HESI Mental Health Practice Exam

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The RN documents the mental status of a female client who has been hospitalized for several days by court order. The client states 'I don't need to be here,' and tells the RN that she believes that the TV talks to her. The RN should document these assessment statements in which section of the mental status exam?

  • A. Insight and judgment.
  • B. Mood and affect.
  • C. Remote memory.
  • D. Level of concentration.
Correct Answer: A

Rationale: The correct answer is A: Insight and judgment. The client's statements indicate her lack of insight into her need for hospitalization ('I don't need to be here') and the presence of a delusion (believing that the TV talks to her). These statements reflect the client's insight into her condition and judgment. This information is crucial for assessing the client's understanding of her situation and decision-making capacity. Choice B, Mood and affect, focuses on the client's emotional state rather than her insight and judgment. Choice C, Remote memory, pertains to the ability to recall past events, which is not the primary focus of the client's statements. Choice D, Level of concentration, is not directly related to the client's statements about her need for hospitalization and the delusional belief about the TV.

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What is the best initial action for the nurse to take with a manic depressive male client who becomes loud and verbally aggressive towards a nurse?

  • A. Have the staff escort the client to his room.
  • B. Tell the client that his behavior will be recorded in his record.
  • C. Redirect the client by asking him to engage in a game with peers.
  • D. Review the medication record for an antipsychotic drug.
Correct Answer: C

Rationale: In dealing with a manic depressive client who is being verbally aggressive, the best initial action for the nurse is to redirect the client by engaging him in a more constructive activity, such as playing card games with peers. This approach can help de-escalate the situation, shift the client's focus positively, and provide a distraction from the current behavior. Having the staff escort the client to his room may escalate the situation further. Threatening to record the behavior in his record is not likely to be effective in managing the immediate situation. Reviewing the medication record for an antipsychotic drug is important but would not be the best initial action in this scenario when the client is being verbally aggressive.

During a manic episode, what is the most appropriate nursing intervention for a client with bipolar disorder?

  • A. Allow the client to engage in any activities they choose.
  • B. Provide a quiet and structured environment.
  • C. Encourage the client to participate in group activities.
  • D. Allow the client to take short naps during the day.
Correct Answer: B

Rationale: During a manic episode, individuals with bipolar disorder often experience excessive energy and impulsivity. Providing a quiet and structured environment is crucial to help manage these symptoms. This intervention promotes stability, reduces overstimulation, and supports the client in regaining control over their behaviors. Choices A and C may exacerbate impulsivity and overstimulation, while choice D does not address the need for environmental structure and may not be effective in managing manic symptoms.

A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). The nurse should include which information in the client's discharge teaching?

  • A. This medication can cause physical dependence.
  • B. It may take 2 to 4 weeks before you notice improvement.
  • C. Avoid alcohol while taking this medication.
  • D. You may experience sedation as a side effect.
Correct Answer: B

Rationale: Corrected Rationale: Buspirone takes time to become fully effective, so the client should be informed to expect a gradual improvement in anxiety symptoms. Choice A is incorrect because buspirone is not associated with physical dependence. Choice C is not directly related to buspirone but is generally a good practice when taking any medication. Choice D is less common with buspirone compared to other anxiety medications.

A client with a diagnosis of major depressive disorder is prescribed fluoxetine (Prozac). What is the most important side effect for the LPN/LVN to monitor?

  • A. Weight gain.
  • B. Sexual dysfunction.
  • C. Nausea.
  • D. Constipation.
Correct Answer: B

Rationale: The correct answer is B: Sexual dysfunction. When monitoring a client taking fluoxetine (Prozac), the LPN/LVN should prioritize observing for sexual dysfunction. This side effect is crucial to monitor as it can significantly impact the client's quality of life and may affect their adherence to the medication. Weight gain (choice A) is a possible side effect of fluoxetine but is not as critical as sexual dysfunction in terms of monitoring. Nausea (choice C) and constipation (choice D) are common side effects of fluoxetine, but they are generally less concerning compared to the impact of sexual dysfunction on the client's well-being and treatment compliance.

A client with obsessive-compulsive disorder (OCD) spends hours checking and rechecking the locks on the doors. What is the best nursing intervention?

  • A. Allow the client to continue the behavior to reduce anxiety.
  • B. Encourage the client to discuss the thoughts and feelings behind the behavior.
  • C. Prevent the client from checking the locks to break the cycle.
  • D. Schedule specific times for the client to check the locks.
Correct Answer: B

Rationale: The best nursing intervention for a client with OCD who spends excessive time checking locks is to encourage the client to discuss the thoughts and feelings behind the behavior. By exploring the underlying anxiety and triggers, the client can gain insight and work towards behavior modification. Choice A is incorrect because enabling the behavior does not address the underlying issues. Choice C is incorrect as it may lead to increased anxiety and distress. Choice D is incorrect as it does not address the root cause of the behavior.

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