HESI- Behaviors

A nurse is counselling the parents of a 13-year-old child. Which of these behaviors will the nurse include in the discussion? Select all that apply. 1 Animism 2 Egocentrism 3 Logical reasoning 4 Concrete thinking 5 Imaginary audience

2,3,5

For which clinical indication should a nurse observe a child in whom autism is suspected? 1 Lack of eye contact 2 Crying for attention 3 Catatonia-like rigidity 4 Engaging in parallel play

1

A client is admitted to the mental health unit of the hospital because of agitation and unprovoked hostile verbal attacks toward others in the workplace. What is the priority nursing intervention for this client? 1 Developing trust 2 Maintaining safety 3 Refocusing hostile energy 4 Preventing hostile outbursts

2

How would an adolescent mother ensure the appropriate cognitive development of her child? 1 The adolescent mother should stay alone. 2 The adolescent mother should receive nursing guidance. 3 The adolescent mother should perform well in academics. 4 The adolescent mother and the grandmother should stay together.

2

Which of these features would the nurse state are exhibited by a preschooler? 1 Temper tantrums 2 Attempts to control situations 3 Synchronization of moral skills 4 Eagerness for formal education 5 Learn to function independently

4,5

A 6-year-old child has been wetting the bed at night since the birth of a baby brother. What defense mechanism is the child using to cope with the stress of accepting a new family member? 1 Regression 2 Repression 3 Dissociation 4 Displacement

1

A client with dementia has been cared for by the spouse for 5 years. During the last month the client has become agitated and aggressive and is incontinent of urine and feces. What is the priority nursing care while this client is in an inpatient mental health facility? 1 Managing the behavior 2 Preventing further deterioration 3 Focusing on the needs of the spouse 4 Establishing an elimination retraining program

1

A client with the diagnosis of bipolar I disorder, manic episode, is hospitalized because he has been stopped by the police several times for reckless driving. The client rarely eats or sleeps and talks constantly. On the second day of hospitalization the client is attempting to organize the other clients in the lounge to form a softball team. What is the most therapeutic nursing intervention? 1 Taking the client for a walk 2 Suggesting a time-out in the client's room 3 Having the client play cards with another client 4 Explaining that there is no place for the clients to play softball

1

A client with the diagnosis of borderline personality disorder is manipulative and uses this behavior to get cigarettes from other clients. One day the client begins to badger another client. What should the nurse say while removing the client from the area? 1 "You must leave people alone; this behavior is unacceptable." 2 "There will be consequences if you do not stop annoying people." 3 "Tell me how you feel when you are exerting control over people." 4 "I'm surprised that you're still bothering people; you seemed to have improved lately."

1

A nurse determines that a client is pretending to be ill. What does this behavior usually indicate? 1 Psychosis 2 Malingering 3 Use of conversion 4 Lack of contact with reality

2

A nurse has just completed a mental status examination on a newly admitted psychiatric client and returns to the nurses' station to document the results. The nurse reflects on the client's drawn-out explanation of the reason for the admission and concludes that excessive detail was given before the client eventually answered the questions. What mental process does the nurse identify? 1 Flight of ideas 2 Circumstantiality 3 Thought blocking 4 Tangential thinking

2

A nurse reminds a client that it is time for group therapy. The client responds by shouting, "You're always telling me what to do, just like my father!" What defense mechanism is the client using? 1 Regression 2 Transference 3 Reaction formation 4 Cognitive distortion

2

A 32-year-old client is hospitalized with a diagnosis of a bipolar disorder, manic episode. The client becomes loud and vulgar and disturbs the other clients. What is the best reaction by the nurse to this situation? 1 Telling the client that the behavior is bothering the other clients 2 Ignoring the vulgar talk because it is part of the illness 3 Segregating the client until this phase of the illness passes 4 Commenting that this kind of talk is not appreciated on the unit

3

A client's history demonstrates a pervasive pattern of unstable and intense relationships, impulsiveness, inappropriate anger, manipulation, offensive behavior, and hostility. The admitting diagnosis is borderline personality disorder. What does the nurse anticipate that this client may attempt to do? 1 Act out to intimidate others. 2 Cooperate with the staff to gain praise. 3 Divide the staff into opposing factions to gain self-esteem. 4 Remain removed from others to avoid interacting with them.

