PSYCHIATRIC (MENTAL
HEALTH) HESI FINAL EXAM
QUESTIONS AND ANSWERS
1.
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin decanoate) is being
discharged in the morning. A repeat dose of medication is scheduled for 20 days after discharge. The
client tells the nurse that he is going on vacation in the Bahamas and will return in 18 days. Which
statement by the client indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to the clinic to get my Prolixin injection.
B) While I am on vacation and when I return, I will not eat or drink anything that contains alcohol.
C) I will notify the healthcare provider if I have a sore throat or flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin) every day. - CORRECT ANSWER -
Photosensitivity is a side effect of Prolixin and a vacation in the Bahamas (with its tropical island climate)
increases the client's chance of experiencing this side effect. He should be instructed to avoid direct sun
(A) and wear sunscreen. (B, C, and D) indicate accurate knowledge. Alcohol acts synergistically with
Prolixin (B). (C) lists signs of agranulocytosis, which is also a side effect of Prolixin. In order to avoid
extrapyramidal symptoms (EPS), anticholinergic drugs, such as Cogentin, are often prescribed
prophylactically with Prolixin.
Correct Answer(s): A
2.
A male client is admitted to the mental health unit because he was feeling depressed about the loss of
his wife and job. The client has a history of alcohol dependency and admits that he was drinking alcohol
12 hours ago. Vital signs are: temperature, 100° F, pulse 100, and BP 142/100. The nurse plans to cgive
cthe cclient clorazepam c(Ativan) cbased con cwhich cpriority cnursing cdiagnosis?
A) cRisk cfor cinjury crelated cto csuicidal cideation.
,B) cRisk cfor cinjury crelated cto calcohol cdetoxification.
C) cKnowledge cdeficit crelated cto cineffective ccoping.
D) cHealth cseeking cbehaviors crelated cto cpersonal ccrisis. c- cCORRECT cANSWER c-The cmost cimportant
cnursing cdiagnosis cis crelated cto calcohol cdetoxification c(B) cbecause cthe cclient chas celevated cvital
csigns, ca csign cof calcohol cdetoxification. cMaintaining cclient csafety crelated cto c(A) cshould cbe
caddressed cafter cgiving cthe cclient cAtivan cfor celevated cvital csigns csecondary cto calcohol cwithdrawal.
c(C cand cD) ccan cbe caddressed cwhen cimmediate cneeds cfor csafety care cmet.
Correct cAnswer(s): cB
3.
The ccharge cnurse cis ccollaborating cwith cthe cnursing cstaff cabout cthe cplan cof ccare cfor ca cclient
cwho cis cvery cdepressed. cWhat cis cthe cmost cimportant cintervention cto cimplement cduring cthe
cfirst c48 chours cafter cthe cclient's cadmission cto cthe cunit?
A) cMonitor cappetite cand cobserve cintake cat cmeals.
B) cMaintain csafety cin cthe cclient's cmilieu.
C) cProvide congoing, csupportive ccontact.
D) cEncourage cparticipation cin cactivities. c- cCORRECT cANSWER c-The cmost cimportant creason cfor
cclosely cobserving ca cdepressed cclient cimmediately cafter cadmission cis cto cmaintain csafety c(B), csince
csuicide cis ca crisk cwith cdepression. c(A, cC, cand cD) care call cimportant cinterventions, cbut csafety cis cthe
cpriority.
Correct cAnswer(s): cB
4.
A c38-year-old cfemale cclient cis cadmitted cwith ca cdiagnosis cof cparanoid cschizophrenia. cWhen
cher ctray cis cbrought cto cher, cshe crefuses cto ceat cand ctells cthe cnurse, c"I cknow cyou care ctrying
cto cpoison cme cwith cthat cfood." cWhich cresponse cis cmost cappropriate cfor cthe cnurse cto cmake?
A) cI'll cleave cyour ctray chere. cI cam cavailable cif cyou cneed canything celse.
