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Mental Health HESI 2023
1. A client with post-traumatic stress disorder (PTSD) reports having frequent nightmares. What is the nurse's best response?
- A. Nightmares are common with PTSD and should decrease over time.
- B. Try to avoid thinking about the trauma before going to bed.
- C. Let's discuss some relaxation techniques you can use before bedtime.
- D. I will ask the healthcare provider to prescribe a sleep aid.
Correct answer: C
Rationale: The best response for the nurse is to discuss relaxation techniques with the client that can help reduce anxiety and stress before bedtime. This approach may potentially decrease the frequency of nightmares by promoting a more calming and peaceful pre-sleep routine. Choice A is incorrect because while nightmares can be common with PTSD, it is not guaranteed that they will decrease over time. Choice B is incorrect as avoiding thinking about the trauma may not address the underlying issue causing the nightmares. Choice D is incorrect as prescribing a sleep aid should be considered as a last resort after trying non-pharmacological interventions.
2. A client with a history of alcohol dependence tells the nurse that he has been sober for three months but has recently started drinking again. What should the nurse do next?
- A. Ask the client why he started drinking again.
- B. Provide information about support groups for sobriety.
- C. Discuss the consequences of drinking on his health.
- D. Encourage the client to express his feelings about relapse.
Correct answer: D
Rationale: Encouraging the client to express his feelings about relapse is the most appropriate action for the nurse to take in this situation. This approach allows the nurse to address the underlying emotions and factors contributing to the relapse. Choice A, asking the client why he started drinking again, may come across as judgmental and might not be as effective in exploring the client's emotions. Choice B, providing information about support groups, is important but should come after addressing the client's current emotional state. Choice C, discussing the consequences of drinking, may be necessary at some point, but initially, the focus should be on the client's feelings and emotions surrounding the relapse.
3. For a female client with major depressive disorder reporting feelings of hopelessness and helplessness, what is the nurse's priority intervention?
- A. Encourage the client to join a support group.
- B. Refer the client for cognitive-behavioral therapy (CBT).
- C. Assess the client's risk for suicide.
- D. Suggest the client participate in daily exercise.
Correct answer: C
Rationale: The correct answer is to assess the client's risk for suicide. When a client expresses feelings of hopelessness and helplessness, it indicates a high risk of self-harm or suicide. Therefore, the priority intervention should be to assess the client's safety. Encouraging the client to join a support group (choice A) may be beneficial but not the priority at this time. Referring the client for cognitive-behavioral therapy (CBT) (choice B) and suggesting daily exercise (choice D) are important interventions in managing depression but assessing the risk for suicide takes precedence due to the immediate safety concern.
4. A client with generalized anxiety disorder is being taught about buspirone (BuSpar) by a nurse. Which statement by the client indicates a need for further teaching?
- A. I should take this medication on an empty stomach.
- B. It may take several weeks before I feel better.
- C. This medication does not cause dependence.
- D. I can drink alcohol while taking this medication.
Correct answer: D
Rationale: The statement 'I can drink alcohol while taking this medication' (D) indicates a need for further teaching. Clients should avoid alcohol while taking buspirone because it can increase the risk of side effects such as dizziness and drowsiness. Choices A, B, and C are correct statements regarding buspirone and do not require further teaching.
5. A client in the manic phase of bipolar disorder is pacing the hallway and talking rapidly. What is the best intervention for the nurse?
- A. Encourage the client to join a group activity.
- B. Offer the client a high-calorie snack and a drink.
- C. Direct the client to a quieter area of the unit.
- D. Instruct the client to sit down and relax.
Correct answer: B
Rationale: In the manic phase of bipolar disorder, clients often exhibit increased activity and may burn a lot of energy. Offering a high-calorie snack and a drink is the best intervention as it helps maintain their nutritional needs while allowing them to continue their activity. Encouraging the client to join a group activity (Choice A) may further stimulate their behavior. Directing the client to a quieter area (Choice C) might not address their energy expenditure. Instructing the client to sit down and relax (Choice D) may not be effective during the manic phase.
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