2022/2023 MODULE 4 EXAM_HESI VN (LATEST questions and answers)

2022/2023 MODULE 4 EXAM_HESI VN (LATEST questions and answers) A client with schizophrenia says, "I'm away for the day ... but don't think we should play or do we have feet of clay?" Which alteration in the client's speech does the nurse document? Neologism Word salad Clang association Associative looseness - ANSWER-Clang association A client with schizophrenia and his parents are meeting with the nurse. One of the young man's parents says to the nurse, "We were stunned when we learned that our son had schizophrenia. He was no different than from his older brother when they were growing up. Now he's had another relapse, and we can't understand why he stopped his medication." Which response by the nurse is appropriate? Telling the parents, "Medication noncompliance is the most frequent reason that people with this diagnosis relapse." Telling the parents, "Well, it's his decision to take his medicine, but it's yours to have him live with you if he stops the medication." Asking the client, "How can we help you to take your medicine or to tell us when you're having problems so that your medication can be adjusted?" Saying to the parents, "Your concerns are appropriate, but I wonder whether your son was having trouble telling someone that he had c - ANSWER-Asking the client, "How can we help you to take your medicine or to tell us when you're having problems so that your medication can be adjusted?" An acutely ill client with schizophrenia says to the nurse, "He keeps saying that he likes you, and I keep telling him you're married, but he won't listen, and I think he's going to get fresh with you." Once the nurse has determined that the client is hallucinating, which response to the client would be most appropriatestatement? "Try not to listen to the voices right now so that I can talk with you." "I think that you can help him stop his behavior if you concentrate." "Tell him I said to mind his p's and q's or I'll call the police on him." "I think that you're trying to share your own feelings toward me, but you're shy." - ANSWER-"Try not to listen to the voices right now so that I can talk with you." A client says to the nurse, "It's over for me — the whole thing is over." Which response by the nurse would be therapeutic? "What do you mean, 'The whole thing is over'?" "Over? Well, that sounds pretty drastic to me. Let's discuss this in the strictest confidence." "Can you tell me more about why it's over for you? I'll keep your thoughts strictly confidential." "Let's talk more about your feeling that the whole thing is over for you. This is important, and I may need to share your feelings with other staff members." - ANSWER-"Let's talk more about your feeling that the whole thing is over for you. This is important, and I may need to share your feelings with other staff members." The nurse performing a lethality assessment asks the client whether he is thinking of suicide. Which statement by the client would be of most concern to the nurse? "No, I wasn't, but I am now, thanks to you." "I hadn't thought of that, but I can see that you are." "Of course not, but there are days when I think that I should be." "What is suicide going to do for me except get me excommunicated from the church?" - ANSWER-"No, I wasn't, but I am now, thanks to you." A client who has expressed suicidal ideation in the past says to the nurse, while shuffling several documents in an effort to organize them, "Well, I'm feeling so much better now since I got organized. My lawyer wrote my will and durable power of attorney." Which response by the nurse is most appropriate? "Good grief! You don't look organized to me." "Okay, what are you up to today? Your behavior is not appropriate." "You talk about getting organized. Are you thinking of killing yourself?" "If you keep behaving like this, you know that I'll have to tell the health care provider, and we'll have to seclude you." - ANSWER-"You talk about getting organized. Are you thinking of killing yourself?" An adolescent client says, "I'm just a burden to my folks. They wish I'd never been born. My dad told me he had to marry Mom because she got pregnant." Which response by the nurse would be therapeutic? "You're feeling that your folks didn't want you, but they chose to marry and have you." "You feel that you were a burden and not wanted? Let's talk with your parents to see whether you're right." "Let's speak with your parents about what you've just told me. Let's ask whether you were truly unwanted." "Sounds like your father was very inappropriate, but I'm certain that he didn't mean that you were a burden to him." - ANSWER-"You're feeling that your folks didn't want you, but they chose to marry and have you." A client says to the nurse, "I've ruined my life. I left college with only a few credits to go. I keep telling myself that I'm going to make it as a writer, but I'll be a loser and a nothing for the rest of my life." Which response by the nurse is therapeutic? "What are you