PSYCHIATRIC-MENTAL HEALTH
PRACTICE EXAM HESI
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
answers)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 answers)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 answers)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 answers)(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.)
Correct Answer(s): A
5.
A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting,
and drowsiness. What action should the nurse take?
A) Notify the healthcare provider immediately and prepare for administration of an antidote.
B) Notify the healthcare provider of the symptoms prior to the next administration of the drug.
C) Record the symptoms as normal side effects and continue administration of the prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the drug. (correct answers)Early
side effects of lithium carbonate (occurring with serum lithium levels below 2.0 mEq per liter) generally
follow a progressive pattern beginning with diarrhea, vomiting, drowsiness, and muscular weakness. At
higher levels, ataxia, tinnitus, blurred vision, and large dilute urine output may occur. (B) is the best
choice. Although these are expected symptoms, the healthcare provider should be notified prior to the
next administration of the drug. (A, C, and D) would not reflect good nursing judgment.
Correct Answer(s): B
6.
The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but responsive. The
mother states, "I think he took some of my pain pills." During initial assessment of the teenager, what
information is most important for the nurse to obtain from the parents?
, A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs. (correct answers)Knowledge of all substances taken (C) will
guide further treatment, such as administration of antagonists, so obtaining this information has the
highest priority. (A and B) are also valuable in planning treatment. (D) is not appropriate during the
acute management of a drug overdose.
Correct Answer(s): C
7.
The wife of a male client recently diagnosed with schizophrenia asks the nurse, "What exactly is
schizophrenia? Is my husband all right?" Which response is best for the nurse to provide to this family
member?
A) It sounds like you're worried about your husband. Let's sit down and talk.
B) It is a chemical imbalance in the brain that causes disorganized thinking.
C) Your husband will be just fine if he takes his medications regularly.
D) I think you should talk to your husband's psychologist about this question. (correct answers)The
nurse should answer the client's question with factual information and explain that schizophrenia is a
chemical imbalance in the brain (B). (A) is a therapeutic response but does not answer the question, and
may be an appropriate response after the nurse answers the question asked. Although (C) is likely true
to some degree, it is also true that some clients continue to have disorganized thinking even with
antipsychotic medications. Referring the spouse to the psychologist (D) is avoiding the issue; the nurse
can and should answer the question.
Correct Answer(s): B
8.
PRACTICE EXAM HESI
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
answers)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 answers)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 answers)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 answers)(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.)
Correct Answer(s): A
5.
A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting,
and drowsiness. What action should the nurse take?
A) Notify the healthcare provider immediately and prepare for administration of an antidote.
B) Notify the healthcare provider of the symptoms prior to the next administration of the drug.
C) Record the symptoms as normal side effects and continue administration of the prescribed dosage.
D) Hold the medication and refuse to administer additional amounts of the drug. (correct answers)Early
side effects of lithium carbonate (occurring with serum lithium levels below 2.0 mEq per liter) generally
follow a progressive pattern beginning with diarrhea, vomiting, drowsiness, and muscular weakness. At
higher levels, ataxia, tinnitus, blurred vision, and large dilute urine output may occur. (B) is the best
choice. Although these are expected symptoms, the healthcare provider should be notified prior to the
next administration of the drug. (A, C, and D) would not reflect good nursing judgment.
Correct Answer(s): B
6.
The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but responsive. The
mother states, "I think he took some of my pain pills." During initial assessment of the teenager, what
information is most important for the nurse to obtain from the parents?
, A) If he has seemed depressed recently.
B) If a drug overdose has ever occurred before.
C) If he might have taken any other drugs.
D) If he has a desire to quit taking drugs. (correct answers)Knowledge of all substances taken (C) will
guide further treatment, such as administration of antagonists, so obtaining this information has the
highest priority. (A and B) are also valuable in planning treatment. (D) is not appropriate during the
acute management of a drug overdose.
Correct Answer(s): C
7.
The wife of a male client recently diagnosed with schizophrenia asks the nurse, "What exactly is
schizophrenia? Is my husband all right?" Which response is best for the nurse to provide to this family
member?
A) It sounds like you're worried about your husband. Let's sit down and talk.
B) It is a chemical imbalance in the brain that causes disorganized thinking.
C) Your husband will be just fine if he takes his medications regularly.
D) I think you should talk to your husband's psychologist about this question. (correct answers)The
nurse should answer the client's question with factual information and explain that schizophrenia is a
chemical imbalance in the brain (B). (A) is a therapeutic response but does not answer the question, and
may be an appropriate response after the nurse answers the question asked. Although (C) is likely true
to some degree, it is also true that some clients continue to have disorganized thinking even with
antipsychotic medications. Referring the spouse to the psychologist (D) is avoiding the issue; the nurse
can and should answer the question.
Correct Answer(s): B
8.
