HERZING UNIVERSITY HESI MENTAL HEALTH Rationale: Short-term involuntary care may be initiated to protect the
client if she has a plan to harm herself. It can also be initiated if she
COMPREHENSIVE EXAM 2026 QUESTIONS presents an intentional danger to others.
WITH ANSWERS GUARANTEED TO PASS
◉ The client signs the treatment form and is admitted to the mental
health unit. During the first days of hospitalization, she begins
antidepressant therapy with fluoxetine 10 mg.
◉ The client is assessed by the nurse, a social worker, and the healthcare
provider (HCP). Based on their assessments, hospitalization is
recommended for psychotic depression. In what classification of drugs is the antidepressant fluoxetine. Answer:
Selective serotonin reuptake inhibitor (SSRI).
Which behavior is inconsistent with depression. Answer: Hearing a
man's voice. Rationale: Fluoxetine is an SSRI antidepressant.
Rationale: Auditory hallucinations are inconsistent with depression and
are more likely to occur with psychoses. However, clients may ◉ What is the major action of SSRI antidepressants. Answer: Increase
experience a psychotic depression in which there is evidence of availability of serotonin.
psychosis.
Rationale: The major action of SSRIs is to selectively inhibit the
reuptake of serotonin and increase the availability of serotonin.
◉ The nurse asks the client to sign the consent for treatment.
◉ The nurse understands that SSRIs are now more widely prescribed
If the client refuses treatment, which behaviors justify short-term than tricyclics for antidepressant therapy. What is the rationale. Answer:
involuntary treatment? (Select all that apply. One, some, or all options Tricyclics have more dangerous side effects.
may be correct.). Answer: Unable to meet basic self-care needs. Rationale: SSRIs are more widely prescribed than tricyclics because
Rationale: Involuntary treatment can be initiated if the client is unable to they have fewer side effects, and tricyclics can be lethal in an overdose
meet basic self-care needs in such a way that he or she is a danger to because they are cardiotoxic.
self.
States she has a plan to harm herself.
,◉ When the client receives fluoxetine, the nurse must explain the Rationale: Antipsychotic medications target symptoms related to
purpose and when to expect therapeutic effectiveness. What should the disorders of thinking such as psychosis and behaviors associated with
nurse tell the client regarding when she will begin to feel less depressed. agitation and disorganization or speech and behavior.
Answer: Generally within 1 to 4 weeks.
Rationale: In general, it takes 2 to 4 weeks for antidepressant effects to ◉ The nurse is reviewing the client's admission lab work on the third
begin. However, it depends on the individual, and some clients may feel
day of hospitalization. Admission labs include thyroid profile, urinalysis,
effects start as soon as 1 week or as late as 4 weeks. It is suggested that chemistry panel, pregnancy test, urine drug screen, and VDRL (RPR)
depression occurs when a depletion of neurotransmitters in the synapse which tests for venereal disease.
cause the transmitter receptors to increase. As the antidepressants make
more transmitters available, it takes the receptors several weeks to return
their numbers back to normal and allow normal synaptic activity. A thyroid profile is important for several reasons. What role do thyroid
levels play in depression. Answer: Hypothyroidism can lead to feeling
sluggish and depressed.
◉ The nurse should be aware of common side effects of SSRI
antidepressants such as fluoxetine. Which side effect should be Rationale: Thyroid levels can help detect hypothyroidism, which can
communicated to the client that commonly occur in clients who are lead to depression.
taking SSRI antidepressants. Answer: Gastrointestinal disturbances.
Rationale: GI disturbances such as nausea and diarrhea, as well as ◉ The nurse understands that a VDRL is routinely done on admission
genitourinary side effects such as sexual dysfunction, are common with for which reason. Answer: It is a screening test for syphilis.
SSRIs. SSRIs do not have significant anticholinergic, cardiovascular, or
Rationale: A VDRL (RPR) is a serum screening test for syphilis, which
sedative side effects.
can be undetected and dormant and can cause cognitive impairment in
later stages. If the screening serum test is positive, a more specific test is
◉ The client also begins an atypical antipsychotic, risperidone, because required to make the diagnosis of syphilis.
she reports hearing a "scary voice" upon admission. Although the client
remains very withdrawn and noncommunicative, the nurse must explain
◉ When the client awakens in the morning, she sits for periods of time
the purpose of risperidone. Which explanation is best. Answer:
at the edge of her bed. She does not initiate combing her hair, getting
Risperidone will help the think more clearly.
dressed, or going to breakfast. Which intervention should the nurse
implement. Answer: Help the client with daily activities.
