HESI LPN
Mental Health HESI Practice Questions
1. What is the most important nursing intervention during the first 48 hours for a client with anorexia nervosa admitted to the hospital?
- A. Providing high-calorie, high-protein meals.
- B. Monitoring vital signs and electrolytes.
- C. Encouraging the client to talk about feelings.
- D. Observing for signs of purging.
Correct answer: B
Rationale: The most important nursing intervention during the first 48 hours for a client with anorexia nervosa is monitoring vital signs and electrolytes (B) to assess for life-threatening complications. This helps in early detection of any physiological imbalances that could lead to serious consequences. Providing high-calorie, high-protein meals (A) is important for nutritional rehabilitation but comes after ensuring the client's physical stability. Encouraging the client to talk about feelings (C) and observing for signs of purging (D) are relevant aspects of care but are not as critical as monitoring vital signs and electrolytes in the initial phase of treatment.
2. An anxious client expressing a fear of people and open places is admitted to the psychiatric unit. What is the most effective way for the nurse to assist this client?
- A. Plan an outing within the second week of admission.
- B. Distract the client whenever they express discomfort about being with others.
- C. Confront the client's fears and discuss the possible causes of these fears.
- D. Accompany the client outside for an increasing amount of time each day.
Correct answer: D
Rationale: The most effective way to assist a client with a fear of people and open places is through gradual desensitization by controlled exposure to the situation which is feared (D). This method helps the client confront their fears in a safe and supportive manner, allowing them to gradually build confidence and reduce anxiety. Planning an outing within the second week of admission (A) may be too soon and overwhelming for the client. Distracting the client whenever they express discomfort (B) does not address the underlying issue and may promote denial. Confronting the client's fears and discussing possible causes (C) could be too aggressive initially and may not be well-tolerated by the client.
3. Unresolved feelings related to loss are most likely to be recognized during which phase of the therapeutic nurse-client relationship?
- A. Working
- B. Trusting
- C. Orientation
- D. Termination
Correct answer: D
Rationale: Unresolved feelings related to loss are often recognized and explored during the termination phase of the nurse-client relationship. This phase involves preparing the client for separation from the nurse, which can trigger unresolved feelings related to loss. During the termination phase, clients may confront their emotions about ending the therapeutic relationship and may also revisit unresolved issues or losses that have surfaced during the course of therapy. Choices A, B, and C are incorrect because the working phase focuses on active problem-solving and goal achievement, the trusting phase emphasizes establishing rapport and building trust, and the orientation phase involves initial introductions and orientation to the therapeutic process, respectively.
4. A client with generalized anxiety disorder (GAD) is prescribed alprazolam (Xanax). What is the most important teaching point for the nurse to include?
- A. Take this medication at the first sign of anxiety.
- B. Do not stop taking this medication abruptly.
- C. You may experience weight gain while taking this medication.
- D. This medication may cause vivid dreams.
Correct answer: B
Rationale: The most important teaching point for a client prescribed alprazolam is not to stop taking the medication abruptly. Abruptly stopping alprazolam, a benzodiazepine, can lead to withdrawal symptoms. It is crucial to taper off the medication under medical supervision to prevent adverse effects. Choice A is incorrect because taking the medication at the first sign of anxiety is not the key teaching point. Choice C is incorrect because weight gain is not a common side effect of alprazolam. Choice D is incorrect because vivid dreams are not a significant concern compared to the risks of abrupt discontinuation of the medication.
5. A client with schizophrenia is being treated with haloperidol (Haldol). The client reports feeling restless and unable to sit still. What should the nurse do first?
- A. Instruct the client to take deep breaths and relax.
- B. Assess the client for signs of akathisia.
- C. Encourage the client to engage in physical activity.
- D. Administer a PRN dose of lorazepam (Ativan).
Correct answer: B
Rationale: Restlessness and inability to sit still are signs of akathisia, an extrapyramidal side effect of antipsychotic medications. The nurse should first assess the client for signs of akathisia by observing their movements and behavior. Assessing for akathisia is crucial to differentiate it from other conditions and to intervene appropriately. Instructing the client to relax or engage in physical activity may not address the underlying issue of akathisia. Administering lorazepam should not be the first action as it may mask the symptoms of akathisia temporarily without addressing the root cause.
Similar Questions
Access More Features
HESI LPN Basic
$69.99/ 30 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $69.99
HESI LPN Premium
$149.99/ 90 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $149.99