a client who has been diagnosed with borderline personality disorder is exhibiting manipulative behavior what is the most important intervention for t
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Mental Health HESI Practice Questions

1. A client who has been diagnosed with borderline personality disorder is exhibiting manipulative behavior. What is the most important intervention for the LPN/LVN to implement?

Correct answer: A

Rationale: Setting clear, consistent limits on manipulative behavior is the most important intervention for a client diagnosed with borderline personality disorder. This approach helps establish boundaries, maintain a therapeutic environment, and provide structure for the client. Choice B is incorrect because ignoring manipulative behavior can lead to its reinforcement. Choice C, while important, may not be as effective as directly setting limits. Choice D focuses on consequences rather than immediate intervention, making it less effective than setting clear limits.

2. A client with depression is started on a selective serotonin reuptake inhibitor (SSRI). What should the LPN/LVN include in the teaching plan?

Correct answer: C

Rationale: Teaching the client that the medication may take 4 to 6 weeks to become fully effective is crucial as it helps set realistic expectations. While choice A is important to reduce nausea, it is not the most critical information to provide initially. Choice B is incorrect as improvement usually occurs after several weeks of treatment, not within 1 to 2 weeks. Choice D is also relevant, but informing about the full effectiveness of the medication is more important for long-term adherence.

3. A client with schizophrenia is admitted to the psychiatric care unit for aggressive behavior, auditory hallucinations, and potential for self-harm. The client has not been taking medications as prescribed and insists that the food has been poisoned and refuses to eat. What intervention should the RN implement?

Correct answer: D

Rationale: The correct intervention is to provide the client with food in unopened containers. This approach can help alleviate the client's fear of poisoning and encourage eating. Choice A may not address the client's specific fear and may be perceived as dismissive. Choice B, while providing information about symptoms of schizophrenia, does not address the immediate issue of the client's refusal to eat due to the fear of poisoning. Choice C of obtaining an order for tube feeding is premature and invasive before exploring less restrictive options.

4. Which diet selection by a client who is depressed and taking the MAO inhibitor tranylcypromine sulfate (Parnate) indicates to the nurse that the client understands the dietary restrictions imposed by this medication regimen?

Correct answer: D

Rationale: The correct answer is (D) Roast beef, baked potato with butter, and iced tea. This diet selection indicates that the client understands the dietary restrictions imposed by taking tranylcypromine sulfate (Parnate) because it does not contain tyramine. Tyramine in foods can interact with MAO inhibitors like Parnate, leading to a hypertensive crisis, which is life-threatening. Choices (A, B, and C) contain foods high in tyramine like cheese, pepperoni, and chocolate, which are contraindicated for clients taking MAO inhibitors.

5. A client with obsessive-compulsive disorder (OCD) spends hours each day washing their hands. Which nursing intervention is most appropriate initially?

Correct answer: A

Rationale: Initially, it is most appropriate to allow the client to continue the behavior to reduce anxiety (A). For clients with OCD, abruptly stopping compulsive behaviors can lead to increased anxiety and distress. Setting strict limits (B) may exacerbate anxiety at first. Distraction with other activities (C) may not address the underlying issue effectively. While support groups (D) can be beneficial, they are typically introduced after establishing trust and gradually working on reducing compulsive behaviors.

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