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Mental Health HESI Practice Questions
1. A client with major depressive disorder is started on fluoxetine (Prozac). What should the nurse include in the client's discharge teaching?
- A. It may take 4-6 weeks for the medication to be effective.
- B. You should take this medication at bedtime.
- C. Avoid consuming dairy products while taking this medication.
- D. You can stop taking the medication once you feel better.
Correct answer: A
Rationale: The correct answer is A: "It may take 4-6 weeks for the medication to be effective." SSRIs like fluoxetine typically take 4-6 weeks to reach their full effect, so clients should be informed to expect a gradual improvement in symptoms. Choice B is incorrect because fluoxetine is usually taken in the morning to prevent sleep disturbances. Choice C is incorrect as there is no specific need to avoid consuming dairy products while taking fluoxetine. Choice D is incorrect because clients should never stop taking antidepressants abruptly, as it can lead to withdrawal symptoms and worsening of the condition.
2. 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.
3. The community health nurse talks to a male client who has bipolar disorder. The client explains that he sleeps 4 to 5 hours a night and is working with his partner to start two new businesses and build an empire. The client stopped taking his medications several days ago. What nursing problem has the highest priority?
- A. Excessive work activity.
- B. Decreased need for sleep.
- C. Medication management.
- D. Inflated self-esteem.
Correct answer: D
Rationale: The priority is to manage the client's medication adherence to prevent escalation of manic behavior. Inflated self-esteem is the highest priority as it indicates the client's potential for harmful behaviors due to lack of medication compliance. While excessive work activity and decreased need for sleep are characteristics of mania, they are not as immediately concerning as the risk of harm related to inflated self-esteem.
4. An older female adult who lives in a nursing home is loudly demanding that the nurse call her son who has been deceased for five years. Which intervention should the nurse implement?
- A. Assist the client in making the phone call.
- B. Remind the client about her son's passing.
- C. Escort the client to a private area.
- D. Direct the client to a new activity.
Correct answer: D
Rationale: In this situation, the most appropriate intervention is to direct the client to a new activity. This approach can help redirect the client's attention, distract her from the distressing request, and engage her in a more positive interaction. Choice A could exacerbate the client's distress by attempting to make the impossible call, and reminding the client about her son's passing (Choice B) may increase her emotional distress. Escorting the client to a private area (Choice C) does not address the underlying issue and may not effectively manage the situation.
5. A male client is admitted to the psychiatric unit for recurrent negative symptoms of chronic schizophrenia and medication adjustment of risperidone (Risperdal). When the client walks to the nurse's station in a laterally contracted position, he states that something has made his body contort into a monster. What action should the nurse take?
- A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril).
- B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
- C. Direct the client to occupational therapy to distract him from somatic complaints.
- D. Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia.
Correct answer: D
Rationale: The correct action for the nurse to take in this situation is to administer the prescribed anticholinergic benztropine (Cogentin) for dystonia. Dystonia can be a side effect of antipsychotic medications like risperidone, leading to involuntary muscle contractions and abnormal postures. Benztropine is an anticholinergic medication commonly used to treat dystonia. Choices A, B, and C are incorrect because thioridazine is not the appropriate medication in this case, a hot pack would not address the underlying issue of dystonia, and occupational therapy is not the primary intervention for addressing acute dystonic reactions.
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