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HESI Psych Mental Health Exit Exam (V1, V2, V3)
Study Guide / Brand New Q &A Included!! A+
A 25-year-old client has been particularly restless
and the nurse finds the client trying to leave the
psychiatric unit. The client 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." - Answer-ANS: D
(D) is the best response because it offers support
without judgment or demands. (A) is challenging the
client's delusion. (B) is offering false reassurance.
(C) is a violation of therapeutic communication
because the nurse is telling the client how she or he
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feels (frightened and lonely), rather than allowing the
client to describe his or her own feelings.
Hallucinating and delusional clients are not capable
of discussing their feelings, particularly when they
perceive a crisis.
Physical examination of a 6-year-old boy 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 would be most appropriate?
A."I need to tell the health care provider about your
child's tendency to be accident-prone."
B."Tell me more about these accidents that your
child has been having."
C."I need to 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." -
Answer-ANS: B
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(B) seeks more information using an open-ended,
nonthreatening statement. (A) might be appropriate,
but is not the best answer because the nurse is
being somewhat sarcastic and is also avoiding the
situation by referring it to the health care provider for
resolution. Although it is true that suspected cases of
child abuse must be reported, (C) is almost an attack
and is jumping ahead before conclusive data are
obtained. (D) is a cliché and dismisses the
seriousness of the situation.
A 27-year-old client is admitted to the psychiatric
hospital with a diagnosis of bipolar disorder, manic
phase. The client is demanding and active. Which
intervention should the nurse include in this client's
plan of care?
A.Schedule the client to attend various group
activities.
B.Reinforce the client's ability to make decisions.
C.Encourage the client to identify feelings of anger.
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D.Provide a structured environment with little stimuli.
- Answer-ANS: D
Clients in the manic phase of a bipolar disorder
require decreased stimuli and a structured
environment (D). Noncompetitive activities that can
be carried out alone should be planned for these
clients. (A) is contraindicated because stimuli should
be reduced as much as possible. Impulsive decision
making is characteristic of clients with bipolar
disorder. To prevent future complications, the nurse
should monitor these clients' decisions and assist
them in the decision making process (B). (C) is more
often associated with depression than with bipolar
disorder.
A middle-aged adult was discharged from a
treatment center 6 weeks ago following treatment for
suicide ideation and alcohol abuse. In a follow-up
visit to the mental health clinic, the client complains
of lethargy, apathy, irritability, and anxiety. Which
question is most important for the nurse to ask?
HESI Psych Mental Health Exit Exam (V1, V2, V3)
Study Guide / Brand New Q &A Included!! A+
A 25-year-old client has been particularly restless
and the nurse finds the client trying to leave the
psychiatric unit. The client 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." - Answer-ANS: D
(D) is the best response because it offers support
without judgment or demands. (A) is challenging the
client's delusion. (B) is offering false reassurance.
(C) is a violation of therapeutic communication
because the nurse is telling the client how she or he
,2|Page
feels (frightened and lonely), rather than allowing the
client to describe his or her own feelings.
Hallucinating and delusional clients are not capable
of discussing their feelings, particularly when they
perceive a crisis.
Physical examination of a 6-year-old boy 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 would be most appropriate?
A."I need to tell the health care provider about your
child's tendency to be accident-prone."
B."Tell me more about these accidents that your
child has been having."
C."I need to 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." -
Answer-ANS: B
,3|Page
(B) seeks more information using an open-ended,
nonthreatening statement. (A) might be appropriate,
but is not the best answer because the nurse is
being somewhat sarcastic and is also avoiding the
situation by referring it to the health care provider for
resolution. Although it is true that suspected cases of
child abuse must be reported, (C) is almost an attack
and is jumping ahead before conclusive data are
obtained. (D) is a cliché and dismisses the
seriousness of the situation.
A 27-year-old client is admitted to the psychiatric
hospital with a diagnosis of bipolar disorder, manic
phase. The client is demanding and active. Which
intervention should the nurse include in this client's
plan of care?
A.Schedule the client to attend various group
activities.
B.Reinforce the client's ability to make decisions.
C.Encourage the client to identify feelings of anger.
, 4|Page
D.Provide a structured environment with little stimuli.
- Answer-ANS: D
Clients in the manic phase of a bipolar disorder
require decreased stimuli and a structured
environment (D). Noncompetitive activities that can
be carried out alone should be planned for these
clients. (A) is contraindicated because stimuli should
be reduced as much as possible. Impulsive decision
making is characteristic of clients with bipolar
disorder. To prevent future complications, the nurse
should monitor these clients' decisions and assist
them in the decision making process (B). (C) is more
often associated with depression than with bipolar
disorder.
A middle-aged adult was discharged from a
treatment center 6 weeks ago following treatment for
suicide ideation and alcohol abuse. In a follow-up
visit to the mental health clinic, the client complains
of lethargy, apathy, irritability, and anxiety. Which
question is most important for the nurse to ask?
