HESI LPN
HESI Mental Health
1. Which action should the nurse implement during the termination phase of the nurse-client relationship?
- A. Identify new problem areas.
- B. Confront changes not completed.
- C. Explore the client's past in depth.
- D. Help summarize accomplishments.
Correct answer: D
Rationale: During the termination phase of the nurse-client relationship, it is essential for the nurse to help summarize accomplishments. This action provides closure by reflecting on the progress and goals achieved during treatment. It reinforces the positive aspects of the therapeutic relationship and helps the client acknowledge their growth and achievements. Choices A, B, and C are incorrect. Identifying new problem areas is not appropriate during termination, as the focus should be on closure. Confronting changes not completed may create tension and disrupt the positive closure process. Exploring the client's past in depth is more suitable for earlier stages of the therapeutic relationship, not during termination.
2. A client on the psychiatric unit appears to imitate a certain nurse on the unit. The client seeks out this particular nurse and imitates her mannerisms. Which defense mechanism does the nurse recognize in this client?
- A. Sublimation.
- B. Identification.
- C. Introjection.
- D. Repression.
Correct answer: B
Rationale: Identification is the correct answer. It is a defense mechanism where an individual unconsciously models themselves after someone they admire or feel close to. In this scenario, the client is imitating the nurse's mannerisms, indicating identification. Sublimation involves channeling unacceptable impulses into socially acceptable activities. Introjection is the internalization of external attitudes or voices, while repression involves suppressing unwanted thoughts or desires.
3. An LPN/LVN is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse determines that this type of crisis is caused by:
- A. Witnessing a murder
- B. The death of a loved one
- C. A fire that destroyed the client's home
- D. A recent rape episode experienced by the client
Correct answer: B
Rationale: The correct answer is B: 'The death of a loved one.' A situational crisis, like the death of a loved one, can lead to anxiety due to a significant change or loss in the person's life. Choices A, C, and D involve traumatic events, but a situational crisis typically refers to life events that disrupt an individual's normal pattern of living, such as the death of a loved one.
4. A client with bipolar disorder is experiencing a manic episode. Which nursing intervention is most appropriate?
- A. Encourage group activities to decrease isolation.
- B. Provide a structured environment with routine activities.
- C. Limit the client's physical activity to prevent exhaustion.
- D. Allow the client to choose activities freely.
Correct answer: B
Rationale: During a manic episode, individuals with bipolar disorder may exhibit excessive energy, impulsivity, and disorganized behavior. Providing a structured environment with routine activities is the most appropriate nursing intervention. This approach can help regulate the client's behavior, reduce impulsivity, and prevent engaging in potentially harmful activities. Encouraging group activities (Choice A) may exacerbate the client's symptoms due to overstimulation. Limiting physical activity (Choice C) may not address the need for structure and routine during a manic episode. Allowing the client to choose activities freely (Choice D) can lead to impulsive decision-making and may not provide the necessary boundaries required to manage the manic symptoms effectively.
5. A client is preparing to attend a Gamblers Anonymous meeting for the first time. The prototype used by this group is the 12-step program developed by Alcoholics Anonymous. Number in order of priority how the steps would be addressed.
- A. Admitting to oneself and to another human being the exact nature of one's wrongs
- B. Acknowledging that one is entirely ready to have his or her defects of character removed
- C. Admitting that oneself is powerless over gambling and that one's life has become unmanageable
- D. Making an effort to practice the 12-step principles in all affairs, and to carry out this message to other compulsive gamblers
Correct answer: D
Rationale: The correct order of addressing the 12-step program typically begins with admitting powerlessness over the addiction and recognizing the unmanageability of one's life (Choice C). Following this, individuals move towards acknowledging their wrongs and sharing them with others (Choice A), then being ready to work on changing their character defects (Choice B), and finally, integrating the 12-step principles into their daily lives and helping others (Choice D). Choices A, B, and C are important steps in the program but come after admitting powerlessness and unmanageability, which is why Choice D is the correct answer.
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