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Mental Health HESI Practice Questions
1. A female client with obsessive-compulsive disorder (OCD) is describing her obsessions and compulsions and asks the nurse why these make her feel safer. What information should the nurse include in this client's teaching plan? (select one that does not apply.)
- A. Compulsions relieve anxiety
- B. Anxiety is the key reason for OCD
- C. Obsessions cause compulsions
- D. Obsessive thoughts are linked to levels of neurochemicals
Correct answer: C
Rationale: The correct answer is C. Obsessions do not cause compulsions; rather, obsessions are intrusive, unwanted thoughts, images, or urges that trigger intensely distressing feelings, while compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rules that must be applied rigidly. Choices A, B, and D are incorrect. Choice A is incorrect because compulsions are behaviors or mental acts aimed at reducing distress or preventing a dreaded event or situation. Choice B is incorrect because while anxiety is often a significant component of OCD, it is not the only reason for the disorder. Choice D is incorrect because obsessive thoughts are not solely linked to levels of neurochemicals but are more complex and multifactorial.
2. 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.
3. A client with obsessive-compulsive disorder (OCD) repeatedly checks the locks on the doors. What is the most therapeutic nursing intervention?
- A. Allow the client to continue the behavior to reduce anxiety.
- B. Encourage the client to discuss the thoughts and feelings behind the behavior.
- C. Restrict the client's access to the locks.
- D. Schedule specific times for the client to check the locks.
Correct answer: B
Rationale: The most therapeutic nursing intervention for a client with obsessive-compulsive disorder (OCD) who repeatedly checks locks is to encourage the client to discuss the thoughts and feelings behind the behavior. By exploring the underlying anxiety and triggers, the client can work towards understanding and managing their compulsions. Choice A is incorrect because allowing the client to continue the behavior does not address the root cause or help modify the behavior. Choice C is inappropriate as restricting access to locks can increase anxiety and worsen symptoms. Choice D of scheduling specific times for checking locks does not address the underlying psychological issues driving the behavior.
4. A 27-year-old female client is admitted to the psychiatric hospital with a diagnosis of bipolar disorder, manic phase. She is demanding and active. Which intervention should the nurse include in this client's plan of care?
- A. Schedule noncompetitive activities that can be carried out alone.
- B. Monitor her decision-making process.
- C. Encourage her to identify feelings of anger.
- D. Provide a structured environment with little stimuli.
Correct answer: D
Rationale: Clients in the manic phase of bipolar disorder require a structured environment with decreased stimuli to help manage their symptoms. Providing a structured environment with little stimuli (D) can help reduce the risk of escalating behaviors. Scheduling noncompetitive activities that can be carried out alone (A) is more appropriate than group activities as excessive stimuli should be avoided. Monitoring decision-making processes (B) is important due to impulsivity in manic phases. Encouraging the client to identify feelings of anger (C) is not the priority in managing manic symptoms, as it is more often associated with depression than bipolar disorder.
5. 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.
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