,
you should eliminate (D) because it is a "why" question, and the client does not know
why!
9. A nurse working in the emergency room of a children's hospital admits a
child whose injuries could have resulted from abuse. Which statement most
accurately describes the nurse's responsibility in cases of suspected child
abuse?
A. The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B. The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C. The nurse should report any case of suspected child abuse to the nurse in
charge.
D. The nurse should note in the client's record any suspicions of child abuse
so that a history of such suspicions can be tracked.: C. The nurse should report
any case of suspected child abuse to the nurse in charge.
Study online at https://quizlet.com/_d4hs47
1. At the first meeting of a group of older adults at a daycare center for the
elderly, the nurse asks one of the members what kinds of things she would
like to do with the group. The older woman shrugs her shoulders and says,
"You tell me, you're the leader." What is 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 during
this time?"
C. "Yes, I have been assigned to be the leader of this group. I will be here for
the next six weeks."
D. "Yes, I am the leader. You seem angry about not being the leader yourself."-
: B. "Yes, I will be leading this group. What would you like to accomplish during this
time?"
Anxiety over participation in a group and testing of the leader characteristically occur
in the initial phase of group dynamics.
(B) provides information and focuses the group back to defining its function.
(A) is manipulative bargaining.
Although (C) provides information, it does not focus the group on its purpose or task.
(D) is interpreting the client's feelings and is almost challenging.
2. Over a period of several weeks, one male participant of a socialization
group at a community day care center for the elderly monopolizes most of
the group's time and interrupts others when they are talking. What is the best
action for the nurse to take in this situation?
A. Talk to the client outside the group about his behavior during group meet-
ings.
B. Remind the client to allow others in the group a chance to talk.
C. Allow the group to handle the problem.
D. Ask the client to join another group.: C. Allow the group to handle the problem.
After several weeks, the group is in the working phase and the group members
should be allowed to determine the direction of the group. The nurse should ignore
the client's comments and allow the group to handle the situation (C). A good leader
should not have separate meetings with group members (A), as such behavior is
manipulative on the part of the leader. (B) is dictatorial and is not in keeping with good
leadership skills. (D) is avoiding the problem. Remember, identify what phase the
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
group is in--initial, working, or termination--this will help determine communication
style.
3. An 86-year-old female client with Alzheimer's disease is wandering the busy
halls of the extended care facility and asks the nurse, "Where should I stand
for the parade?" Which response is best for the nurse to provide?
A. "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B. "You are confused because of all the activity in the hall. There is no parade."
C. "Let's go back to the activity room and see what is going on in there."
D. "Remember I told you that this is a nursing home and I am your nurse.": C.
"Let's go back to the activity room and see what is going on in there."
It is common for those with Alzheimer's disease to use the wrong words. Redirecting
the client (using an accepting non-judgmental dialogue) to a safer place and familiar
activities (C) is most helpful because clients experience short-term memory loss.
(A) dismisses the client's attempt to find order and does not help her relate to her
surroundings. (B) dismisses the client and may increase her anxiety level because
it merely labels the client's behavior and offers no solution. It is very frustrating for
those with Alzheimer's disease to "remember," and scolding them (D) may hurt their
feelings.
4. Physical examination of a 6-year-old reveals several bite marks in various
locations on his body. X-ray examination reveals healed fractures of the ribs.
The mother tells the nurse that her child is always having accidents. Which
initial response by the nurse is most appropriate?
A. "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B. "Tell me more specifically about your child's accidents."
C. "I must report these injuries to the authorities because they do not seem
accidental."
D. "Boys this age always seem to require more supervision and can be quite
accident prone.": B. "Tell me more specifically about your child's accidents."
(B) seeks more information using an open ended, non-threatening statement. (A)
could be appropriate, but it is not the best answer because the nurse is being
somewhat sarcastic and is also avoiding the situation by referring it to the healthcare
provider for resolution. Although it is true that suspected cases of child abuse
must be reported, (C) is virtually an attack and is jumping to conclusions before
conclusive data has been obtained. (D) is a cliché and dismisses the seriousness
of the situation.
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
5. 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.: C. projecting her feelings onto the nurse.
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.
6. A 38-year-old female client is admitted with a diagnosis of paranoid schizo-
phrenia. 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 would be
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.": A. "I'll leave your tray here. I am available if you need anything else."
(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).
7. A 25-year-old female client has been particularly restless and the nurse
finds her trying to leave the psychiatric unit. She tells the nurse, "Please let
me go! I must leave because the secret police are after me." Which response
is best for the nurse to make?
, PSYCHIATRIC/MENTAL HEALTH PRACTICE EXAM EVOLVE HESI QUESTION
Study online at https://quizlet.com/_d4hs47
A. "No one is after you, you're safe here."
B. "You'll feel better after you have rested."
C. "I know you must feel lonely and frightened."
D. "Come with me to your room and I will sit with you.": D. "Come with me to
your room and I will sit with you."
(D) is the best response because it offers support without judgment or demands. (A)
is arguing with the client's delusion. (B) is offering false reassurance. (C) is a violation
of therapeutic communication in that the nurse is telling the client how she feels
(frightened and lonely), rather than allowing the client to describe her own feelings.
Hallucinating and/or delusional clients are not capable of discussing their feelings,
particularly when they perceive a crisis.
8. A 45-year-old male client tells the nurse that he used to believe that he was
Jesus Christ, but now he knows he is not. Which response is best for the nurse
to make?
A. "Did you really believe you were Jesus Christ?"
B. "I think you're getting well."
C. "Others have had similar thoughts when under stress."
D. "Why did you think you were Jesus Christ?": C. "Others have had similar
thoughts when under stress."
(C) offers support by assuring the client that others have suffered as he has (also
the principle on which Alcoholics Anonymous acts). (A) is belittling. (B) is making an
inappropriate judgment. You may have narrowed your choices to (C and D). However,
you should eliminate (D) because it is a "why" question, and the client does not know
why!
9. A nurse working in the emergency room of a children's hospital admits a
child whose injuries could have resulted from abuse. Which statement most
accurately describes the nurse's responsibility in cases of suspected child
abuse?
A. The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B. The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C. The nurse should report any case of suspected child abuse to the nurse in
charge.
D. The nurse should note in the client's record any suspicions of child abuse
so that a history of such suspicions can be tracked.: C. The nurse should report
any case of suspected child abuse to the nurse in charge.
