HESI LPN
Mental Health HESI Practice Questions
1. A nurse is providing discharge teaching to a client with major depressive disorder who is prescribed fluoxetine (Prozac). What is the most important teaching point for the nurse to include?
- A. You may experience dizziness, so avoid driving.
- B. It may take several weeks to feel the full effect of the medication.
- C. Avoid foods high in tyramine while taking this medication.
- D. Take this medication only when you feel depressed.
Correct answer: B
Rationale: The correct answer is B because SSRIs like fluoxetine typically take several weeks to reach their full therapeutic effect, so it's important to set realistic expectations for the client. Choice A is incorrect as dizziness is a common side effect but not the most important teaching point. Choice C is incorrect as avoiding tyramine-rich foods is more relevant for MAOIs. Choice D is incorrect as fluoxetine should be taken consistently, not only when the client feels depressed, to maintain therapeutic blood levels.
2. A 38-year-old female client is admitted with a diagnosis of paranoid schizophrenia. When her tray is brought to her, she refuses to eat and tells the nurse, 'I know you are trying to poison me with that food.' Which response would be most appropriate for the nurse to make?
- A. 'I'll leave your tray here. I am available if you need anything else.'
- B. 'You're not being poisoned. Why do you think someone is trying to poison you?'
- C. 'No one on this unit has ever died from poisoning. You're safe here.'
- D. 'I will talk to your healthcare provider about the possibility of changing your diet.'
Correct answer: A
Rationale: Choice (A) offers support without confrontation, allowing the client to feel safe and respected. Choices (B) and (C) directly challenge the client's delusion, which can increase anxiety and distrust. Choice (D) focuses on a non-essential issue and does not address the client's immediate emotional needs.
3. An older homeless client visits the psychiatric clinic to obtain a prescription renewal for alprazolam (Xanax). During the health assessment, the client complains of chest pain. Which action should the RN take first?
- A. Refer the client to the cardiology unit.
- B. Obtain the client's blood pressure.
- C. Assess the client for substance abuse.
- D. Determine if Xanax was taken recently.
Correct answer: D
Rationale: Determining if Xanax was taken recently is crucial as it helps assess whether the chest pain is related to medication use or another issue, guiding appropriate immediate care. This action can provide essential information to address the client's current complaint effectively. Referring the client to the cardiology unit (Choice A) may be premature without assessing the Xanax use first. While obtaining the client's blood pressure (Choice B) is important, it is not the priority when the client presents with chest pain and a history of taking Xanax. Assessing the client for substance abuse (Choice C) is also important but is secondary to first determining the potential link between Xanax and the chest pain.
4. 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.
5. A client who has been admitted to the psychiatric unit tells the nurse, 'My problems are so bad that no one can help me.' Which response is best for the nurse to make?
- A. How can I help?
- B. Things probably aren't as bad as they seem right now.
- C. Let's talk about what is right with your life.
- D. I hear how miserable you are, but things will get better soon.
Correct answer: A
Rationale: Offering self shows empathy and caring (A) and is the best choice provided. (B) dismisses the client's feelings and reality. (C) avoids addressing the client's concerns directly and may come across as invalidating. Although (D) starts with acknowledging the client's feelings, the second part about things getting better soon can be perceived as offering false reassurance, which is not recommended in therapeutic communication.
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