saying? Sounds like you need to pull yourself together and go back to school." "Having faith in yourself is one thing, but looking at your alternatives realistically is another." "You seem to be saying that your choices are final and that you've lost any other opportunities." "Sounds like you feel that things should come easy for you, unlike the rest of us, who work for what we get." - ANSWER-"You seem to be saying that your choices are final and that you've lost any other opportunities." A client who has twice attempted suicide says, "If people would just leave me alone and let me do what I want with my life, I could get on with what I want to do." Which response should the nurse give to the client? "Of course you can't be left alone to get on with what you want to do." "Okay, go ahead and do whatever you want to do. Human beings have free will." "You've tried to end your life twice, yet you feel that everyone should let you do what you want to do?" "Sounds like you're angry with people for caring enough about you to try to keep you from hurting yourself." - ANSWER-"You've tried to end your life twice, yet you feel that everyone should let you do what you want to do?" A client experiencing homelessness, with an antisocial disorder, is brought to the emergency department by the police after disturbing customers in a department store. The client says to the nurse, "I need to be hospitalized. It's getting cold out, and I need a warm bed. If you don't get me into a hospital, I'll jump off a bridge." Which nursing intervention would be therapeutic? Sending the client to the psychiatric hospital intake center immediately for evaluation Asking the police to pick the client up and arrest him for vagrancy, as they should have done immediately Discharging the client with a follow-up appointment for the next day and guaranteeing him a hospital bed if he shows up Sending the client to a shelter that will provide temporary housing if he signs a contract agreeing not to attempt suicide - ANSWER-Sending the client to a shelter that will provide temporary housing if he signs a contract agreeing not to attempt suicide A client is admitted to the medical-surgical unit of a hospital, and suicide precautions are taken until the client can be admitted to the psychiatric unit. Which nursing intervention should the nurse implement? Placing the client in a private room and locking the client's closets and bathroom Placing the client in a private room and removing all knives and glass from the client's meal tray Allowing the client to go out on pass as long as the client is accompanied by a responsible adult Placing the client in a semiprivate room, providing plastic utensils for eating, and keeping an arm's distance from the client at all times - ANSWER-Placing the client in a semiprivate room, providing plastic utensils for eating, and keeping an arm's distance from the client at all times A client is admitted to the psychiatric inpatient unit and suicide precautions are instituted. Which intervention should the nurse implement? Restricting visitors Placing the client in a private room and locking the bathroom door Removing perfume, shampoo, and other toiletries from the client's room Placing flowers brought to the client in a small glass vase and putting them in the client's room - ANSWER-Removing perfume, shampoo, and other toiletries from the client's room A client who is undergoing psychiatric counseling calls a nurse on a hotline, crying, and states, "My priest assaulted me when I was an altar boy, and my dad just found out. He's got a gun, and he's driving over to the church rectory. I don't know what to do." Which response by the nurse is most appropriate initially? "How did your dad learn of your abuse by clergy?" "Call the police immediately and then call the priest to warn him that your dad has a gun." "Call the priest immediately and tell him to lock the doors until the police arrive. I'll call the police." "You will want to come in to see our psychiatrist with your father, but, for now, call the police and tell them what happened." - ANSWER-"Call the priest immediately and tell him to lock the doors until the police arrive. I'll call the police." The nurse determines that a client whose son died in a car accident is at risk for selfharm. Which intervention is most appropriate initially? Making a "no suicide" contract with the client Telling the client that anger should be suppressed Providing a peaceful place for the client to meditate Helping the client control expression of his feelings - ANSWER-Making a "no suicide" contract with the client A client says to the nurse, "I'm worried about my husband. He's talking about ending it all since his law practice dropped off and his son by his late first wife died of a drug overdose — but he's too intelligent to hurt himself, isn't he?" Which response by the nurse is appropriate? "Yes, he's too intelligent to end it all." "I'm not sure. I don't know him that well." "Most people who talk about ending it all are just looking for attention."