Hesi Psych Mental Health Exit Exam (V1, V2, V3) Review Questions and
Answers 2023/2024 Test Bank
- A male adult comes to the mental health clinic and walks back and forth in front of the office door, but does
not enter the office. He then walks around a chair that is in the hallway several times beforesitting down in
the chair. What action should the nurse take first? observe the client in the chair - A female client engages in repeated checks of door and window locks. Behavior that prevents herfrom
arriving on time and interferes with her ability to function e²ectively. What action should the nurse take
plan a list of activities to be carried out daily - A male client with schizophrenia is admitted to the mental health unit after abruptly stopping his
prescription for ziprasidone (Geodon) one month ago. Which question is most important for the nurseto ask
the client – Do you hear voices? - A female client with a history of drinking who was admitted 8 hours ago after receiving treatment for minor
abrasions occurred from a fall at home. The nurse determines the client’s blood alcohol level (BAL) was not
analyzed on administration action should the nurse take – Ask client about alcoholquantity, frequency, and
time of last drink - A female client on a psychiatric unit is sweating profusely while she vigorously does push-ups and then runs
the length of the corridor several times before crashing into the furniture in the sitting room.Picking herself
up, she begins to toss chairs aside, looking for a red one to sit in. When another clientobjects to the
disturbances, the client shouts,” I am the boss here. I do what I want.” Which nursing problem best supports
these observations – Risk for other related violence related to disruptive - What is the most important goal for a client diagnosed with major depression who has beenreceiving
an antidepressant medication for two weeks do not attempt to commit suicide - Alcohol-Pancreatitis health assessment of history of alcohol dependency WHAT ELSE WOULD BEA
CONCERN – pancreatitis - Anorexia Nervosa-syncope Syncope is a clinical feature Abuse-BAL9. Admission A female client with a history of drinking who was admitted 8 hours ago after receiving
treatment for minor abrasions occurred from a fall at home. The nurse determines the client’s blood alcohol
level (BAL) was not analyzed on administration action should the nurse take Blood alcohol level
Ask the client about alcohol quantity, frequency, and time of the last drink
10.IPV- difficulty leaving victim of intimate partner violence what 3 things should you do 1. establish acode
with family and friends to signify violence, 2. plan an escape route to use if the abuser blocks main exit, a
bag ready that has extra clothes for self and children
11.Anger Management Give the client permission to be angry
12.Antisocial- interrupting A female client with bipolar disorder, manic phase, is planning weekend
activities with the other clients on the unit. The client interrupts the group, insists that they change their
plans to a disco party, and begins to curse loudly when the group refuses to change the plans.Which
intervention should the nurse implement?
Escort the client to a quieter place
13.borderline personality disorder self-inflicted lacerations on abdomen perform the dressing changein a nonjudgmental manner *ask to summarize-others need time also Borderline-interaction
14.The nurse is assessing a client who is believed to have a borderline personality disorder. Which
question is most important to include in this assessment? C. Do you frequently have temper tantrums?
15.Self-critical demanding, whiney, manipulative, argumentative and can be verbally abusive suicidal
gestures. borderline personality disorder self-inflicted lacerations on abdomen perform the dressing
change in a non -judge mental manner.
16.Conversion disorder patient complains of blindness Conversion Disorder characterized by
transferring a mental conflict into a physical symptom for which there is no organic cause. Ex:
blindness, paralysis, seizures, deafness, and pseudocyesis (false pregnancy).
17.Countertransference occurs when a mental health care professional redirects his or her feelingstoward a
client or becomes emotionally entangled with a client counter transference.
18.After returning to work after a weekend off the nurse gets report that a depressed client has beenin bed all
weekend. What should the nurse to first? Assist the client out of bed and involve in activity.
19.A client with dementia uses the defense mechanism of confabulation. What is the reasoning? Todecrease
anxiety
20.A husband states to the nurse that his wife is not sleeping, buying impulsively, taking last minutetrips, and
has lost 22 pounds one month. What is an appropriate nursing dx? Disturbed thought process
21.A nurse is explaining a fire drill routine to a group of clients. A client becomes disruptive andcontinually
interrupts the group. What is the nurse’s best response?
When you interrupt, I cannot explain what to do to the group
22.When performing a MSE on a client which assessment intervention would best assist the nurse?Ask the client
to interpret the proverb a stitch in time saves nine
23.A client comes in after being in a car accident and is experiencing alcohol withdrawal, magnesiumlevel of 1.1,
cardiac dysrhythmias. What would you give first?
Magnesium
24.A woman is just told of her husband’s dx of terminal cancer. What would the nurse offer for thespouse
(wife)? How would you like to be involved with your husband’s care?
25.A nurse is to remove staples from an abdominal incision, the client is very anxious. What is themost
important intervention? Attempt to distract the client with general conversation.
26.A man who was stranded on the roof of his house for two days after a natural disaster, monthslater …
Implement anxiety control strategies
27.A man dx with bipolar disorder states, “I don’t understand, I believe in God and have not done anything to
deserve this”. What is the nurse’s best response? You didn’t do anything wrong. You havea chemical
imbalance in your brain
28.A client becomes upset when the nurse he requests is not assigned to him, what is the nurse’sbest
response? Advise the client that nursing assignments are not based on client requests
- A client needs to wash her hands for two hours before able to go on with her morning. She doesn’t want
to sit on the chairs in the dayroom for fear of getting dirty. What is this mechanism?Compulsion
30.A client in group is talking about her prostitution, the nurse asks her if she was abused by her parents. She
states, “my mother ran my father out when I was young”. What defense mechanism wasused? Repression
31.A woman calls the crisis hotline and says she has a loaded gun and is going to kill herself. To maintain
patient confidentiality what would the nurse do? Contact the person the client chooses to goto the home and
remove the weapon
32.A client with anger management issues uses belt making and bangs the leather heavily. Whatdefense
mechanisms is being used? Sublimation
33.A bipolar client comes into the clinic and tells the nurse that the next time she sees her sister I’mgoing to kill
her. What should the nurse do? Inform the sister
34.What would be the nurse’s highest priority for a newly admitted depressed client upon admission?The nurse
should go through the client’s belongings.
35.Who is most prone to being abused (elder abuse)? Females over 75 living with their families.
36.A client in the dayroom had tipped over a table and is escalating and has picked up a chair whichhe is
threatening to throw at another client. What should the nurse do first? Go and get more staff assistance.