Mental Health Hesi Practice Questions

Which S&S are characteristic of Alzheimer dementia? Select all that apply. a. ambivalence b. forgetfulness c. flight of ideas d. loose associations e. expressive aphasia

b, e

A client with dementia is trying to open the door and says, "I want to leave now". Which intervention would the nurse use? a. ask the client where he or she is going and how they plan to get there b. invite the client to attend an activity program that he or she enjoys c. allow the client to leave; she or he has the right to refuse treatment d. explain that the family & doctor want her or him to stay for safety

b -the nurse would use distraction to direct the client away from the door; provides safety without confrontation

Which action would the nurse take for a client with schizophrenia who is paranoid, delusional, withdrawn, and negative? a. invite the client to play a game of cards with the nurse b. explain to the client the benefits of joining a group activity c. encourage the client to become involved in group activities d. mention to the client that the psychiatrist has prescribed increased activity

a -use activities that require limited interpersonal contact (less threatening)

Which action would the nurse take for a daughter who states that she gives sleeping pills to her mother who has dementia to stop wandering at night? a. explore hiring a home health aide to stay with the client at night b. discuss the possibility of having the client placed in a nursing home c. suggest moving the client among family members on a monthly basis d. empathize with the daughter but suggest that wrist restraints would be preferable

a exploring hiring a home health aide w/ the client at night will reduce the need for sleeping pills

For a client with schizophrenia, which symptoms are classified as negative symptoms? Select all that apply. a. lack of energy b. anhedonia c. illogical speech d. ideas of reference e. agitated behavior

a, b -neg symptoms reflect a loss of normal functioning & is the absence of symptoms that SHOULD be there

Which clinical manifestations would the nurse expect when assessing a client with schizophrenia? Select all that apply. a. paranoid behaviors b. loose associations c. inappropriate affect d. feelings of depression e. flashbacks

a, b, c

Which manifestations are seen in an older adult with the diagnosis of dementia? Select all that apply. a. resistance to change b. inability to recognize familiar objects c. preoccupation with personal appearance d. inability to concentrate on new activities e. tendency to dwell on the past

a, b, d, e

Which characteristic will the client with chronic schizophrenia most likely exhibit? Select all that apply. a. apathy b. hostility c. flatness d. elation e. sadness f. depression

a, c

Which conditions can precipitate delirium? Select all that apply. a. Infection b. Dementia c. Dehydration d. Urine retention e. Medications

a, c, d, e

Which manifestations are associated with moderate dementia? Select all that apply. a. sundowning b. hypervigilance c. increased inhibition d. exaggeration of premorbid traits e. inability to recognize family members

a, d

In distinguishing between dementia and delirium, which factors are unique to delirium? Select all that apply. a. slurred speech b. lability of mood c. long-term memory loss d. visual or tactile hallucinations e. insidious deterioration of cognition f. a fluctuating level of consciousness

a, d, f

A client with schizophrenia repeatedly says, "No moley, jandu!" Which language disturbance is the client exhibiting? a. echolalia b. neologism c. concretism d. perseveration

b

A hostile client with the diagnosis of schizophrenia says, "The voices are saying that they are going to poison me because I'm bad". Which type of schizophrenic behavior is the client displaying? a. residual b. paranoid c. catatonic d. disorganized

b

For a client with schizophrenia, undifferentiated type, which client statement reflects the most commonly used defense mechanism? a. "The nurses are mentally ill and are trying to kill me" b. "I don't want to take a bath. The water is cold and it hurts" c. "Something bad happened, but I can't remember anything" d. "I didn't have any money so I didn't buy my medications"

b

In comparing assessment findings in clients with vascular dementia and dementia of the Alzheimer's type, which factor is unique to vascular dementia? a. memory impairment b. abrupt onset of symptoms c. difficulty making decisions d. inability to use words to communicate

b

To increase involvement in unit activities, which response would the nurse make to a withdrawn client with schizophrenia who has auditory hallucinations? a. "You'll get a reward if you go to the gym" b. "Would you like to participate in the group walk today?" c. "Those voices you hear would like it if you did a little exercise" d. "There's a positive relationship between exercise and good mental health"

b

Which action would the nurse take to assist a client with schizophrenia who moves to the counter to choose food but is unable to decide what to do next? a. provide nonverbal communication b. speak in simple declarative statements c. ask basic questions requiring simple choices d. reward the client for each of the food items chosen

b

Which guideline would the nurse consider when planning care for a hospitalized older client with Alzheimer disease? a. physical contact will increase dependency needs b. routines provide stability for clients with neurocognitive disorders c. regressive behavior should be interrupted immediately d. procedures do not have to be explained to client with neurocognitive disorders

b

For an older client with early onset dementia, which purpose does confabulation serve? a. prevents regression b. increases self-esteem c. attracts attention of others d. helps recall achievements

b -cognitive deficients cause memory lapse, so the client confabulates by filling in the blanks with made-up stories

For a client with the diagnosis of paranoid schizophrenia, which clinical findings increase the risk for harm to self or others? Select all that apply. a. aloofness b. prominent delusions c. anxiety d. stilted interactions e. common hallucinations

b, e

Which characteristic would the nurse consider when attempting to assess the defense mechanisms of an older adult with neurocognitive disorder due to vascular impairment? a. avoids use of any defense mechanisms b. uses one method of defense for every situation c. makes exaggerated use of old, familiar mechanisms d. attempts two develop new defense mechanisms for the current situtation

c -client try to use mechanisms that have worked in the past, but in an exaggerated manner

A client with paranoid schizophrenia shouts at the nurse, "You're the one who made me lover leave me". Which conclusion would the nurse make? a. the client is disorganized & confused b. the client is actively hallucinating c. the client feels a sense of vulnerability d. the client needs to have limits set

c -the client's low self-esteem precipitates doubts of the lover's feelings, creating a sense of vulnerability & is projected onto the nurse as part of the delusion

A client says, "My legs are turning to rubber because I have an incurable disease called schizophrenia". Which alteration in perception is the client perceiving? a. hallucination b. illusion c. depersonalization d. derealization

c -the state in which the client feels unreal or believes that part of the body are distorted

Which defense mechanism is most commonly used by client who are diagnosed with schizophrenia, undifferentiated type? a. projection b. repression c. regression d. conversion

c. regression -regression reduces anxiety by returning to behavior that was successful in earlier years; can lead to disorganized thought processes

Which goal would the nurse add to the plan of care for a forgetful, disoriented client who has dementia? a. restrict gross motor activity to prevent injury b. prevent further deterioration in the client's condition c. maintain scheduled activities through behavior modification d. rechannel the client's energies into more appropriate behaviors

d

Which nursing intervention would be helpful in meeting the needs of an older adult with Alzheimer disease? a. providing nutritious foods that are high in carbs & proteins b. offering opportunities for choices in the daily schedule to stimulate interest c. developing a consistent plan with a fixed time schedule to fulfill emotional needs d. simplifying the environment as much as possible by limiting the need for decision

d

A client with schizophrenia is apathetic and exhibits an inappropriate affect. Which behavior is the client likely to exhibit? a. logical deductions b. suicidal preoccupations c. absence of self-criticism d. response to internal stimulation

d -have increased levels of dopamine which produces hallucinations, typically auditory ones, & causes the client to respond to internal stimulation

For a client with the diagnosis of schizophrenia, which clinical findings are positive symptoms/signs? Select all that apply. a. anergy b. flat affect c. social withdrawal d. disorganized thoughts e. auditory hallucinations

d, e -pos symptoms reflect an excess/distortion of function & is the presence of symptoms that SHOULD NOT be there