HESI Mental Health Practice Questions

HESI Mental Health Practice Questions Related

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A 46-year-old female client has been on antipsychotic neuroleptic medication for the past three days. She has had a decrease in psychotic behavior and appears to be responding well to the medication. On the fourth day, the client's blood pressure increases, she becomes pale and febrile, and demonstrates muscular rigidity. Which action will the nurse initiate?

  • A. Place the client on seizure precautions and monitor closely.
  • B. Immediately transfer the client to the ICU.
  • C. Report the symptoms to the charge nurse and document in the client's chart.
  • D. No action is required at this time as these are known side effects of such medications.
Correct Answer: B

Rationale: These symptoms are indicative of neuroleptic malignant syndrome (NMS), which is a severe and life-threatening reaction to neuroleptic drugs. The major symptoms include fever, rigidity, autonomic instability, and encephalopathy. Respiratory failure, cardiovascular collapse, arrhythmias, and/or renal failure can lead to death. This is an emergency situation requiring immediate critical care, thus the correct action is to transfer the client to the ICU (B). Seizure precautions (A) are not relevant in this scenario. Merely describing the symptoms to the charge nurse and documenting them (C) or taking no action assuming these are common side effects (D) fail to address the critical nature of the situation and the urgency of immediate intervention.

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Which action should the nurse implement first for a client experiencing alcohol withdrawal?

  • A. Apply vest or extremity restraints.
  • B. Give an alpha-adrenergic blocker.
  • C. Provide a diet high in protein and calories.
  • D. Prepare the environment to prevent self-injury.
Correct Answer: D

Rationale: The correct action for the nurse to implement first for a client experiencing alcohol withdrawal is to prepare the environment to prevent self-injury. Clients undergoing alcohol withdrawal are at risk of seizures and other symptoms that may lead to self-harm. By ensuring a safe environment, the nurse can mitigate the risk of injury. Applying restraints (Choice A) should only be considered if less restrictive measures fail, as restraints can agitate the client further. Giving an alpha-adrenergic blocker (Choice B) may be part of the treatment plan for alcohol withdrawal but is not the first action to take. Providing a diet high in protein and calories (Choice C) is important for overall health but is not the priority when addressing immediate safety concerns.

A client with bipolar disorder, manic phase, is admitted to the psychiatric unit. Which meal is most appropriate for this client?

  • A. Spaghetti and meatballs
  • B. Chicken salad sandwich
  • C. Steak and potatoes
  • D. Hamburger and fries
Correct Answer: B

Rationale: A chicken salad sandwich (B) is the most appropriate choice as it is easy to eat on the go, which is important for a client in the manic phase who may have difficulty sitting still for a meal. Spaghetti and meatballs (A) and steak and potatoes (C) require more time and effort to eat, which may be challenging for a client experiencing mania. While hamburger and fries (D) could be an option, a chicken salad sandwich is a healthier and more manageable choice, considering the client's potential hyperactive state.

A nurse working in a psychiatric unit is assessing a client who appears to be responding to internal stimuli. The client is laughing and talking to himself. What is the nurse's best initial response?

  • A. Approach the client and ask if he is hearing voices.
  • B. Ignore the behavior as it is common in psychiatric settings.
  • C. Encourage the client to express his thoughts verbally.
  • D. Observe the client's behavior from a distance.
Correct Answer: A

Rationale: Approaching the client and asking if he is hearing voices is the best initial response by the nurse. This action can help assess the situation and determine if the client is experiencing hallucinations that may require immediate intervention. Choice B is incorrect because ignoring the behavior could lead to missing important signs of distress or potential risks. Choice C may not address the immediate concern of assessing for hallucinations. Choice D is also not ideal as observing from a distance may not provide the necessary information for immediate assessment and intervention.

A client with panic disorder is experiencing a panic attack. What is the nurse's priority intervention?

  • A. Encourage the client to breathe slowly and deeply.
  • B. Ask the client to describe the sensations they are experiencing.
  • C. Encourage the client to focus on a calming image.
  • D. Administer a PRN dose of lorazepam (Ativan).
Correct Answer: A

Rationale: The correct answer is A. Encouraging slow, deep breathing is the priority intervention during a panic attack as it can help reduce the physiological symptoms and assist the client in regaining control. This technique can help decrease hyperventilation and promote relaxation. Choice B, asking the client to describe sensations, may be beneficial after the panic attack has subsided to gain insight into triggers or manifestations. Choice C, encouraging the client to focus on a calming image, can be helpful in managing anxiety but may not be as effective during the acute phase of a panic attack. Choice D, administering a PRN dose of lorazepam (Ativan), should only be considered if the client does not respond to initial non-pharmacological interventions or if the symptoms are severe and unmanageable.

A client with bipolar disorder is being discharged with a prescription for lithium. What is the most important instruction the nurse should provide?

  • A. Avoid foods high in sodium.
  • B. Drink plenty of fluids, especially during hot weather.
  • C. Take your medication with food.
  • D. Monitor your blood pressure regularly.
Correct Answer: B

Rationale: The correct answer is to instruct the client to drink plenty of fluids, especially during hot weather. Maintaining adequate hydration is crucial for clients taking lithium as dehydration can lead to lithium toxicity. Choice A is incorrect because while it is important to monitor sodium intake, staying hydrated is more critical. Choice C is incorrect as lithium is usually recommended to be taken with food to reduce stomach upset. Choice D is also important but not the most crucial instruction compared to ensuring proper hydration.

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