HESI Psych

Question 1

The purpose of therapeutic interaction with clients is?

Answer 1

allow them the autonomy to make choices when appropriate. Keep statements value-free, advice-free, and reassurance-free. Remember, just the facts! No opinions!

Question 2

What action should the nurse take in a psychiatric situation when the client describes a physical problem?

Answer 2

Assess! If a client in the psychiatric unit with paranoid schizophrenia complains of chest pain, take his or her bp.

Question 3

A question concerning nurse-client confidentiality appears often on the NCLEX-RN. For the nurse to tell a client that he or she will not tell anyone abou their discussion puts the nurse in a difficult position, why?

Answer 3

Some information must be shared with other team members for the client’s safety (eg. suicide plan ) and optimal therapy

Question 4

What is the most common complaint after ECT?

Answer 4

Nausea. Vomiting by an unconscious client can lead to aspiration. Because post-ECT clients are unconscious, the nurse must observe closely for the possibility of aspiration: maintain a patent airway!

Question 5

On an in-patient unit, clients are expected to get up at a certain time, attend breakfast at a certain time, and arrive for their medications at the correct time. What form of therapy is incorporated into the unit?

Answer 5

Milieu

Question 6

the wife of a man killed in a motor vehicle accdent has just arrived at the emergency department and is told of her husbands death. What nursing actions are appropriate for dealing with this crisis?

Answer 6

take her to a quiet room and ask her if there are family members friends or clergy you can call for her. Assess her need for medication and discuss it with health care provider. Stay with her, be firm and directive, and assess previous successful coping strategies

Question 7

A 66-year old woman is admitted to the psychiatric unit with agitated depression. She has not responded to antidepressants in the past. What would be the medical treatment of choice?

Answer 7

ECT

Question 8

The nurse should place an anxious client were there are?

Answer 8

reduced stimuli ( a quiet area of the unit, away from the nurses station)

Question 9

When is the client’s anxiety lowest?

Answer 9

at the competion of the performed ritual.

Question 10

what acts are used in response to anxiety?

Answer 10

compulsive acts. May or may not be related to obsession. It is the nurse’s responsibility to help alleviate anxiety: actively listen, acknowledge the effects that ritualistic acts have on the client, demonstrate empathy, avoid being judgemental

Question 11

Avoid giving what to clients with disociative disorder?

Answer 11

avoid giving too much information about past events at one time. The various types of amnesia that accompany dissociative disorders provide protection from pain. Too much too soon may cause decompensation.

Question 12

Describe the difference between psychogenic amnesia and psycogenic fugue

Answer 12

• Psychogenic amnesia: sudden inability to recall certain events in one’s own life
• Psychogenic fugue: state characterized by the individuals leaving home and bein unable to recall his or her identity or past

Question 13

obsessive compulsive disorder

Answer 13

orderly, rigid

Question 14

antisocial

Answer 14

unable to conform to social norms

Question 15

borderline

Answer 15

needy, always in a crisis, self-mutilating, unable to sustain relationships, splitting behavior

Question 16

dependent

Answer 16

unable to make decisions for self, allows others to assume responsibility for his or her life

Question 17

narcissistic

Answer 17

feelings of self-importance and entitlement, may exploit others to get own needs met

Question 18

histrionic

Answer 18

dramatic, flamboyant, needs to be the center of attention

Question 19

paranoid

Answer 19

distrustful, suspicious, is watchful and secretive

Question 20

schizoid

Answer 20

isolated and introverted, no close friends

Question 21

People with anorexia gain pleasure from?

Answer 21

providing others with food and watchin gthem eat. do not allow these clients to plan or prepare food for unit-based activities

Question 22

Anorexia nervosa may be precipitated by what factors?

Answer 22

mother-daughter conflicts usually focusing on independence/dependence issues, discomfor with maturation, need for control, desire for perfection

Question 23

what might the initial treatment include for a client admitted to the hospital with a dx of bulimia nervosa?

Answer 23

blood work to evaluate electrolyte status, replensihment of electrolytes and fluids as indicated, careful monitoring for evidence of vomiting

Question 24

The most important signs and symptoms of depression are?

