HESI RN
RN HESI Mental Health 2023 Questions
Extract:
Question 1 of 5
A client requests permission for the spouse to remain in the room during the admission assessment. While interviewing the client, the nurse notes a discrepancy between the client's verbal and nonverbal communication. Which action should the nurse take?
Correct Answer: D
Rationale: Paying close attention and documenting nonverbal messages gathers comprehensive data for further exploration. Ignoring nonverbal cues misses important information. Integrating messages prematurely may misinterpret the discrepancy. Asking the spouse to interpret is inappropriate and may not be accurate.
Extract:
Nurses' Notes
• Diagnosis: depression and post-traumatic stress disorder Diphenhydramine 12.5 mg PO every night at sleep (HS) • Buspirone hydrochloride 7.5 mg PO twice a day
During the conversation with the client, the nurse documents a statement by the client about wishing she had died in the crash.
Question 2 of 5
During the conversation with the client, the nurse documents a statement by the client about wishing she had died in the crash. The statement by the client represents and should be followed up with an
Correct Answer: A
Rationale: The client's statement reflects suicidal ideation, requiring immediate assessment of suicide risk factors (e.g., history, stressors, support systems) to determine appropriate interventions, ranging from monitoring to psychiatric evaluation.
Extract:
Question 3 of 5
The nurse is using the CAGE questionnaire as a screening tool for a client who is seeking help because his wife said he had a drinking problem. Which information should the nurse explore in depth with the client based on this screening tool?
Correct Answer: A
Rationale: The CAGE questionnaire focuses on four key aspects: efforts to Cut down, Annoyance with questions, Guilt about drinking, and Eye-opener use. Exploring these provides insight into potential alcohol problems. Other options include relevant aspects but are not specific to the CAGE questionnaire.
Question 4 of 5
A client with a history of alcoholism is admitted for detoxification. Based on treatment protocol, the nurse gives the client a dose of lorazepam 6 mg. Which additional prescription should the nurse administer immediately?
Correct Answer: D
Rationale: Vitamin B1 (thiamine) is crucial in alcohol detoxification to prevent Wernicke's encephalopathy and Korsakoff's syndrome due to thiamine deficiency. Folic acid is beneficial but not immediate. Haloperidol and trazodone are not indicated for detoxification.
Question 5 of 5
Which reason(s) should the nurse expect a female client to use when she is having difficulty leaving a relationship where she is a victim of intimate partner violence? Select all that apply.
Correct Answer: A,B,C,E
Rationale: A: Shame and guilt can prevent leaving due to fear of judgment. B: Children influence staying for their well-being or custody concerns. C: Religious beliefs about marriage may emphasize staying. E: Financial dependency is a common barrier. D: Belief the perpetrator won't change is not a reason to stay but rather a reason to leave.