HESI RN PSYCHIATRIC MENTAL HEALTH EXIT
EXAM QUESTIONS & 100% CORRECT ANSWERS
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."
3. "You're Feeling Angry That Your Family Continues To Hope For You To Be Cured?"
4. "You Are Probably Very Depressed, Which Is Understandable With Such A Diagnosis."
(Ans- 3. "You're Feeling Angry That Your Family Continues To Hope For You To Be Cured?"
Rationale:
Restating Is A Therapeutic Communication Technique In Which The Nurse Repeats What The
Client Says To Show Understanding And To Review What Was Said. While It Is Appropriate
For The Nurse To Attempt To Assess The Client's Ability To Discuss Feelings Openly With
Family Members, It Does Not Help The Client Discuss The Feelings Causing The Anger. The
Nurse's Attempt To Focus On The Central Issue Of Anger Is Premature. The Nurse Would
Never Make A Judgment Regarding The Reason For The Client's Feeling; This Is
Nontherapeutic In The One-To-One Relationship.
On Review Of The Client's Record, The Nurse Notes That The Mental Health Admission Was
Voluntary. Based On This Information, The Nurse Anticipates Which Client Behavior?
1. Fearfulness Regarding Treatment Measures.
2. Anger And Aggressiveness Directed Toward Others.
3. An Understanding Of The Pathology And Symptoms Of The Diagnosis.
4. A Willingness To Participate In The Planning Of The Care And Treatment Plan.
(Ans- 4. A Willingness To Participate In The Planning Of The Care And Treatment Plan.
Rationale:
In General, Clients Seek Voluntary Admission. If A Client Seeks Voluntary Admission, The
Most Likely Expectation Is That The Client Will Participate In The Treatment Program Since
EXAM QUESTIONS & 100% CORRECT ANSWERS
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."
3. "You're Feeling Angry That Your Family Continues To Hope For You To Be Cured?"
4. "You Are Probably Very Depressed, Which Is Understandable With Such A Diagnosis."
(Ans- 3. "You're Feeling Angry That Your Family Continues To Hope For You To Be Cured?"
Rationale:
Restating Is A Therapeutic Communication Technique In Which The Nurse Repeats What The
Client Says To Show Understanding And To Review What Was Said. While It Is Appropriate
For The Nurse To Attempt To Assess The Client's Ability To Discuss Feelings Openly With
Family Members, It Does Not Help The Client Discuss The Feelings Causing The Anger. The
Nurse's Attempt To Focus On The Central Issue Of Anger Is Premature. The Nurse Would
Never Make A Judgment Regarding The Reason For The Client's Feeling; This Is
Nontherapeutic In The One-To-One Relationship.
On Review Of The Client's Record, The Nurse Notes That The Mental Health Admission Was
Voluntary. Based On This Information, The Nurse Anticipates Which Client Behavior?
1. Fearfulness Regarding Treatment Measures.
2. Anger And Aggressiveness Directed Toward Others.
3. An Understanding Of The Pathology And Symptoms Of The Diagnosis.
4. A Willingness To Participate In The Planning Of The Care And Treatment Plan.
(Ans- 4. A Willingness To Participate In The Planning Of The Care And Treatment Plan.
Rationale:
In General, Clients Seek Voluntary Admission. If A Client Seeks Voluntary Admission, The
Most Likely Expectation Is That The Client Will Participate In The Treatment Program Since
