HESI PN Mental Health Exam Prep Questions & Knowledge Review (latest update)

A married male client with three children has lost his job and states that he feels useless. He is tearful, upset, and embarrassed. What is an appropriate objective of care for this client? 1. Limiting tearfulness 2. Increasing self-esteem 3. Controlling feelings of sadness 4. Promoting acceptance by others - 2. Increasing self-esteem The loss of a job can precipitate negative feelings about the self and decrease self-esteem. Feelings should be expressed, not limited; attempting to decrease a client's crying often ends up worsening it. Crying is not necessarily an expression of sadness; other feelings are involved. The focus should be on the client's self-acceptance, not acceptance by others. A 44-year-old client has been unable to function since her husband asked for a divorce 2 weeks ago. She is brought to the crisis intervention center by a friend. What type of crisis is this situation? 1. Social 2. Situational 3. Maturational 4. Developmental - 2. Situational Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the client. Social crises involve multiple losses such as those occurring during major disasters. Maturational crises occur in response to stress experienced as one struggles with developmental tasks. Developmental (maturational) crises are associated with developmental tasks; divorce is not a developmental task. A resident in a nursing home recently immigrated to the United States from Italy. How does the nurse plan to provide emotional support? 1. By offering choices consistent with the client's heritage 2. By ensuring that the client understands American beliefs 3. By assisting the client in adjusting to the American culture 4. By correcting the client's misconceptions about appropriate health practices - 1. By offering choices consistent with the client's heritage Adherence to a plan of care is enhanced by the nurse's providing choices consistent with the client's cultural beliefs and practices. The nurse's cultural or personal beliefs and biases should not influence or interfere with the implementation of appropriate care. Helping the client adjust to the American culture is not the priority at this time; care should be adapted to the client's needs and culture. The person's cultural practices should not be addressed unless they are detrimental to the person's health. A nurse should reassess an older adult client's needs and current plan of care when the client's behavior indicates the development of what symptom? 1. Confusion 2. Hypochondriasis 3. Additional complaints 4. Increased socialization - 1. Confusion The development of confusion indicates that the client's ability to maintain equilibrium has not been achieved and that further disequilibrium is occurring. Hypochondriasis and additional complaints do not indicate that the plan needs to be changed unless the client's history demonstrates no prior use of these defenses. Increased socialization is a positive response to the plan of care that does not require reassessment. An injured child is brought to the emergency department by the parents. While interviewing the parents, the nurse begins to suspect child abuse. Which parental behaviors might support this conclusion? Select all that apply. 1. Demonstrating concern for the injured child 2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 4. Asking questions about the injury and the child's prognosis 5. Giving an explanation of how the injury occurred that is not consistent with the injury - 2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 5. Giving an explanation of how the injury occurred that is not consistent with the injury The child is often made the scapegoat in the situation; the parents blame the child because they have unrealistic expectations of the child. Discrepancies or inconsistencies in the history result from attempts to present a story that is not based in fact. Discrepancies between the parental explanation for the child's injuries and the physical findings or discrepancies in the history that each parent gives are common because the information that is being provided is not based in fact. Abusive parents usually do not ask questions about the injury or prognosis and demonstrate little or no interest in their child's well-being. A nurse is planning to teach a client about self-care. What level of anxiety will best enhance the client's learning abilities? 1. Mild 2. Panic 3. Severe 4. Moderate - 1. Mild Mild anxiety motivates one to action, such as learning or making changes. Higher levels of anxiety tend to blur the individual's perceptions and interfere with functioning. Attention is severely reduced by panic. The perceptual field is greatly reduced with severe anxiety and narrowed with moderate anxiety. A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems? Select all that apply. 1. Dementia 2. Multiple losses 3. Declines in health 4. A milestone birthday 5. An injury requiring hospitalization - 2. Multiple losses 3. Declines in health Depression in the older adult is most often associated with the loss of family members and friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health, particularly when associated with a chronic illness, frequently precipitates depression in older adults. Dementia is a cognitive problem. Research does not correlate the onset of depression with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of depression in the older adult as often as does a chronic illness. The nurse observes biting, rocking, sucking, and lags in intellectual development in a child. She also concludes the child is suffering from sleep disorders. What could be the reason for the child's condition? 1. Physical neglect 2. Sexual abuse 3. Physical abuse 4. Emotional abuse - 4. Emotional abuse The child may be neglected if the parent is having a mental illness such as psychosis. Sleep disorders, feeding disorders, biting, rocking, sucking, and lags in intellectual development are behavioral findings associated with emotional abuse. Physical neglect, sexual abuse, and physical abuse manifest in different sets of signs and symptoms. Which emotional condition may be apparent in a client with an addiction? 1. Insomnia 2. Social isolation 3. Acute confusion 4. Functional urinary incontinence - 2. Social isolation Social isolation is an emotional condition that may be apparent in a client with an addiction. Insomnia, acute confusion, and functional urinary incontinence are physical, not emotional, conditions that may be apparent in clients with addiction. A client who has been battling cancer of the ovary for 7 years is admitted to the hospital in a debilitated state. The healthcare provider tells the client that she is too frail for surgery or further chemotherapy. When making rounds during the night, the nurse enters the client's room and finds her crying. Which is the most appropriate intervention by the nurse? 