Comprehensive Predictor Study Guide. Good for
NCLEX
HESI Comprehensive Exit Exam NGN EXAM
LATEST EXAM GRADED A+
1A teenager who has lost 20 pounds in the last three months is admitted
to the hospital with hypotension and tachycardia. The client reports
irregular menses and hair loss. Which intervention is most important for
the nurse to include in the clients plans of care?A. Initiate caloric and
nutritional therapy.
B. Implement behavioral modification therapy.
C. Evaluate the client for low self-esteem.
D. Record daily weights and graft trend.
(The client presents with evidence of anorexia nervosa
resulting from self-starvation,which is a life-threatening
condition. Providing nutrition and calories is the priority
intervention so that the risk of electrolyte imbalance and
severed dehydration can be reduced)
1. The nurse is developing unit policies that will include nursing
guidelines for maintaining a therapeutic milieu. Which
interventions should be included when providing a therapeutic
milieu in an inpatient setting?
A. Opportunities to contribute to one’s treatment plan.
B.One on one dialogue sessions with the therapist.
C.Regularly scheduled unit activities for peer interaction.
D.Home visits to reintergrate into the family.
(The nurse is responsible for maintaining a therapeutic
milieu which provides a secireand structure environment
that promotes client’s safety, provide opportunities for the
client to learn healthy coping skills)
2. After receiving treatment for anorexia, a student asks the
school nurse for permission towork in the school cafeteria as
part of the school’s work study program. What action should
the nurse take?
A. Recommend assignment to the receptionist’s office.
B.Suggest that the student work in the athletic department.
C.Refer the student to a psychiatrist for further discussion.
, D.Determine the parent’s opinion of the work assignment
(Client with anorexia are obsessed with food and exercise, which
often trigger self
indulgence. Assignment to the receptionist’s office decreases
the opportunity for thestudent to be distracted with obsession
associated with anorexia)
3. A middle-aged remale client with no previous psychiatric
history is seen in the mentalhealth clinic because her family
describes her as having paranoid thoughts. On assessment, she
tells the nurse “I want to find out why these people are
stalking me” which response should the nurse provide?
A. “It sounds like this experience is frightening for you”
B.“What makes you think people are stalking you?’
C.“I know you are frightened, but no one is stalking you”
D.“Do you think someone is trying to harm you”
(The nurse should respond to the client’s fear without
addressing the delusion.)
4. A male veteran who recently returned from a war zone has post
traumatic stress disorder (PTSD) and is admitted to the
psychiatric ward because of admitted suicidal ideation. On
admission, the client’s family informed the HCP that therapy
sessions did not seem to be helping. Select only one intervention
that as the highest priority?
A. Administer paraxeitne 40 mg as prescribed.
B.Develop a list of
therapy programs.C.
Remove all shaving
equipment.
D. Determine if client has a suicide plan.
(Keeping the client safe is priority, so suicide precautions
should be implemented, C ispriority)
5. A male adolescent was admitted to the unit two days ago for
depression. When the mental health nurse tries to interview
the client to establish rapport, he becomes veryirritated and
sarcastic. Which action is best for the nurse to take?
A. Offer to play a game of cards with the client.
B.Report the behavior to the next shift.
C.Document the behavior in the chart.
D.Plan to talk with the client the next day.
(Playing a game with the adolescent will establish rapport
, because adolescent usuallycommunicate more easily if
involve in an activity)
6. Which client statement suggests to the nurse that the client is
using the defense mechanism of projection to deal with
anxiety related to admission to a psychiatric unit.A. “ I am
here because the police thought I as doing something wrong”
B. “At least I hit the wall instead of hitting the psychiatric aide”
C. “I want to be here because I know it is the best psychiatric
facility”
D. “Don’t believe everything my family tells you, I am not crazy”
(Blaming others for unacceptable desires, thought,
shortcomings or mistakes is using thedefense mechanism of
projection)
7. A female high school teacher who was a child alcoholic parents
seeks counseling at the community health clinic because of
depression over a student who was killed by a drunk driver.
After several weeks of counseling, which client behavior is the
best indicator thatthe client is coping well with anxiety related
to the student’s dealth?
A. Signs a safety contract with the nurse agreeing not to hurt
herself or others
B.Confront her parents about the hurt she felt as
achild of alcoholic parents. C. Becomes the faculty
sponsor for Student Against Drunk Driving (SADD)
D. Describes alternatives to becoming depressed over the
student’s death.