B) cYou're cnot cbeing cpoisoned. cWhy cdo cyou cthink csomeone cis ctrying cto cpoison cyou?
,C) cNo cone con cthis cunit chas cever cdied cfrom cpoisoning. cYou're csafe chere.
D) cI cwill ctalk cto cyour chealthcare cprovider cabout cthe cpossibility cof cchanging cyour cdiet. c- cCORRECT
cANSWER
-(A) cis cthe cbest cchoice ccited. cThe cnurse cdoes cnot cargue cwith cthe cclient cnor cdemand cthat cshe
ceat, cbut c offers csupport cby cagreeing cto c"be cthere cif cneeded", ce.g., cto cwarm cthe cfood. c(B cand cC)
care carguing cwith cthe cclient's cdelusions, cand c(B) casks c"why" cwhich cis cusually cnot ca cgood
cquestion cfor ca cpsychotic cclient. c(D) chas cnothing cto cdo cwith cthe cactual cproblem; ci.e., cthe
cproblem cis cnot cthe cdiet c(she cthinks cany cfood cgiven cto cher cis cpoisoned.)
Correct cAnswer(s): cA
5.
A cclient cwho cis cbeing ctreated cwith clithium ccarbonate cfor cbipolar cdisorder cdevelops cdiarrhea,
cvomiting, cand cdrowsiness. cWhat caction cshould cthe cnurse ctake?
A) cNotify cthe chealthcare cprovider cimmediately cand cprepare cfor cadministration cof can cantidote.
B) cNotify cthe chealthcare cprovider cof cthe csymptoms cprior cto cthe cnext cadministration cof cthe cdrug.
C) cRecord cthe csymptoms cas cnormal cside ceffects cand ccontinue cadministration cof cthe cprescribed
cdosage.
D) cHold cthe cmedication cand crefuse cto cadminister cadditional camounts cof cthe cdrug. c- cCORRECT
cANSWER c- cEarly cside ceffects cof clithium ccarbonate c(occurring cwith cserum clithium clevels cbelow
c2.0 cmEq cper cliter) cgenerally cfollow ca cprogressive cpattern cbeginning cwith cdiarrhea, cvomiting,
cdrowsiness, cand cmuscular cweakness. cAt chigher clevels, cataxia, ctinnitus, cblurred cvision, cand clarge
cdilute curine coutput cmay coccur. c(B) cis cthe cbest cchoice. cAlthough cthese care cexpected csymptoms,
cthe chealthcare cprovider cshould cbe cnotified cprior cto cthe cnext cadministration cof cthe cdrug. c(A, cC,
cand cD) cwould cnot creflect cgood cnursing cjudgment.
Correct cAnswer(s): cB
6.
The cparents cof ca c14-year-old cboy cbring ctheir cson cto cthe chospital. cHe cis clethargic, cbut cresponsive.
cThe cmother cstates, c"I cthink che ctook csome cof cmy cpain cpills." cDuring cinitial cassessment cof cthe
cteenager, cwhat cinformation cis cmost cimportant cfor cthe cnurse cto cobtain cfrom cthe cparents?
A) cIf che chas cseemed cdepressed crecently.
B) cIf ca cdrug coverdose chas cever coccurred cbefore.
, C) cIf che cmight chave ctaken cany cother cdrugs.
D) cIf che chas ca cdesire cto cquit ctaking cdrugs. c- cCORRECT cANSWER c-Knowledge cof call csubstances
ctaken c(C) cwill cguide cfurther ctreatment, csuch cas cadministration cof cantagonists, cso cobtaining cthis
cinformation chas cthe chighest cpriority. c(A cand cB) care calso cvaluable cin cplanning ctreatment. c(D) cis
cnot cappropriate cduring cthe cacute cmanagement cof ca cdrug coverdose.
Correct cAnswer(s): cC
7.
The cwife cof ca cmale cclient crecently cdiagnosed cwith cschizophrenia casks cthe cnurse, c"What cexactly
cis cschizophrenia? cIs cmy chusband call cright?" cWhich cresponse cis cbest cfor cthe cnurse cto cprovide cto
cthis cfamily cmember?
