MENTAL HEALTH (PSYCH) HESI -
PRACTICE 2021-2026
Instructions
All answers are underlined.
Questions
A 60-year-old client diagnosed with chronic schizophrenia presents in an
emergency department with uncontrollable tongue movements, stiff neck, and
difficulty swallowing. Which medical diagnosis and treatment should a nurse
anticipate when planning care for this client?
A. Neuroleptic malignant syndrome treated by discontinuing antipsychotic
medications.
B. Agranulocytosis treated by administration of clozapine (Clozaril).
C. Extrapyramidal symptoms treated by administration of benztropine (Cogentin).
D. Tardive dyskinesia treated by discontinuing antipsychotic medications.
<answer>:
D. Tardive dyskinesia treated by discontinuing antipsychotic medications.
(Happens after pt has chronically taken antipsychotic medications. When prescribing
antipsychotics, you want to start low and gradually increase dose because of this.
Question clues: "Chronic schizophrenia", "uncontrollable tongue movements, stiff neck,
difficulty swallowing")
,A client began taking lithium for the treatment of BP disorder approximately 1
month ago. The client asks if it is normal to have gained 12 pounds in this time
frame. Which is the appropriate nursing response?
A. "That’s strange. Weight loss is the typical pattern."
B. "What have you been eating? Weight gain is not usually associate with
lithium."
C. "Weight gain is a common but troubling side effect."
D. "Weight gain only occurs during the first month of treatment with this drug."
<answer>
C. "Weight gain is a common but troubling side effect."
A client diagnosed with a history of anorexia nervosa comes to an outpatient
clinic after being medically cleared. The client states, "My parents watch me like a
hawk and never let me out of their sight. " Which nursing diagnosis would take
priority at this time?
A. Altered nutrition less than body requirements
B. Altered social interaction
C. Impaired verbal communication
D. Altered family processes <answer>:
D. Altered family processes
A client diagnosed with antisocial personality disorder comes to a nurses' station
at 11:00 p.m. requesting to phone a lawyer to discuss filing for divorce. The unit
rules state that no phone calls are permitted after 10:00 p.m. Which nursing
response is most appropriate?
A. "Go ahead and use the phone. I know this pending divorce is stressful."
B. "You know better than break the rules. I’m surprised at you. "
C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow."
D. "The decision to divorce should not be considered until you have had a good
night’s sleep." <answer>
C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow."
,A client diagnosed with bipolar disorder is distraught over insomnia experienced
over the last 3 nights and a 12- pound weight loss over the past 2 weeks. Which
should be this client's priority nursing diagnosis?
A. Knowledge deficit R/T bipolar disorder AEB concern about symptoms.
B. Altered nutrition: Less than body requirements r/t hyperactivity AEB weight
loss.
C. Risk for suicide r/t powerlessness AEB insomnia and anorexia.
D. Altered sleep patterns r/t mania AEB insomnia for the past 3 nights. <answer>
B. Altered nutrition: Less than body requirements r/t hyperactivity AEB weight loss.
(Physical needs/health always priority.)
A client diagnosed with bipolar disorder: depressive phase intentionally
overdoses on sertraline (Zoloft). Family members report that the client has
experience anorexia, insomnia, and recent job loss. What should be the priority
nursing diagnosis for this client?
A. Risk for suicide r/t hopelessness.
B. Anxiety: severe r/t hyperactivity
C. Imbalanced nutrition: less than body requirements r/t refusal to eat
D. Dysfunctional grieving r/t loss of employment. <answer>
A. Risk for suicide r/t hopelessness.
A client diagnosed with borderline personality disorder brings up a conflict with
the staff in a community meeting and develops a following of clients who
unreasonably demand modification of unit rules. How can the nursing staff best
handle this situation?
A. Allow the clients to apply the democratic process when developing unit rules.
B. Maintain consistency of care by open communication to avoid staff
manipulation.