(C is a method if channeling anxiety and denotes an adaptive
behavior to a crisis situation)
8. While interviewing a client, the nurse takes notes to assist with
accurate documentationlater. Which statement is most
accurate regarding note-taking during an interview?
A. The nurse’ ability to directly observe the client’s nonverbal
communication is limited with note taking.
B.Taking notes during an interview is a legal obligation of the
examining nurse.
C.The client’s comfort level is increased when the nurse breaks
eye contact to take noteto take note.
D.The interview process is enhanced with note taking and
allows the client speak atnormal pace.
, (Although note-taking is important, particularly when a
detailed report is vital to theassessment, note-taking
requires a break in eye contact and impedes the nurse’s
observation of the client’s nonverbal behavior)
9. An adolescent make receives a prescription for an
antidepressant drug because he is exhibiting a depressed affect.
While the client is taking the antidepressant, which comparison
of the client’s behavior before and after taking the drug is most
important forthe nurse to obtain?
A. His appetite.
B.The emotional quality of his attitude
C.His level of activity.
D.The interactions he has with others.
(The most important assessment is related to mood or the
emotional quality of his attitude so the nurse should assess for
the presence of depressed mood and suicide ideation)
10. A nurse is providing education about strategies for a safety plan
for a female client who isa victim of intimate partner violence.
Which strategies should be included in the safety plan?
A. Purchase a gun to use for protection
B.Establish a code with family and friends to
signify violence. C. Plan an escape route to
use if the abuser blocks the main exit.D.
Have a big ready that has extra clothes for
self and children.
E. Take a self defense course that retaliates the
abuser with injury. (B, C, D are all strategies
that should be included in the safety plan)
11. While setting in the dayroom of the mental health unit, a male
adolescent avoids eye contact, looks at the floor, and talks
softly when interacting verbally with the nurse. Thetwo trade
places, and the nurse demonstrate the client’s behavior. What
is the main goalof this therapeutic techniques?
A. Discuss the client’s feeling when
he responds. B. Allow the client to
identify the way he interacts.
C. Initiate a non-threatening conversation with the client.
NCLEX
HESI Comprehensive Exit Exam NGN EXAM
LATEST EXAM GRADED A+
1A teenager who has lost 20 pounds in the last three months is admitted
to the hospital with hypotension and tachycardia. The client reports
irregular menses and hair loss. Which intervention is most important for
the nurse to include in the clients plans of care?A. Initiate caloric and
nutritional therapy.
B. Implement behavioral modification therapy.
C. Evaluate the client for low self-esteem.
D. Record daily weights and graft trend.
(The client presents with evidence of anorexia nervosa
resulting from self-starvation,which is a life-threatening
condition. Providing nutrition and calories is the priority
intervention so that the risk of electrolyte imbalance and
severed dehydration can be reduced)
1. The nurse is developing unit policies that will include nursing
guidelines for maintaining a therapeutic milieu. Which
interventions should be included when providing a therapeutic
milieu in an inpatient setting?
A. Opportunities to contribute to one’s treatment plan.
B.One on one dialogue sessions with the therapist.
C.Regularly scheduled unit activities for peer interaction.
D.Home visits to reintergrate into the family.
(The nurse is responsible for maintaining a therapeutic
milieu which provides a secireand structure environment
that promotes client’s safety, provide opportunities for the
client to learn healthy coping skills)
2. After receiving treatment for anorexia, a student asks the
school nurse for permission towork in the school cafeteria as
part of the school’s work study program. What action should
the nurse take?
A. Recommend assignment to the receptionist’s office.
B.Suggest that the student work in the athletic department.
C.Refer the student to a psychiatrist for further discussion.
, D.Determine the parent’s opinion of the work assignment
(Client with anorexia are obsessed with food and exercise, which
often trigger self
indulgence. Assignment to the receptionist’s office decreases
the opportunity for thestudent to be distracted with obsession
associated with anorexia)
3. A middle-aged remale client with no previous psychiatric
history is seen in the mentalhealth clinic because her family
describes her as having paranoid thoughts. On assessment, she
tells the nurse “I want to find out why these people are
stalking me” which response should the nurse provide?
A. “It sounds like this experience is frightening for you”
B.“What makes you think people are stalking you?’
