PSYCHIATRIC/MENTAL HEALTH PRACTICE
EXAM EVOLVE HESI QUESTIONS WITH 100%
CORRECT ANSWERS.
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." - Correct Answer-B. "Yes, I will be leading this group. What would
you like to accomplish during this time?"
Anxiety over participation in a group and testing of the leader
characteristically occur in the initial phase of group dynamics.
(B) provides information and focuses the group back to defining its function.
(A) is manipulative bargaining.
Although (C) provides information, it does not focus the group on its purpose
or task.
(D) is interpreting the client's feelings and is almost challenging.
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. - Correct Answer-C. Allow the group
to handle the problem.
After several weeks, the group is in the working phase and the group
members should be allowed to determine the direction of the group. The
nurse should ignore the client's comments and allow the group to handle the
situation (C). A good leader should not have separate meetings with group
members (A), as such behavior is manipulative on the part of the leader. (B)
is dictatorial and is not in keeping with good leadership skills. (D) is avoiding
the problem. Remember, identify what phase the group is in--initial, working,
or termination--this will help determine communication style.
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's 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." -
Correct Answer-C. "Let's go back to the activity room and see what is going
on in there."
It is common for those with Alzheimer's disease to use the wrong words.
Redirecting the client (using an accepting non-judgmental dialogue) to a
safer place and familiar activities (C) is most helpful because clients
experience short-term memory loss. (A) dismisses the client's attempt to find
order and does not help her relate to her surroundings. (B) dismisses the
client and may increase her anxiety level because it merely labels the
client's behavior and offers no solution. It is very frustrating for those with
Alzheimer's disease to "remember," and scolding them (D) may hurt their
feelings.
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 is 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." - Correct Answer-B. "Tell me more specifically about your
child's accidents."
(B) seeks more information using an open ended, non-threatening
statement. (A) could be appropriate, but it is not the best answer because
the nurse is being somewhat sarcastic and is also avoiding the situation by
referring it to the healthcare provider for resolution. Although it is true that
suspected cases of child abuse must be reported, (C) is virtually an attack
and is jumping to conclusions before conclusive data has been obtained. (D)
is a cliché and dismisses the seriousness of the situation.
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. - Correct Answer-C. projecting her feelings onto the
nurse.
Projection is attributing one's own thoughts, impulses, or behaviors onto
another--it is the mother who is probably harming the child and she is
attributing her actions to the nurse (C). The mother may be immature, but
(A) is not the best description of her behavior. (B) is substituting a socially
acceptable feeling for an unacceptable one. These are not socially
acceptable feelings. The mother may be suppressing her fear (D) by
displaying anger, but such an interpretation cannot be concluded from the
data presented.
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 would be 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." - Correct Answer-A. "I'll leave your tray here. I am available if you
need anything else."
(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).
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." - Correct Answer-D.
"Come with me to your room and I will sit with you."
(D) is the best response because it offers support without judgment or
demands. (A) is arguing with the client's delusion. (B) is offering false
reassurance. (C) is a violation of therapeutic communication in that the nurse
is telling the client how she feels (frightened and lonely), rather than
allowing the client to describe her own feelings. Hallucinating and/or
delusional clients are not capable of discussing their feelings, particularly
when they perceive a crisis.
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."
EXAM EVOLVE HESI QUESTIONS WITH 100%
CORRECT ANSWERS.
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." - Correct Answer-B. "Yes, I will be leading this group. What would
you like to accomplish during this time?"
Anxiety over participation in a group and testing of the leader
characteristically occur in the initial phase of group dynamics.
(B) provides information and focuses the group back to defining its function.
(A) is manipulative bargaining.
Although (C) provides information, it does not focus the group on its purpose
or task.
(D) is interpreting the client's feelings and is almost challenging.
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. - Correct Answer-C. Allow the group
to handle the problem.
After several weeks, the group is in the working phase and the group
members should be allowed to determine the direction of the group. The
nurse should ignore the client's comments and allow the group to handle the
situation (C). A good leader should not have separate meetings with group
members (A), as such behavior is manipulative on the part of the leader. (B)
is dictatorial and is not in keeping with good leadership skills. (D) is avoiding
the problem. Remember, identify what phase the group is in--initial, working,
or termination--this will help determine communication style.
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's 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." -
Correct Answer-C. "Let's go back to the activity room and see what is going
on in there."
It is common for those with Alzheimer's disease to use the wrong words.
Redirecting the client (using an accepting non-judgmental dialogue) to a
safer place and familiar activities (C) is most helpful because clients
experience short-term memory loss. (A) dismisses the client's attempt to find
order and does not help her relate to her surroundings. (B) dismisses the
client and may increase her anxiety level because it merely labels the
client's behavior and offers no solution. It is very frustrating for those with
Alzheimer's disease to "remember," and scolding them (D) may hurt their
feelings.
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 is 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." - Correct Answer-B. "Tell me more specifically about your
child's accidents."
(B) seeks more information using an open ended, non-threatening
statement. (A) could be appropriate, but it is not the best answer because
the nurse is being somewhat sarcastic and is also avoiding the situation by
referring it to the healthcare provider for resolution. Although it is true that
suspected cases of child abuse must be reported, (C) is virtually an attack
and is jumping to conclusions before conclusive data has been obtained. (D)
is a cliché and dismisses the seriousness of the situation.
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. - Correct Answer-C. projecting her feelings onto the
nurse.
Projection is attributing one's own thoughts, impulses, or behaviors onto
another--it is the mother who is probably harming the child and she is
attributing her actions to the nurse (C). The mother may be immature, but
(A) is not the best description of her behavior. (B) is substituting a socially
acceptable feeling for an unacceptable one. These are not socially
acceptable feelings. The mother may be suppressing her fear (D) by
displaying anger, but such an interpretation cannot be concluded from the
data presented.
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 would be 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." - Correct Answer-A. "I'll leave your tray here. I am available if you
need anything else."
(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).
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." - Correct Answer-D.
"Come with me to your room and I will sit with you."
(D) is the best response because it offers support without judgment or
demands. (A) is arguing with the client's delusion. (B) is offering false
reassurance. (C) is a violation of therapeutic communication in that the nurse
is telling the client how she feels (frightened and lonely), rather than
allowing the client to describe her own feelings. Hallucinating and/or
delusional clients are not capable of discussing their feelings, particularly
when they perceive a crisis.
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."
