HESI Case Study-Psychiatric/Mental Health
Practice Exam, Answered 2023
At the first meeting of a group of older adults at a daycare center for the elderly,
the nurse asks one of the members what kinds of things she would like to do with
the group. The older woman shrugs her shoulders and says, "You tell me, you're
the leader." What is the best response for the nurse to make?
A) "Yes, I am the leader today. Would you like to be the leader tomorrow?"
B) "Yes, I will be leading this group. What would you like to accomplish during
this time?"
C) "Yes, I have been assigned to be the leader of this group. I will be here for the
next six weeks."
D) "Yes, I am the leader. You seem angry about not being the leader yourself."
B. "Yes, I will be leading this group. What would you like to accomplish during this
time?"
Over a period of several weeks, one male participant of a socialization group at a
community day care center for the elderly monopolizes most of the group's time
and interrupts others when they are talking. What is the best action for the nurse
to take in this situation?
A) Talk to the client outside the group about his behavior during group meetings.
B) Remind the client to allow others in the group a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
C. Allow the group to handle the problem.
An 86-year-old female client with Alzheimer's disease is wandering the busy halls
of the extended care facility and asks the nurse, "Where should I stand for the
parade?" Which response is best for the nurse to provide?
A) "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B) "You are confused because of all the activity in the hall. There is no parade."
C) "Let us go back to the activity room and see what is going on in there."
D) "Remember I told you that this is a nursing home and I am your nurse."
C. "Let's go back to the activity room and 1see what is going on there."
Physical examination of a 6-year-old reveals several bite marks in various
locations on his body. X-ray examination reveals healed fractures of the ribs. The
mother tells the nurse that her child is always having accidents. Which initial
response by the nurse would be most appropriate?
A) "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B) "Tell me more specifically about your child's accidents."
C) "I must report these injuries to the authorities because they do not seem
accidental."
D) "Boys this age always seem to require more supervision and can be quite
accident prone."
B. "Tell me more specifically about your child's accidents."
,A child is brought to the emergency room with a broken arm. Because of other
injuries, the nurse suspects the child may be a victim of abuse. When the nurse
tries to give the child an injection, the child's mother becomes very loud and
shouts, "I won't leave my son! Don't you touch him! You'll hurt my child!" What is
the best interpretation of the mother's statements? The mother is
A) regressing to an earlier behavior pattern.
B) sublimating her anger.
C) projecting her feelings onto the nurse.
D) suppressing her fear.
C. projecting her anger on to the nurse
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."
A. "I'll leave your tray here. I am available if you need anything else."
A 25-year-old female client has been particularly restless and the nurse finds her
trying to leave the psychiatric unit. She tells the nurse, "Please let me go! I must
leave because the secret police are after me." Which response is best for the
nurse to make?
A) "No one is after you, you're safe here."
B) "You'll feel better after you have rested."
C) "I know you must feel lonely and frightened."
D) "Come with me to your room and I will sit with you."
D. "Come with me to your room and I will sit with you."
A 45-year-old male client tells the nurse that he used to believe that he was Jesus
Christ, but now he knows he is not. Which response is best for the nurse to
make?
A) "Did you really believe you were Jesus Christ?"
B) "I think you're getting well."
C) "Others have had similar thoughts when under stress."
D) "Why did you think you were Jesus Christ?"
Others have has similar thoughts when under stress
A nurse working in the emergency room of a children's hospital admits a child
whose injuries could have resulted from abuse. Which statement most accurately
describes the nurse's responsibility in cases of suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in
, charge.
D) The nurse should note in the client's record any suspicions of child abuse so
that a history of such suspicions can be tracked.
C. The nurse should report any case of suspected child abuse to the nurse in charge
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.
B. Notify the healthcare provider of the symptoms prior to the next administration of the
drug.
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The
client seeks out this particular nurse and imitates her mannerisms. The nurse
knows that the client is using which defense mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression.
B. Identification
The nurse is planning the care for a 32-year-old male client with acute
depression. Which nursing intervention bests helps this client deal with his
depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
D) Encourage the client to explore the rationale for his depression.
B. Assist the client in exploring feelings of shame, anger, and guilt.
An anxious client expressing a fear of people and open places is admitted to the
psychiatric unit. What is the most effective way for the nurse to assist this client?
A) Plan an outing within the first week of admission.
B) Distract her whenever she expresses her discomfort about being with others.
C) Confront her fears and discuss the possible causes of these fears.
D) Accompany her outside for an increasing amount of time each day.
D. Accompany her outside for an increasing amount of time each day.
A client with bipolar disorder on the mental health unit becomes loud, and shouts
at one of the nurses, "You fat tub of lard! Get something done around here!" What
is the best initial action for the nurse to take?
A) Have the orderly escort the client to his room.
B) Tell the client his healthcare provider will be notified if he continues to be
verbally abusive.
C) Redirect the client's energy by asking him to tidy the recreation room.
D) Call the healthcare provider to obtain a prescription for a sedative.
Practice Exam, Answered 2023
At the first meeting of a group of older adults at a daycare center for the elderly,
the nurse asks one of the members what kinds of things she would like to do with
the group. The older woman shrugs her shoulders and says, "You tell me, you're
the leader." What is the best response for the nurse to make?
A) "Yes, I am the leader today. Would you like to be the leader tomorrow?"
