HESI LPN
HESI Mental Health
1. A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A mental health aide asks the nurse why the client is this way after being on fluphenazine (Prolix) 10 mg for 7 days. The LPN/LVN should tell the health aide:
- A. Prolixin is the most effective with positive symptoms of schizophrenia.
- B. The client will be less withdrawn and unmotivated when the Prolixin takes effect.
- C. The client's Prolixin dose probably needs to be increased again.
- D. Lack of motivation is a common side effect of the Prolixin.
Correct answer: A
Rationale: Prolixin is more effective with positive symptoms of schizophrenia, such as hallucinations and delusions, rather than negative symptoms like withdrawal and lack of motivation.
2. The LPN/LVN is caring for a client who has been prescribed a monoamine oxidase inhibitor (MAOI) for depression. Which statement by the client indicates a need for further teaching?
- A. I need to avoid foods that are high in tyramine, like aged cheese and cured meats.
- B. I should take this medication with food to avoid nausea.
- C. I can drink alcohol in moderation while taking this medication.
- D. I can stop taking this medication once I feel better.
Correct answer: C
Rationale: The statement 'I can drink alcohol in moderation while taking this medication' indicates a need for further teaching because alcohol consumption can have dangerous interactions with MAOIs. MAOIs can interact with alcohol to cause a hypertensive crisis, which can be life-threatening. Choices A and B are correct statements as avoiding tyramine-rich foods and taking the medication with food can help prevent adverse effects. Choice D is incorrect because abruptly stopping an antidepressant medication like an MAOI can lead to withdrawal symptoms and a relapse of depression.
3. During the manic phase of bipolar disorder, what is the priority nursing intervention for a female client who has not slept for the past 48 hours, is hyperactive, talkative, and engaging in risky behaviors?
- A. Encourage the client to participate in a quiet activity.
- B. Provide a safe environment and limit stimuli.
- C. Administer a sedative to help the client sleep.
- D. Discuss the consequences of her risky behaviors.
Correct answer: B
Rationale: The correct priority nursing intervention for a female client in the manic phase of bipolar disorder, who has not slept for 48 hours, is hyperactive, talkative, and engaging in risky behaviors, is to provide a safe environment and limit stimuli. This approach is crucial to prevent harm to the client and others. Encouraging a quiet activity (Choice A) may not effectively address the need for safety during the manic phase. Administering a sedative (Choice C) should be done under the guidance of a healthcare provider and does not address the immediate safety concerns. Discussing consequences of risky behaviors (Choice D) may not be effective during the manic phase when the client's judgment is impaired.
4. A client with depression is prescribed an SSRI. The client asks, 'Why do I need to take this medication every day?' What is the best response by the nurse?
- A. This medication will help balance the chemicals in your brain.
- B. This medication needs to be taken regularly to be effective.
- C. This medication will start working immediately to improve your mood.
- D. You should take this medication only when you feel sad or depressed.
Correct answer: D
Rationale: Explaining that the medication may take several weeks to take full effect helps manage the client's expectations and encourages adherence to the prescribed treatment.
5. A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). The client asks how long it will take for the medication to start working. What is the nurse's best response?
- A. You should start feeling better within a few days.
- B. It may take 2 to 4 weeks before you notice an improvement.
- C. Buspirone works immediately to reduce anxiety symptoms.
- D. You will need to take this medication for at least a year.
Correct answer: B
Rationale: The correct answer is B. Buspirone typically takes 2 to 4 weeks to become fully effective. It is essential to inform the client that it may take some time before they notice an improvement. Choice A is incorrect because buspirone does not work immediately. Choice C is also incorrect as buspirone does not provide immediate relief. Choice D is incorrect as it suggests a longer duration of treatment than necessary.
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