C. Allow the client spokesman to verbalize concerns during a unit staff meeting.
D. Maintain unit order by the application of autocratic leadership. <answer>
, B. Maintain consistency of care by open communication to avoid staff manipulation.
(Borderline personality disorder is very manipulative. They want to cause splitting which
looks like pitting the nurses against each other, or one day you are the best nurse ever
and then the next day you are the worst nurse in the world.)
A client diagnosed with BP disorder has been taking lithium carbonate (Lit Haine)
for 1 year. The client presents in an emergency department with a temp of 101F
(38C), severe diarrhea, blurred vision, and tinnitus. How should the nurse
interpret these symptoms?
A. Symptoms indicate consumption of foods high in tyramine.
B. Symptoms indicate lithium carbonate discontinuation syndrome.
C. Symptoms indicate the development of lithium carbonate tolerance.
D. Symptoms indicate lithium carbonate toxicity. <answer>
D. Symptoms indicate lithium carbonate toxicity. (0.6-1.2 normal range. blurred vision
and tinnitus is most obvious clue)
A client diagnosed with BP disorder is exhibiting severe manic behaviors. A
physician prescribes lithium carbonate (Eska Lith) and olanzapine (Zyprexa). The
client's spouse questions the Zyprexa order. Which is the appropriate nursing
response?
A. "Zyprexa in combination with Eska Lith cures manic symptoms."
B. "Zyprexa prevents extrapyramidal side effects."
C. "Zyprexa ensures a good night's sleep."
D. "Zyprexa calms hyperactivity until the Eska Lith takes effect." <answer>
D. "Zyprexa calms hyperactivity until the Eska Lith takes effect."
(When it comes to psych meds, it takes 4-6 wks. to see effect. Give Zyprexa as a bridge
until Lithium takes in effect."
A client diagnosed with BP disorder: manic episode refuses to take lithium
carbonate due to excessive weight gain. in order to increase compliance, which
medication should a nurse anticipate that a physician will prescribe?
PRACTICE 2021-2026
Instructions
All answers are underlined.
Questions
A 60-year-old client diagnosed with chronic schizophrenia presents in an
emergency department with uncontrollable tongue movements, stiff neck, and
difficulty swallowing. Which medical diagnosis and treatment should a nurse
anticipate when planning care for this client?
A. Neuroleptic malignant syndrome treated by discontinuing antipsychotic
medications.
B. Agranulocytosis treated by administration of clozapine (Clozaril).
C. Extrapyramidal symptoms treated by administration of benztropine (Cogentin).
D. Tardive dyskinesia treated by discontinuing antipsychotic medications.
<answer>:
D. Tardive dyskinesia treated by discontinuing antipsychotic medications.
(Happens after pt has chronically taken antipsychotic medications. When prescribing
antipsychotics, you want to start low and gradually increase dose because of this.
Question clues: "Chronic schizophrenia", "uncontrollable tongue movements, stiff neck,
difficulty swallowing")
,A client began taking lithium for the treatment of BP disorder approximately 1
month ago. The client asks if it is normal to have gained 12 pounds in this time
frame. Which is the appropriate nursing response?
A. "That’s strange. Weight loss is the typical pattern."
B. "What have you been eating? Weight gain is not usually associate with
lithium."
C. "Weight gain is a common but troubling side effect."
D. "Weight gain only occurs during the first month of treatment with this drug."
<answer>
C. "Weight gain is a common but troubling side effect."
A client diagnosed with a history of anorexia nervosa comes to an outpatient
clinic after being medically cleared. The client states, "My parents watch me like a
hawk and never let me out of their sight. " Which nursing diagnosis would take
priority at this time?
A. Altered nutrition less than body requirements
B. Altered social interaction
C. Impaired verbal communication
D. Altered family processes <answer>:
D. Altered family processes
A client diagnosed with antisocial personality disorder comes to a nurses' station
at 11:00 p.m. requesting to phone a lawyer to discuss filing for divorce. The unit
rules state that no phone calls are permitted after 10:00 p.m. Which nursing
response is most appropriate?