B) "Yes, I will be leading this group. What would you like to accomplish during
this time?"
C) "Yes, I have been assigned to be the leader of this group. I will be here for the
next six weeks."
D) "Yes, I am the leader. You seem angry about not being the leader yourself."
B. "Yes, I will be leading this group. What would you like to accomplish during this
time?"
Over a period of several weeks, one male participant of a socialization group at a
community day care center for the elderly monopolizes most of the group's time
and interrupts others when they are talking. What is the best action for the nurse
to take in this situation?
A) Talk to the client outside the group about his behavior during group meetings.
B) Remind the client to allow others in the group a chance to talk.
C) Allow the group to handle the problem.
D) Ask the client to join another group.
C. Allow the group to handle the problem.
An 86-year-old female client with Alzheimer's disease is wandering the busy halls
of the extended care facility and asks the nurse, "Where should I stand for the
parade?" Which response is best for the nurse to provide?
A) "Anywhere you want to stand as long as you do not get hurt by those in the
parade."
B) "You are confused because of all the activity in the hall. There is no parade."
C) "Let us go back to the activity room and see what is going on in there."
D) "Remember I told you that this is a nursing home and I am your nurse."
C. "Let's go back to the activity room and 1see what is going on there."
Physical examination of a 6-year-old reveals several bite marks in various
locations on his body. X-ray examination reveals healed fractures of the ribs. The
mother tells the nurse that her child is always having accidents. Which initial
response by the nurse would be most appropriate?
A) "I need to inform the healthcare provider about your child's tendency to be
accident prone."
B) "Tell me more specifically about your child's accidents."
C) "I must report these injuries to the authorities because they do not seem
accidental."
D) "Boys this age always seem to require more supervision and can be quite
accident prone."
B. "Tell me more specifically about your child's accidents."
,A child is brought to the emergency room with a broken arm. Because of other
injuries, the nurse suspects the child may be a victim of abuse. When the nurse
tries to give the child an injection, the child's mother becomes very loud and
shouts, "I won't leave my son! Don't you touch him! You'll hurt my child!" What is
the best interpretation of the mother's statements? The mother is
A) regressing to an earlier behavior pattern.
B) sublimating her anger.
C) projecting her feelings onto the nurse.
D) suppressing her fear.
C. projecting her anger on to the nurse
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."
A. "I'll leave your tray here. I am available if you need anything else."
A 25-year-old female client has been particularly restless and the nurse finds her
trying to leave the psychiatric unit. She tells the nurse, "Please let me go! I must
leave because the secret police are after me." Which response is best for the
nurse to make?
A) "No one is after you, you're safe here."
B) "You'll feel better after you have rested."
C) "I know you must feel lonely and frightened."
D) "Come with me to your room and I will sit with you."
D. "Come with me to your room and I will sit with you."
A 45-year-old male client tells the nurse that he used to believe that he was Jesus
Christ, but now he knows he is not. Which response is best for the nurse to
make?
A) "Did you really believe you were Jesus Christ?"
B) "I think you're getting well."
C) "Others have had similar thoughts when under stress."
D) "Why did you think you were Jesus Christ?"
Others have has similar thoughts when under stress
A nurse working in the emergency room of a children's hospital admits a child
whose injuries could have resulted from abuse. Which statement most accurately
describes the nurse's responsibility in cases of suspected child abuse?
A) The nurse should obtain objective data such as x-rays before reporting
suspicions to the authorities.
B) The nurse should confirm any suspicions of child abuse with the healthcare
provider before reporting to the authorities.
C) The nurse should report any case of suspected child abuse to the nurse in
, charge.
D) The nurse should note in the client's record any suspicions of child abuse so
that a history of such suspicions can be tracked.
C. The nurse should report any case of suspected child abuse to the nurse in charge
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.
B. Notify the healthcare provider of the symptoms prior to the next administration of the
drug.
A client on the psychiatric unit appears to imitate a certain nurse on the unit. The
client seeks out this particular nurse and imitates her mannerisms. The nurse
knows that the client is using which defense mechanism?
A) Sublimation.
B) Identification.
C) Introjection.
D) Repression.
B. Identification
The nurse is planning the care for a 32-year-old male client with acute
depression. Which nursing intervention bests helps this client deal with his
depression?
A) Ensure that the client's day is filled with group activities.
B) Assist the client in exploring feelings of shame, anger, and guilt.
C) Allow the client to initiate and determine activities of daily living.
D) Encourage the client to explore the rationale for his depression.
B. Assist the client in exploring feelings of shame, anger, and guilt.
An anxious client expressing a fear of people and open places is admitted to the
psychiatric unit. What is the most effective way for the nurse to assist this client?
A) Plan an outing within the first week of admission.
B) Distract her whenever she expresses her discomfort about being with others.
C) Confront her fears and discuss the possible causes of these fears.
D) Accompany her outside for an increasing amount of time each day.
D. Accompany her outside for an increasing amount of time each day.
A client with bipolar disorder on the mental health unit becomes loud, and shouts
at one of the nurses, "You fat tub of lard! Get something done around here!" What
is the best initial action for the nurse to take?
A) Have the orderly escort the client to his room.
B) Tell the client his healthcare provider will be notified if he continues to be
verbally abusive.
C) Redirect the client's energy by asking him to tidy the recreation room.
D) Call the healthcare provider to obtain a prescription for a sedative.
