HESI LPN
Mental Health HESI 2023
1. A female client with post-traumatic stress disorder (PTSD) has been experiencing flashbacks. Which intervention should the nurse implement to help the client?
- A. Encourage the client to talk about the trauma.
- B. Advise the client to avoid triggers that cause flashbacks.
- C. Help the client stay grounded in the present moment.
- D. Refer the client to group therapy for PTSD.
Correct answer: C
Rationale: The correct intervention for a client with PTSD experiencing flashbacks is to help them stay grounded in the present moment. This technique can reduce the intensity of flashbacks and provide a sense of safety. Encouraging the client to talk about the trauma (Choice A) may exacerbate the symptoms and should be done cautiously under professional guidance. Advising the client to avoid triggers (Choice B) is important, but solely relying on avoidance may not address the underlying issues. Referring the client to group therapy (Choice D) can be beneficial, but in the immediate context of managing flashbacks, grounding techniques are more appropriate.
2. 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.
3. The LPN/LVN is assessing a client who is taking an antipsychotic medication. Which of the following symptoms is uniquely indicative of neuroleptic malignant syndrome (NMS) and requires immediate attention?
- A. Very high temperature
- B. Muscular rigidity
- C. Tremors
- D. Altered consciousness
Correct answer: A
Rationale: A very high temperature is a hallmark symptom of Neuroleptic Malignant Syndrome (NMS), which is a rare but potentially life-threatening side effect of antipsychotic medications. This symptom is uniquely indicative of NMS and requires immediate medical attention. Muscular rigidity, tremors, and altered consciousness can be seen in other conditions but are not as specifically linked to NMS as a very high temperature.
4. A male client who has been on lithium therapy for 5 years is experiencing frequent urination and increased thirst. What should the nurse's next action be?
- A. Instruct the client to increase fluid intake.
- B. Assess for signs of lithium toxicity.
- C. Suggest the client reduce salt intake.
- D. Notify the healthcare provider immediately.
Correct answer: B
Rationale: Frequent urination and increased thirst can be signs of lithium toxicity, which can lead to serious complications if not addressed promptly. Assessing for signs of lithium toxicity is crucial to determine the client's condition and prevent further harm. Instructing the client to increase fluid intake (Choice A) may worsen the situation by exacerbating lithium toxicity. Suggesting the client reduce salt intake (Choice C) is not the priority when signs of toxicity are present. Notifying the healthcare provider immediately (Choice D) is important, but the initial action should be to assess the client for signs of lithium toxicity to provide immediate care.
5. A client with a history of substance abuse is admitted to the hospital for detoxification. What is the most important intervention for the LPN/LVN to implement?
- A. Monitor the client for signs of withdrawal.
- B. Encourage the client to express feelings about substance use.
- C. Provide the client with information about support groups.
- D. Administer prescribed medications to manage withdrawal symptoms.
Correct answer: D
Rationale: Administering prescribed medications to manage withdrawal symptoms is the priority intervention for a client undergoing detoxification. This intervention aims to prevent severe complications that may arise during the detox process. Monitoring for signs of withdrawal (choice A) is important but providing immediate medical management through medications takes precedence to ensure the client's safety. Encouraging the client to express feelings (choice B) and providing information about support groups (choice C) are essential aspects of care but are not as urgent as administering medications to manage withdrawal symptoms.
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