NR 326 MENTAL HESI 2 – 2020

NR 326 MENTAL HESI 2 – 2020 1. A male employee who is assessed weekly in the employee clinic for blood pressure because of a history of hypertension tells the nurse that he is so upset with one of his co-workers that he would like to shoot him. What action should the nurse take first? a.) Determine if the client has a weapon available for use. b.) Inform the health care provider of the threat to harm a co-worker. c.) Notify security of the client’s intention to harm a co-worker. d.) Have the employee escorted to a mental health facility. 2. A male client who is participating in an anger management assignment asks if he can make a leather belt in occupational therapy. The client begins pounding the leather vigorously with a mallet to imprint designs on the belt. What defense mechanism is the client using? a.) Sublimation. b.) Suppression. c.) Regression. d.) Compensation. 3. A 20-year-old female client with schizophrenia is scheduled to receive risperidone (Risperdal) 2mg at bedtime. When the nurse attempts to administer the medication, the client states. “I am not going to take that medicine, and you can’t make me.” What action should the nurse take? a.) Administer the medication via a nasogastric tube. b.) Substitute an injectable form of the medication. c.) Encourage the client to take the medicine because it will help her sleep. d.) Document in the client’s record that the medication was refused. 4. An adult female client tells the nurse that though she is afraid her abusive boyfriend might one day kill her, she keeps hoping that he will change. What action should the nurse take first? a.) Discuss treatment options for abusive partners. b.) Explore client’s readiness to discuss the situation. c.) Determine the frequency and type of client’s abuse. d.) Report the finding to the police department. 5. A male client with bipolar disorder has not slept or eaten in four days. He paces and becomes increasingly agitated and loud while the nurse talks to his spouse. What intervention is the best for the nurse to implement at this time? a.) Move to a quiet area and provide peanut butter with crackers. b.) Walk with the client to the cafeteria and star as he eats lunch.