Mental Health Practice HESI

Mental Health Practice HESI 2025/2026 An adult female client has been increasingly restless, and the nurse finds her trying to leave the psychiatric unit. She tells the nurse, "Please let me go! I must leave because the secret police are after me." Which response is best for the nurse to make?

• No one is after you, you're safe here.
• You'll feel better after you have rested.
• I know you must feel lonely and frightened. - - Come with me to your room and I

will sit with you. - ANSWER - Come with me to your room and I will sit with you.

• The best response offers support without judgment or demands. The other

responses are not therapeutic communication for a client who is hallucinating or experiencing a delusion, which are perceive by this client as a crisis.A 35-year-old male client on the psychiatric unit of a general hospital believes that someone is trying to poison him. The nurse understands that a client's delusions are most likely related to which client assessment finding?

• early childhood experiences involving authority issues.
• anger about being hospitalized.
• erroneous interpretation of reality.
• phobic fear of food. - ANSWER - erroneous interpretation of reality.
• Psychotic clients have difficulty with trust and interpreting reality. Nursing care

should be directed at building trust and promoting an accurate reality. Activities with limited concentration and no competition should be encouraged in order to build self-esteem. The other assessment findings are not specifically related to the development of delusions.When preparing a teaching plan for a client who is to be discharged with a prescription for lithium carbonate (Lithonate), which instruction is most important for the nurse to include?

• It may take 3 to 4 weeks to achieve therapeutic effects. 1 / 3

• Keep your dietary salt intake consistent.
• Avoid eating aged cheese and chicken liver.
• Eat foods high in fiber such as whole grain breads. - ANSWER -

Keep your dietary salt intake consistent.

• The effectiveness of Lithium is influenced by salt intake, so the client should

maintain a consistent amount of salt intake. Too much salt causes more lithium to be excreted, thereby decreasing the effectiveness of the drug. Too little salt causes less lithium to be excreted, potentially resulting in toxicity. The other instructions are not specific to teaching about lithium carbonate (Lithonate).On admission to a residential care facility, an older female client tells the nurse that she enjoys cooking, quilting, and watching television. Twenty-fours after admission, the nurse notes that the client is withdrawn and isolated. Which activity should the nurse encourage the client to become involved and participate?

• Clean the unit kitchen cabinets.
• Participate in a group quilting project.
• Watch television in the activity room.
• Bake a cake for a resident's birthday. - ANSWER - Participate in a

group quilting project

• Peer interaction in a group activity that is identified by the client has a hobby or

diversion helps to engage the client with others, which prevents social isolation and withdrawal. The other activities do not involve peer interaction and may promote social isolation.An adult male client who was admitted to the mental health unit yesterday tells the nurse that microchips were planted in his head for military surveillance of his every move. Which response is best for the nurse to provide?

• You are in the hospital, and I am the nurse caring for you.
• It must be difficult for you to control your anxious feelings.
• Go to occupational therapy and start a project.
• You are not in a war area now; this is the United States. - ANSWER
• Go to occupational therapy and start a project.
• Delusions, which are often well-fixed, often generate fear and isolation. The

nurse should help the client participate in activities that avoid focusing on the false belief and encourage interaction with others. The other responses are not indicated and do not distract the client or reassure that he is in a safe place. 2 / 3

The nurse observes a client who is admitted to the mental health unit and identifies that the client is talking continuously, using words that rhyme but that have no context or relationship with one topic to the next in the conversation. This client's behavior and thought processes are consistent with which syndrome?

• Dementia.
• Depression.
• Schizophrenia.
• Chronic brain syndrome. - ANSWER - Schizophrenia
• The client is demonstrating disorganized speech that may include word salad

using both real and imaginary words in no logical order, incoherent speech, and clanging (rhyming), which are positive symptoms of schizophrenia. The other syndromes are not manifested by word salad, clanging, or neologisms.A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the nurse take?

• Notify the healthcare provider immediately and prepare for administration of an

antidote.

• Notify the healthcare provider of the symptoms prior to the next administration of

the drug.

• Record the symptoms as normal side effects and continue administration of the

prescribed dosage.

• Hold the medication and refuse to administer additional amounts of the drug. -

ANSWER - Notify the healthcare provider of the symptoms prior to the next administration of the drug

• Early side effects of lithium carbonate that occur with a serum lithium levels

below 2.0 mEq/L generally follow a progressive pattern beginning with diarrhea, vomiting, drowsiness, and muscular weakness. The nurse should notify the healthcare provider before giving the next dose, which can contribute to higher serum drug levels that may cause ataxia, tinnitus, blurred vision, and large dilute urine output. The other actions are not indicated.The nurse is leading a "current events group" with client who have chronic psychiatric illnesses. One group member states, "Clara Barton was my nurse

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