A) cIt csounds clike cyou're cworried cabout cyour chusband. cLet's csit cdown cand ctalk.
B) cIt cis ca cchemical cimbalance cin cthe cbrain cthat ccauses cdisorganized cthinking.
C) cYour chusband cwill cbe cjust cfine cif che ctakes chis cmedications cregularly.
D) cI cthink cyou cshould ctalk cto cyour chusband's cpsychologist cabout cthis cquestion. c- cCORRECT
cANSWER c-The cnurse cshould canswer cthe cclient's cquestion cwith cfactual cinformation cand cexplain
cthat cschizophrenia cis ca cchemical cimbalance cin cthe cbrain c(B). c(A) cis ca ctherapeutic cresponse cbut
cdoes cnot canswer cthe cquestion, cand cmay cbe can cappropriate cresponse cafter cthe cnurse canswers
cthe cquestion casked. cAlthough c(C) cis clikely ctrue cto csome cdegree, cit cis calso ctrue cthat csome
cclients ccontinue cto chave cdisorganized cthinking ceven cwith cantipsychotic cmedications. cReferring
cthe cspouse cto cthe cpsychologist c(D) cis cavoiding cthe cissue; cthe cnurse ccan cand cshould canswer cthe
cquestion.
Correct cAnswer(s): cB
8.
The ccommunity chealth cnurse ctalks cto ca cmale cclient cwho chas cbipolar cdisorder. cThe cclient cexplains
cthat che csleeps c4 cto c5 chours ca cnight cand cis cworking cwith chis cpartner cto cstart ctwo cnew
cbusinesses cand cbuild can cempire. cThe cclient cstopped ctaking chis cmedications cseveral cdays cago.
cWhat cnursing cproblem chas cthe chighest cpriority?
A) cExcessive cwork cactivity.
HEALTH) HESI FINAL EXAM
QUESTIONS AND ANSWERS
1.
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin decanoate) is being
discharged in the morning. A repeat dose of medication is scheduled for 20 days after discharge. The
client tells the nurse that he is going on vacation in the Bahamas and will return in 18 days. Which
statement by the client indicates a need for health teaching?
A) When I return from my tropical island vacation, I will go to the clinic to get my Prolixin injection.
B) While I am on vacation and when I return, I will not eat or drink anything that contains alcohol.
C) I will notify the healthcare provider if I have a sore throat or flu-like symptoms.
D) I will continue to take my benztropine mesylate (Cogentin) every day. - CORRECT ANSWER -
Photosensitivity is a side effect of Prolixin and a vacation in the Bahamas (with its tropical island climate)
increases the client's chance of experiencing this side effect. He should be instructed to avoid direct sun
(A) and wear sunscreen. (B, C, and D) indicate accurate knowledge. Alcohol acts synergistically with
Prolixin (B). (C) lists signs of agranulocytosis, which is also a side effect of Prolixin. In order to avoid
extrapyramidal symptoms (EPS), anticholinergic drugs, such as Cogentin, are often prescribed
prophylactically with Prolixin.
Correct Answer(s): A
2.
A male client is admitted to the mental health unit because he was feeling depressed about the loss of
his wife and job. The client has a history of alcohol dependency and admits that he was drinking alcohol
12 hours ago. Vital signs are: temperature, 100° F, pulse 100, and BP 142/100. The nurse plans to cgive
cthe cclient clorazepam c(Ativan) cbased con cwhich cpriority cnursing cdiagnosis?
A) cRisk cfor cinjury crelated cto csuicidal cideation.
,B) cRisk cfor cinjury crelated cto calcohol cdetoxification.
C) cKnowledge cdeficit crelated cto cineffective ccoping.
