NSG-322 PRACTICE HESI Questions and
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The nurse completes an emergency admission of a male client with
schizophrenia who has not been taking his antipsychotic
medications. The client is pacing, is extremely irritable, and has a
blood pressure of 146/96. What is the priority nursing action?
Ans: Reevaluate the client's blood pressure in an hour.
A young adult female client with panic disorder arrives in the
Emergency Center with a 4-day history of chest pain that began
when her boyfriend left her. Initial assessment reveals normal
cardiopulmonary findings. Which information is most important for
the nurse to obtain?
Ans: Drugs taken in last 7 days.
A female client comes to an outpatient therapy appointment
intoxicated. The spouse tells the nurse, "There wasn't anything I could
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do to stop her drinking this morning." What intervention should the
nurse take at this time?
Ans: Tell the client that therapy cannot take place while she is
intoxicated.
The nurse is planning care for a client with major depression who is
admitted to the unit after a recent suicide attempt. Which
intervention has the highest priority for inclusion in this client's plan of
care?
Ans: Search the client's personal belongings.
A male client is brought to the emergency department by a police
officer, who reports the client was "disturbing the peace" by running
naked in the street, striking out at others, and smashing car windows.
Which behaviors should the client demonstrate to determine if he
should be evaluated for involuntary commitment? (Choose all that
apply.)
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Ans: Threats to kill his friend, hears voices telling him to kill himself, reports
he has not needed a bath in 4 months and says he has not eaten in 3
days.
The nurse is caring for an adult male client with catatonic
schizophrenia who is mute and motionless. What is the priority nursing
problem?
Ans: High risk for fluid and electrolyte imbalance.
At the end of a group therapy session, a client who is hospitalized for
psychosis falls to the floor when attempting to stand. What
intervention should the nurse implement first?
Ans: Ask a group member to seek help.
Which nursing intervention should the nurse implement with parents
who experience a fetal demise and express the wish not to see the
baby?