3

During the first meeting of a therapy group, the members become quite uncomfortable. The nurse notes frequent periods of silence, tense laughter, and nervous movement in the group. What does the nurse conclude about these responses? 1 They require active leader intervention to relieve signs of obvious stress. 2 They indicate unhealthy group processes and an unwillingness to relate openly. 3 They are expected group behaviors because relationships are not yet established. 4 They should be addressed immediately so members will not become too uncomfortable.

3

In which period of Piaget's theory does the adolescent feel a sense of invulnerability? 1 Sensorimotor 2 Preoperational 3 Formal operations 4 Concrete operations

3

It is observed that at times a client with a personality disorder clings to the nurse and at other times he maintains a noticeable distance. From this pattern of behavior what does the nurse determine are the client's conflicting fears? 1 Shame versus rejection 2 Lost self-esteem versus hostility 3 Abandonment versus identity loss 4 Engulfment versus interdependence

3

A 3-year-old child feels a sense of rivalry with his father and wants him to die. Shortly after these feelings emerge, the child's father dies in a road accident. The child then begins to feel intense guilt, believing that he caused the death. What is the best nursing intervention in this situation? 1 Teach relaxation techniques to the child. 2 Encourage the child to play with his siblings. 3 Suggest that the child's uncle spend time with him. 4 Explain to the child that wishes do not make things happen.

4

A nurse educates a group of teenagers about the physical changes they will experience. What statement made by the teenager shows inadequate learning? 1 "My shoulders will change in width." 2 "My reproductive system will develop." 3 "My body fat distribution will be altered." 4 "My bones will grow at a decreased rate."

4

In the process of development the individual strives to maintain, protect, and enhance the integrity of the self. The nurse determines that this is usually accomplished through the use of what? 1 Affective reactions 2 Withdrawal patterns 3 Ritualistic behaviors 4 Defense mechanisms

4

The nurse at the mental health clinic is counseling a client with obsessive-compulsive disorder who spends a lot of time each day engaged in handwashing and has trouble keeping appointments on time as a result. What is the most therapeutic initial intervention by the nurse? 1 Discouraging the frequent handwashing to prevent skin breakdown 2 Encouraging the client to hasten the ritual so appointments can be kept on time 3 Telling the client how angry others become when activities are delayed for handwashing 4 Accepting the ritualistic behavior with a matter-of-fact attitude without displaying criticism

4

At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group? 1 Good boy-nice girl orientation 2 Society-maintaining orientation 3 Instrumental relativist orientation 4 Universal ethical principle orientation

1

While playing with a toy car, a toddler accidentally hits the wall and falls down. The toddler then gets angry at the wall for making him fall. Which characteristic of preoperational thought does this behavior indicate? 1 Animism 2 Centration 3 Egocentrism 4 Irreversibility

1

Which behaviors should the nurse explain to parents as being normal in a 4-year-old child? Select all that apply. 1 Animism 2 Superego 3 Imagination 4 Concrete thinking 5 Object permanence

1,3

What behavior does the nurse suggest a parent will notice in her 2-year-old child after the death of a family member? 1 The child shows resiliency over the loss. 2 The child understands the cause of the loss. 3 The child exhibits changes in sleeping patterns. 4 The child is unable to develop an autonomous sense of self.

3

What is the similarity between the preoperational period and the formal operations period of Piaget's theory? 1 Both periods involve the concept of an imaginary audience judging an individual's decisions. 2 Both periods demonstrate animism in a child. 3 Both periods explain the idea of egocentric thought in an individual. 4 Both periods occur at the beginning of an individual's cognitive development

3

According to Piaget's theory, which of these statements would a nurse say to a mother about her four-year-old child? Select all that apply. 1 "The child will only be able to consider his or her own point of view." 2 "The child will consider that inanimate objects may be alive." 3 "The child will think about an action before performing it." 4 "The child will believe that his or her actions are scrutinized." 5 "The child will be able to order things according to length."

