HESI LPN
Mental Health HESI 2023
1. The nurse is leading a 'current events group' with chronic psychiatric clients. One group member states, 'Clara Barton was my nurse during my last hospitalization. She was a very mean nurse and wasn't nice to me.' Which response would be best for the nurse to make?
- A. 'Clara Barton was not your nurse.'
- B. 'What did she do to you that was so mean?'
- C. 'I didn't know that Clara Barton was a nurse.'
- D. 'Clara Barton started the American Red Cross.'
Correct answer: D
Rationale: (D) presents the reality of the situation in relation to American culture. The fact that Clara Barton was a nurse during the Civil War should be addressed on an individual basis. Since this is group therapy, the nurse would be illustrating the concept of universality. (A) is likely to promote defensiveness. (B and C) would support the delusion. Therefore, the most appropriate response is (D) as it provides factual information that can redirect the conversation in a constructive manner.
2. The LPN/LVN is assessing a client's intelligence. Which factor should the nurse remember during this part of the mental status exam?
- A. Acute psychiatric illnesses impair intelligence.
- B. Intelligence is influenced by social and cultural factors.
- C. Poor concentration skills suggest limited intelligence.
- D. The inability to think abstractly indicates limited intelligence.
Correct answer: B
Rationale: The correct answer is B because intelligence is influenced by social and cultural factors. Social and cultural beliefs can impact how intelligence is perceived and expressed. Choice A is incorrect because acute psychiatric illnesses can affect cognitive functioning but not necessarily intelligence. Choice C is incorrect because poor concentration skills do not always correlate with limited intelligence. Choice D is incorrect because the inability to think abstractly is just one aspect of intelligence and does not solely indicate limited intelligence.
3. A client in the manic phase of bipolar disorder is pacing the hallway and talking rapidly. What is the best intervention for the nurse?
- A. Encourage the client to join a group activity.
- B. Offer the client a high-calorie snack and a drink.
- C. Direct the client to a quieter area of the unit.
- D. Instruct the client to sit down and relax.
Correct answer: B
Rationale: In the manic phase of bipolar disorder, clients often exhibit increased activity and may burn a lot of energy. Offering a high-calorie snack and a drink is the best intervention as it helps maintain their nutritional needs while allowing them to continue their activity. Encouraging the client to join a group activity (Choice A) may further stimulate their behavior. Directing the client to a quieter area (Choice C) might not address their energy expenditure. Instructing the client to sit down and relax (Choice D) may not be effective during the manic phase.
4. A client diagnosed with bipolar disorder tells the nurse that she wants to stop taking her lithium. She states, 'I feel fine, and I don't think I need it anymore.' What should the nurse do first?
- A. Agree with the client that she seems fine now.
- B. Remind the client of the importance of lithium.
- C. Ask the healthcare provider to discontinue the lithium prescription.
- D. Arrange for a psychiatric evaluation for the client.
Correct answer: B
Rationale: When a client with bipolar disorder expresses a desire to stop taking lithium because they feel fine, the nurse's initial action should be to remind the client of the importance of lithium. This approach helps educate the client about the necessity of medication adherence in managing bipolar disorder. Agreeing with the client or immediately arranging a psychiatric evaluation may not address the root issue of medication non-adherence. Asking the healthcare provider to discontinue the prescription without further assessment and intervention could potentially jeopardize the client's stability and treatment plan.
5. When preparing a teaching plan for a client who is to be discharged with a prescription for lithium carbonate (Lithonate), which instruction is most important for the nurse to include?
- A. It may take 3 to 4 weeks to achieve therapeutic effects.
- B. Keep your dietary salt intake consistent.
- C. Avoid eating aged cheese and chicken liver.
- D. Eat foods high in fiber such as whole grain breads.
Correct answer: B
Rationale: The correct answer is B: 'Keep your dietary salt intake consistent.' Consistent salt intake is crucial when taking lithium carbonate to avoid lithium toxicity or ineffectiveness due to its renal excretion mechanism. Option A is incorrect because it focuses on the time to achieve therapeutic effects, which is important but not as critical as maintaining consistent salt intake. Option C is incorrect as it mentions avoiding aged cheese and chicken liver, which is more relevant for individuals taking MAOIs. Option D is incorrect as it suggests eating high-fiber foods, which is not directly related to lithium carbonate therapy.
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