HESI Case Study - Psychiatric/Mental
Health Practice Exam/75 Q/A
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?"
-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
meetings.
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.
-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 us 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 1see what is going on there."
-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 would be 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."
-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 anger on to the nurse
-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." - -A. "I'll leave your tray here. I am available if you need anything
else."
-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?
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."
-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?" - -Others have has similar
thoughts when under stress
-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
-A client who is being treated with lithium carbonate for bipolar disorder
develops diarrhea, vomiting, and drowsiness. What action should the nurse
take?
A) Notify the healthcare provider immediately and prepare for administration
of an antidote.
B) Notify the healthcare provider of the symptoms prior to the next
administration of the drug.
C) Record the symptoms as normal side effects and continue administration
of the prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the
drug. - -B. Notify the healthcare provider of the symptoms prior to the next
administration of the drug.
-A client on the psychiatric unit appears to imitate a certain nurse on the
unit. The client seeks out this particular nurse and imitates her mannerisms.
The nurse knows that the client is using which defense mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression. - -B. Identification
-The nurse is planning the care for a 32-year-old male client with acute
depression. Which nursing intervention bests helps this client deal with his
depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
Health Practice Exam/75 Q/A
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?"
-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
meetings.
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.
-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 us 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 1see what is going on there."
-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 would be 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."
-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 anger on to the nurse
-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." - -A. "I'll leave your tray here. I am available if you need anything
else."
-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?
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."
-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?" - -Others have has similar
thoughts when under stress
-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
-A client who is being treated with lithium carbonate for bipolar disorder
develops diarrhea, vomiting, and drowsiness. What action should the nurse
take?
A) Notify the healthcare provider immediately and prepare for administration
of an antidote.
B) Notify the healthcare provider of the symptoms prior to the next
administration of the drug.
C) Record the symptoms as normal side effects and continue administration
of the prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the
drug. - -B. Notify the healthcare provider of the symptoms prior to the next
administration of the drug.
-A client on the psychiatric unit appears to imitate a certain nurse on the
unit. The client seeks out this particular nurse and imitates her mannerisms.
The nurse knows that the client is using which defense mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression. - -B. Identification
-The nurse is planning the care for a 32-year-old male client with acute
depression. Which nursing intervention bests helps this client deal with his
depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
