Psych/Mental Health Exit HESI – Saunders Exam
Questions With Detailed Correct Verified Answers
QUESTION>The mental health nurse is caring for a client with a social phobia. The nurse tells the client
that a music therapy session has been scheduled as part of the treatment plan. The client tells the nurse
that she cannot sing and refuses to attend. What is the appropriate nursing response?
1. "You must go. You have no choice."
2. "Why don't you want to attend? What is the real reason?"
3. "The health care provider has prescribed this therapy for you."
4. "You don't have to sing at the session. You can listen and enjoy the music." - ANSWER~4. "You don't
have to sing at the session. You can listen and enjoy the music."
Rationale:
The correct option encourages the client to socialize and indicates that it is not necessary to sing. Option
2 asks why, and use of this word should be avoided. Options 1 and 3 imply a demand and do not address
the client's concern. The correct option is the only one that addresses the client's concern.
QUESTION>The nurse is monitoring a client who has been placed in restraints because of violent
behavior. When should the nurse determine that it will be safe to remove the restraints?
1. Administered medication has taken effect.
2. The client verbalizes the reasons for the violent behavior.
3. The client apologizes and tells the nurse that it will never happen again.
4. No acts of aggression have been observed within 1 hour after the release of two of the extremity
restraints. - ANSWER~4. No acts of aggression have been observed within 1 hour after the release of two
of the extremity restraints.
Rationale:
The best indicator that the behavior is controlled is the fact that the client exhibits no signs of aggression
after partial release of restraints. Options 1, 2, and 3 do not ensure that the client has controlled the
behavior.
,QUESTION>The mental health nurse is conducting a group therapy session and is monitoring a client
with a diagnosis of agoraphobia who has been attending the sessions for several months. The nurse
notes that the client is cooperative, sharing with peers, and making appropriate suggestions during
group discussions. How should the nurse interpret this behavior?
1. Manipulation
2. Improvement
3. Attention seeking
4. Desire to be accepted - ANSWER~2. Improvement
Rationale:
The behaviors identified in the question indicate improvement in the client's condition. The question
presents no information indicating that the client is being manipulative. Acting out is attention-seeking
behavior. All clients have a desire to be accepted.
QUESTION>The nurse is preparing a client for electroconvulsive therapy (ECT). The family of the client
asks the nurse about this treatment. The nurse responds, knowing that which statements are accurate
regarding this treatment? Select all that apply.
1. The average series involves 6 to 12 treatments.
2. Some confusion may be noted after the procedure.
3. Memory loss will occur but will resolve with time.
4. This treatment is a permanent cure to the condition.
5. This treatment is tried before the use of medications. - ANSWER~1, 2, 3
Rationale:
ECT as a form of treatment is considered when medication therapy has failed, the client is at high risk for
suicide, or depression is judged to be overwhelmingly severe. Treatments are administered three times a
week, with an average series involving 8 to 12 treatments over a duration of 2 to 4 weeks. The most
common side effect is amnesia for events occurring near the period of treatment. Memory deficits may
occur and tend to resolve with time. This treatment is not a permanent cure to the client's condition.
,QUESTION >The home care nurse is visiting an older client whose spouse died 6 months ago. Which
behavior by the client indicates ineffective coping?
1. Neglecting personal grooming
2. Looking at old snapshots of family
3. Participating in a senior citizens' program
4. Visiting their spouse's grave once a month - ANSWER~1. Neglecting personal grooming
Rational:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death,
ineffective coping is manifested by an extreme behavior that in some cases may be harmful to the
individual physically or psychologically. The correct option is indicative of a behavior that identifies an
ineffective coping behavior in the grieving process.
QUESTION>A client with a diagnosis of major depression who has attempted suicide says to the nurse, "I
should have died. I've always been a failure. Nothing ever goes right for me." Which response
demonstrates therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?" - ANSWER~4. "You've been feeling like a failure for a
while?"
Rationale:
Responding to the feelings expressed by a client is an effective therapeutic communication technique.
The correct option is an example of the use of restating. The remaining options block communication
because they minimize the client's experience and do not facilitate exploration of the client's expressed
feelings. In addition, use of the word "why" is nontherapeutic.
QUESTION>When the mental health nurse visits a client at home, the client states, "I haven't slept at all
the last couple of nights." Which response by the nurse illustrates a therapeutic communication
response to this client?
, 1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too." - ANSWER~3. "You're having difficulty sleeping?"
Rationale:
The correct option uses the therapeutic communication technique of restatement. Although restatement
is a technique that has a prompting component to it, it repeats the client's major theme, which assists
the nurse to obtain a more specific perception of the problem from the client. The remaining options are
not therapeutic responses since none encourage the client to expand on the problem. Offering personal
experiences moves the focus away from the client and onto the nurse.
QUESTION>A client experiencing disturbed thought processes believes that his food is being poisoned.
Which communication technique should the nurse use to encourage the client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition - ANSWER~1. Using open-ended questions
and silence
Rationale:
Open-ended questions and silence are strategies used to encourage clients to discuss their problems.
Sharing personal food preferences is not a client-centered intervention. The remaining options are not
helpful to the client because they do not encourage the client to express feelings. The nurse should not
offer opinions and should encourage the client to identify the reasons for the behavior.
QUESTION>A client admitted to a mental health unit for treatment of psychotic behavior spends hours
at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong here." What
defense mechanism is the client implementing?