D) cHealth cseeking cbehaviors crelated cto cpersonal ccrisis. c- cCORRECT cANSWER c-The cmost cimportant
cnursing cdiagnosis cis crelated cto calcohol cdetoxification c(B) cbecause cthe cclient chas celevated cvital
csigns, ca csign cof calcohol cdetoxification. cMaintaining cclient csafety crelated cto c(A) cshould cbe
caddressed cafter cgiving cthe cclient cAtivan cfor celevated cvital csigns csecondary cto calcohol cwithdrawal.
c(C cand cD) ccan cbe caddressed cwhen cimmediate cneeds cfor csafety care cmet.
Correct cAnswer(s): cB
3.
The ccharge cnurse cis ccollaborating cwith cthe cnursing cstaff cabout cthe cplan cof ccare cfor ca cclient
cwho cis cvery cdepressed. cWhat cis cthe cmost cimportant cintervention cto cimplement cduring cthe
cfirst c48 chours cafter cthe cclient's cadmission cto cthe cunit?
A) cMonitor cappetite cand cobserve cintake cat cmeals.
B) cMaintain csafety cin cthe cclient's cmilieu.
C) cProvide congoing, csupportive ccontact.
D) cEncourage cparticipation cin cactivities. c- cCORRECT cANSWER c-The cmost cimportant creason cfor
cclosely cobserving ca cdepressed cclient cimmediately cafter cadmission cis cto cmaintain csafety c(B), csince
csuicide cis ca crisk cwith cdepression. c(A, cC, cand cD) care call cimportant cinterventions, cbut csafety cis cthe
cpriority.
Correct cAnswer(s): cB
4.
A c38-year-old cfemale cclient cis cadmitted cwith ca cdiagnosis cof cparanoid cschizophrenia. cWhen
cher ctray cis cbrought cto cher, cshe crefuses cto ceat cand ctells cthe cnurse, c"I cknow cyou care ctrying
cto cpoison cme cwith cthat cfood." cWhich cresponse cis cmost cappropriate cfor cthe cnurse cto cmake?
A) cI'll cleave cyour ctray chere. cI cam cavailable cif cyou cneed canything celse.
B) cYou're cnot cbeing cpoisoned. cWhy cdo cyou cthink csomeone cis ctrying cto cpoison cyou?
,C) cNo cone con cthis cunit chas cever cdied cfrom cpoisoning. cYou're csafe chere.
D) cI cwill ctalk cto cyour chealthcare cprovider cabout cthe cpossibility cof cchanging cyour cdiet. c- cCORRECT
cANSWER
-(A) cis cthe cbest cchoice ccited. cThe cnurse cdoes cnot cargue cwith cthe cclient cnor cdemand cthat cshe
ceat, cbut c offers csupport cby cagreeing cto c"be cthere cif cneeded", ce.g., cto cwarm cthe cfood. c(B cand cC)
care carguing cwith cthe cclient's cdelusions, cand c(B) casks c"why" cwhich cis cusually cnot ca cgood
cquestion cfor ca cpsychotic cclient. c(D) chas cnothing cto cdo cwith cthe cactual cproblem; ci.e., cthe
cproblem cis cnot cthe cdiet c(she cthinks cany cfood cgiven cto cher cis cpoisoned.)
Correct cAnswer(s): cA
5.
A cclient cwho cis cbeing ctreated cwith clithium ccarbonate cfor cbipolar cdisorder cdevelops cdiarrhea,
cvomiting, cand cdrowsiness. cWhat caction cshould cthe cnurse ctake?
A) cNotify cthe chealthcare cprovider cimmediately cand cprepare cfor cadministration cof can cantidote.
B) cNotify cthe chealthcare cprovider cof cthe csymptoms cprior cto cthe cnext cadministration cof cthe cdrug.
C) cRecord cthe csymptoms cas cnormal cside ceffects cand ccontinue cadministration cof cthe cprescribed
cdosage.