1,2

A nurse plans to teach a group of parents about sleeping patterns of their children between the ages of 4 to 5 years. Which information should the nurse provide to the parents? Select all that apply. 1 Total sleep averages 12 hours at night. 2 In the awake period, the child may sleepwalk. 3 The child normally takes several naps during the day. 4 It is common for the child to awaken during the night. 5 During this period, the child may be unwilling to go to bed at night.

1,2,4

A preschooler who is recently admitted to a school shows aggressive behavior towards his or her teacher. The child resists playing and interacting with other children. What is the temperament of the child according to Stella Chess and Alexander Thomas's longitudinal study? 1 The easy child 2 The difficult child 3 The hyperactive child 4 The slow to warm-up child

2

A registered nurse is teaching a nursing student about Lawrence Kohlberg's Theory of Moral Development. Which information provided by the registered nurse regarding Postconventional Reasoning needs correction? 1 "In this level, an individual starts to wonder what an ideal society would be like." 2 "In this level, emphasis is given on social rules and a community-centered approach." 3 "In this level, an individual finds a balance between basic human rights and obligations and societal rules and regulations." 4 "In this level, an individual moves away from moral decisions based on authority or conformity to groups to define their own moral values and principles."

2

A nurse is concerned when an 11-month-old infant is brought to the pediatric clinic weighing 9 lb 3 oz (4167 g). The nurse suspects that the infant is suffering from physical and emotional neglect. What observations lead the nurse to suspect maltreatment? Select all that apply. 1 Stranger anxiety 2 Inappropriate clothing 3 Social unresponsiveness 4 Frequent rocking motions 5 Adequate personal hygiene

2,3,4

A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate? 1 Domestic mimicry 2 Causal relationship 3 Spatial relationship 4 Object permanence

3

A child wants to be on time for a family dinner. According to Kohlberg's theory, what stage of development is the child going through? 1 Good boy-nice girl orientation 2 Society-maintaining orientation 3 Instrumental relativist orientation 4 Universal ethical principle orientation

3

One afternoon the nurse on the unit overhears a young female client having an argument with her boyfriend. A while later the client complains to the nurse that dinner is always late and the meals are terrible. The nurse identifies the defense mechanism that the client is using as what? 1 Projection 2 Dissociation 3 Displacement 4 Intellectualization

3

What would the nurse state is true about the sleep pattern of preschoolers? 1 They sleep at least 15 hours during the day. 2 It is uncommon for them to wake up during night. 3 It is difficult for them to relax after they have had long and active days. 4 About 50% of their sleep is under random eye movement (REM) sleep.

3

A client is hospitalized for a bipolar mood disorder, manic episode. The client is hyperactive and obnoxious, calls the nurse names, is sarcastic to the staff, and taps the nurse playfully on the buttocks. What is the most important action of the nurse? 1 Spend extra time with the client. 2 Place the client alone in a quiet room. 3 Disregard the client's acting-out behavior. 4 Assess personal feelings toward the client

4

A depressed client frequently expresses doubts about living and admits to thinking about suicide while denying having developed a plan. During this period, what action by the nurse is essential? 1 Have a staff member stay with the client continuously. 2 Plan to involve the client in activities that foster independence. 3 Explain in detail to the client how the staff will prevent self-harm. 4 Make frequent unobtrusive observations of the client's moods and activities.

4

A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario? 1 Trait theory 2 Two-factor theory 3 Expectancy theory 4 Situational-contingency theory

4

The client repeatedly performs ritualistic behaviors throughout the day to limit anxious feelings. How does the nurse characterize these behaviors? 1 Obsessions 2 Compulsions 3 Under personal control 4 Related to rebelliousness

2

After an automobile collision involving a fatality and a subsequent arrest for speeding, a client has amnesia regarding the events surrounding the accident. Which defense mechanism is being used by the client? 1 Projection 2 Repression 3 Suppression 4 Rationalization

2

During the eighth session of a therapy group, a member who talks frequently is interrupted by one who doesn't. When the interrupting person is finished talking, the one who usually contributes says, "I'm so glad that you feel like talking today." While saying this, the client sits rigidly and looks angry. How should the nurse respond? 1 Comment on the interrupted client's angry behavior and pleasant words. 2 State that it appears that these members of the group are not getting along. 3 Agree with the interrupted client that it is good to have the quiet client talk. 4 Ignore the comment and speak with the talkative member privately about being hostile.

