Mental Health/Psych HESI Review Questions (50 Q study with
rationale)
1. Response to Older Adult in Group Setting
Your Chosen Answer: B) "Yes, I will be leading this group. What would you like to accomplish?"
- Rationale: This response effectively acknowledges the nurse's role while refocusing the group
discussion on their goals and interests. It encourages participation and sets a collaborative tone for the
group. Responses A, C, and D do not appropriately encourage input or collaboration from group
members.
2. Client on Lithium Carbonate
Your Chosen Answer: B) Prior to giving the next dose, notify the health care provider of these symptoms.
- Rationale: This answer correctly emphasizes the importance of notifying the healthcare provider
before administering the next dose of lithium, especially given the concerning symptoms. Monitoring is
essential because these symptoms could indicate lithium toxicity or escalating side effects. Option A is
misleading, as forcing fluids could worsen the situation, while C does not prioritize patient safety. D is
premature without further assessment.
3. Husband Exhibiting Multiple Personalities
Your Chosen Answer: A) Dissociative disorder.
- Rationale: The symptoms described—sleepwalking, memory loss, and exhibiting multiple
personalities—are characteristic of dissociative disorders. This disorder often involves disconnection
from one's conscious awareness. Other provided options do not fit the symptom profile.
4. Client Hearing Voices
Your Chosen Answer: C) "No matter what I do, I cannot make the voices go away."
- Rationale: This statement indicates that the client is struggling significantly with their auditory
hallucinations and may be at risk of self-harm or behaving in a way that endangers themselves or others.
This necessitates hospitalization for safety. The other statements do reflect various levels of coping but
do not indicate an immediate need for hospitalization.
,5. Client Refusing to Wear Clothes
Your Chosen Answer: B) Redirect the client to physically demanding activities.
- Rationale: Redirecting the client to engage in physically demanding activities helps manage
inappropriate behavior by channeling energy into constructive actions. This intervention can be useful in
promoting routine and appropriate behavior in a setting where self-care and social norms need
reinforcement. Options A, C, and D do not actively address the issue and can potentially exacerbate the
behavior.
The client is exhibiting manic behavior related to bipolar disorder, and the nurse should redirect the
client to activities that are physically demanding (B) so that energy can be expended in a socially
acceptable manner. Psychotic clients are not capable of (A). When exhibiting acting-out behavior, the
client is distracted and (C) is difficult. (D) is likely to increase manic behaviors, such as mood swings and
acting-out behaviors.
A client on the psychiatric unit seeks out a particular nurse and imitates her mannerisms. Which defense
mechanism does the nurse recognize in this client?
A.Sublimation
B.Identification
C.Introjection
D.Repression ✔️ANS: B
Identification (B) is an attempt to be like someone or emulate the personality traits of another. (A) is
substituting an unacceptable feeling for one that is more socially acceptable. (C) is incorporating the
values or qualities of an admired person or group into one's own ego structure. (D) is the involuntary
exclusion of painful thoughts or memories from one's awareness.
A client begins taking an atypical antipsychotic medication. The nurse must provide informed consent
and education about common medication side effects. Which client education will be most important?
A.Maintain a balanced diet and adequate exercise.
, B.Be sure that the diet is adequate in salt intake.
C.Monitor for any changes in sleep pattern.
D.Report any unusual facial movements. ✔️ANS: A
Several atypical antipsychotic medications can cause significant weight gain, so the client should be
advised to maintain a balanced diet and adequate exercise (A). (B) is important with lithium, a mood
stabilizer. (C and D) are less common than weight gain.
A 35-year-old client admitted to the psychiatric unit of an acute care hospital tells the nurse that
someone is trying to poison her. The client's delusions are most likely related to which factor?
A.Authority issues in childhood
B.Anger about being hospitalized
C.Low self-esteem
D.Phobia of food ✔️ANS: C
Delusional clients have difficulty with trust and have low self-esteem (C). Nursing care should be
directed at building trust and promoting positive self-esteem. Activities with limited concentration and
no competition should be encouraged to build self-esteem. (A, B, and D) are not specifically related to
the development of delusions.
Clients are preparing to leave the mental health unit for an outdoor smoke break. A client on constant
observation cannot leave and becomes agitated and demands to smoke a cigarette. Which action should
the nurse take first?
A.Remind the client to wear the nicotine (NicoDerm) patch.
B.Determine if the client still needs constant observation.
C.Encourage the client to attend the smoking cessation group.
