HESI Case Study - Psychiatric/Mental Health Practice Exam
Guaranteed Success
Scenario 1: Group Activity Planning
Best Response: B) "Yes, I will be leading this group. What would you like to accomplish during this
time?"
- Rationale: This response acknowledges the nurse's role as the leader while actively encouraging the
elderly woman to voice her needs and preferences. It is important to empower group members to
participate in decision-making, fostering a sense of ownership in the group activities.
Scenario 2: Monopolizing Group Discussions
Best Action: C) Allow the group to handle the problem.
- Rationale: Allowing the group to manage the situation enables members to assert themselves and
encourages group dynamics. Interventions by the nurse can be helpful, but often peer interactions can
address social behaviors effectively.
Scenario 3: Alzheimer's Disease Patient Wandering
Best Response: C) "Let’s go back to the activity room and see what is going on in there."
- Rationale: This response redirects the patient in a non-threatening manner and provides a structure
that can help orient her without directly confronting her confusion about the "parade."
Scenario 4: Injuries in a Child
Best Initial Response: B) "Tell me more specifically about your child's accidents."
- Rationale: This open-ended question encourages the mother to provide more detailed information,
which may give valuable context and insight into the child's injuries, while also avoiding premature
judgment or confrontation.
Scenario 5: Mother's Reaction in Emergency Room
Best Interpretation: C) projecting her feelings onto the nurse.
- Rationale: The mother's loud and defensive reaction indicates she may be projecting her fears and
anxieties about her child's treatments onto the healthcare staff, potentially because of her guilt or
concern regarding the situation.
,Scenario 6: Paranoid Schizophrenia Client
Best Response: A) "I'll leave your tray here. I am available if you need anything else."
- Rationale: This response respects the client's feelings and paranoia while maintaining a non-
confrontational stance. It also provides an opening for future communication without invalidating her
experience.
Scenario 7: Client Feeling Threatened
Best Response: D) "Come with me to your room and I will sit with you."
- Rationale: This response provides safety and support, acknowledging the client’s fears while providing
a sense of security. It encourages the client to defer her anxiety in a supportive environment.
Scenario 8: Client's Past Delusion
Best Response: C) "Others have had similar thoughts when under stress."
- Rationale: This response normalizes the client’s experience, showing understanding and empathy
without invalidating the feelings, promoting therapeutic communication and rapport.
A nurse working in the emergency room of a children's hospital admits a child whose injuries could have
resulted from abuse. Which statement most accurately describes the nurse's responsibility in cases of
suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare provider before reporting
to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in charge.
D) The nurse should note in the client's record any suspicions of child abuse so that a history of such
suspicions can be tracked. ✔️C. The nurse should report any case of suspected child abuse to the nurse
in charge
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. ✔️B. Notify the
healthcare provider of the symptoms prior to the next administration of the drug.
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this
particular nurse and imitates her mannerisms. The nurse knows that the client is using which defense
mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression. ✔️B. Identification
The nurse is planning the care for a 32-year-old male client with acute depression. Which nursing
intervention bests helps this client deal with his depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
D) Encourage the client to explore the rationale for his depression. ✔️B. Assist the client in exploring
feelings of shame, anger, and guilt.
An anxious client expressing a fear of people and open places is admitted to the psychiatric unit. What is
the most effective way for the nurse to assist this client?
A) Plan an outing within the first week of admission.
B) Distract her whenever she expresses her discomfort about being with others.
C) Confront her fears and discuss the possible causes of these fears.
D) Accompany her outside for an increasing amount of time each day. ✔️D. Accompany her outside for
an increasing amount of time each day.
A client with bipolar disorder on the mental health unit becomes loud, and shouts at one of the nurses,
"You fat tub of lard! Get something done around here!" What is the best initial action for the nurse to
take?
Guaranteed Success
Scenario 1: Group Activity Planning
Best Response: B) "Yes, I will be leading this group. What would you like to accomplish during this
time?"
- Rationale: This response acknowledges the nurse's role as the leader while actively encouraging the
elderly woman to voice her needs and preferences. It is important to empower group members to
participate in decision-making, fostering a sense of ownership in the group activities.
Scenario 2: Monopolizing Group Discussions
Best Action: C) Allow the group to handle the problem.
- Rationale: Allowing the group to manage the situation enables members to assert themselves and
encourages group dynamics. Interventions by the nurse can be helpful, but often peer interactions can
address social behaviors effectively.
Scenario 3: Alzheimer's Disease Patient Wandering
Best Response: C) "Let’s go back to the activity room and see what is going on in there."
- Rationale: This response redirects the patient in a non-threatening manner and provides a structure
that can help orient her without directly confronting her confusion about the "parade."
Scenario 4: Injuries in a Child
Best Initial Response: B) "Tell me more specifically about your child's accidents."
- Rationale: This open-ended question encourages the mother to provide more detailed information,
which may give valuable context and insight into the child's injuries, while also avoiding premature
judgment or confrontation.
Scenario 5: Mother's Reaction in Emergency Room
Best Interpretation: C) projecting her feelings onto the nurse.
- Rationale: The mother's loud and defensive reaction indicates she may be projecting her fears and
anxieties about her child's treatments onto the healthcare staff, potentially because of her guilt or
concern regarding the situation.
,Scenario 6: Paranoid Schizophrenia Client
Best Response: A) "I'll leave your tray here. I am available if you need anything else."
- Rationale: This response respects the client's feelings and paranoia while maintaining a non-
confrontational stance. It also provides an opening for future communication without invalidating her
experience.
Scenario 7: Client Feeling Threatened
Best Response: D) "Come with me to your room and I will sit with you."
- Rationale: This response provides safety and support, acknowledging the client’s fears while providing
a sense of security. It encourages the client to defer her anxiety in a supportive environment.
Scenario 8: Client's Past Delusion
Best Response: C) "Others have had similar thoughts when under stress."
- Rationale: This response normalizes the client’s experience, showing understanding and empathy
without invalidating the feelings, promoting therapeutic communication and rapport.
A nurse working in the emergency room of a children's hospital admits a child whose injuries could have
resulted from abuse. Which statement most accurately describes the nurse's responsibility in cases of
suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare provider before reporting
to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in charge.
D) The nurse should note in the client's record any suspicions of child abuse so that a history of such
suspicions can be tracked. ✔️C. The nurse should report any case of suspected child abuse to the nurse
in charge
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. ✔️B. Notify the
healthcare provider of the symptoms prior to the next administration of the drug.
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this
particular nurse and imitates her mannerisms. The nurse knows that the client is using which defense
mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression. ✔️B. Identification
The nurse is planning the care for a 32-year-old male client with acute depression. Which nursing
intervention bests helps this client deal with his depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
D) Encourage the client to explore the rationale for his depression. ✔️B. Assist the client in exploring
feelings of shame, anger, and guilt.
An anxious client expressing a fear of people and open places is admitted to the psychiatric unit. What is
the most effective way for the nurse to assist this client?
A) Plan an outing within the first week of admission.
B) Distract her whenever she expresses her discomfort about being with others.
C) Confront her fears and discuss the possible causes of these fears.
D) Accompany her outside for an increasing amount of time each day. ✔️D. Accompany her outside for
an increasing amount of time each day.
A client with bipolar disorder on the mental health unit becomes loud, and shouts at one of the nurses,
"You fat tub of lard! Get something done around here!" What is the best initial action for the nurse to
take?
