HESI RN
Quizlet HESI Mental Health Questions
Question 1 of 5
A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The nurse also determines that the client is homeless and slightly suspicious. This client's treatment plan should include what priority problem?
Correct Answer: D
Rationale: The correct answer is 'D: Acute confusion.' In the given scenario, the client is disoriented, disorganized, and confused, indicating acute confusion. This is a priority issue to address for immediate safety and appropriate care. Option A, self-care deficit, is not the priority as the client's safety and mental status take precedence. Option B, disturbed sensory perception, does not align with the client's presentation of confusion. Option C, ineffective community coping, is not the immediate concern as the client's cognitive state needs urgent attention.
Question 2 of 5
The nurse on the day shift receives report about a client with depression who was found on the floor in the morning. What intervention is best for the nurse to implement?
Correct Answer: A
Rationale: Assisting the client to engage in activities is the best intervention as it can help improve mood and prevent further decline in function. Option B, monitoring appetite and sleep patterns, is important but not the most immediate intervention needed in this situation. Option C, assessing feelings about the hospital stay, is also important but addressing the client's physical safety and well-being should take precedence. Option D, explaining the frequency of staff checks, is not as effective in addressing the client's immediate needs for engagement and support.
Question 3 of 5
Narcan was administered to an adult client following a suicide attempt with an overdose of hydrocodone bitartrate (Vicodin). Within 15 minutes, the client is alert and oriented. In planning nursing care, which intervention has the highest priority at this time?
Correct Answer: C
Rationale: Observing the client for further narcotic effects is the priority at this time. It is crucial to monitor the client closely to prevent a relapse of symptoms or potential complications from the overdose. Encouraging fluid intake, obtaining serum Vicodin levels, and determining the reason for the suicide attempt are important but are secondary to ensuring the client's immediate safety and well-being by observing for any lingering effects of the narcotic.
Question 4 of 5
A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the nurse take?
Correct Answer: A
Rationale: Diarrhea, vomiting, and drowsiness in a client being treated with lithium carbonate for bipolar disorder may indicate lithium toxicity. The nurse should promptly notify the healthcare provider to ensure immediate medical intervention. The correct action is to prepare for the administration of an antidote if necessary. Holding the medication (Choice B) could delay necessary treatment. Considering the symptoms as normal side effects (Choice C) is incorrect as they suggest a potential serious issue. Notifying the healthcare provider before the next administration of the drug (Choice D) may delay urgent intervention required for lithium toxicity.
Question 5 of 5
A female client engages in repeated checks of door and window locks, a behavior that prevents her from arriving on time and interferes with her ability to function effectively. What action should the nurse take?
Correct Answer: D
Rationale: Planning a list of daily activities can help the client manage her time better and reduce the impact of her compulsive behaviors. Option A is incorrect because simply asking why the client checks the locks may not address the underlying issue effectively. Option B is not relevant to the compulsive behavior of checking locks. Option C does not directly address the client's compulsive behavior but focuses on the physical attributes of the locks.