PSYCHIATRIC-MENTAL HEALTH PRACTICE EXAM HESI
QUESTIONS WITH ACCURATE ANSWERS
A client is receiving carbamazepine (Tegretol) for the treatment of a manic
episode of bipolar disorder. What should the nurse include when planning client
teaching about this medication? Select all that apply.
1
"You have to eat a low-sodium diet every day."
2
"You'll have to take a diuretic with this medication."
3
"You'll have to take this medication for the rest of your life."
4
"You may want to suck on hard candy when you get a dry mouth."
5
"We'll need to test your blood often during the first few weeks of therapy."
correct answer 45
Sucking on hard candy or frequent rinsing may relieve a dry mouth, a side effect
of carbamazepine. Carbamazepine can cause severe bone marrow depression in
the early phase of therapy. Also, the drug level needs to be checked frequently to
ensure a therapeutic level. A low-sodium diet is not required; nor is a diuretic. The
client may or may not have to take the medication for life.
.
A newly admitted client quietly listens to a nurse's explanation of the services and
activities available on the mental health unit. When the nurse is finished, the
client looks around and says, "So this is where they keep the crazies." What is the
most appropriate initial response by the nurse?
,1
"These people are emotionally ill, not crazy."
2
"Some people feel that way. Let's talk about mental health."
3
"Do you want me to explain the purpose of a mental health unit?"
4
"Are you feeling that a person has to be crazy to need mental health services?"
correct answer 4
The response "Are you feeling that a person has to be crazy to need mental health
services?" addresses the client's misconceptions about mental health services and
the specific fear of being "crazy." The response "These people are emotionally ill,
not crazy" ignores the feelings behind the client's statement and focuses on facts.
Acknowledging that some people feel that way and offering to talk about mental
health or asking whether the client wants the nurse to explain the purpose of a
mental health unit ignores the feelings behind the client's statement and focuses
on facts.
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 give the
client lorazepam (Ativan) based on which priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
D) Health seeking behaviors related to personal crisis. correct answer The most
important nursing diagnosis is related to alcohol detoxification (B) because the
client has elevated vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client Ativan for
elevated vital signs secondary to alcohol withdrawal. (C and D) can be addressed
when immediate needs for safety are met.
Correct Answer(s): B
, 3.
The charge nurse is collaborating with the nursing staff about the plan of care for
a client who is very depressed. What is the most important intervention to
implement during the first 48 hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities. correct answer The most important
reason for closely observing a depressed client immediately after admission is to
maintain safety (B), since suicide is a risk with depression. (A, C, and D) are all
important interventions, but safety is the priority.
Correct Answer(s): B
4.
A 38-year-old female client is admitted with a diagnosis of paranoid
schizophrenia. When her tray is brought to her, she refuses to eat and tells the
nurse, "I know you are trying to poison me with that food." Which response is
most appropriate for the nurse to make?
A) I'll leave your tray here. I am available if you need anything else.
B) You're not being poisoned. Why do you think someone is trying to poison you?
C) No one on this unit has ever died from poisoning. You're safe here.
D) I will talk to your healthcare provider about the possibility of changing your
diet. correct answer (A) is the best choice cited. The nurse does not argue with
the client nor demand that she eat, but offers support by agreeing to "be there if
needed", e.g., to warm the food. (B and C) are arguing with the client's delusions,
and (B) asks "why" which is usually not a good question for a psychotic client. (D)
has nothing to do with the actual problem; i.e., the problem is not the diet (she
thinks any food given to her is poisoned.)
QUESTIONS WITH ACCURATE ANSWERS
A client is receiving carbamazepine (Tegretol) for the treatment of a manic
episode of bipolar disorder. What should the nurse include when planning client
teaching about this medication? Select all that apply.
1
"You have to eat a low-sodium diet every day."
2
"You'll have to take a diuretic with this medication."
3
"You'll have to take this medication for the rest of your life."
4
"You may want to suck on hard candy when you get a dry mouth."
5
"We'll need to test your blood often during the first few weeks of therapy."
correct answer 45
Sucking on hard candy or frequent rinsing may relieve a dry mouth, a side effect
of carbamazepine. Carbamazepine can cause severe bone marrow depression in
the early phase of therapy. Also, the drug level needs to be checked frequently to
ensure a therapeutic level. A low-sodium diet is not required; nor is a diuretic. The
client may or may not have to take the medication for life.
.
A newly admitted client quietly listens to a nurse's explanation of the services and
activities available on the mental health unit. When the nurse is finished, the
client looks around and says, "So this is where they keep the crazies." What is the
most appropriate initial response by the nurse?
,1
"These people are emotionally ill, not crazy."
2
"Some people feel that way. Let's talk about mental health."
3
"Do you want me to explain the purpose of a mental health unit?"
4
"Are you feeling that a person has to be crazy to need mental health services?"
correct answer 4
The response "Are you feeling that a person has to be crazy to need mental health
services?" addresses the client's misconceptions about mental health services and
the specific fear of being "crazy." The response "These people are emotionally ill,
not crazy" ignores the feelings behind the client's statement and focuses on facts.
Acknowledging that some people feel that way and offering to talk about mental
health or asking whether the client wants the nurse to explain the purpose of a
mental health unit ignores the feelings behind the client's statement and focuses
on facts.
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 give the
client lorazepam (Ativan) based on which priority nursing diagnosis?
A) Risk for injury related to suicidal ideation.
B) Risk for injury related to alcohol detoxification.
C) Knowledge deficit related to ineffective coping.
D) Health seeking behaviors related to personal crisis. correct answer The most
important nursing diagnosis is related to alcohol detoxification (B) because the
client has elevated vital signs, a sign of alcohol detoxification. Maintaining client
safety related to (A) should be addressed after giving the client Ativan for
elevated vital signs secondary to alcohol withdrawal. (C and D) can be addressed
when immediate needs for safety are met.
Correct Answer(s): B
, 3.
The charge nurse is collaborating with the nursing staff about the plan of care for
a client who is very depressed. What is the most important intervention to
implement during the first 48 hours after the client's admission to the unit?
A) Monitor appetite and observe intake at meals.
B) Maintain safety in the client's milieu.
C) Provide ongoing, supportive contact.
D) Encourage participation in activities. correct answer The most important
reason for closely observing a depressed client immediately after admission is to
maintain safety (B), since suicide is a risk with depression. (A, C, and D) are all
important interventions, but safety is the priority.
Correct Answer(s): B
4.
A 38-year-old female client is admitted with a diagnosis of paranoid
schizophrenia. When her tray is brought to her, she refuses to eat and tells the
nurse, "I know you are trying to poison me with that food." Which response is
most appropriate for the nurse to make?
A) I'll leave your tray here. I am available if you need anything else.
B) You're not being poisoned. Why do you think someone is trying to poison you?
C) No one on this unit has ever died from poisoning. You're safe here.
D) I will talk to your healthcare provider about the possibility of changing your
diet. correct answer (A) is the best choice cited. The nurse does not argue with
the client nor demand that she eat, but offers support by agreeing to "be there if
needed", e.g., to warm the food. (B and C) are arguing with the client's delusions,
and (B) asks "why" which is usually not a good question for a psychotic client. (D)
has nothing to do with the actual problem; i.e., the problem is not the diet (she
thinks any food given to her is poisoned.)