, Rationale: When a client is very depressed, it is necessary to assist with Rationale: Considering Maslow's hierarchy, physiologic needs should be
daily activities because the client has decreased energy. Physical care is addressed first, so this is the priority problem because the client is
more important with severe depression. receiving inadequate sleep. Eating 50% of her meals is acceptable,
provided that the client is not losing weight.
◉ Since the client has decreased energy, which additional intervention
should the nurse implement. Answer: Plan a scheduled rest period. ◉ Since the client is eating 50% of her meals, which nursing
intervention should be included on the treatment plan. Answer: Weigh
Rationale: It is best to plan rest periods according to the client's energy
weekly and document.
level because some clients feel best in the morning and others feel best
in the evening. Rationale: The most objective assessment related to the client's intake is
frequent weighing to document any changes in weight that should be
monitored more closely.
◉ As the nurse initially communicates with the client, which
communication technique is important. Answer: Acknowledge the
client's courage in seeking help, then offer to sit quietly with the client. ◉ One morning, the nurse takes the client's vital signs and notes her
blood pressure is 141/108 mmHg. The progress notes indicate this is the
Rationale: Offering nonjudgmental acceptance and companionship will
third incidence of a high blood pressure.
help develop trust. Acknowledging the step the client took in seeking
help may restore the client's sense of control over her situation.
Which consideration by the nurse is accurate. Answer: The client's diet,
which consists of primarily high sodium foods, could be contributing to
◉ According to the nursing progress notes, the client demonstrates
her high blood pressure.
decreased social interaction, she rarely talks, she needs assistance to her
room and appears confused. The client only slept 30 minutes in the past Rationale: A high sodium diet can lead to hypertension and fluid
24 hours, and the daily graphics indicate that she has slept an average of retention.
2 hours in the past week. She is eating 50% of her meals.
◉ The nurse reports the elevated blood pressure to the HCP, and the
According to this data, what is the priority nursing problem. Answer: client is prescribed hydrochlorothiazide 25 mg by mouth (PO) daily. The
Sleep disturbance. nurse collaborates with the dietitians about the client's meal plan.
client if she has a plan to harm herself. It can also be initiated if she
COMPREHENSIVE EXAM 2026 QUESTIONS presents an intentional danger to others.
WITH ANSWERS GUARANTEED TO PASS
◉ The client signs the treatment form and is admitted to the mental
health unit. During the first days of hospitalization, she begins
antidepressant therapy with fluoxetine 10 mg.
◉ The client is assessed by the nurse, a social worker, and the healthcare
provider (HCP). Based on their assessments, hospitalization is
recommended for psychotic depression. In what classification of drugs is the antidepressant fluoxetine. Answer:
Selective serotonin reuptake inhibitor (SSRI).
Which behavior is inconsistent with depression. Answer: Hearing a
man's voice. Rationale: Fluoxetine is an SSRI antidepressant.
Rationale: Auditory hallucinations are inconsistent with depression and
are more likely to occur with psychoses. However, clients may ◉ What is the major action of SSRI antidepressants. Answer: Increase
experience a psychotic depression in which there is evidence of availability of serotonin.
psychosis.
Rationale: The major action of SSRIs is to selectively inhibit the
reuptake of serotonin and increase the availability of serotonin.
◉ The nurse asks the client to sign the consent for treatment.
◉ The nurse understands that SSRIs are now more widely prescribed
If the client refuses treatment, which behaviors justify short-term than tricyclics for antidepressant therapy. What is the rationale. Answer:
involuntary treatment? (Select all that apply. One, some, or all options Tricyclics have more dangerous side effects.
may be correct.). Answer: Unable to meet basic self-care needs. Rationale: SSRIs are more widely prescribed than tricyclics because
Rationale: Involuntary treatment can be initiated if the client is unable to they have fewer side effects, and tricyclics can be lethal in an overdose
meet basic self-care needs in such a way that he or she is a danger to because they are cardiotoxic.
self.
States she has a plan to harm herself.
,◉ When the client receives fluoxetine, the nurse must explain the Rationale: Antipsychotic medications target symptoms related to
purpose and when to expect therapeutic effectiveness. What should the disorders of thinking such as psychosis and behaviors associated with
nurse tell the client regarding when she will begin to feel less depressed. agitation and disorganization or speech and behavior.
