Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
1. The home care nurse is visiting an old- 1. Neglecting personal grooming
er client whose spouse died 6 months
ago. Which behavior by the client indi- Rational:
cates ineffective coping? Coping mechanisms are behaviors
used to decrease stress and anx-
1. Neglecting personal grooming iety. In response to a death, in-
2. Looking at old snapshots of family effective coping is manifested by
3. Participating in a senior citizens' an extreme behavior that in some
program cases may be harmful to the indi-
4. Visiting their spouse's grave once a vidual physically or psychological-
month ly. The correct option is indicative
of a behavior that identifies an inef-
fective coping behavior in the griev-
ing process.
2. A client with a diagnosis of major 4. "You've been feeling like a failure
depression who has attempted sui- for a while?"
cide says to the nurse, "I should
have died. I've always been a fail- Rationale:
ure. Nothing ever goes right for me." Responding to the feelings ex-
Which response demonstrates thera- pressed by a client is an effective
peutic communication? therapeutic communication tech-
nique. The correct option is an ex-
1. "You have everything to live for." ample of the use of restating. The
2. "Why do you see yourself as a fail- remaining options block communi-
ure?" cation because they minimize the
3. "Feeling like this is all part of being client's experience and do not facil-
depressed." itate exploration of the client's ex-
4. "You've been feeling like a failure for pressed feelings. In addition, use of
a while?" the word "why" is nontherapeutic.
3. When the mental health nurse visits 3. "You're having difficulty sleep-
a client at home, the client states, "I ing?"
haven't slept at all the last couple of
nights." Which response by the nurse Rationale:
illustrates a therapeutic communica- The correct option uses the thera-
tion response to this client? peutic communication technique of
restatement. Although restatement
1. "I see." is a technique that has a prompt-
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
2. "Really?" ing component to it, it repeats the
3. "You're having difficulty sleeping?" client's major theme, which assists
4. "Sometimes, I have trouble sleeping the nurse to obtain a more specific
too." perception of the problem from the
client. The remaining options are
not therapeutic responses since
none encourage the client to ex-
pand on the problem. Offering per-
sonal experiences moves the focus
away from the client and onto the
nurse.
4. A client experiencing disturbed 1. Using open-ended questions
thought processes believes that his and silence
food is being poisoned. Which com-
munication technique should the Rationale:
nurse use to encourage the client to Open-ended questions and si-
eat? lence are strategies used to en-
courage clients to discuss their
1. Using open-ended questions and si- problems. Sharing personal food
lence preferences is not a client-cen-
2. Sharing personal preference re- tered intervention. The remaining
garding food choices options are not helpful to the client
3. Documenting reasons why the because they do not encourage
client does not want to eat the client to express feelings. The
4. Offering opinions about the neces- nurse should not offer opinions
sity of adequate nutrition and should encourage the client to
identify the reasons for the behav-
ior.
5. A client admitted to a mental health 1. Denial
unit for treatment of psychotic behav-
ior spends hours at the locked exit Rationale:
door shouting, "Let me out. There's Denial is refusal to admit to a
nothing wrong with me. I don't belong painful reality, which is treated as
here." What defense mechanism is the if it does not exist. In projection, a
client implementing? person unconsciously rejects emo-
tionally unacceptable features and
1. Denial attributes them to other persons,
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
2. Projection objects, or situations. Regression
3. Regression allows the client to return to an ear-
4. Rationalization lier, more comforting, although less
mature, way of behaving. Rational-
ization is justifying illogical or un-
reasonable ideas, actions, or feel-
ings by developing acceptable ex-
planations that satisfy the teller
and the listener.
6. A client diagnosed with terminal can- 3. "You're feeling angry that your
cer says to the nurse, "I'm going to family continues to hope for you to
die, and I wish my family would stop be cured?"
hoping for a cure! I get so angry when
they carry on like this. After all, I'm the Rationale:
one who's dying." Which response by Restating is a therapeutic com-
the nurse is therapeutic? munication technique in which the
nurse repeats what the client says
1. "Have you shared your feelings with to show understanding and to re-
your family?" view what was said. While it is ap-
2. "I think we should talk more about propriate for the nurse to attempt
your anger with your family." to assess the client's ability to
3. "You're feeling angry that your fam- discuss feelings openly with fam-
ily continues to hope for you to be ily members, it does not help the
cured?" client discuss the feelings causing
4. "You are probably very depressed, the anger. The nurse's attempt to
which is understandable with such a focus on the central issue of anger
diagnosis." is premature. The nurse would nev-
er make a judgment regarding the
reason for the client's feeling; this
is nontherapeutic in the one-to-one
relationship.
