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HESI Mental Health Practice Questions
1. 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.
2. The parents of a nuclear family attending a support group for parents of adolescents are being assessed by the nurse. According to Erikson, these parents who are adapting to middle adulthood should exhibit which characteristic?
- A. Loss of independence.
- B. Increased self-understanding.
- C. Isolation from society.
- D. Development of intimate relationships.
Correct answer: B
Rationale: The correct answer is B: Increased self-understanding. According to Erikson's psychosocial development theory, middle adulthood is characterized by generativity, self-reflection, understanding, and acceptance. Middle-aged adults focus on guiding the next generation and finding meaning in their lives. Choices A and C are incorrect because loss of independence and isolation from society are maladaptive behaviors in middle adulthood. While developing and maintaining intimate relationships is important throughout life, the initial development of intimate relationships typically occurs during young adulthood, not middle adulthood.
3. A client with a diagnosis of schizophrenia is prescribed risperidone (Risperdal). Which statement by the client indicates a need for further teaching?
- A. I can stop taking this medication once I feel better.
- B. I need to avoid foods that are high in tyramine.
- C. I should avoid drinking alcohol while taking this medication.
- D. This medication may cause drowsiness, so avoid driving.
Correct answer: A
Rationale: The correct answer is A. The statement 'I can stop taking this medication once I feel better' indicates a need for further teaching. Antipsychotic medications, like risperidone, should be taken consistently even when symptoms improve to prevent relapse. Choice B is incorrect because avoiding foods high in tyramine is unrelated to risperidone. Choice C is incorrect as avoiding alcohol is a standard precaution with many medications. Choice D is incorrect because being cautious about drowsiness and avoiding driving is a common safety measure associated with risperidone.
4. A client with schizophrenia is being treated with risperidone (Risperdal). The nurse notices that the client has a shuffling gait and tremors. What is the nurse's priority action?
- A. Administer a PRN dose of an anticholinergic medication.
- B. Document the findings and continue to monitor the client.
- C. Assess the client's blood glucose level.
- D. Notify the healthcare provider immediately.
Correct answer: A
Rationale: A shuffling gait and tremors may indicate extrapyramidal side effects (EPS) from risperidone. The nurse's priority action should be to administer an anticholinergic medication as it can help alleviate these symptoms associated with EPS. Documenting the findings and monitoring the client (Choice B) are important but addressing the immediate symptoms takes precedence. Assessing the client's blood glucose level (Choice C) is not directly related to the observed symptoms of shuffling gait and tremors. While notifying the healthcare provider (Choice D) is important, it is not the priority action when dealing with EPS symptoms.
5. A client is admitted with a diagnosis of depression. The nurse knows that which characteristic is most indicative of depression?
- A. Grandiose ideation.
- B. Self-destructive thoughts.
- C. Suspiciousness of others.
- D. A negative view of self and the future.
Correct answer: D
Rationale: A negative view of self and the future (D) is a prominent characteristic of depression. It reflects the core symptoms of low self-esteem and hopelessness that are commonly associated with this condition. Grandiose ideation (A) and suspiciousness of others (C) are more indicative of other mental health disorders like paranoia. While self-destructive thoughts (B) can be present in depression, they are not as specific and common as the negative self-view and hopelessness, making option (D) the most indicative characteristic of depression.
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