HESI LPN
HESI Mental Health Practice Exam
1. A male hospital employee is pushed out of 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 nurse. 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
Correct answer: C
Rationale: The correct answer is C: 'Was physically abused by his mother.' A history of physical abuse can lead to heightened responses to physical contact. In this scenario, the employee's reaction of becoming very angry and swinging at the female employee after being pushed may be influenced by past experiences of physical abuse. This history can contribute to increased sensitivity to physical interactions and may trigger defensive or aggressive responses. Choices A, B, and D are less directly related to the employee's reaction in this specific context. While worrying about losing his job to a woman could contribute to underlying stress or insecurity, torturing animals as a child reflects a different type of behavioral issue, and hating to be touched by anyone suggests personal boundaries unrelated to the observed behavior in this scenario.
2. A client with schizophrenia who has been stabilized on medication is being discharged from the hospital. What discharge teaching is most important for the LPN/LVN to reinforce?
- A. The importance of adhering to the prescribed medication regimen.
- B. How to recognize early signs of relapse.
- C. The need to continue follow-up appointments with the healthcare provider.
- D. The importance of maintaining a healthy lifestyle, including proper diet and exercise.
Correct answer: A
Rationale: The correct answer is A. Reinforcing the importance of adhering to the prescribed medication regimen is crucial for preventing relapse in clients with schizophrenia. Compliance with medication is essential in managing the symptoms and preventing a worsening of the condition. Choice B, recognizing early signs of relapse, is important but secondary to ensuring medication adherence. Choice C, follow-up appointments, is also important but not as critical as medication compliance immediately post-discharge. Choice D, maintaining a healthy lifestyle, is beneficial for overall health but is not as directly linked to preventing relapse in schizophrenia as medication adherence.
3. An 86-year-old female client with Alzheimer's disease is wandering the busy halls of the extended care facility and asks the nurse, 'Where should I stand for the parade?' Which response is best for the nurse to provide?
- A. "You can stand wherever you'd like as long as you stay safe from those in the parade."
- B. "You seem confused because of all the activity in the hall. There is no parade."
- C. "Let's go back to the activity room and see what is going on in there."
- D. "Remember, this is a nursing home, and I am here to help you."
Correct answer: C
Rationale: (C) is the best response as it redirects the client to a safer, familiar place. (A) is dismissive and does not address the client's needs directly. (B) labels the behavior, which may increase the client's anxiety. (D) is scolding and may not be helpful in the situation.
4. A male client with bipolar disorder has not slept or eaten in four days. He paces and becomes increasingly agitated and loud while the nurse talks to his spouse. What intervention is the best for the nurse to implement at this time?
- A. Move to a quiet area and provide peanut butter with crackers.
- B. Walk with the client to the cafeteria and star as he eats lunch.
- C. Request a full lunch tray from the dietary department.
- D. Encourage the spouse to eat lunch with the client.
Correct answer: A
Rationale: In this situation, the best intervention for the nurse to implement is to move the client to a quiet area and provide peanut butter with crackers. The client's behavior indicates increasing agitation and loudness, which could be exacerbated by a noisy environment. Providing a quiet space can help reduce stimuli and promote a sense of calm. Additionally, offering a small, manageable snack like peanut butter with crackers can address the client's immediate needs for sustenance without overwhelming him. Choices B, C, and D do not address the client's current agitation and lack of sleep or food effectively, making them less appropriate interventions in this scenario.
5. A client who has been admitted to the psychiatric unit tells the nurse, 'My problems are so bad that no one can help me.' Which response is best for the nurse to make?
- A. How can I help?
- B. Things probably aren't as bad as they seem right now.
- C. Let's talk about what is right with your life.
- D. I hear how miserable you are, but things will get better soon.
Correct answer: A
Rationale: Offering self shows empathy and caring (A) and is the best choice provided. (B) dismisses the client's feelings and reality. (C) avoids addressing the client's concerns directly and may come across as invalidating. Although (D) starts with acknowledging the client's feelings, the second part about things getting better soon can be perceived as offering false reassurance, which is not recommended in therapeutic communication.
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