HESI MENTAL HEALTH RN V1-V3

2019 TEST BANKS (ALL TOGETHER)

A client with depression remains in bed most of the day, and

declines activities. Which nursing problem has the greatest

priority for this client?

A. Loss of interest in diversional activity.

B. Social isolation.

C. Refusal to address nutritional needs.

D. Low self-esteem.

The RN is preparing medications for a client with bipolar

disorder and notices that the client discontinued

antipsychotic medication for several days. Which medication

should also be discontinued?

a. Lithium. (Lithotabs)

b. Benzotropine (Cogentin).

c. Alprazolam (Xanax).

d. Magnesium (Milk of Magnesia).

A female client requests that her husband be allowed to stay

in the room during the admission assessment. When

interviewing the client, the RN notes a discrepancy between

the client’s verbal and nonverbal communication.

What action does the RN take?

A. Pay close attention and document the nonverbal messages.

B. Ask the client’s husband to interpret the discrepancy.

C. Ignore the nonverbal behavior and focus on the

client’s verbal messages.

D. Integrate the verbal and nonverbal messages and

interpret them as one.

A male client approaches the RN with an angry expression on

his face and raises his voice, saying “My roommate is the

most selfish, self-centered, angry person I have ever met. If

he loses his temper one more time with me, I am going to

punch him out!” The RN recognizes that the client is using

which defense mechanism?

A.

Denial. B.

Projection.

C. Rationalization.

D. Splitting.

A male client with bipolar disorder who began taking lithium

carbonate five days ago is complaining of excessive thirst,

and the RN finds him attempting to drink water from the

bathroom sink faucet. Which intervention should the RN

implement?

A. Report the client’s serum lithium level to the HCP.

B. Encourage the client to suck on hard candy to relieve the

symptoms.

C. No action is needed since polydipsia is a common side

effect.

D. Tell the client that drinking from the faucet is not allowed.

The RN is teaching a client about the initiation of the prescribed

abstinence therapy using disulfiram (Antabuse). What

information should the client acknowledge understanding?

A. Completely abstain from heroin or cocaine use.

B. Remain alcohol free for 12 hours prior to the first dose.

C. Attend monthly meetings of alcoholics anonymous.

D. Admit to others that he is a substance user.

A male client with schizophrenia is admitted to the mental

health unit after abruptly stopping his prescription for

ziprasidone (Geodon) one month ago. Which question is

most important for the RN to ask the client?

A. Have you lost interest in the things that you used to enjoy?

B. Is your ability to think or concentrate decreased?

C. How many continuous hours do you sleep

at night? D. Do you hear sounds or voices

that others do not hear?

During an annual physical by the occupational RN working in

a corporate clinic, a male employee tells the RN that is highstress job is causing trouble in his personal life. He further

explains that he often gets so angry while driving to and

from work that he has considered “getting even” with other

drivers. How should the RN respond?

A. “Anger is contagious and could result in major

confrontation.”

B. “Try not to let your anger cause you to act impulsively.”

C. “Expressing your anger to a stranger could result

in an unsafe situation.”

D. “It sounds as if there are many situations that make you

feel angry.”

A client who has agoraphobia (a fear of crowds) is beginning

desensitization with the therapist, and the RN is reinforcing

the process. Which intervention has the highest priority for

this client’s plan of care?

A. Encourage substitution of positive thoughts and

negative ones. B. Establish trust by providing a calm,

safe environment.

C. Progressively expose the client to larger crowds.

D. Encourage deep breathing when anxiety escalates in a

crowd.

Which nursing actions are likely to help promote the selfesteem of a male client with modern depression?

A. Ask the client what his long term goals are.

B. Discuss the challenges of his medical condition.

C. Include the client in determining treatment

protocol. D. Encourage the client to engage in

recreational therapy.

E. Provide opportunities for the client to discuss his concerns.

A male client is admitted to the psychiatric unit for recurrent

negative symptoms of chronic schizophrenia and medication

adjustment of Risperidone (Risperdal). When the client walks

to the nurse’s station in a laterally contracted position, he

states that something has made his body contort into a

monster. What action should the RN take?

A. Medicate the client with the prescribed

antipsychotic thioridazine (Mellaril).

B. Offer the client a prescribed physical therapy hot

pack for muscle spasms.

C. Direct client to occupational therapy to distract him

from somatic complaints.

D. Administer the prescribed anticholinergic benztropine

(Cogentin) for dystonia.

A mental health worker is caring for a client with escalating

aggressive behavior. Which action by the MHW warrant

immediate intervention by the RN?

A. Is attempting to physically restrain the patient.

B. Tells the client to go to the quiet area of the unit.

C. Is using a loid voice to talk to the client.

D. Remains at a distance of 4 feet from the client.

A client on the mental health unit is becoming more agitated,

shouting at the staff, and pacing in the hallway. When the

PRN medication is offered, the client refuses the medication

and defiantly sits on the floor in the middle of the unit

hallway. What nursing intervention should the RN implement

first?

A. Transport of the client to the seclusion room.

B. Quietly approach the client with additional

staff members. C. Take other clients in the area

to the client lounge.

D. Administer medication to chemically restrain the patient.

A client is admitted to the mental health unit and reports

taking extra antianxiety medication because, “I’m so

stressed out. I just want to go to sleep.” The RN should

plan one-on-one observation of the client based on which

statement?

A. “What should I do? Nothing seems to help.”

B. “I have been so tired lately and needed to sleep.”

C. “I really think that I don’t need to be here.”

D. “I don’t want to walk. Nothing matters anymore.”

A male hospital employee is pushed out the way by a female

employee because of an oncoming gurney. The pushed

employee becomes very angry and swings at the female

employee. Both employees are referred for counseling with

the staff psychiatric RN. Which factor in the pushed

employee’s history is most related to the reaction that

occurred?

A. Is worried about losing his job to a woman.

B. Tortured animals as a child.

C. Was physically abused by his mother.

D. Hates to be touched by anyone.

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 the television talks to her. The RN should

document these assessment findings in which section of the

mental status exam/

A. Level of

concentration. B.

Insight and

judgement.

C. Remote memory.

D. Mood and affect.

A client is admitted to the mental health unit reports shortness

of breath and dizziness. The client tells the RN, “I feel like I’m

going to die”. Which nursing problem should the RN include in

this client’s plan of care?

A. Mood

disturbance. B.

Moderate anxiety.

C. Altered thoughts.

D. Social isolation.