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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. What is the most important goal of care for a client diagnosed with generalized anxiety disorder (GAD) who has been taking the benzodiazepine alprazolam (Xanax) long-term? The client will:
- A. Describe a decrease in anxiety using a 1 to 10 anxiety scale.
- B. State the importance of not abruptly stopping the medication.
- C. Not experience dizziness, lightheadedness, or sedation.
- D. Attend scheduled individual and group therapy sessions.
Correct answer: B
Rationale: The correct answer is B. The most important goal of care for a client with generalized anxiety disorder (GAD) taking alprazolam long-term is to ensure they understand the importance of not abruptly stopping the medication. Abruptly stopping benzodiazepines can lead to withdrawal symptoms and potential complications. Choice A is not the most critical goal as the focus should be on the safe continuation of the medication. Choice C is important but not as crucial as preventing abrupt discontinuation. Choice D is beneficial for overall treatment but not the most important goal in this scenario.
3. A client with bipolar disorder is experiencing a manic episode. Which nursing intervention is most appropriate?
- A. Encourage group activities to decrease isolation.
- B. Provide a structured environment with routine activities.
- C. Limit the client's physical activity to prevent exhaustion.
- D. Allow the client to choose activities freely.
Correct answer: B
Rationale: During a manic episode, individuals with bipolar disorder may exhibit excessive energy, impulsivity, and disorganized behavior. Providing a structured environment with routine activities is the most appropriate nursing intervention. This approach can help regulate the client's behavior, reduce impulsivity, and prevent engaging in potentially harmful activities. Encouraging group activities (Choice A) may exacerbate the client's symptoms due to overstimulation. Limiting physical activity (Choice C) may not address the need for structure and routine during a manic episode. Allowing the client to choose activities freely (Choice D) can lead to impulsive decision-making and may not provide the necessary boundaries required to manage the manic symptoms effectively.
4. A client is on a methadone maintenance program for opioid addiction. What is the most important assessment to perform?
- A. Monitor for signs of withdrawal.
- B. Assess for signs of methadone toxicity.
- C. Evaluate the client's respiratory status.
- D. Check the client's blood pressure regularly.
Correct answer: C
Rationale: The most important assessment to perform for a client on a methadone maintenance program is to evaluate the client's respiratory status. Methadone can cause respiratory depression as a side effect, making it crucial to monitor the client's breathing to prevent potential complications. Monitoring for signs of withdrawal (choice A) is important but not the most critical in this scenario. Assessing for signs of methadone toxicity (choice B) is relevant, but respiratory status takes precedence due to the risk of respiratory depression. Checking the client's blood pressure regularly (choice D) is important for overall assessment but is not as crucial as monitoring respiratory status in this case.
5. A male adolescent is admitted with bipolar disorder after being released from jail for assault with a deadly weapon. When the nurse asks the teen to identify his reason for the assault, he replies, 'Because he made me mad!' Which goal is best for the nurse to include in the client's plan of care? The client will
- A. outline methods for managing anger.
- B. control impulsive actions toward self and others.
- C. verbalize feelings when anger occurs.
- D. recognize consequences for behaviors exhibited.
Correct answer: B
Rationale: In this scenario, the client's response indicates poor impulse control, a common issue in individuals with bipolar disorder. The most critical goal for the nurse to include in the client's plan of care is to help the client control impulsive actions toward self and others. This goal is essential for preventing harmful behaviors and mitigating the social consequences associated with impulsivity. While outlining methods for managing anger, verbalizing feelings when anger occurs, and recognizing consequences for behaviors exhibited are important aspects of therapy, they do not directly address the urgent need to control impulsive behavior in this case.
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