HESI LPN
Mental Health HESI Practice Questions
1. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessment finding requires immediate follow-up?
- A. Describes life as without purpose.
- B. Exhibits an increase in sweating.
- C. States is often fatigued and drowsy.
- D. Complains of nausea and loss of appetite.
Correct answer: A
Rationale: The correct answer is A. Expressing that life is without purpose can indicate deepening depression or suicidal ideation, which requires immediate attention. While sweating, fatigue, drowsiness, nausea, and loss of appetite can be side effects of duloxetine (Cymbalta), they do not indicate the same level of urgency as a statement suggesting deepening depression or suicidal ideation.
2. 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.
3. The LPN/LVN is caring for a client who has been prescribed lithium carbonate. What is the most important instruction for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Do not change your salt intake while on this medication.
- C. Drink plenty of water and maintain a consistent salt intake.
- D. Avoid excessive intake of caffeine while on this medication.
Correct answer: B
Rationale: The most important instruction for a client prescribed lithium carbonate is not to change their salt intake. Alterations in sodium levels can impact lithium levels, leading to an increased risk of toxicity. Choice A is not crucial for lithium carbonate administration. While hydration is essential, maintaining a consistent salt intake is more critical than just increasing water intake (Choice C). Although caffeine can interact with lithium, it is not as important as maintaining a consistent salt intake (Choice D).
4. An LPN/LVN is caring for a suicidal client. The appropriate nursing intervention in dealing with this client is to:
- A. Demonstrate confidence in the client's ability to deal with stressors
- B. Provide hope and reassurance that the problems will resolve themselves
- C. Display an attitude of detachment, confrontation, and efficiency
- D. Provide authority, action, and participation
Correct answer: D
Rationale: When caring for a suicidal client, providing authority, taking action, and encouraging the client's participation in their care are essential. Choice A is incorrect as it may not be sufficient for the critical situation of a suicidal client. Choice B, while offering hope, may not address the immediate risk of harm. Choice C's attitude of detachment and confrontation can be counterproductive in establishing trust and rapport with the client. Therefore, the most appropriate intervention is to provide authority, take action to ensure safety, and involve the client in the care process.
5. A male client approaches the nurse with an angry expression on his face and raises his voice, saying, 'My roommate is the most selfish, self-centered, angry person I have ever met. If he loses his temper one more time with me, I am going to punch him out!' The nurse recognizes that the client is using which defense mechanism?
- A. Denial
- B. Projection
- C. Rationalization
- D. Splitting
Correct answer: B
Rationale: The correct answer is B: Projection. In this scenario, the client is projecting his own feelings of anger and selfishness onto his roommate. Projection is a defense mechanism where individuals attribute their own unacceptable thoughts, feelings, and motives to another person. Choices A, C, and D are incorrect. Denial is refusing to acknowledge an aspect of reality or experience. Rationalization is providing logical-sounding reasons to justify unacceptable behaviors or feelings. Splitting is seeing individuals as all good or all bad, with no middle ground.
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