1. Denial
Questions With Detailed Correct Verified Answers
QUESTION>The mental health nurse is caring for a client with a social phobia. The nurse tells the client
that a music therapy session has been scheduled as part of the treatment plan. The client tells the nurse
that she cannot sing and refuses to attend. What is the appropriate nursing response?
1. "You must go. You have no choice."
2. "Why don't you want to attend? What is the real reason?"
3. "The health care provider has prescribed this therapy for you."
4. "You don't have to sing at the session. You can listen and enjoy the music." - ANSWER~4. "You don't
have to sing at the session. You can listen and enjoy the music."
Rationale:
The correct option encourages the client to socialize and indicates that it is not necessary to sing. Option
2 asks why, and use of this word should be avoided. Options 1 and 3 imply a demand and do not address
the client's concern. The correct option is the only one that addresses the client's concern.
QUESTION>The nurse is monitoring a client who has been placed in restraints because of violent
behavior. When should the nurse determine that it will be safe to remove the restraints?
1. Administered medication has taken effect.
2. The client verbalizes the reasons for the violent behavior.
3. The client apologizes and tells the nurse that it will never happen again.
4. No acts of aggression have been observed within 1 hour after the release of two of the extremity
restraints. - ANSWER~4. No acts of aggression have been observed within 1 hour after the release of two
of the extremity restraints.
Rationale:
The best indicator that the behavior is controlled is the fact that the client exhibits no signs of aggression
after partial release of restraints. Options 1, 2, and 3 do not ensure that the client has controlled the
behavior.
,QUESTION>The mental health nurse is conducting a group therapy session and is monitoring a client
with a diagnosis of agoraphobia who has been attending the sessions for several months. The nurse
notes that the client is cooperative, sharing with peers, and making appropriate suggestions during
group discussions. How should the nurse interpret this behavior?
1. Manipulation
2. Improvement
3. Attention seeking
4. Desire to be accepted - ANSWER~2. Improvement
Rationale:
The behaviors identified in the question indicate improvement in the client's condition. The question
presents no information indicating that the client is being manipulative. Acting out is attention-seeking
behavior. All clients have a desire to be accepted.
QUESTION>The nurse is preparing a client for electroconvulsive therapy (ECT). The family of the client
asks the nurse about this treatment. The nurse responds, knowing that which statements are accurate
regarding this treatment? Select all that apply.
1. The average series involves 6 to 12 treatments.
2. Some confusion may be noted after the procedure.
3. Memory loss will occur but will resolve with time.
4. This treatment is a permanent cure to the condition.
5. This treatment is tried before the use of medications. - ANSWER~1, 2, 3
Rationale:
ECT as a form of treatment is considered when medication therapy has failed, the client is at high risk for
suicide, or depression is judged to be overwhelmingly severe. Treatments are administered three times a
week, with an average series involving 8 to 12 treatments over a duration of 2 to 4 weeks. The most
common side effect is amnesia for events occurring near the period of treatment. Memory deficits may
occur and tend to resolve with time. This treatment is not a permanent cure to the client's condition.
,QUESTION >The home care nurse is visiting an older client whose spouse died 6 months ago. Which
behavior by the client indicates ineffective coping?
1. Neglecting personal grooming
2. Looking at old snapshots of family
3. Participating in a senior citizens' program
4. Visiting their spouse's grave once a month - ANSWER~1. Neglecting personal grooming
Rational:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death,
ineffective coping is manifested by an extreme behavior that in some cases may be harmful to the
individual physically or psychologically. The correct option is indicative of a behavior that identifies an
ineffective coping behavior in the grieving process.
QUESTION>A client with a diagnosis of major depression who has attempted suicide says to the nurse, "I
should have died. I've always been a failure. Nothing ever goes right for me." Which response
demonstrates therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?" - ANSWER~4. "You've been feeling like a failure for a
while?"
Rationale:
Responding to the feelings expressed by a client is an effective therapeutic communication technique.
The correct option is an example of the use of restating. The remaining options block communication
because they minimize the client's experience and do not facilitate exploration of the client's expressed
feelings. In addition, use of the word "why" is nontherapeutic.
QUESTION>When the mental health nurse visits a client at home, the client states, "I haven't slept at all
the last couple of nights." Which response by the nurse illustrates a therapeutic communication
response to this client?
, 1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too." - ANSWER~3. "You're having difficulty sleeping?"
Rationale:
The correct option uses the therapeutic communication technique of restatement. Although restatement
is a technique that has a prompting component to it, it repeats the client's major theme, which assists
the nurse to obtain a more specific perception of the problem from the client. The remaining options are
not therapeutic responses since none encourage the client to expand on the problem. Offering personal
experiences moves the focus away from the client and onto the nurse.
QUESTION>A client experiencing disturbed thought processes believes that his food is being poisoned.
Which communication technique should the nurse use to encourage the client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition - ANSWER~1. Using open-ended questions
and silence
Rationale:
Open-ended questions and silence are strategies used to encourage clients to discuss their problems.
Sharing personal food preferences is not a client-centered intervention. The remaining options are not
helpful to the client because they do not encourage the client to express feelings. The nurse should not
offer opinions and should encourage the client to identify the reasons for the behavior.
QUESTION>A client admitted to a mental health unit for treatment of psychotic behavior spends hours
at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong here." What
defense mechanism is the client implementing?
1. Denial
