HESI RN PSYCHIATRIC MENTAL
HEALTH EXIT EXAM QUESTIONS &
ANSWERS WITH RATIONALES 2024
The home care nurse is visiting an older client whose spouse died 6 months ago.
Which behavior by the client indicates ineffective coping?
1. Neglecting personal grooming
2. Looking at old snapshots of family
3. Participating in a senior citizens' program
4. Visiting their spouse's grave once a month
(ANS- 1. Neglecting personal grooming
Rationale:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response
to a death, ineffective coping is manifested by an extreme behavior that in some
cases may be harmful to the individual physically or psychologically. The correct
option is indicative of a behavior that identifies an ineffective coping behavior in
the grieving process.
,A client with a diagnosis of major depression who has attempted suicide says to
the nurse, "I should have died. I've always been a failure. Nothing ever goes right
for me." Which response demonstrates therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?"
(ANS- 4. "You've been feeling like a failure for a while?"
Rationale:
Responding to the feelings expressed by a client is an effective therapeutic
communication technique. The correct option is an example of the use of restating.
The remaining options block communication because they minimize the client's
experience and do not facilitate exploration of the client's expressed feelings. In
addition, use of the word "why" is nontherapeutic.
When the mental health nurse visits a client at home, the client states, "I haven't
slept at all the last couple of nights." Which response by the nurse illustrates a
therapeutic communication response to this client?
1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too."
(ANS- 3. "You're having difficulty sleeping?"
,Rationale:
The correct option uses the therapeutic communication technique of restatement.
Although restatement is a technique that has a prompting component to it, it
repeats the client's major theme, which assists the nurse to obtain a more specific
perception of the problem from the client. The remaining options are not
therapeutic responses since none encourage the client to expand on the problem.
Offering personal experiences moves the focus away from the client and onto the
nurse.
A client experiencing disturbed thought processes believes that his food is being
poisoned. Which communication technique should the nurse use to encourage the
client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition
(ANS- 1. Using open-ended questions and silence
Rationale:
Open-ended questions and silence are strategies used to encourage clients to
discuss their problems. Sharing personal food preferences is not a client-centered
intervention. The remaining options are not helpful to the client because they do
not encourage the client to express feelings. The nurse should not offer opinions
and should encourage the client to identify the reasons for the behavior.
, A client admitted to a mental health unit for treatment of psychotic behavior
spends hours at the locked exit door shouting, "Let me out. There's nothing wrong
with me. I don't belong here." What defense mechanism is the client
implementing?
1. Denial
2. Projection
3. Regression
4. Rationalization
(ANS- 1. Denial
Rationale:
Denial is refusal to admit to a painful reality, which is treated as if it does not exist.
In projection, a person unconsciously rejects emotionally unacceptable features
and attributes them to other persons, objects, or situations. Regression allows the
client to return to an earlier, more comforting, although less mature, way of
behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or
feelings by developing acceptable explanations that satisfy the teller and the
listener.
A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I
wish my family would stop hoping for a cure! I get so angry when they carry on
like this. After all, I'm the one who's dying." Which response by the nurse is
therapeutic?
1. "Have you shared your feelings with your family?"
2. "I think we should talk more about your anger with your family."
HEALTH EXIT EXAM QUESTIONS &
ANSWERS WITH RATIONALES 2024
The home care nurse is visiting an older client whose spouse died 6 months ago.
Which behavior by the client indicates ineffective coping?
1. Neglecting personal grooming
2. Looking at old snapshots of family
3. Participating in a senior citizens' program
4. Visiting their spouse's grave once a month
(ANS- 1. Neglecting personal grooming
Rationale:
Coping mechanisms are behaviors used to decrease stress and anxiety. In response
to a death, ineffective coping is manifested by an extreme behavior that in some
cases may be harmful to the individual physically or psychologically. The correct
option is indicative of a behavior that identifies an ineffective coping behavior in
the grieving process.
,A client with a diagnosis of major depression who has attempted suicide says to
the nurse, "I should have died. I've always been a failure. Nothing ever goes right
for me." Which response demonstrates therapeutic communication?
1. "You have everything to live for."
2. "Why do you see yourself as a failure?"
3. "Feeling like this is all part of being depressed."
4. "You've been feeling like a failure for a while?"
(ANS- 4. "You've been feeling like a failure for a while?"
Rationale:
Responding to the feelings expressed by a client is an effective therapeutic
communication technique. The correct option is an example of the use of restating.
The remaining options block communication because they minimize the client's
experience and do not facilitate exploration of the client's expressed feelings. In
addition, use of the word "why" is nontherapeutic.
When the mental health nurse visits a client at home, the client states, "I haven't
slept at all the last couple of nights." Which response by the nurse illustrates a
therapeutic communication response to this client?
1. "I see."
2. "Really?"
3. "You're having difficulty sleeping?"
4. "Sometimes, I have trouble sleeping too."
(ANS- 3. "You're having difficulty sleeping?"
,Rationale:
The correct option uses the therapeutic communication technique of restatement.
Although restatement is a technique that has a prompting component to it, it
repeats the client's major theme, which assists the nurse to obtain a more specific
perception of the problem from the client. The remaining options are not
therapeutic responses since none encourage the client to expand on the problem.
Offering personal experiences moves the focus away from the client and onto the
nurse.
A client experiencing disturbed thought processes believes that his food is being
poisoned. Which communication technique should the nurse use to encourage the
client to eat?
1. Using open-ended questions and silence
2. Sharing personal preference regarding food choices
3. Documenting reasons why the client does not want to eat
4. Offering opinions about the necessity of adequate nutrition
(ANS- 1. Using open-ended questions and silence
Rationale:
Open-ended questions and silence are strategies used to encourage clients to
discuss their problems. Sharing personal food preferences is not a client-centered
intervention. The remaining options are not helpful to the client because they do
not encourage the client to express feelings. The nurse should not offer opinions
and should encourage the client to identify the reasons for the behavior.
, A client admitted to a mental health unit for treatment of psychotic behavior
spends hours at the locked exit door shouting, "Let me out. There's nothing wrong
with me. I don't belong here." What defense mechanism is the client
implementing?
1. Denial
2. Projection
3. Regression
4. Rationalization
(ANS- 1. Denial
Rationale:
Denial is refusal to admit to a painful reality, which is treated as if it does not exist.
In projection, a person unconsciously rejects emotionally unacceptable features
and attributes them to other persons, objects, or situations. Regression allows the
client to return to an earlier, more comforting, although less mature, way of
behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or
feelings by developing acceptable explanations that satisfy the teller and the
listener.
A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I
wish my family would stop hoping for a cure! I get so angry when they carry on
like this. After all, I'm the one who's dying." Which response by the nurse is
therapeutic?
1. "Have you shared your feelings with your family?"
2. "I think we should talk more about your anger with your family."