1

What should the nurse teach parents about childhood depression? 1 May appear as acting-out behavior 2 Looks almost identical to adult depression 3 Does not respond to conventional treatment 4 Is short in duration and has an early resolution

1

Which action of the clinical nurse is consistent with Gardner's task of "achieving work unity"? 1 Helping clients accomplish optimal functioning 2 Relating to and inspiring clients to achieve their vision 3 Providing self-care to enhance the ability to care for staff, clients, and families 4 Representing nursing and the unit on task forces and shared governance councils

1

The nurse and client have entered the working phase of a therapeutic relationship. What can the nurse expect the client to do during this phase? Select all that apply. 1 Initiate topics of discussion. 2 Focus the conversation on the nurse. 3 Repress emotionally charged material. 4 Accept limits on unacceptable behavior. 5 Express emotions related to transference

1,4,5

After several interactions with a client, the nurse at the mental health clinic identifies a pattern of withdrawal and nonparticipation in situations requiring communication with others. In which area should the nurse expect the client to have difficulty? 1 Personal identity 2 Social interaction 3 Sensory perception 4 Verbal communication

2

An 18-month-old toddler is admitted to the pediatric unit. The child has never been separated from the mother before this admission. What behavior does the nurse expect from the toddler? 1 Sitting quietly, uninterested in playing 2 Crying relentlessly and consoled by no one but a parent 3 Looking sad but becoming content after meeting roommates 4 Screaming when people enter the room but smiling after several minutes

2

An executive assistant experiences an overwhelming impulse to count and arrange the rubber bands and paper clips in his desk. The client feels that something dreadful will occur if the ritual is not carried out. Considering the client's symptoms, what does the nurse conclude about the rituals? 1 They are useful in our society as long as they can be controlled 2 They serve to control anxiety resulting from unconscious impulses 3 They are a displacement of general anxiety onto an unrelated specific fear 4 They serve to consciously limit the associated anxiety that otherwise is overwhelming

2

When a disturbed client who has a history of using neologisms says to the nurse, "My lacket huss kelong mon," how should the nurse respond? 1 Trying to learn the language of the client 2 Telling the client that these words cannot be understood 3 Communicating in simple terms directed toward the client 4 Recognizing that the client needs a nurse who can understand the fantasies expressed

2

The clients on a mental health unit go on a supervised day trip to a baseball game. When returning to the bus, a client with a narcissistic personality disorder insists on leaving the group to get an autograph from a player. What is the most appropriate response by the nurse? 1 Holding the client by the arm to keep the client from leaving the group 2 Instructing the client in a loud voice to get on the bus so the group can go home 3 Informing the client in a matter-of-fact tone that everyone must remain with the group 4 Telling the client that the baseball player will not be permitted to give anyone an autograph

3

A mother complains to the nurse that her 4-year-old child partially awakens from sleep, sweats profusely, and screams in the night. What is the best nursing action in this situation? 1 Recommend that the mother take her child into her own bed. 2 Ask the child to describe the dream that he or she saw last night. 3 Advise the mother to accept the child's dream as a real fear for the child. 4 Advise the mother to observe her child for a few minutes until the child is calm

4

What should nursing management of a forgetful, disoriented client who exhibits inappropriate behaviors signifying dementia be directed toward? 1 Restricting gross motor activity to prevent injury 2 Preventing further deterioration in the client's condition 3 Maintaining scheduled activities through behavior modification 4 Rechanneling the client's energies into more appropriate behaviors

4

Which adolescent's thought corresponds to the good boy-nice girl orientation stage? 1 "I should avoid parties where alcohol is served." 2 "I should follow the rules or else the teacher will punish me." 3 "I should follow all the laws formulated by the government." 4 "I should complete my homework on time so that the teacher will reward me."

4

Which type of play will help develop a leader-follower type of relationship? 1 Solitary play 2 Parallel play 3 Associative play 4 Cooperative play

4