HESI LPN
HESI Mental Health Practice Exam
1. A male client turns over a table in the dayroom of a psychiatric unit and threatens to throw a chair at another client. Which action is most important for the nurse to implement?
- A. Calmly approach the client and remove the chair from the client.
- B. Obtain staff assistance to help diffuse the escalating situation.
- C. Offer feedback about the client's behavior.
- D. Summon the hospital security guards as a 'show of force.'
Correct answer: B
Rationale: In a situation where a client is displaying aggressive behavior, the most important action for the nurse to implement is to obtain staff assistance to help diffuse the escalating situation. This approach ensures the safety of all individuals involved and prevents the situation from escalating further. Calmly approaching the client and removing the chair directly could agitate the client further and pose a risk to the nurse. Offering feedback about the client's behavior may not address the immediate safety concerns. Summoning hospital security guards as a 'show of force' should be a last resort after other de-escalation attempts have failed, as it may further provoke the client.
2. A client post-thoracotomy is complaining of severe pain with deep breathing and coughing. What should the nurse encourage the client to do to manage the pain and prevent respiratory complications?
- A. Hold a pillow against the chest while coughing (splinting).
- B. Take shallow breaths to avoid pain.
- C. Increase the dose of pain medication.
- D. Avoid deep breathing exercises.
Correct answer: A
Rationale: Splinting the chest with a pillow helps manage pain during deep breathing and coughing, which is essential to prevent respiratory complications such as atelectasis or pneumonia after thoracic surgery. Holding a pillow against the chest while coughing (splinting) supports the incision site and reduces the pain associated with deep breathing and coughing. Encouraging shallow breaths (Choice B) can lead to respiratory complications due to inadequate lung expansion. Increasing pain medication (Choice C) should be done based on healthcare provider orders and not solely for this situation. Avoiding deep breathing exercises (Choice D) can worsen respiratory function and increase the risk of complications.
3. Multifetal pregnancies with triplets occur at a rate of 1 in 8,100 births, but twins occur much more frequently with a rate of:
- A. 1 in 85 births.
- B. 1 in 5400 births.
- C. 1 in 2700 births.
- D. 1 in 540 births
Correct answer: A
Rationale: The correct answer is A: 1 in 85 births. The rate of twin pregnancies is approximately 1 in 85 births. This means that twins are more common compared to triplets, which occur at a rate of 1 in 8,100 births. Choices B, C, and D are incorrect because they do not reflect the correct frequency of twin pregnancies as stated in the question.
4. When should discharge planning for a patient admitted to the neurological unit with a diagnosis of stroke begin?
- A. At the time of admission
- B. The day before the patient is to be discharged
- C. When outpatient therapy is no longer needed
- D. As soon as the patient's discharge destination is known
Correct answer: A
Rationale: Discharge planning for a patient admitted to the neurological unit with a stroke diagnosis should begin at the time of admission. Initiating discharge planning early allows for a comprehensive assessment of the patient's needs, enables better coordination of care, and ensures a smooth transition from the hospital to the next level of care. Option B is incorrect because waiting until the day before discharge does not provide enough time for adequate planning. Option C is incorrect because waiting until outpatient therapy is no longer needed delays the planning process. Option D is incorrect because waiting until the discharge destination is known may result in rushed planning and inadequate preparation for the patient's needs.
5. Which of the following is a nursing issue of concern today?
- A. Safe staffing
- B. Low workloads
- C. Increasing professional autonomy
- D. Improving salaries
Correct answer: A
Rationale: The correct answer is A: Safe staffing. Safe staffing is a critical issue in nursing today due to its impact on patient outcomes and nurse well-being. While low workloads (choice B) may seem beneficial, they can also indicate understaffing, leading to burnout and compromising patient care. Increasing professional autonomy (choice C) is generally viewed positively as it empowers nurses, and improving salaries (choice D) is important but may not directly address patient safety concerns related to staffing levels.