RN Hesi Mental Health

Extract:

Question 1 of 5

The nurse is assessing a client who reports using cocaine several times in the past week. Which observations should the nurse expect on assessment?

Correct Answer: B

Rationale: Cocaine, a stimulant, typically causes stimulation, increased heart rate, and dilated pupils. Bradycardia/bradypnea, hallucinations/delusions, or lethargy/depression are less common or associated with withdrawal/overdose.

Question 2 of 5

A female client engages in repeated checks of door and window locks and behavior that prevents her from arriving on time and interfering with her ability to function effectively. Which action should the nurse take?

A. Ask the client why she checks the locks. B. Determine the type and size of the locks. C. Discuss checking the time frequently. D. Plan a list of activities to be carried out daily.

Correct Answer: D

Rationale: Planning daily activities redirects focus from compulsive checking, reducing anxiety and improving function, suitable for OCD-like behaviors.

Question 3 of 5

The nurse is developing a plan of care for an older client with hypertension who reports chest pain on exertion. Which outcome should the nurse include in the plan of care for this client?

A. The nurse will call the client weekly to monitor the client's blood pressure and symptoms. B. The nurse will encourage the client to walk thirty minutes every day. C. The client will take up to 4 nitroglycerine tablets sublingually for chest pain. D. The client will record episodes of angina and self-management for one week.

Correct Answer: D

Rationale: Recording episodes of angina and self-management for one week is a specific and appropriate outcome to monitor the client's chest pain and response to interventions. Weekly monitoring, daily walking, and nitroglycerine use are important but do not directly address tracking angina episodes for management.

Question 4 of 5

The mother of an 8-month-old infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?

A. Encourage the mother to write thoughts and feelings in a journal. B. Determine if the mother has other children who do not have developmental disabilities. C. Reassure the mother that her child will achieve some growth and development milestones. D. Ask the mother if she has ever thought about harming herself or her child.

Correct Answer: D

Rationale: Asking about thoughts of self-harm or harm to the child assesses the severity of depression and risk, a critical first step. [Note: Document incorrectly lists A; D is more appropriate for safety.]

Question 5 of 5

When responding to a call light, the nurse finds a client with aggressive behaviors pacing, and restless in the room. The client shouts, 'What took you so long to get in here!' Which action should the nurse implement?

A. Request backup from the staff. B. Stand in the doorway. C. Provide for personal space. D. Encourage the client to sit down.

Correct Answer: C

Rationale: Providing personal space reduces the perception of threat, helping de-escalate agitation safely.

RN Hesi Mental Health | Nurselytic

Nurselytic

HESI RN

HESI RN