Answer 24

a depressed mood with a loss of interest in the pleasures in life. the client has sustained a loss. Other symptoms include” significant chang in appetite, often accompanied by a change in weight, insomnia or hypersomnia, fatigue, hopelessness and worthlessness, guilt, loss of ability to concentrate or think clearly, preocupation with death or suicide

Question 25

The nurse knows a depressed client is improving when they?

Answer 25

being to take an interest in their appearance or begin to perform self-care activities that were previously of little or no interest to them

Question 26

The nurse should suspect an imminent suicide attempt if a depressed client becomes?

Answer 26

“better”, be aware that a happy affect may signify that the client feel relieved that a plan has been made and is prepared for the suicide attempt

Question 27

An important nursing intervention for the depressed client is to ?

Answer 27

sit quietly with the client. When answering NCLEX questions, remember that you are working at Utopia general and there is plenty of time and staff to provide ideal nursing care. Do not let the realitites of clinical situations deter you from choosing the best nursing intervention. The best intervention is to sit quietly with the client, offering support with your presence

Question 28

Antianxiety drug side effects

Answer 28

sedation, drowsiness

Question 29

antidepressant drug side effects

Answer 29

anticholinergic effects, postural hypotension

Question 30

MAOI drug side effects

Answer 30

hypertensive crisis

Question 31

Lithium requires what to be assessed and monitored.

Answer 31

renal function

Question 32

phenothiazines cause ?

Answer 32

extrapyramidal effects, tardive dyskinesia

Question 33

phenothiazines cause?

Answer 33

photosensitivity, so client must wear protective clothing and sunglasses

Question 34

MAOI require what restrictions?

Answer 34

dietary restrictions to prevent hypertensive crisis

Question 35

atypical antipsychotic drugs are also indicated for?

Answer 35

mania (risperidone, olansapine, quetiapine, aripiprazole, and siprasidone

Question 36

Monitor serum lithium levels to be between?

Answer 36

0.5-1.5. Signs of toxicity are eviden when lithium level above 1.5, blood levels should be drawn 12 hours after last dose

Question 37

What activities are appropriate for a manic client?

Answer 37

noncompetative physical activities that require the use of large muscle groups

Question 38

what interventions should the nurse use if a client becomes abusive?

Answer 38

• redirect negative behavior or verbal abuse in a calm, firm, nonjudgemental, nondefensive manner
• suggest a walk or other physical activity
• set limits on intrusive behavior

Question 39

important characteristics of schizophrenia?

Answer 39

• Autism (preoccupied with self)
• affect (flat)
• associations (loose)
• ambivalence (difficulty making decisions)

Question 40

In a client with delusions, do not?

Answer 40

do not argue, logic does not work, it only increases the client’s anxiety. Be matter-of-fact and divert delusional thought to reality.

Question 41

what medications can the nurse expect to administer to chemically dependent clients?

Answer 41

In alcohol withdrawl, Librium or Ativan are commonly used. Anatbuse is often used as a deterrent to drink alcohol. Client teaching should include the effects of consuming any alcohol while on antabuse. Encourage client to read all labels of over-the-counter medications and food products that may contain small amounts of alcohol

Question 42

What type of therapy is used with chemically dependent clients?

Answer 42

Group therapy is effective, as are support groups such as alcoholics anonymous and narcotics anonymous

Question 43

What basic needs take priority when working with chemically dependent clients?

Answer 43

nutrition is a priotity. Alcohol and drug intake has superseded the intake of food for these clients

Question 44

With a child who has been abused, how do you assign care to them for their stay?

Answer 44

assign only one nurse to care for them. Abused children have difficulty establishing trust. they will be less anxious with one caregiver

Question 45

When does battering of women often begin or escalate?

Answer 45

during pregnancy

Question 46

Basic difference between delirium and dementia?

Answer 46

delirium is acute and reversible, whereas dementia is gradual and permanent

Question 47

confabulation is?

Answer 47

not lying. It is used by the client to decrease anxiety and protect the ego

Question 48

what is a priority in planning nursing care for the confused older client?

Answer 48

providing a consistent caregiver

Question 49

Children also experience depression, which often presents as?

Answer 49

headaches, stomachaches, and other somatic complaints.

Question 50

NCLEX-RN questions ask about teaching and designing rehavilitation preframs for older adults. The answers should contain?

Answer 50

something about exercise and nutrition