A. "Go ahead and use the phone. I know this pending divorce is stressful."
B. "You know better than break the rules. I’m surprised at you. "
C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow."
D. "The decision to divorce should not be considered until you have had a good
night’s sleep." <answer>
C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow."
,A client diagnosed with bipolar disorder is distraught over insomnia experienced
over the last 3 nights and a 12- pound weight loss over the past 2 weeks. Which
should be this client's priority nursing diagnosis?
A. Knowledge deficit R/T bipolar disorder AEB concern about symptoms.
B. Altered nutrition: Less than body requirements r/t hyperactivity AEB weight
loss.
C. Risk for suicide r/t powerlessness AEB insomnia and anorexia.
D. Altered sleep patterns r/t mania AEB insomnia for the past 3 nights. <answer>
B. Altered nutrition: Less than body requirements r/t hyperactivity AEB weight loss.
(Physical needs/health always priority.)
A client diagnosed with bipolar disorder: depressive phase intentionally
overdoses on sertraline (Zoloft). Family members report that the client has
experience anorexia, insomnia, and recent job loss. What should be the priority
nursing diagnosis for this client?
A. Risk for suicide r/t hopelessness.
B. Anxiety: severe r/t hyperactivity
C. Imbalanced nutrition: less than body requirements r/t refusal to eat
D. Dysfunctional grieving r/t loss of employment. <answer>
A. Risk for suicide r/t hopelessness.
A client diagnosed with borderline personality disorder brings up a conflict with
the staff in a community meeting and develops a following of clients who
unreasonably demand modification of unit rules. How can the nursing staff best
handle this situation?
A. Allow the clients to apply the democratic process when developing unit rules.
B. Maintain consistency of care by open communication to avoid staff
manipulation.
C. Allow the client spokesman to verbalize concerns during a unit staff meeting.
D. Maintain unit order by the application of autocratic leadership. <answer>
, B. Maintain consistency of care by open communication to avoid staff manipulation.
(Borderline personality disorder is very manipulative. They want to cause splitting which
looks like pitting the nurses against each other, or one day you are the best nurse ever
and then the next day you are the worst nurse in the world.)
A client diagnosed with BP disorder has been taking lithium carbonate (Lit Haine)
for 1 year. The client presents in an emergency department with a temp of 101F
(38C), severe diarrhea, blurred vision, and tinnitus. How should the nurse
interpret these symptoms?
A. Symptoms indicate consumption of foods high in tyramine.
B. Symptoms indicate lithium carbonate discontinuation syndrome.
C. Symptoms indicate the development of lithium carbonate tolerance.
D. Symptoms indicate lithium carbonate toxicity. <answer>
D. Symptoms indicate lithium carbonate toxicity. (0.6-1.2 normal range. blurred vision
and tinnitus is most obvious clue)
A client diagnosed with BP disorder is exhibiting severe manic behaviors. A
physician prescribes lithium carbonate (Eska Lith) and olanzapine (Zyprexa). The
client's spouse questions the Zyprexa order. Which is the appropriate nursing
response?
A. "Zyprexa in combination with Eska Lith cures manic symptoms."
B. "Zyprexa prevents extrapyramidal side effects."
C. "Zyprexa ensures a good night's sleep."
D. "Zyprexa calms hyperactivity until the Eska Lith takes effect." <answer>
D. "Zyprexa calms hyperactivity until the Eska Lith takes effect."
(When it comes to psych meds, it takes 4-6 wks. to see effect. Give Zyprexa as a bridge
until Lithium takes in effect."
A client diagnosed with BP disorder: manic episode refuses to take lithium
carbonate due to excessive weight gain. in order to increase compliance, which
medication should a nurse anticipate that a physician will prescribe?