7. On review of the client's record, the 4. A willingness to participate in the
nurse notes that the mental health planning of the care and treatment
admission was voluntary. Based on plan.
this information, the nurse anticipates
which client behavior? Rationale:
In general, clients seek voluntary
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
1. Fearfulness regarding treatment admission. If a client seeks volun-
measures. tary admission, the most likely ex-
2. Anger and aggressiveness directed pectation is that the client will par-
toward others. ticipate in the treatment program
3. An understanding of the pathology since they are actively seeking
and symptoms of the diagnosis. help. The remaining options are not
4. A willingness to participate in the characteristics of this type of ad-
planning of the care and treatment mission. Fearfulness, anger, and
plan. aggressiveness are more charac-
teristic of an involuntary admis-
sion. Voluntary admission does not
guarantee a client's understanding
of their illness, only of their desire
for help.
8. When reviewing the admission as- 1. Monitor closely for harm to self
sessment, the nurse notes that a client or others.
was admitted to the mental health unit
involuntarily. Based on this type of Rationale:
admission, the nurse should provide Involuntary admission is neces-
which intervention for this client? sary when a person is a danger
to self or others or is in need of
1. Monitor closely for harm to self or psychiatric treatment regardless of
others. the client's willingness to consent
2. Assist in completing an application to the hospitalization. A written re-
for admission. quest is a component of a volun-
3. Supply the client with written infor- tary admission. Providing written
mation about their mental illness. information regarding the illness is
4. Provide an opportunity for the fam- likely premature initially. The family
ily to discuss why they felt the admis- may have had no role to play in the
sion was needed. client's admission.
9. The nurse is preparing a client for the 2. Making appointment referrals
termination phase of the nurse-client
relationship. The nurse prepares to Rationale:
implement which nursing task that is Tasks of the termination phase
most appropriate for this phase? include evaluating client perfor-
mance, evaluating achievement of
1. Planning short-term goals expected outcomes, evaluating fu-
with Verified Answers
1. The home care nurse is visiting an old- 1. Neglecting personal grooming
er client whose spouse died 6 months
ago. Which behavior by the client indi- Rational:
cates ineffective coping? Coping mechanisms are behaviors
used to decrease stress and anx-
1. Neglecting personal grooming iety. In response to a death, in-
2. Looking at old snapshots of family effective coping is manifested by
3. Participating in a senior citizens' an extreme behavior that in some
program cases may be harmful to the indi-
4. Visiting their spouse's grave once a vidual physically or psychological-
month ly. The correct option is indicative
of a behavior that identifies an inef-
fective coping behavior in the griev-
ing process.
2. A client with a diagnosis of major 4. "You've been feeling like a failure
depression who has attempted sui- for a while?"
cide says to the nurse, "I should
have died. I've always been a fail- Rationale:
ure. Nothing ever goes right for me." Responding to the feelings ex-
Which response demonstrates thera- pressed by a client is an effective
peutic communication? therapeutic communication tech-
nique. The correct option is an ex-
1. "You have everything to live for." ample of the use of restating. The
2. "Why do you see yourself as a fail- remaining options block communi-
ure?" cation because they minimize the
3. "Feeling like this is all part of being client's experience and do not facil-
depressed." itate exploration of the client's ex-
4. "You've been feeling like a failure for pressed feelings. In addition, use of
a while?" the word "why" is nontherapeutic.
3. When the mental health nurse visits 3. "You're having difficulty sleep-
a client at home, the client states, "I ing?"
haven't slept at all the last couple of
nights." Which response by the nurse Rationale:
illustrates a therapeutic communica- The correct option uses the thera-
tion response to this client? peutic communication technique of
restatement. Although restatement
1. "I see." is a technique that has a prompt-
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
2. "Really?" ing component to it, it repeats the
3. "You're having difficulty sleeping?" client's major theme, which assists
4. "Sometimes, I have trouble sleeping the nurse to obtain a more specific
too." perception of the problem from the
client. The remaining options are
not therapeutic responses since
none encourage the client to ex-
pand on the problem. Offering per-
sonal experiences moves the focus
away from the client and onto the
nurse.
