HESI PSYCHIATRIC-MENTAL HEALTH
PRACTICE EXAM WITH QUESTIONS
AND CORRECT ANSWERS
[FOR ANY OTHER EXAM OR ASSIGNMRNT EMAIL @ MACHARIALWS]
1.
A male client with schizophrenia who is taking fluphenazine
decanoate (Prolixin decanoate) is being discharged in the
morning. A repeat dose of medication is scheduled for 20 days
after discharge. The client tells the nurse that he is going on
vacation in the Bahamas and will return in 18 days. Which
statement by the client indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to
the clinic to get my Prolixin injection.
B) While I am on vacation and when I return, I will not eat or
drink anything that contains alcohol.
C) I will notify the healthcare provider if I have a sore throat or
flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin)
every day. - ANSWER>>>>>Photosensitivity is a side effect of
Prolixin and a vacation in the Bahamas (with its tropical island
climate) increases the client's chance of experiencing this side
effect. He should be instructed to avoid direct sun (A) and wear
sunscreen. (B, C, and D) indicate accurate knowledge. Alcohol
acts synergistically with Prolixin (B). (C) lists signs of
agranulocytosis, which is also a side effect of Prolixin. In order
to avoid extrapyramidal symptoms (EPS), anticholinergic drugs,
such as Cogentin, are often prescribed prophylactically with
Prolixin.
ANSWERA
2.
,A male client is admitted to the mental health unit because he
was feeling depressed about the loss of his wife and job. The
client has a history of alcohol dependency and admits that he
was drinking alcohol 12 hours ago. Vital signs are:
temperature, 100° F, pulse 100, and BP 142/100. The nurse
plans to give the client lorazepam (Ativan) based on which
priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
D) Health seeking behaviors related to personal crisis. -
ANSWER>>>>>The most important nursing diagnosis is related
to alcohol detoxification (B) because the client has elevated
vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client
Ativan for elevated vital signs secondary to alcohol withdrawal.
(C and D) can be addressed when immediate needs for safety
are met.
ANSWERB
3.
The charge nurse is collaborating with the nursing staff about
the plan of care for a client who is very depressed. What is the
most important intervention to implement during the first 48
hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities. - ANSWER>>>>>The
most important reason for closely observing a depressed client
immediately after admission is to maintain safety (B), since
,suicide is a risk with depression. (A, C, and D) are all important
interventions, but safety is the priority.
ANSWERB
4.
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. - ANSWER>>>>>(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.)
ANSWERA
5.
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. - ANSWER>>>>>Early side effects of
lithium carbonate (occurring with serum lithium levels below
2.0 mEq per liter) generally follow a progressive pattern
beginning with diarrhea, vomiting, drowsiness, and muscular
weakness. At higher levels, ataxia, tinnitus, blurred vision, and
large dilute urine output may occur. (B) is the best choice.
Although these are expected symptoms, the healthcare
provider should be notified prior to the next administration of
the drug. (A, C, and D) would not reflect good nursing
judgment.
ANSWERB
6.
The parents of a 14-year-old boy bring their son to the hospital.
He is lethargic, but responsive. The mother states, "I think he
took some of my pain pills." During initial assessment of the
teenager, what information is most important for the nurse to
obtain from the parents?
A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs. -
ANSWER>>>>>Knowledge of all substances taken (C) will guide
further treatment, such as administration of antagonists, so
obtaining this information has the highest priority. (A and B)
PRACTICE EXAM WITH QUESTIONS
AND CORRECT ANSWERS
[FOR ANY OTHER EXAM OR ASSIGNMRNT EMAIL @ MACHARIALWS]
1.
A male client with schizophrenia who is taking fluphenazine
decanoate (Prolixin decanoate) is being discharged in the
morning. A repeat dose of medication is scheduled for 20 days
after discharge. The client tells the nurse that he is going on
vacation in the Bahamas and will return in 18 days. Which
statement by the client indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to
the clinic to get my Prolixin injection.
B) While I am on vacation and when I return, I will not eat or
drink anything that contains alcohol.
C) I will notify the healthcare provider if I have a sore throat or
flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin)
every day. - ANSWER>>>>>Photosensitivity is a side effect of
Prolixin and a vacation in the Bahamas (with its tropical island
climate) increases the client's chance of experiencing this side
effect. He should be instructed to avoid direct sun (A) and wear
sunscreen. (B, C, and D) indicate accurate knowledge. Alcohol
acts synergistically with Prolixin (B). (C) lists signs of
agranulocytosis, which is also a side effect of Prolixin. In order
to avoid extrapyramidal symptoms (EPS), anticholinergic drugs,
such as Cogentin, are often prescribed prophylactically with
Prolixin.
ANSWERA
2.
,A male client is admitted to the mental health unit because he
was feeling depressed about the loss of his wife and job. The
client has a history of alcohol dependency and admits that he
was drinking alcohol 12 hours ago. Vital signs are:
temperature, 100° F, pulse 100, and BP 142/100. The nurse
plans to give the client lorazepam (Ativan) based on which
priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
D) Health seeking behaviors related to personal crisis. -
ANSWER>>>>>The most important nursing diagnosis is related
to alcohol detoxification (B) because the client has elevated
vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client
Ativan for elevated vital signs secondary to alcohol withdrawal.
(C and D) can be addressed when immediate needs for safety
are met.
ANSWERB
3.
The charge nurse is collaborating with the nursing staff about
the plan of care for a client who is very depressed. What is the
most important intervention to implement during the first 48
hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities. - ANSWER>>>>>The
most important reason for closely observing a depressed client
immediately after admission is to maintain safety (B), since
,suicide is a risk with depression. (A, C, and D) are all important
interventions, but safety is the priority.
ANSWERB
4.
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. - ANSWER>>>>>(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.)
ANSWERA
5.
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. - ANSWER>>>>>Early side effects of
lithium carbonate (occurring with serum lithium levels below
2.0 mEq per liter) generally follow a progressive pattern
beginning with diarrhea, vomiting, drowsiness, and muscular
weakness. At higher levels, ataxia, tinnitus, blurred vision, and
large dilute urine output may occur. (B) is the best choice.
Although these are expected symptoms, the healthcare
provider should be notified prior to the next administration of
the drug. (A, C, and D) would not reflect good nursing
judgment.
ANSWERB
6.
The parents of a 14-year-old boy bring their son to the hospital.
He is lethargic, but responsive. The mother states, "I think he
took some of my pain pills." During initial assessment of the
teenager, what information is most important for the nurse to
obtain from the parents?
A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs. -
ANSWER>>>>>Knowledge of all substances taken (C) will guide
further treatment, such as administration of antagonists, so
obtaining this information has the highest priority. (A and B)