1. Sit down quietly next to the bed and allow her to cry. 2. Pull the curtain and leave the room to provide privacy for the client. 3. Explain to the client that her feelings are expected and they will pass with time. 4. Observe the length of time the client cries and document her difficulty accepting her impending death. - 1. Sit down quietly next to the bed and allow her to cry. Sitting down quietly next to the bed and allowing her to cry demonstrates acceptance of the client's behavior and provides an opportunity for the client to verbally express feelings if desired. Pulling the curtain and leaving the room to provide privacy for the client may make the client feel that the behavior is wrong or is annoying others. Also, it abandons the client when support is needed. Explaining to the client that her feelings are expected and they will pass with time closes off communication and does not provide an opportunity for the client to talk about feelings. Also, it provides false reassurance. The length of time she cries is unimportant at this time. Assuming that she is having difficulty accepting her impending death is a conclusion without enough information. Which of these are symptoms of depression commonly observed in older adults? Select all that apply. 1. Fatigue 2. Sadness 3. Agitation 4. Increased sleep 5. Increased appetite - 1. Fatigue 2. Sadness 3. Agitation Symptoms of depression that are often observed in older adults include fatigue, sadness, and agitation. Insomnia is more likely than increased sleep to occur in depressed older adults. Anorexia, rather than increased appetite, is more likely to occur in depressed older adults. A nurse is aware that after the administration of alprazolam (Xanax) is started, it is important to observe the client for side effects. What is the nurse's initial action? 1. Measuring the client's urine output 2. Examining the client's pupils daily 3. Checking the client's blood pressure 4. Monitoring the abdomen for distention - 3. Checking the client's blood pressure Orthostatic hypotension is a common side effect of alprazolam (Xanax) that occurs early in therapy. Central nervous system depression is not an early side effect, but it may occur after prolonged use. An alteration in urine output is not a common side effect, but it may occur after prolonged use. Distention is not a common side effect, but distention from constipation may occur after prolonged use. A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications? 1. They reduce postural hypotension. 2. They potentiate the effects of the neuroleptic drug. 3. They combat the extrapyramidal side effects of the neuroleptic drug. 4. They ameliorate the depression that may accompany schizophrenia. - 3. They combat the extrapyramidal side effects of the neuroleptic drug. Benztropine and trihexyphenidyl control the extrapyramidal (parkinsonian) manifestations associated with the neuroleptics and are classified as antiparkinsonian drugs. These drugs do not reduce postural hypotension, nor do they potentiate phenothiazine derivatives or have an effect on depression. At night an older client with dementia sleeps very little and becomes more disoriented. How can the nurse best limit this confusion resulting from sleep deprivation? 1. Shutting the client's door during the night 2. Applying a vest restraint when the client is in bed 3. Leaving a dim light on in the client's room at night 4. Administering the client's prescribed as-needed sedative medication - 3. Leaving a dim light on in the client's room at night A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment. A disoriented and confused client should be closely observed, not isolated. Restraints are a last resort; less restrictive interventions should be used first. Sedatives should be used sparingly in older adults, because they may cause further confusion and agitation. An older client with the diagnosis of dementia of the Alzheimer type is admitted to a long-term care facility. What should the nurse keep in mind regarding confusion when planning care for this client? 1. Confusion occurs with a transfer to new surroundings. 2. Confusion will be unchanged despite reality orientation. 3. Confusion is a common finding and is expected with aging. 4. Confusion results from brain changes that make interventions futile. - 1. Confusion occurs with a transfer to new surroundings. A change in environment and introduction of unfamiliar stimuli precipitate confusion in clients with dementia-type disorders; with appropriate intervention, including frequent reorientation, confusion can be reduced. Reality orientation can reduce confusion when these clients are confronted with unfamiliar surroundings. The assertions that reality orientation is ineffective, that confusion is an expected finding in aging, and that brain changes in dementia make interventions futile are all untrue. A nurse is caring for a client who is angry and agitated. What is the best approach for the nurse to use with this client? 1. Confronting the client about the behavior 2. Turning on the television to distract the client 3. Maintaining a calm, consistent approach with the client 4. Explaining to the client why the behavior is unacceptable - 3. Maintaining a calm, consistent approach with the client Consistency ensures an approach that is known and less frightening than the unknown. A calming approach can decrease agitation. Confronting the client about the behavior may escalate the client's anger and agitation. Environmental stimulants should be decreased, not increased. An agitated client is not capable of comprehending logical explanations; the nurse must avoid criticisms and arguments with the client. A depressed client has been receiving venlafaxine (Effexor) 25 mg three times a day by mouth. The health care provider increases the dose to 37.5 mg three times a day by mouth. The pharmacy supplies scored 25-mg tablets of Effexor. How many tablets should the nurse administer? Record your answer using one decimal place. _________ tablets - Solve the problem by using ratio and proportion. Desire 37.5 mg x tablets ------------------- = --------- Have 25 mg 1 tablet 25x = 37.5 x = 37.5 ÷ 25 x = 1.5 tablets. What is the nurse's specific responsibility when the rights of a client on a mental health unit are restricted by the use of seclusion? 1. Informing the client's family 2. Monitoring pharmacological interventions 3. Completing a denial-of-rights form and forwarding it to the administrative officer