4. A client experiencing disturbed 1. Using open-ended questions
thought processes believes that his and silence
food is being poisoned. Which com-
munication technique should the Rationale:
nurse use to encourage the client to Open-ended questions and si-
eat? lence are strategies used to en-
courage clients to discuss their
1. Using open-ended questions and si- problems. Sharing personal food
lence preferences is not a client-cen-
2. Sharing personal preference re- tered intervention. The remaining
garding food choices options are not helpful to the client
3. Documenting reasons why the because they do not encourage
client does not want to eat the client to express feelings. The
4. Offering opinions about the neces- nurse should not offer opinions
sity of adequate nutrition and should encourage the client to
identify the reasons for the behav-
ior.
5. A client admitted to a mental health 1. Denial
unit for treatment of psychotic behav-
ior spends hours at the locked exit Rationale:
door shouting, "Let me out. There's Denial is refusal to admit to a
nothing wrong with me. I don't belong painful reality, which is treated as
here." What defense mechanism is the if it does not exist. In projection, a
client implementing? person unconsciously rejects emo-
tionally unacceptable features and
1. Denial attributes them to other persons,
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
2. Projection objects, or situations. Regression
3. Regression allows the client to return to an ear-
4. Rationalization lier, more comforting, although less
mature, way of behaving. Rational-
ization is justifying illogical or un-
reasonable ideas, actions, or feel-
ings by developing acceptable ex-
planations that satisfy the teller
and the listener.
6. A client diagnosed with terminal can- 3. "You're feeling angry that your
cer says to the nurse, "I'm going to family continues to hope for you to
die, and I wish my family would stop be cured?"
hoping for a cure! I get so angry when
they carry on like this. After all, I'm the Rationale:
one who's dying." Which response by Restating is a therapeutic com-
the nurse is therapeutic? munication technique in which the
nurse repeats what the client says
1. "Have you shared your feelings with to show understanding and to re-
your family?" view what was said. While it is ap-
2. "I think we should talk more about propriate for the nurse to attempt
your anger with your family." to assess the client's ability to
3. "You're feeling angry that your fam- discuss feelings openly with fam-
ily continues to hope for you to be ily members, it does not help the
cured?" client discuss the feelings causing
4. "You are probably very depressed, the anger. The nurse's attempt to
which is understandable with such a focus on the central issue of anger
diagnosis." is premature. The nurse would nev-
er make a judgment regarding the
reason for the client's feeling; this
is nontherapeutic in the one-to-one
relationship.
7. On review of the client's record, the 4. A willingness to participate in the
nurse notes that the mental health planning of the care and treatment
admission was voluntary. Based on plan.
this information, the nurse anticipates
which client behavior? Rationale:
In general, clients seek voluntary
, Psych/Mental Health Exit HESI – Saunders Test Questions
with Verified Answers
1. Fearfulness regarding treatment admission. If a client seeks volun-
measures. tary admission, the most likely ex-
2. Anger and aggressiveness directed pectation is that the client will par-
toward others. ticipate in the treatment program
3. An understanding of the pathology since they are actively seeking
and symptoms of the diagnosis. help. The remaining options are not
4. A willingness to participate in the characteristics of this type of ad-
planning of the care and treatment mission. Fearfulness, anger, and
plan. aggressiveness are more charac-
teristic of an involuntary admis-
sion. Voluntary admission does not
guarantee a client's understanding
of their illness, only of their desire
for help.
8. When reviewing the admission as- 1. Monitor closely for harm to self
sessment, the nurse notes that a client or others.
was admitted to the mental health unit
involuntarily. Based on this type of Rationale:
admission, the nurse should provide Involuntary admission is neces-
which intervention for this client? sary when a person is a danger
to self or others or is in need of
1. Monitor closely for harm to self or psychiatric treatment regardless of
others. the client's willingness to consent
2. Assist in completing an application to the hospitalization. A written re-
for admission. quest is a component of a volun-
3. Supply the client with written infor- tary admission. Providing written
mation about their mental illness. information regarding the illness is
4. Provide an opportunity for the fam- likely premature initially. The family
ily to discuss why they felt the admis- may have had no role to play in the
sion was needed. client's admission.
9. The nurse is preparing a client for the 2. Making appointment referrals
termination phase of the nurse-client
relationship. The nurse prepares to Rationale:
implement which nursing task that is Tasks of the termination phase
most appropriate for this phase? include evaluating client perfor-
mance, evaluating achievement of
1. Planning short-term goals expected outcomes, evaluating fu-