Answer: Generally within 1 to 4 weeks.
Rationale: In general, it takes 2 to 4 weeks for antidepressant effects to ◉ The nurse is reviewing the client's admission lab work on the third
begin. However, it depends on the individual, and some clients may feel
day of hospitalization. Admission labs include thyroid profile, urinalysis,
effects start as soon as 1 week or as late as 4 weeks. It is suggested that chemistry panel, pregnancy test, urine drug screen, and VDRL (RPR)
depression occurs when a depletion of neurotransmitters in the synapse which tests for venereal disease.
cause the transmitter receptors to increase. As the antidepressants make
more transmitters available, it takes the receptors several weeks to return
their numbers back to normal and allow normal synaptic activity. A thyroid profile is important for several reasons. What role do thyroid
levels play in depression. Answer: Hypothyroidism can lead to feeling
sluggish and depressed.
◉ The nurse should be aware of common side effects of SSRI
antidepressants such as fluoxetine. Which side effect should be Rationale: Thyroid levels can help detect hypothyroidism, which can
communicated to the client that commonly occur in clients who are lead to depression.
taking SSRI antidepressants. Answer: Gastrointestinal disturbances.
Rationale: GI disturbances such as nausea and diarrhea, as well as ◉ The nurse understands that a VDRL is routinely done on admission
genitourinary side effects such as sexual dysfunction, are common with for which reason. Answer: It is a screening test for syphilis.
SSRIs. SSRIs do not have significant anticholinergic, cardiovascular, or
Rationale: A VDRL (RPR) is a serum screening test for syphilis, which
sedative side effects.
can be undetected and dormant and can cause cognitive impairment in
later stages. If the screening serum test is positive, a more specific test is
◉ The client also begins an atypical antipsychotic, risperidone, because required to make the diagnosis of syphilis.
she reports hearing a "scary voice" upon admission. Although the client
remains very withdrawn and noncommunicative, the nurse must explain
◉ When the client awakens in the morning, she sits for periods of time
the purpose of risperidone. Which explanation is best. Answer:
at the edge of her bed. She does not initiate combing her hair, getting
Risperidone will help the think more clearly.
dressed, or going to breakfast. Which intervention should the nurse
implement. Answer: Help the client with daily activities.
, Rationale: When a client is very depressed, it is necessary to assist with Rationale: Considering Maslow's hierarchy, physiologic needs should be
daily activities because the client has decreased energy. Physical care is addressed first, so this is the priority problem because the client is
more important with severe depression. receiving inadequate sleep. Eating 50% of her meals is acceptable,
provided that the client is not losing weight.
◉ Since the client has decreased energy, which additional intervention
should the nurse implement. Answer: Plan a scheduled rest period. ◉ Since the client is eating 50% of her meals, which nursing
intervention should be included on the treatment plan. Answer: Weigh
Rationale: It is best to plan rest periods according to the client's energy
weekly and document.
level because some clients feel best in the morning and others feel best
in the evening. Rationale: The most objective assessment related to the client's intake is
frequent weighing to document any changes in weight that should be
monitored more closely.
◉ As the nurse initially communicates with the client, which
communication technique is important. Answer: Acknowledge the
client's courage in seeking help, then offer to sit quietly with the client. ◉ One morning, the nurse takes the client's vital signs and notes her
blood pressure is 141/108 mmHg. The progress notes indicate this is the
Rationale: Offering nonjudgmental acceptance and companionship will
third incidence of a high blood pressure.
help develop trust. Acknowledging the step the client took in seeking
help may restore the client's sense of control over her situation.
Which consideration by the nurse is accurate. Answer: The client's diet,
which consists of primarily high sodium foods, could be contributing to
◉ According to the nursing progress notes, the client demonstrates
her high blood pressure.
decreased social interaction, she rarely talks, she needs assistance to her
room and appears confused. The client only slept 30 minutes in the past Rationale: A high sodium diet can lead to hypertension and fluid
24 hours, and the daily graphics indicate that she has slept an average of retention.
2 hours in the past week. She is eating 50% of her meals.
◉ The nurse reports the elevated blood pressure to the HCP, and the
According to this data, what is the priority nursing problem. Answer: client is prescribed hydrochlorothiazide 25 mg by mouth (PO) daily. The
Sleep disturbance. nurse collaborates with the dietitians about the client's meal plan.
