Mental Health HESI

Mental Health HESI Related

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A male client with a long history of alcohol dependency arrives in the emergency department describing the feeling of bugs crawling on his body. His BP is 170/102, pulse rate is 110 bpm, and his blood alcohol level (BAL) is 0 mg/dl. Which medication should the nurse administer?

  • A. Haloperidol (Haldol)
  • B. Thiamine (Vitamin B1)
  • C. Diphenhydramine (Benadryl)
  • D. Lorazepam (Ativan)
Correct Answer: D

Rationale: In this scenario, the client is experiencing hallucinations and symptoms of alcohol withdrawal. Lorazepam (Ativan) is the appropriate choice as it helps manage withdrawal symptoms, including hallucinations and elevated blood pressure in alcohol-dependent clients. Haloperidol (Haldol) (Choice A) is an antipsychotic but is not the first-line treatment for alcohol withdrawal symptoms. Thiamine (Vitamin B1) (Choice B) is essential in alcohol withdrawal treatment for preventing Wernicke's encephalopathy, but in this case, addressing the acute withdrawal symptoms is the priority. Diphenhydramine (Benadryl) (Choice C) is an antihistamine that may help with itching or mild anxiety but is not the preferred choice for managing alcohol withdrawal symptoms like hallucinations and elevated blood pressure.

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A client with Bulimia and depression who is taking phenelzine (Nardil) 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. What dietary choices should the RN instruct the client to avoid?

  • A. Pan-seared catfish.
  • B. Pepperoni pizza.
  • C. Deep-fried shrimp.
  • D. Beef strips with gravy.
Correct Answer: D

Rationale: When a client is taking MAO inhibitors like phenelzine, foods containing tyramine should be avoided. Tyramine-rich foods can interact with MAO inhibitors and lead to a hypertensive crisis. Beef strips with gravy contain tyramine, making choice D the correct answer. Choices A, B, and C do not contain high levels of tyramine and are not specifically contraindicated with MAO inhibitors.

When preparing to administer a prescribed medication to a homeless male at a community psychiatric clinic, the client tells the nurse that he usually takes a different dosage. What action should the nurse take?

  • A. Tell him to take the medication then verify the dosage at the next healthcare team meeting.
  • B. Withhold the medication until the dosage can be confirmed.
  • C. Inform him that he may refuse the medication and document whether or not he takes it.
  • D. Explain to the client that the dosage has been changed.
Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

A male client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. What intervention is best for the nurse to implement?

  • A. Avoid acknowledging the behavior.
  • B. Isolate the client from other clients.
  • C. Administer a PRN sedative.
  • D. Escort the client to his room.
Correct Answer: D

Rationale: The best intervention for a male client with schizophrenia displaying echolalia, which is disruptive to others, is for the nurse to escort the client to his room. Echolalia, the constant repetition of others' words, can be disruptive in a communal setting. By guiding the client to a private space like his room, the nurse helps manage the behavior without isolating or medicating the client unnecessarily. Avoiding acknowledging the behavior (Choice A) does not address the issue, isolating the client (Choice B) may exacerbate feelings of exclusion, and administering a PRN sedative (Choice C) should be reserved for situations where there is imminent risk or severe agitation, not for managing echolalia.

A client with an eating disorder tells the RN, 'I've been eating only 400 calories per day and have been taking diuretics to lose weight.' What is the RN's best response?

  • A. "Your diet is very harmful and needs to be changed immediately."
  • B. "It's important to monitor your calorie intake carefully."
  • C. "Have you noticed any physical effects from this low-calorie diet?"
  • D. "The diuretics could be causing your body to lose essential nutrients."
Correct Answer: D

Rationale: The correct response is D. By addressing the potential harm of diuretics and the low-calorie diet, the nurse effectively addresses both aspects of the client's disordered eating behavior. Choice A is too direct and does not provide information on the specific issue of diuretics. Choice B focuses solely on monitoring calorie intake without addressing the use of diuretics. Choice C inquires about physical effects but does not address the overall risks associated with diuretics and low-calorie intake.

A client with obsessive-compulsive disorder (OCD) is undergoing behavioral therapy. Which outcome should the nurse recognize as an indication that the client is responding positively to therapy?

  • A. The client reports increased frequency of obsessive thoughts.
  • B. The client demonstrates a decrease in compulsive behaviors.
  • C. The client expresses a desire to leave therapy early.
  • D. The client avoids participating in exposure tasks.
Correct Answer: B

Rationale: A decrease in compulsive behaviors is a positive response to behavioral therapy for OCD. Behavioral therapy aims to reduce these behaviors and promote healthier coping mechanisms. Option A, reporting an increased frequency of obsessive thoughts, would indicate a lack of improvement or worsening of symptoms. Option C, expressing a desire to leave therapy early, suggests resistance or dissatisfaction with therapy. Option D, avoiding participation in exposure tasks, goes against the principles of exposure therapy, which is commonly used in OCD treatment to help clients confront their fears and reduce anxiety.

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