D.Explain that clients on constant observation cannot smoke. ✔️ANS: B
rationale)
1. Response to Older Adult in Group Setting
Your Chosen Answer: B) "Yes, I will be leading this group. What would you like to accomplish?"
- Rationale: This response effectively acknowledges the nurse's role while refocusing the group
discussion on their goals and interests. It encourages participation and sets a collaborative tone for the
group. Responses A, C, and D do not appropriately encourage input or collaboration from group
members.
2. Client on Lithium Carbonate
Your Chosen Answer: B) Prior to giving the next dose, notify the health care provider of these symptoms.
- Rationale: This answer correctly emphasizes the importance of notifying the healthcare provider
before administering the next dose of lithium, especially given the concerning symptoms. Monitoring is
essential because these symptoms could indicate lithium toxicity or escalating side effects. Option A is
misleading, as forcing fluids could worsen the situation, while C does not prioritize patient safety. D is
premature without further assessment.
3. Husband Exhibiting Multiple Personalities
Your Chosen Answer: A) Dissociative disorder.
- Rationale: The symptoms described—sleepwalking, memory loss, and exhibiting multiple
personalities—are characteristic of dissociative disorders. This disorder often involves disconnection
from one's conscious awareness. Other provided options do not fit the symptom profile.
4. Client Hearing Voices
Your Chosen Answer: C) "No matter what I do, I cannot make the voices go away."
- Rationale: This statement indicates that the client is struggling significantly with their auditory
hallucinations and may be at risk of self-harm or behaving in a way that endangers themselves or others.
This necessitates hospitalization for safety. The other statements do reflect various levels of coping but
do not indicate an immediate need for hospitalization.
,5. Client Refusing to Wear Clothes
Your Chosen Answer: B) Redirect the client to physically demanding activities.
- Rationale: Redirecting the client to engage in physically demanding activities helps manage
inappropriate behavior by channeling energy into constructive actions. This intervention can be useful in
promoting routine and appropriate behavior in a setting where self-care and social norms need
reinforcement. Options A, C, and D do not actively address the issue and can potentially exacerbate the
behavior.
The client is exhibiting manic behavior related to bipolar disorder, and the nurse should redirect the
client to activities that are physically demanding (B) so that energy can be expended in a socially
acceptable manner. Psychotic clients are not capable of (A). When exhibiting acting-out behavior, the
client is distracted and (C) is difficult. (D) is likely to increase manic behaviors, such as mood swings and
acting-out behaviors.
A client on the psychiatric unit seeks out a particular nurse and imitates her mannerisms. Which defense
mechanism does the nurse recognize in this client?
A.Sublimation
B.Identification
C.Introjection
D.Repression ✔️ANS: B
Identification (B) is an attempt to be like someone or emulate the personality traits of another. (A) is
substituting an unacceptable feeling for one that is more socially acceptable. (C) is incorporating the
values or qualities of an admired person or group into one's own ego structure. (D) is the involuntary
exclusion of painful thoughts or memories from one's awareness.
A client begins taking an atypical antipsychotic medication. The nurse must provide informed consent
and education about common medication side effects. Which client education will be most important?
A.Maintain a balanced diet and adequate exercise.
, B.Be sure that the diet is adequate in salt intake.
C.Monitor for any changes in sleep pattern.
D.Report any unusual facial movements. ✔️ANS: A
Several atypical antipsychotic medications can cause significant weight gain, so the client should be
advised to maintain a balanced diet and adequate exercise (A). (B) is important with lithium, a mood
stabilizer. (C and D) are less common than weight gain.
A 35-year-old client admitted to the psychiatric unit of an acute care hospital tells the nurse that
someone is trying to poison her. The client's delusions are most likely related to which factor?
A.Authority issues in childhood
B.Anger about being hospitalized
C.Low self-esteem
D.Phobia of food ✔️ANS: C
Delusional clients have difficulty with trust and have low self-esteem (C). Nursing care should be
directed at building trust and promoting positive self-esteem. Activities with limited concentration and
no competition should be encouraged to build self-esteem. (A, B, and D) are not specifically related to
the development of delusions.
Clients are preparing to leave the mental health unit for an outdoor smoke break. A client on constant
observation cannot leave and becomes agitated and demands to smoke a cigarette. Which action should
the nurse take first?
A.Remind the client to wear the nicotine (NicoDerm) patch.
B.Determine if the client still needs constant observation.
C.Encourage the client to attend the smoking cessation group.
D.Explain that clients on constant observation cannot smoke. ✔️ANS: B