D) cHold cthe cmedication cand crefuse cto cadminister cadditional camounts cof cthe cdrug. c- cCORRECT
cANSWER c- cEarly cside ceffects cof clithium ccarbonate c(occurring cwith cserum clithium clevels cbelow
c2.0 cmEq cper cliter) cgenerally cfollow ca cprogressive cpattern cbeginning cwith cdiarrhea, cvomiting,
cdrowsiness, cand cmuscular cweakness. cAt chigher clevels, cataxia, ctinnitus, cblurred cvision, cand clarge
cdilute curine coutput cmay coccur. c(B) cis cthe cbest cchoice. cAlthough cthese care cexpected csymptoms,
cthe chealthcare cprovider cshould cbe cnotified cprior cto cthe cnext cadministration cof cthe cdrug. c(A, cC,
cand cD) cwould cnot creflect cgood cnursing cjudgment.
Correct cAnswer(s): cB
6.
The cparents cof ca c14-year-old cboy cbring ctheir cson cto cthe chospital. cHe cis clethargic, cbut cresponsive.
cThe cmother cstates, c"I cthink che ctook csome cof cmy cpain cpills." cDuring cinitial cassessment cof cthe
cteenager, cwhat cinformation cis cmost cimportant cfor cthe cnurse cto cobtain cfrom cthe cparents?
A) cIf che chas cseemed cdepressed crecently.
B) cIf ca cdrug coverdose chas cever coccurred cbefore.
, C) cIf che cmight chave ctaken cany cother cdrugs.
D) cIf che chas ca cdesire cto cquit ctaking cdrugs. c- cCORRECT cANSWER c-Knowledge cof call csubstances
ctaken c(C) cwill cguide cfurther ctreatment, csuch cas cadministration cof cantagonists, cso cobtaining cthis
cinformation chas cthe chighest cpriority. c(A cand cB) care calso cvaluable cin cplanning ctreatment. c(D) cis
cnot cappropriate cduring cthe cacute cmanagement cof ca cdrug coverdose.
Correct cAnswer(s): cC
7.
The cwife cof ca cmale cclient crecently cdiagnosed cwith cschizophrenia casks cthe cnurse, c"What cexactly
cis cschizophrenia? cIs cmy chusband call cright?" cWhich cresponse cis cbest cfor cthe cnurse cto cprovide cto
cthis cfamily cmember?
A) cIt csounds clike cyou're cworried cabout cyour chusband. cLet's csit cdown cand ctalk.
B) cIt cis ca cchemical cimbalance cin cthe cbrain cthat ccauses cdisorganized cthinking.
C) cYour chusband cwill cbe cjust cfine cif che ctakes chis cmedications cregularly.
D) cI cthink cyou cshould ctalk cto cyour chusband's cpsychologist cabout cthis cquestion. c- cCORRECT
cANSWER c-The cnurse cshould canswer cthe cclient's cquestion cwith cfactual cinformation cand cexplain
cthat cschizophrenia cis ca cchemical cimbalance cin cthe cbrain c(B). c(A) cis ca ctherapeutic cresponse cbut
cdoes cnot canswer cthe cquestion, cand cmay cbe can cappropriate cresponse cafter cthe cnurse canswers
cthe cquestion casked. cAlthough c(C) cis clikely ctrue cto csome cdegree, cit cis calso ctrue cthat csome
cclients ccontinue cto chave cdisorganized cthinking ceven cwith cantipsychotic cmedications. cReferring
cthe cspouse cto cthe cpsychologist c(D) cis cavoiding cthe cissue; cthe cnurse ccan cand cshould canswer cthe
cquestion.
Correct cAnswer(s): cB
8.
The ccommunity chealth cnurse ctalks cto ca cmale cclient cwho chas cbipolar cdisorder. cThe cclient cexplains
cthat che csleeps c4 cto c5 chours ca cnight cand cis cworking cwith chis cpartner cto cstart ctwo cnew
cbusinesses cand cbuild can cempire. cThe cclient cstopped ctaking chis cmedications cseveral cdays cago.
cWhat cnursing cproblem chas cthe chighest cpriority?
A) cExcessive cwork cactivity.