C.“I know you are frightened, but no one is stalking you”
D.“Do you think someone is trying to harm you”
(The nurse should respond to the client’s fear without
addressing the delusion.)
4. A male veteran who recently returned from a war zone has post
traumatic stress disorder (PTSD) and is admitted to the
psychiatric ward because of admitted suicidal ideation. On
admission, the client’s family informed the HCP that therapy
sessions did not seem to be helping. Select only one intervention
that as the highest priority?
A. Administer paraxeitne 40 mg as prescribed.
B.Develop a list of
therapy programs.C.
Remove all shaving
equipment.
D. Determine if client has a suicide plan.
(Keeping the client safe is priority, so suicide precautions
should be implemented, C ispriority)
5. A male adolescent was admitted to the unit two days ago for
depression. When the mental health nurse tries to interview
the client to establish rapport, he becomes veryirritated and
sarcastic. Which action is best for the nurse to take?
A. Offer to play a game of cards with the client.
B.Report the behavior to the next shift.
C.Document the behavior in the chart.
D.Plan to talk with the client the next day.
(Playing a game with the adolescent will establish rapport
, because adolescent usuallycommunicate more easily if
involve in an activity)
6. Which client statement suggests to the nurse that the client is
using the defense mechanism of projection to deal with
anxiety related to admission to a psychiatric unit.A. “ I am
here because the police thought I as doing something wrong”
B. “At least I hit the wall instead of hitting the psychiatric aide”
C. “I want to be here because I know it is the best psychiatric
facility”
D. “Don’t believe everything my family tells you, I am not crazy”
(Blaming others for unacceptable desires, thought,
shortcomings or mistakes is using thedefense mechanism of
projection)
7. A female high school teacher who was a child alcoholic parents
seeks counseling at the community health clinic because of
depression over a student who was killed by a drunk driver.
After several weeks of counseling, which client behavior is the
best indicator thatthe client is coping well with anxiety related
to the student’s dealth?
A. Signs a safety contract with the nurse agreeing not to hurt
herself or others
B.Confront her parents about the hurt she felt as
achild of alcoholic parents. C. Becomes the faculty
sponsor for Student Against Drunk Driving (SADD)
D. Describes alternatives to becoming depressed over the
student’s death.
(C is a method if channeling anxiety and denotes an adaptive
behavior to a crisis situation)
8. While interviewing a client, the nurse takes notes to assist with
accurate documentationlater. Which statement is most
accurate regarding note-taking during an interview?
A. The nurse’ ability to directly observe the client’s nonverbal
communication is limited with note taking.
B.Taking notes during an interview is a legal obligation of the
examining nurse.
C.The client’s comfort level is increased when the nurse breaks
eye contact to take noteto take note.
D.The interview process is enhanced with note taking and
allows the client speak atnormal pace.
, (Although note-taking is important, particularly when a
detailed report is vital to theassessment, note-taking
requires a break in eye contact and impedes the nurse’s
observation of the client’s nonverbal behavior)
9. An adolescent make receives a prescription for an
antidepressant drug because he is exhibiting a depressed affect.
While the client is taking the antidepressant, which comparison
of the client’s behavior before and after taking the drug is most
important forthe nurse to obtain?
A. His appetite.
B.The emotional quality of his attitude
C.His level of activity.
D.The interactions he has with others.
(The most important assessment is related to mood or the
emotional quality of his attitude so the nurse should assess for
the presence of depressed mood and suicide ideation)
10. A nurse is providing education about strategies for a safety plan
for a female client who isa victim of intimate partner violence.
Which strategies should be included in the safety plan?
A. Purchase a gun to use for protection
B.Establish a code with family and friends to
signify violence. C. Plan an escape route to
use if the abuser blocks the main exit.D.
Have a big ready that has extra clothes for
self and children.
E. Take a self defense course that retaliates the
abuser with injury. (B, C, D are all strategies
that should be included in the safety plan)
11. While setting in the dayroom of the mental health unit, a male
adolescent avoids eye contact, looks at the floor, and talks
softly when interacting verbally with the nurse. Thetwo trade
places, and the nurse demonstrate the client’s behavior. What
is the main goalof this therapeutic techniques?
A. Discuss the client’s feeling when
he responds. B. Allow the client to
identify the way he interacts.
C. Initiate a non-threatening conversation with the client.
